Capstone Project Examined factors related to infants being born prematurely, being small for gestational age (SGA), and being born with a low birth weight (<2500g) in the state of North Carolina.

1. Joshua Blaskowski
Risk Factors for Adverse Birth Outcomes
Department of Mathematics and Statistics
POTENTIAL RISK FACTORSGOAL
BIRTH FACTS IN THE U.S.
MAPS
Goal: To examine factors related to infants being born prematurely, being small
for gestational age (SGA), and being born with a low birth weight (<2500g) in
North Carolina.
Every year the North Carolina State Center for Health Statistics gathers
information on all infants born in the state. This information consists of
demographic information, adequacy of prenatal care, medical conditions of the
mother during pregnancy, and birth outcomes.
The data used in this study consists infants born in the year 2007 with
approximately n = 130,886 mother/infant dyads.
 Anemia
 Acute or chronic lung
disease
 Age of Mother
 Cardiac disease
 Diabetes
 Drink during pregnancy
 Eclampsia
 Weight Gained
 Genital Herpes
 Hypertension, Chronic
 Hypertension,
Pregnancy
 Marital Status
 Education of Mother
 Mother Race
 Month Prenatal Care
Began
 Previous
preterm/small infant
 Smoker (Y/N)
 Total Pregnancies
(including This One)
 Uterine Bleeding
 Number of Prenatal
Visits
LOGISTIC REGRESSION
To find which risk factors were most significant a stepwise logistic
regression analysis was used.
Models were developed for low birthweight (<2500g), SGA (small for
gestational age), and premature birth separately
Once all significant factors were found odds ratios were computed
for each of the factors in the model in order to quantify the level of
risk associated with each.
RESULTS
DISCUSSION
 Hispanic mothers have the smallest risk of having a preterm baby, low
birthweight, and SGA. Black mothers have the highest risk for all three
outcomes.
 Smoking was a significant factor for both low birthweight and SGA but
was not significant when considering factors related to pre-term birth.
 Drinking during pregnancy was a significant factor for both pre-term and
low birth weight, however it was not significant for SGA.
 Eclampsia poses the greatest risk for having an infant prematurely,
having an infant with a low birth weight, and is the second largest risk
factor for SGA.
References
 CDC Centers for Disease Control and Prevention
 http://www.cdc.gov/nchs/births.htm
 March of Dimes
 http://www.marchofdimes.org/baby/low-birthweight.aspx
 North Carolina State Center for Health Statistics
 http://www.schs.state.nc.us
 3,957,577 babies were born in the United States in 2013.
 1 in every 12 babies in the United States is born with low birthweight.
 The 2013 preliminary low birthweight rate was 8.02%.
 The 2013 preterm birth rate was 11.39%.
 In 2007, the Institute of Medicine reported that the cost associated with
premature birth in the United States was $26.2 billion each year.
 Premature birth and fetal growth restriction (small for gestational age) are
the two main reasons babies are born with low birthweight.
 Low birth weight is defined as a birthweight of a live-born infant of less than
2,500g (5 pounds 8 ounces) regardless of gestational age.
 Small for gestational age (SGA) babies are those who are smaller in size
than normal for the gestational age, most commonly defined as a weight
below the 10th percentile for the gestational age.
 A birth is considered preterm if the infant has a gestational age less than 37
weeks.
Premature
SGA
From the table above we can see that largest risk factor associated with
prematurity is the mother having eclampsia (OR = 4.12) during pregnancy
followed by previously giving birth to an infant prematurely (OR = 3.80). In
terms of preventable risk factors, maternal drinking during pregnancy
increases the odds of premature birth (OR = 1.44). Also we see that
regular prenatal visits is associated with decreased risk of premature birth
(OR = .90), i.e. a 10% decrease in odds per visit.
Again we can see the largest risk associated with having a low birth
weight infant is a mother having eclampsia (OR = 4.25) followed by
having had a previous premature baby (OR = 3.96). In terms of
preventable behaviors we see maternal smoking and drinking are
associated with increased risk of having an infant with a low birth weight
Maternal smoking during pregnancy is associated with the greatest risk of
having an infant classified as small for gestational age (OR = 2.19).
North Carolina is divided into six perinatal
care regions in order to coordinate health
care and services to improve pregnancy
outcomes . The maps above show
premature birth and SGA rates for
counties in NC. From the maps it is
obvious that counties in Region VI has
several counties with high rates of these
adverse birth outcomes.
Faculty Advisor: Brant Deppa