Odds Of Low Birth Weight Research Articles

Effects of the COVID-19 pandemic on maternal-fetal outcomes in a nonepidemic designated hospital: a retrospective study and clinical experience summary

ObjectiveTo assess the changes in maternal-fetal outcomes in a nonepidemic designated hospital during the COVID-19 pandemic.MethodsThis retrospective cohort study was conducted between January 1, 2019, and December 31, 2021 on pregnant patients. The fixed-effects regression model was used to determine changes in birth outcomes and pregnancy-related complications between three periods with the pre-epidemic cohort as the control group. Logistic regression was applied to determine the odds ratio (OR) for binary outcomes.ResultsThere were 15,261 births during the pre-epidemic period, and this number decreased by 15% and 23% to 12,980 and 11,736 in the first and second epidemic cohorts, respectively. The mean birth weight during the pre-epidemic period was 3319 which decreased to 3309 and 3272 g in the following periods. Excluding stillbirth and preterm, all other outcomes differed significantly between the three periods. Gestational diabetes mellitus (GDM) (17–19%) and maternal hypertension (9.2–11%) appeared to increase. Compared to the pre-epidemic period, the odds of macrosomia and LGA significantly decreased in the second epidemic cohort (adjusted ORs: 0.76 and 0.8), while the odds of low birth weight (LBW) and small gestation age (SGA) increased (ORs: 1.25 and 1.16). The odds of neonatal asphyxia (OR: 1.4), and hypertension (OR: 1.29) appeared to increase in the second epidemic cohort, while GDM decreased in the first cohort (OR: 0.88) and increased in the second cohort (OR: 1.15). Vaginal delivery underwent a marginal decrease in both the first and second epidemic cohorts (ORs: 0.89 and 0.92).ConclusionThe COVID-19 pandemic may have had a substantial and long-term impact on non-infected pregnant women and newborns. Our research results provided precious research information and clinical experience summary for population health research in the future.

Birth Outcomes and Prenatal Care Use in the U.S. During the COVID-19 Pandemic in 2020 and 2021.

The COVID-19 pandemic has posed substantial social and economic disruptions that may have had adverse effects on maternal and infant health. This study examines the changes in birth outcomes and prenatal care use during the COVID-19 pandemic in 2020 and 2021 compared to pre-pandemic years. Data come from birth certificates from the U.S. Vital Statistics Natality Files. The analytical sample includes 18,678,327 births in the 50 states and Washington, DC between 2017 and 2021. An event study is employed to examine changes in multiple birth outcomes and prenatal care use over years adjusting for demographic/socioeconomic characteristics and state of residence. There were very small changes in birth outcomes during pandemic years in 2020 and 2021. Specifically, low birth weight odds were lower in 2020 (OR = 0.99; 95 CI: 0.98-0.99) but higher in 2021 (OR = 1.03; 95% CI: 1.03-1.04) compared to 2019. C-section odds were higher in 2021 (OR = 1.01, 95% CI: 1.002-1.008) than in 2019. The mean number of prenatal visits in both 2020 and 2021 relative to 2019 was lower by about 0.3 visits (95% CI: -0.31 to -0.30 in 2021). Overall, there is no evidence of broad pandemic effects on low birth weight and preterm birth in 2020-2021.

Is Oral Iron and Folate Supplementation during Pregnancy Protective against Low Birth Weight and Preterm Birth in Africa? A Systematic Review and Meta-Analysis.

