Skip to main content
SpringerLink
Log in

Risk Factors Associated with Very Low Birth Weight in a Large Urban Area, Stratified by Adequacy of Prenatal Care

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Objectives This study examined risk and protective factors associated with very low birth weight (VLBW) for babies born to women receiving adequate or inadequate prenatal care. Methods Birth records from St. Louis City and County from 2000 to 2009 were used (n = 152,590). Data was categorized across risk factors and stratified by adequacy of prenatal care (PNC). Multivariate logistic regression and population attributable risk (PAR) was used to explore risk factors for VLBW infants. Results Women receiving inadequate prenatal care had a higher prevalence of delivering a VLBW infant than those receiving adequate PNC (4.11 vs. 1.44 %, p < .0001). The distribution of risk factors differed between adequate and inadequate PNC regarding Black race (36.4 vs. 79.0 %, p < .0001), age under 20 (13.0 vs. 33.6 %, p < .0001), <13 years of education (35.9 vs. 77.9 %, p < .0001), Medicaid status (35.7 vs. 74.9, p < .0001), primiparity (41.6 vs. 31.4 %, p < .0001), smoking (9.7 vs. 24.5 %, p < .0001), and diabetes (4.0 vs. 2.4 %, p < .0001), respectively. Black race, advanced maternal age, primiparity and gestational hypertension were significant predictors of VLBW, regardless of adequate or inadequate PNC. Among women with inadequate PNC, Medicaid was protective against (aOR 0.671, 95 % CI 0.563–0.803; PAR −32.6 %) and smoking a risk factor for (aOR 1.23, 95 % CI 1.01, 1.49; PAR 40.1 %) VLBW. When prematurity was added to the adjusted models, the largest PAR shifts to education (44.3 %) among women with inadequate PNC. Conclusions Community actions around broader issues of racism and social determinants of health are needed to prevent VLBW in a large urban area.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Martin, J., Hamilton, B., Osterman, J., Curtin, S., & Mathews, T. (2013). Births: Final data for 2012. National Vital Statistics Reports, 6. Hyattsville, MD: National Center for Health Statistics.

    Google Scholar 

  2. U.S. Department of Health and Human Services. (n.d.). Office of disease prevention and health promotion. Healthy people 2020. Washington, DC: U.S. Department of Health and Human Services. https://www.healthypeople.gov/node/4834/data_details. Accessed on November 21, 2014.

  3. Missouri Department of Health and Senior Services. (2012) Missouri Information and Community Assessment (MICA). In Birth MICA. Retrieved November 21, 2014 from http://health.mo.gov/data/mica/BirthMICA/.

  4. Balakrishnan, A., Stephens, B., Burke, R., Yatchmink, Y., Alksninis, B., Tucker, R., & Cavanaugh, E. (2011). Impact of very low birth weight infants on the family at 3 months corrected age. Early Human Development, 87, 31–35.

    Article  PubMed  Google Scholar 

  5. Cai, J., Hoff, G., Archer, R., Jones, L., Livingston, P., & Guillory, J. (2007). Perinatal periods of risk analysis of infant mortality in Jackson County, Missouri. Public Health Management Practice, 13, 270–277.

    Article  Google Scholar 

  6. Chen, X., Wen, S., Yang, Q., & Walker, M. (2007). Adequacy of prenatal care and neonatal mortality in infants born to mothers with and without antenatal high risk-conditions. Australian and New Zealand Journal of Obsetrics and Gynecology, 47, 122–127.

    Article  Google Scholar 

  7. Partridge, S., Balayla, J., Holcroft, C., & Abenhaim, H. (2012). Inadequate prenatal care utilization and risks of infant mortality and poor birth outcome: A retrospective analysis of 28,729765 U.S. deliveries over 8 years. American Journal of Perinatology, 29, 787–794.

    Article  PubMed  Google Scholar 

  8. Malabarey, J., Balayla, J., Klam, S., Shrim, A., & Abenhaim, H. (2012). Pregnancies in young adolescent mothers: A population-based study on 37 million births. Pediatric Adolescent Gynecology, 25, 98e102.

    Google Scholar 

  9. Demont-Heinrich, C., Hawkes, A., Ghosh, T., Beam, R., & Vogt, R. (2013). Risk of very low birth weight based on perinatal periods of risk. Public Health Nursing, 31(3), 234–242.

    Article  PubMed  Google Scholar 

  10. Xaverius, P., Salas, J., Kiel, D., & Woolfolk, C. (2014). Very low birth weight and perinatal period of risk: Disparities in St. Louis. BioMed Research International: Obstetrics and Gynecology. doi:10.1155/2014/547234.

    Google Scholar 

  11. Harbert, G. (1994). Efforts to reduce low birth weight and preterm births: A statewide analysis (Virginia). American Journal of Obstetrics and Gynecology, 171, 329–338.

