Document Type

Master's Culminating Experience

Publication Date

2010

Abstract

Objective: To better understand and identify modifiable maternal risk factors that are driving the increased incidence of low birth weight (LBW) in Montgomery County.

Background Information: LBW has lifelong effects on growth and development. These medical and social implications are coupled with an enormous economic burden. In the US, over 5.8 billion dollars are spent annually to care for LBW babies. Despite the recognition of these medical and economic challenges and the implementation of public campaigns to decrease rates, LBW trends have continued to increase. Between 1995 and 2005 the LBW rates in the US incrementally increased from 7.3% to 8.2% of all births. This trend was mirrored on both the state and county level with even higher rates of increase. For the years 1995-2005, Ohio LBW rate rose from 7.3% to 8.7% of all births. In Montgomery County, the average LBW rate over the time period from 2002-2005 was 8.7%. This was well above the average for the US at 8% and Ohio at 8.5%. All of these are well above the Healthy People 2010 goal of

Methodology: As an extension of the existing LBW registry, this project aims to establish a retrospective control population of non-LBW infants born over of the course of the first year of data collection. For this study, data was gathered from a database created by linking records from the Perinatal Database, maintained by Miami Valley Hospital’s Quality Management Department, and the ADT (Admission, Discharge, Transfer) patient report that is a part of the patient medical record. The study included mothers who delivered at Miami Valley Hospital from October 26, 2007 – October 26, 2008. Data was analyzed using basic descriptive statistics, ANOVA, and multiple linear regression.

Results: There were 5011 mothers in the study. Of these pregnancies, 555 (11.08%) resulted in the birth of LBW infants while 4456 (88.92%) resulted in the birth of non-LBW infants. The average birth weight of infants born to black mothers (3030g) was significantly lower then the average birth weight for infants born to mothers in every other racial/ethnic group. Black mothers had the significantly highest prevalence of LBW (15.28%). Mothers who delivered infants on government sponsored insurance plans had significantly lower average birth weight infants and a higher prevalence of LBW infants then those on private insurance plans. Young mothers (under 25 years) had significantly lower average birth weight infants than mothers in the median ages of childbearing (25 years-40 years). These young mothers also accounted for nearly 30% of LBW in this population. Mothers of LBW infants had significantly higher prevalence of tobacco, alcohol, marijuana, and cocaine use. LBW mothers also had a higher prevalence of chronic and gestational hypertension. Non-LBW mothers had a lower prevalence of chorioamnionitis, but a higher prevalence of GBBS than LBW mothers.

Conclusion: In this population there are significant differences in the prevalence (non-LBW vs. LBW) of several maternal risk factors including; race/ethnicity, payer status, age at delivery, substance use, chronic medical conditions and infections. Further research is needed to determine the significance of sub-analyses performed within these risk factor categories. These trends may allow future interventions to be more accurately targeted.

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