Despite recent evidence demonstrating iron and folate supplementation reduces the risk of low birth weight and preterm births, synthesis of the evidence is not sufficient to understand their impacts in Africa. MEDLINE, PsycINFO, Embase, Scopus, CHINAL, Web of Science, Cochrane databases, and Google Scholar were searched for the published and grey literature. Either iron-only, folate-only, or iron-folic acid (IFA) oral supplementation during pregnancy was the primary exposure/intervention. The focus of this review was low birth weight and preterm births in the African region. Qualitative synthesis, meta-analysis, and subgroup analysis were employed. In the qualitative synthesis (n = 4), IFA supplementation showed a positive impact on reducing preterm birth. Additionally, the meta-analysis showed that IFA and iron-only supplementation reduced the odds of low birth weight by 63% (OR 0.37; 95% CI: 0.29, 0.48) and 68% (OR 0.32; 95% CI: 0.21 to 0.50), respectively. Both iron-only and IFA supplementation are effective in reducing the risk of low birth weight in Africa. There is also promising evidence suggesting a potential reduction in preterm births. Consequently, further research is needed, particularly targeting high-risk groups such as women residing in rural areas with limited support and low levels of literacy.

Extreme Temperatures, Birth Outcomes, and Social Inequalities: Evidence from South China

Abstract The impacts of climate change on health are a critical public health issue, but the association between extreme temperatures and birth outcomes remains poorly understood. This paper links over 1 million birth records from Dongguan, China, between 2004 and 2013, to meteorological data. We investigate the relationship between extreme temperatures and birth outcomes and explore the heterogeneity among different demographic and socioeconomic factors, including maternal migrant status, education level, and mode of delivery. We find that one percentage increase in the number of days exposed to extreme heat during pregnancy is associated with a reduction in birth weight of 2.31 g and a 2% increase in odds of low birth weight (LBW), while exposure to extreme cold temperatures is associated with a reduction in birth weight (0.66 g) and an increase in the risk of LBW (1%). The association between extreme high temperatures and adverse birth outcomes is stronger for groups with disadvantaged social status. Specifically, the migrant group (for extreme heat exposure, local residents, −0.37 g; intraprovincial migrants, −2.75 g; out-of-province migrants, −2.49 g), the less-educated group (for extreme heat exposure, middle school or below, −2.47 g; high school or above, −1.66 g), and the group with vaginal birth [for extreme heat exposure, cesarean sections (C-sections), −1.56 g; vaginal birth, −2.62 g] are more sensitive to extreme weather conditions. Our study provides further evidence about the association of extreme temperatures with birth outcomes and for vulnerable groups of pregnant women.

Results of a cognitive behavior therapy-based intervention for antenatal anxiety on birth outcomes in Pakistan: a randomized control trial

Antenatal anxiety is among the risk factors for adverse birth outcomes, which are common in Pakistan. Between 2019 and 2022, we conducted a randomized controlled trial to evaluate the effects of the Happy Mother-Healthy Baby program, designed to reduce anxiety during pregnancy through use of Cognitive Behavior Therapy, on birth outcomes with 796 women in Rwalpindi, Pakistan. We performed intent-to-treat analysis and per protocol analyses. Intention-to-treat analyses showed no difference in the odds of low birthweight (LBW) (Adj. OR = 0.82, 95% CI 0.55–1.28 p = 0.37), preterm birth (PTB) (Adj. OR = 1.20 95% CI 0.83–1.71, p = 0.33) or small-for-gestational age (SGA) birth, (Adj. OR = 0.76, 95% CI 0.56–1.09, p = 0.16). Among completers who received ≥ 5 intervention sessions, the odds of LBW and SGA were 39% and 32% lower (Adj. OR = 0.61, 95% CI 0.43–0.87, p < 0.01; Adj. OR = 0.68, 95% CI 0.53–0.89, p < 0.01). The significant LBW and SGA results among the intervention completers suggest that the program may be effective when a sufficient dose is received. However, confirmation of these findings is needed due to the fact that randomization is not maintained in completer analyses.Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT03880032, 19/03/2019.

Syphilis in pregnancy and adverse birth outcomes: Anationwide longitudinal study in Brazil.

