255: Predictors of neonatal and post-neonatal death among term infants born between 37-40 weeks’ gestation

Abstract

To examine the maternal factors associated with neonatal and post-neonatal death among term infants born between 37-40 weeks’ gestation. We conducted a retrospective cohort study of women with singleton, non-anomalous births in California from 2007 to 2011. We included live births between 37-40 weeks’ gestation. We evaluated neonatal and post-neonatal death separately; neonatal death was defined as death occurring between 0-27 days after birth and post-neonatal death was 28-365 days after birth. We evaluated the association between neonatal and post-neonatal death with a variety of maternal socioeconomic and health characteristics. We only included variables in the multivariable logistic regression model if they were significantly different in bivariate analysis and excluded variables if they were collinear with others. Analyses were considered significant if the p-value was < 0.05. Among 616,597 live births between 37-40 weeks’ gestation, there were 228 (0.04%) neonatal deaths and 536 (0.09%) post-neonatal deaths. We found that low prenatal care attendance, public insurance and chronic hypertension were significantly associated with neonatal death (Table 1). Alternatively, Black race, overweight and obese pre-pregnancy BMI, low prenatal care attendance, diabetes and maternal age < 20 were significantly associated with post-neonatal death, while attending some college was protective (Table 2). Among early-term and term infants born between 37-40 weeks’ gestation, we found that multiple variables are associated with infant death. Differences in the predictors of neonatal and post-neonatal death suggest different interventions may be warranted for each.View Large Image Figure ViewerDownload Hi-res image Download (PPT)