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Maternal Race (maternal + race)
Selected AbstractsThe efficacy of the non-stress test in preventing fetal death in post-term pregnancyPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 3 2001Tong Li Summary We conducted a case,control study to examine the efficacy of non-stress testing in preventing fetal death in post-term pregnancy. The analysis was based on data from the 1988 National Maternal and Infant Health Survey, which was a nationally representative sample of live births, fetal deaths and infant deaths that occurred in 1988. Information on whether a woman had non-stress testing was obtained from a questionnaire sent to prenatal care providers and hospitals. Cases were post-term women (with 42 weeks or more gestation) who had fetal deaths. Three post-term controls, who had live births and who delivered at the same time or later than the cases, were randomly chosen and individually matched to each case by maternal race. The proportion of women who had one or more non-stress tests during pregnancy was compared between cases and controls. Non-stress testing was used in 30.9% of the 126 cases and in 28.5% of the 375 controls. The race-adjusted odds ratio for exposure to non-stress test was 1.12 [95% CI 0.72, 1.75]. After controlling for other important confounding variables the odds ratio was 1.05 [95% CI 0.57, 1.91]. These results do not support the efficacy of non-stress testing in post-term pregnancies. A more detailed evaluation of this widely used screening procedure is needed. [source] Association of Maternal Chronic Disease and Negative Birth Outcomes in a Non-Hispanic Black-White Mississippi Birth CohortPUBLIC HEALTH NURSING, Issue 4 2007Juanita Graham ABSTRACT Objective: To investigate the impact of selected maternal chronic medical conditions, race, and age on preterm birth (PTB), low birth weight (LBW), and infant mortality among Mississippi mothers from 1999 to 2003. Design: A retrospective cohort analysis of linked birth and death certificates. Sample: The 1999,2003 Mississippi birth cohort comprising 202,931 singleton infants born to African American and White women. Measurements: The relationship between maternal chronic conditions and the dependent variables of PTB, LBW, and infant mortality were investigated using logistic regression analysis. Results: PTB, LBW, and infant mortality were more prevalent among African American women, very young women (,15 years), and women with certain chronic medical conditions. Among White mothers, maternal chronic hypertension was significantly associated with PTB and LBW, and maternal diabetes with PTB and infant mortality. Among African American mothers, maternal cardiac disease was significantly associated with PTB and LBW; maternal chronic hypertension was significantly associated with LBW and infant mortality; and maternal diabetes with PTB. Conclusions: Maternal chronic hypertension and diabetes were significantly associated with negative birth outcomes regardless of maternal race. Maternal cardiac disease was only significantly associated with PTB and LBW among African Americans. [source] Teenage Pregnancy in the Texas PanhandleTHE JOURNAL OF RURAL HEALTH, Issue 3 2005Rosa Galvez-Myles MD ABSTRACT: Purpose: This study compares rural and small-city teenage and adult pregnancies, with respect to complication rates and pregnancy outcomes. Methods: Chart review of Medicaid patients (513 teenage [under 20 years] and 174 adult controls [ages 25,34]) delivered (excluding multiple gestation) in Amarillo, Texas, from January 1999 to April 2001. Demographic data collected included maternal race, gravidity, parity, smoking status, drug usage, presence of antenatally diagnosed sexually transmitted disease(s), county type (rural vs small city) and number of prenatal visits. Outcomes included mode of delivery, primary cesarean section rates, preterm birth (<34 or <37 weeks), birth weight, birth weight <2,500 g, preeclampsia, total maternal weight gain, hemoglobin changes after delivery, Apgar scores, and neonatal intensive care unit admissions. Statistical comparisons between groups were made for a number of factors and outcomes (P<.05). Results: Teenagers did not have a significantly higher frequency of either illicit drug or tobacco usage, but teenagers ,17 years had a greater incidence of sexually transmitted diseases (19.8% vs 10.4%, P<008) and preeclampsia (7.1% vs 2.3%, P<.025, odds ratio 3.2 [1.1 to 9.9]) when compared with adults. The total weight gain was highest for teens ,17 years (36.4 pounds vs adults: 28.2, P<.001). The primary cesarean section rate was higher in adults (all teens 18.5% vs adults 38.6%, P<.001). County rurality had no impact on any of the observed findings or variables tested. Conclusions: Young teenagers have a higher incidence of sexually transmitted diseases and preeclampsia and also gain significantly more weight with pregnancy than young adults. However, the pregnancy outcomes were no different for rural vs small city teens. [source] Maternal age and non-chromosomal birth defects, Atlanta,1968,2000: Teenager or thirty-something, who is at risk?,BIRTH DEFECTS RESEARCH, Issue 9 2004Jennita Reefhuis Abstract OBJECTIVE This investigation explored the association between maternal age and non-chromosomal birth defects to assess any increased risk associated with maternal age. METHODS Birth defect cases were ascertained by the Metropolitan Atlanta Congenital Defects Program (MACDP), denominator information was obtained using birth certificate data. Infants with any chromosomal diagnosis were excluded. Effect estimates were calculated using 5-year maternal age categories with 25,29 years as the referent. Multiple logistic regression was used to adjust for maternal race, parity, infant sex, and birth year. RESULTS