The present study aimed to evaluate the association between syphilis in pregnancy and low birth weight, small for gestational age, and preterm birth. This longitudinal study used Brazilian National Information System for livebirths (SINASC) linked to the gestational syphilis cases from Notifiable Diseases Information System (SINAN) from 2011 to 2017. Descriptive statistics and logistic regression were used to compare the birth outcomes of pregnant women with and without syphilis. The study protocol was approved by the Research Ethics Committee of the Institute of Collective Health of the Federal University of Bahia (CAAE: registration no. 18022319.4.0000.5030). A total of 17 930 817 live births were included in the study. Of these, 155 214 (8.7/1000) were exposed to syphilis during pregnancy. Maternal syphilis increased the odds of low birth weight (aOR 1.88, 95% CI: 1.85-1.91), small for gestational age (aOR 1.53, 95% CI: 1.51-1.56), and preterm birth (aOR 1.35, 95% CI: 1.33-1.37). Higher odds were observed for pregnant women with VDRL titer ≥64 and untreated maternal syphilis when compared to mothers without syphilis. Analysis stratified by prenatal care showed higher odds for all adverse birth outcomes for mothers attending ≤6 prenatal appointments. Our findings showed a strong association between gestational syphilis and adverse birth outcomes with increased odds observed among women with higher VDRL titers, lack of treatment, and fewer prenatal appointments. These results highlight the need for adequate screening and treatment for gestational syphilis during pregnancy to mitigate the risk of adverse birth outcomes.

Living in a Neighborhood With Limited Access to Broadband Internet Is Associated With Adverse Pregnancy Outcomes [ID 2683563

INTRODUCTION: The internet is an essential tool for ensuring health care access and delivery. We aimed to estimate the association between living in an area with limited broadband internet access and specific adverse pregnancy outcomes. METHODS: We performed an electronic health record-based retrospective cohort study of pregnant people who delivered at a referral medical center between September 1, 2019, and June 1, 2022. Primary outcomes were preterm birth, low birth weight (less than 2,500 g) and birth weight z-score for gestational age. Neighborhood internet access was defined as the proportion of residents with internet access in the pregnant person’s census tract of residence, based on the 2020 American Community Survey estimate and determined by geocoding. We used multivariable logistic or linear regression analysis to estimate the independent effect of internet access and computed adjusted odds ratios (aOR) or mean differences with 95% CIs for a 5-unit increase in the proportion with internet access for a given census tract. RESULTS: Among 5,190 pregnant people included, 885 (17.1%) had a preterm birth, 728 (14.0%) delivered a low-birth weight neonate, and 515 (9.9%) had a small-for-gestational age neonate. After adjusting for relevant confounders, increasing internet access was associated with reduced odds of preterm birth (aOR 0.97; 95% CI, 0.93–1.00; P=.048), reduced odds of low birth weight (aOR 0.95; 95% CI, 0.91–0.98), and increasing birth weight z-score (Beta 0.02; 95% CI, 0.01–0.03). CONCLUSION: Living in neighborhoods with better broadband internet coverage was associated with reduced odds of preterm birth, decreased odds of delivering a low-birth weight neonate, and increasing birth weight.

Perinatal factors and early neonatal outcomes of abnormal birthweight infants in Hangzhou, China, 2015–2021: a retrospective cohort study

BackgroundThis study aimed to investigate the perinatal factors and early neonatal outcomes of abnormal birth weight (ABW) in Hangzhou, China from 2015 to 2021.MethodsA retrospective cohort study was designed to...

Antenatal depressive symptoms and adverse birth outcomes in healthy start participants: The modifying role of utilization of mental health services

ObjectiveWe examined the association between antenatal depressive symptoms and adverse birth outcomes in Midland Healthy Start (MHS) participants and determined whether receiving mental health services reduced the odds of adverse outcomes among those with elevated antenatal depressive symptoms. MethodData from a retrospective cohort of participants (N = 1,733) served by the MHS in South Carolina (2010–2019) were linked with their birth certificates. A score of ≥16 on the Center for Epidemiologic Studies Depression Scale was defined as elevated antenatal depressive symptoms. Services provided by MHS were categorized into: (1) receiving mental health services, (2) receiving other services, and (3) not receiving any services. Adverse birth outcomes included preterm birth, low birth weight, and small for gestational age. ResultsAround 31 % had elevated antenatal depressive symptoms. The prevalences of preterm birth, low birthweight, and small for gestational age were 9.5 %, 9.1 %, and 14.6 %, respectively. No significant associations were observed between elevated depressive symptoms and adverse outcomes. Among women with elevated antenatal depressive symptoms, the odds for small for gestational age were lower in those who received mental health services (AOR 0.33, 95 % CI 0.15–0.72) or other services (AOR 0.34, 95 % CI 0.16–0.74) compared to those who did not receive any services. The odds for low birth weight (AOR 0.34, 95 % CI 0.13–0.93) were also lower in those who received mental health services. ConclusionsReceiving screening and referral services for antenatal depression reduced the risks of having small for gestational age or low birth weight babies among MHS participants.