    Article  PubMed  Google Scholar 

  12. Piper, J., Mitchel, E., & Ray, W. (1996). Evaluation of a program for prenatal care case management. Family Planning Perspectives, 28, 65–68.

    Article  CAS  PubMed  Google Scholar 

  13. Kleinman, J., & Kessel, S. (1987). Racial differences in low birth weight. New England Journal of Medicine, 317, 749–753.

    Article  CAS  PubMed  Google Scholar 

  14. Gould, J., Madan, A., Qin, C., & Chavez, G. (2003). Perinatal outcomes in tow dissimilar immigrant populations in the United States: A dual epidemiologic paradox. Pediatrics, 111, e676–e682.

    Article  PubMed  Google Scholar 

  15. Bada, H., Das, A., Bauer, C., Shankaran, S., Ester, Gard C., Wright, L., et al. (2005). Low birth weight and preterm births: Etiologica fraction attributable to prenatal drug exposure. Journal of Perinatology, 25, 631–637.

    Article  PubMed  Google Scholar 

  16. Coley, S., & Aronson, R. (2013). Exploring birth outcome disparities and the impact of prenatal care utilization among North Carolina teen mothers. Women’s Health Issues, 23, e287–e294.

    Article  PubMed  Google Scholar 

  17. Adams, M., Alexander, G., Kirby, R., & Wingate, M. (2009). Perinatal epidemiology for public health practice. New York, NY: Springer.

    Book  Google Scholar 

  18. Fingerhut, L., & Kleinman, J. (1985). Comparability of reporting between the birth certificate and the 1980 National Natality Survey. Vital and Health Statistics. Series 2, Data evaluation and methods research. Retrieved from http://www.biomedsearch.com/nih/Comparability-reporting-between-birth-certificate/4082503.html.

  19. Bradford, H., Cardenas, V., Camacho-Carr, K., & Lydon-Rochelle, M. (2011). Accuracy of birth certificate and hospital discharge data: A certified nurse-midwife and physician comparison. Maternal and Child Health Journal, 11, 540–548.

    Article  Google Scholar 

  20. Clark, K., Fu, C., & Burnett, C. (1997). Accuracy of birth certificate data regarding the amount, timing, and adequacy of prenatal care using prenatal clinic medical records as referents. American Journal of Epidemiology, 145(1), 68–71.

    Article  CAS  PubMed  Google Scholar 

  21. Walford H., Trinh S., Wiencrot A., & Lu M. C. (2011). What is the role of prenatal care in reducing racial and ethnic disparities in pregnancy outcomes? In A. Handler, J. Kennelly, & N. Peacock (Eds.), Reducing racial/ethnic disparities in reproductive and perinatal outcomes (pp. 151–179). New York, NY: Springer.

    Google Scholar 

  22. Alexander, G., & Kotelchuck, M. (2001). Assessing the role and effectiveness of prenatal care: History, challenges, and directions for future research. Public Health Reports, 116, 306–316.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  23. Sable, M., & Wilkinson, D. (1998). Pregnancy intentions, pregnancy attitudes, and the use of prenatal care in Missouri. Maternal and Child Health Journal, 2, 155–165.

    Article  CAS  PubMed  Google Scholar 

  24. Sparks, P. (2009). One size does not fit all: An examination of low birthweight disparities among a diverse set of racial/ethnic groups. Maternal and Child Health Journal, 13, 769–779.

    Article  Google Scholar 

Download references

Acknowledgments

The data used in this manuscript was acquired from the Missouri Department of Health and Senior Services (DHSS). The contents of this document including data analysis, interpretation or conclusions are solely the responsibility of the authors and do not represent the official views of DHSS. L.R.H. is supported by the Children’s Discovery Institute (MD-FR-2013-292). This analysis was conducted as part of the epidemiology capstone course at Saint Louis University, College for Public Health and Social Justice. Special thanks to Joanne Salas for her biostatistics consultations.

Author information

Authors and Affiliations

  1. Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Ave., Saint Louis, MO, 63104, USA

    Pamela Xaverius, Cameron Alman & Laura Yarber

  2. Department of Pediatrics, School of Medicine, Washington University, 660 S. Euclid Ave., Saint Louis, MO, 63110, USA

    Lori Holtz

Authors
  1. Pamela Xaverius
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cameron Alman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lori Holtz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Laura Yarber
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pamela Xaverius.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Xaverius, P., Alman, C., Holtz, L. et al. Risk Factors Associated with Very Low Birth Weight in a Large Urban Area, Stratified by Adequacy of Prenatal Care. Matern Child Health J 20, 623–629 (2016). https://doi.org/10.1007/s10995-015-1861-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-015-1861-4

Keywords

Search

Navigation