Biases in Studying Gestational Weight Gain and Infant Mortality in US Birth Certificates
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To the Editor:
In a study recently published in the Maternal and Child Health Journal, Davis and Hofferth presented an analysis of the association between total gestational weight gain (GWG) and risk of infant death in a random sample of 100,000 births from the National Center for Health Statistics 2002 Birth Cohort Linked Birth/Infant Death Data file . We agree that investigating the link between GWG, a modifiable risk factor, and infant mortality using nationally-representative data is an important research priority. However, we believe that the data analysis as reported carries a high likelihood of bias, and that the results from this analysis should be interpreted with caution.
We have four major concerns with the analysis. First, the authors defined inadequate GWG based on the 2009 Institute of Medicine (IOM)-recommend ranges for total GWG at term , but applied these definitions to both preterm and term births. Preterm births in their analysis, therefore, were more likely...
KeywordsInfant Mortality Gestational Weight Gain Birth Certificate Body Mass Index Category Prepregnancy Body Mass Index
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