High ambient air pollution erodes the benefits of using clean cooking fuel in preventing low birth weight in India

A large fraction of the population in rural India continues to use biomass fuel for cooking and heating. In-utero exposure to the resulting household air pollution (HAP), is known to increase the risk of low birth weight (LBW). Mitigating HAP, by shifting to clean cooking fuel (CCF), is expected to minimize the risk associated with LBW. However, India also has high levels of ambient air pollution (AAP). Whether exposure to AAP modifies the effect of reducing HAP by switching to CCF on LBW is not known. The present study addressed this knowledge gap by analyzing the National Family Health Survey (2019–21) data of the most recent full-term, singleton, live births from rural households born after 2017 (n = 56 000). In-utero exposure to AAP was calculated from satellite-derived ambient fine particulate matter (PM2.5) concentration at the level of the primary sampling unit for the pregnancy duration of the mothers. The moderation by ambient PM2.5 level on the odds of LBW among CCF users was examined by logistic regression analysis with interaction. The adjusted odds ratio (aOR) of LBW was 7% lower among users of CCF. At the lowest Decile (20–37 μg m−3) of ambient PM2.5 exposure, the aOR of LBW among CCF users was 0.83 (95% CI:0.81–0.85). At every 10th percentile increase in ambient PM2.5 exposure (in the range 21–144 μg m−3), aOR increased gradually, reaching the value of 1 at PM2.5 level of 93 μg m−3. Our results, therefore, suggest that the benefit of using CCF during pregnancy may be downgraded by moderate to high ambient PM2.5 exposure.

Impact of advanced maternal age on perinatal outcomes in Tanzania: Insights from Kilimanjaro Christian Medical Center Birth Registry

The increasing prevalence of advanced maternal age (AMA) births necessitates the exploration of associated pregnancy outcomes within the healthcare-limited context of northern Tanzania to elucidate potential region-specific risks and implications. This study explored the influence of AMA on pregnancy outcomes in northern Tanzania, where healthcare resources and infrastructure are constrained in comparison to developed countries. This cross-sectional hospital-based study utilized maternally linked data from the Kilimanjaro Christian Medical Center (KCMC) Medical Registry and included 32,798 women who delivered single infants between 2004 and 2013. Multiple logistic regression models were used to determine adjusted odds ratios (aORs) and 95 % confidence intervals (CIs) for AMA-associated adverse pregnancy outcomes. A total of 16 % of mothers belonged to AMA with increased odds of undergoing a cesarean section (aOR: 1.32; 95%CI [1.24–1.41]; P < 0.001), gestational diabetes (aOR: 13.16; 95%CI [3.28–52.86]; P < 0.001) or pregestational diabetes (aOR: 3.15; 95%CI [1.87–5.31]; P < 0.000), and developing pre-eclampsia (aOR: 1.63; 95%CI [1.41–1.89]; P < 0.000). More women with AMA reported alcohol use during pregnancy and had preexisting conditions before conception than did younger women. Maternal education level, employment status, urban residency, and Christianity were statistically significant. This study establishes a connection between AMA and higher odds of cesarean section, gestational diabetes, pregestational diabetes, and pre-eclampsia. Women with AMA were more inclined to consume alcohol during pregnancy and exhibited preexisting conditions before conception. Moreover, AMA was linked to increased odds of low birth weight, stillbirths, and NICU transfers.