A total of 1,050,616 singleton infants, born after ,20 weeks gestation in the five counties of metropolitan Atlanta from 1968 through 2000 who did not have a chromosomal abnormality and whose mother was 14 to 40 years old, were included in the analyses, 32,816 of them were identified with birth defects by the MACDP. Young maternal age (14,19 years) was associated with anencephaly (OR = 1.81, 95% CI = 1.30,2.52), hydrocephaly without neural tube defect (OR = 1.56, 95% CI = 1.23,1.96), all ear defects (OR = 1.28, 95% CI = 1.10,1.49), cleft lip (OR = 1.88, 95% CI = 1.30,2.73), female genital defects (OR = 1.57, 95% CI = 1.12,2.19), hydronephrosis (OR = 1.42, 95% CI = 1.11,1.82), polydactyly (OR = 1.29, 95% CI = 1.09,1.52), omphalocele (OR = 2.08, 95% CI = 1.39,3.12), and gastroschisis (OR = 7.18, 95% CI = 4.39,11.75). Advanced maternal age (35,40 years) was associated with all heart defects (OR = 1.12, 95% CI = 1.03,1.22), tricuspid atresia (OR = 1.24, 95% CI = 1.02,1.50), right outflow tract defects (OR = 1.28, 95% CI = 1.10,1.49), hypospadias 2nd degree or higher (OR = 1.85, 95% CI = 1.33,2.58), male genital defects excluding hypospadias (OR = 1.25, 95% CI = 1.08,1.45) and craniosynostosis (OR = 1.65, 95% CI = 1.18,2.30). CONCLUSIONS Young and advanced maternal ages are associated with different types of birth defects. Underlying causes for these associations are not clear. Birth Defects Research (Part A) 70:572,579, 2004. Published 2004 Wiley-Liss, Inc. [source] Case fatality among infants with congenital malformations by lethalityBIRTH DEFECTS RESEARCH, Issue 9 2004Kirk A. Bol Abstract OBJECTIVE Infant mortality rates continue to show that congenital anomalies are the leading cause of infant death in the United States. However, studies of factors contributing to increased mortality across different types of congenital anomalies have been limited. The objective of this study was to assess whether the likelihood of infant mortality varied by maternal race and ethnic group while considering the severity of the birth defect. METHODS A retrospective cohort analysis was conducted using data from Colorado's statewide, population-based birth defects surveillance system (CRCSN). The cohort included infants, born between 1995 and 2000 to Colorado resident mothers, who were diagnosed with major congenital malformations stratified by degree of lethality. Multiple logistic regression was performed for each level of lethality, and included the following potential explanatory variables: maternal race/ethnicity, clinical gestation, birth weight, maternal education level, maternal age, and sex of child. RESULTS Within the low/very low lethality cohort, maternal race/ethnicity of Black/non-Hispanic was associated with increased risk of infant mortality, OR 2.81 (1.41,5.19), as were low and very low birth weight, OR 2.21 (1.12,4.04) and 19.31 (11.84,31.01), respectively. Maternal race/ethnicity was not a significant risk factor in either high or very high lethality groups; however, the interaction between birth weight and gestational age significantly increased the risk of mortality. CONCLUSIONS Through the use of statewide, population-based birth defects surveillance data, a disparity in infant mortality has been identified in a specific subset of the population that could be investigated further and targeted for prevention activities. Birth Defects Research (Part A) 70:580,585, 2004. © 2004 Wiley-Liss, Inc. [source] Contribution of birth defects to infant mortality in the United StatesBIRTH DEFECTS RESEARCH, Issue S1 2002Joann Petrini Background While overall infant mortality rates (IMR) have declined over the past several decades, birth defects have remained the leading cause of infant death in the United States. To illustrate how this leading cause of infant mortality impacts subgroups within the US population a descriptive analysis of the contribution of birth defects to infant mortality at the national and state level was conducted. Methods Descriptive analyses of birth defects-specific IMRs and proportionate infant mortality due to birth defects were conducted for the US using 1999 mortality data from the National Center for Health Statistics. In 1999, the change to ICD-10 impacted how cause-specific mortality rates were coded. Aggregated 1995-1998 state- birth defects infant death statistics were used for state comparisons. Results In 1999, birth defects accounted for nearly 1 in 5 infant deaths in the US. Variation in birth defects-specific IMRs were observed by maternal race with black infants having the highest rates when compared with other race groups. However, among black infants prematurity/low birthweight was the leading cause of death, followed by birth defects. There is substantial variation in state-specific birth defects IMRs and the state-specific proportion of infant deaths due to birth defects. Conclusions Birth defects remain the leading cause of infant death in the United States, despite the changes that resulted in 1999 from an update in the coding of cause of death from ICD-9 to ICD-10. While birth defects-specific IMRs provide an overall picture of fatal birth defects and a gauge of the impact of life-threatening anomalies, they represent only a fraction of the impact of birth defects, missing those who survive past infancy and those birth defects related losses in the antepartum period. Expansion and support of effective birth defects monitoring systems in each state that include the full spectrum of perinatal outcomes must be a priority. However, paralleling these efforts, analyses of this leading cause of infant mortality provide critical insight into perinatal health and should continue, with appropriate adjustments for the 1999 classification changes. Teratology 66:S3,S6, 2002. © 2002 Wiley-Liss, Inc. [source] | ||||||||||