Prenatal Phenol and Paraben Exposures and Adverse Birth Outcomes: A Prospective Analysis of U.S. Births

BackgroundSynthetic chemicals are increasingly being recognized for potential independent contributions to preterm birth (PTB) and low birth weight (LBW). Bisphenols, parabens, and triclosan are consumer product chemicals that act via similar mechanisms including estrogen, androgen, and thyroid disruption and oxidative stress. Multiple cohort studies have endeavored to examine effects on birth outcomes, and systematic reviews have been limited due to measurement of 1–2 spot samples during pregnancy and limited diversity of populations. ObjectiveTo study the effects of prenatal phenols and parabens on birth size and gestational age (GA) in 3,619 mother-infant pairs from 11 cohorts in the NIH Environmental influences on Child Health Outcomes program. ResultsWhile many associations were modest and statistically imprecise, a 1-unit increase in log10 pregnancy averaged concentration of benzophenone-3 and methylparaben were associated with decreases in birthweight, birthweight adjusted for gestational age and SGA. Increases in the odds of being SGA were 29% (95% CI: 5%, 58%) and 32% (95% CI: 3%, 70%), respectively. Bisphenol S in third trimester was also associated with SGA (OR 1.52, 95% CI 1.08, 2.13). Associations of benzophenone-3 and methylparaben with PTB and LBW were null. In addition, a 1-unit increase in log10 pregnancy averaged concentration of 2,4-dichlorophenol was associated with 43% lower (95% CI: −67%, −2%) odds of low birthweight; the direction of effect was the same for the highly correlated 2,5-dichlorophenol, but with a smaller magnitude (-29%, 95% CI: −53%, 8%). DiscussionIn a large and diverse sample generally representative of the United States, benzophenone-3 and methylparaben were associated with lower birthweight as well as birthweight adjusted for gestational age and higher odds of SGA, while 2,4-dichlorophenol. These associations with smaller size at birth are concerning in light of the known consequences of intrauterine growth restriction for multiple important health outcomes emerging later in life.

Participation in Conditional Cash Transfer Program During Pregnancy and Birth Weight–Related Outcomes

There is limited evidence of the association of conditional cash transfers, an important strategy to reduce poverty, with prevention of adverse birth-related outcomes. To investigate the association between receiving benefits from the Bolsa Família Program (BFP) and birth weight indicators. This cohort study used a linked data resource, the Centro de Integracao de Dados e Conhecimentos Para Saude (CIDACS) birth cohort. All live-born singleton infants born to mothers registered in the cohort between January 2012 and December 2015 were included. Each analysis was conducted for the overall population and separately by level of education, self-reported maternal race, and number of prenatal appointments. Data were analyzed from January 3 to April 24, 2023. Live births of mothers who had received BFP until delivery (for a minimum of 9 months) were classified as exposed and compared with live births from mothers who did not receive the benefit prior to delivery. Low birth weight (LBW), birth weight in grams, and small for gestational age (SGA) were evaluated. Analytical methods used included propensity score estimation, kernel matching, and weighted logistic and linear regressions. Race categories included Parda, which translates from Portuguese as "brown" and is used to denote individuals whose racial background is predominantly Black and those with multiracial or multiethnic ancestry, including European, African, and Indigenous origins. A total of 4 277 523 live births (2 085 737 females [48.8%]; 15 207 among Asian [0.4%], 334 225 among Black [7.8%], 29 115 among Indigenous [0.7%], 2 588 363 among Parda [60.5%], and 1 310 613 among White [30.6%] mothers) were assessed. BFP was associated with an increase of 17.76 g (95% CI, 16.52-19.01 g) in birth weight. Beneficiaries had an 11% lower chance of LBW (odds ratio [OR], 0.89; 95% CI, 0.88-0.90). BFP was associated with a greater decrease in odds of LBW among subgroups of mothers who attended fewer than 7 appointments (OR, 0.85; 95% CI, 0.84-0.87), were Indigenous (OR, 0.73; 95% CI, 0.61-0.88), and had 3 or less years of education (OR, 0.76; 95% CI, 0.72-0.81). There was no association between BFP and SGA, except among less educated mothers, who had a reduced risk of SGA (OR, 0.83; 95% CI, 0.79-0.88). This study found that BFP was associated with increased birth weight and reduced odds of LBW, with a greater decrease in odds of LBW among higher-risk groups. These findings suggest the importance of maintaining financial support for mothers at increased risk of birth weight-related outcomes.

The association between timing in pregnancy of drought and excess rainfall, infant sex, and birthweight: Evidence from Nepal.

Past research on the impact of climatic events, such as drought, on birth outcomes has primarily been focused in Africa, with less research in South Asia, including Nepal. Existing evidence has generally found that drought impacts birthweight and infant sex, with differences by trimester. Additionally, less research has looked at the impact of excess rain on birth outcomes or focused on the impact of rainfall extremes in the preconception period. Using data from a large demographic surveillance system in Nepal, combined with a novel measure of drought/excess rainfall, we explore the impact of these on birthweight by time in pregnancy. Using survey data from the 2016 to 2019 Chitwan Valley Study in rural Nepal combined with data from Climate Hazards InfraRed Precipitation with Station, we explored the association between excess rainfall and drought and birthweight, looking at exposure in the preconception period, and by trimester of pregnancy. We also explore the impact of excess rainfall and drought on infant sex and delivery with a skilled birth attendant. We used multilevel regressions and explored for effect modification by maternal age. Drought in the first trimester is associated with lower birthweight (β = -82.9 g; 95% confidence interval [CI] = 164.7, -1.2) and drought in the preconception period with a high likelihood of having a male (odds ratio [OR] = 1.41; 95% CI = 1.01, 2.01). Excess rainfall in the first trimester is associated with high birthweight (β = 111.6 g; 95% CI = 20.5, 202.7) and higher odds of having a male (OR = 1.48; 95% CI = 1.02, 2.16), and in the third trimester with higher odds of low birth weight (OR = 2.50; 95% CI = 1.40, 4.45). Increasing rainfall extremes will likely impact birth outcomes and could have implications for sex ratios at birth.

In Search of the Promised Land: County-Level Disadvantage and Low Birth Weight among Black Mothers of the Great Migration.

The Great Migration was a movement of roughly eight million Black Southerners relocating to the North and West from 1910 to 1980. Despite being one of the most significant mass internal migrations during the twentieth century, little is known about the health outcomes resulting from migration and whether migrators' destination choices were potential mechanisms. This study measured the association between destination county disadvantage and odds of low birth weight during the last decade of the Great Migration. We used the US Census from 1970 as well as the birth records of first-time Black mothers who migrated from the South collected through the National Center of Health Statistics from 1973 to 1980 (n = 154,145). We examined three measures of area-based opportunity: Black male high school graduation rate, Black poverty rate, and racialized economic residential segregation. We used multilevel logistic regression, where mothers were nested within US counties, to quantify the relationship between county disadvantage and low birth weight. After adjusting for individual risk and protective factors for infant health, there was no relationship between county opportunity measures and low birth weight among migrators. Although high socioeconomic opportunity is typically associated with protection of low birth weight, we did not see these outcomes in this study. These results may support that persistent racial discrimination encountered in the North inhibited infant health even as migrators experienced higher economic opportunity relative to the South.

Association of the 2021 Child Tax Credit Advance Payments With Low Birth Weight in the US

Infants and pregnant people in the US fare worse on almost all health measures compared with those in peer nations. Families in the US are more likely to live in poverty and have a less generous social safety net, which has generated debate over the contribution of economic conditions to this disparity. To assess the association between temporary increases in income during pregnancy through the 2021 expanded Child Tax Credit (CTC) and birth outcomes. This cross-sectional study applied a comparison-population, interrupted time series design to data from US birth certificates (January 1, 2014, through December 31, 2021) to test whether the log odds of low birth weight (LBW) among monthly cohorts of births exposed to the CTC would coincide with a decreased incidence of LBW. All singleton live births to US residents aged 15 to 49 years with available data were included. Monthly birth cohorts exposed to the CTC were defined as those born to parous people during the CTC advance payment period from July through December 2021. The main outcome was the natural logarithm of the odds of LBW (<2500 g) among monthly birth cohorts. Among included births (n = 28 866 466), 61.2% were to parous people, the majority were to people aged 20 to 39 years (91.7%), and 6.5% were born LBW. The odds of LBW increased above expected values in 5 of the 6 months of the CTC payments (range of increases, 3.3%-5.4% across the 5 months). The outlier-adjusted odds of LBW increased, on average, by 4.2% (95% CI, 2.7%-5.7%) among the monthly birth cohorts exposed to the CTC. This study found that the odds of LBW among birth cohorts exposed to the CTC increased above expected values in 5 of the 6 months of the CTC advance payments. Additional research is needed to evaluate rival explanations for this increase in LBW among births exposed to the CTC payments.

Trends in smoking during pregnancy stratified by the use of opioid agonist therapy and the contribution of smoking to poor outcome in neonates prenatally exposed to opioid agonist treatment

High rates of cigarette smoking have been observed in pregnant women on opioid agonist therapy (OAT). However, it is unclear if these rates have changed overtime in line with the general population and the degree to which smoking contributes to poor outcomes in neonates born to women on OAT. Women who gave birth in Western Australia (WA) between 2003 and 2018 were identified from whole-population midwives records. Linked records were used to identify women who had been dispensed OAT during pregnancy and those who had smoking during pregnancy. Temporal changes in smoking during pregnancy were examined for women on OAT (n = 1059) and women not on OAT (n = 397,175) using Joinpoint regression. In women treated with OAT during pregnancy, neonatal outcomes were compared between smoking and non-smoking women using generalised linear models. During the study period, 76.3% of women on OAT smoked during pregnancy compared with 12.0% of the general population. There was a decrease in the prevalence of smoking during pregnancy among women not on OAT (APC: − 5.7, 95%CI: − 6.3, − 5.2), but not in women on OAT (APC: 0.8, 95%CI: − 0.4, 2.1). For women receiving OAT, smoking was associated with an increased odds of low birth weight (OR: 1.57, 95%CI: 1.06, 2.32) and neonatal abstinence syndrome (OR: 1.34, 95%CI: 1.01, 1.78) compared with non-smoking. Despite reductions in the prevalence of smoking during pregnancy in the general population, similar reductions have not occurred in pregnant women on OAT. The high prevalence of smoking in pregnant women on OAT is contributing to poor neonatal outcomes.

EPH166 The Effect of COVID-19 on Maternal and Neonatal Outcomes in a Large Tertiary Health System in Saudi Arabia

There is a scarcity of data comparing the rates of maternal and neonatal outcomes in pregnant women with and without COVID-19 infection. Our aim was to assess the effect of COVID-19 on maternal outcomes (stillbirths and miscarriage) and neonatal outcomes (low birth weight <2500 gm Apgar-1 minute score < 7, and Apgar-5 minute score < 7). This is a multicenter retrospective cohort study that included pregnant women who were followed and delivered at three National Guard health System hospitals between March 2020 and October 2021. A laboratory test confirmed the diagnosis of COVID-19 during pregnancy. Multivariable Logistic regression was conducted to assess the risks of maternal and neonatal outcomes. The study included 644 pregnant women with a confirmed COVID-19 infection and 654 pregnant women with no COVID-19 infection. There was no statistically significant difference in the risk of stillbirth (adjusted odds ratio, aOR1.93, 95% CI 0.55, 8.12) or miscarriage (aOR 0.52, 95% CI 0.23, 1.10) between COVID-19 infected pregnant women and non-infected pregnant women. COVID-19 infection, on the other hand, was associated with increased odds of low birth weight (aOR 1.5, 95%CI 1.06, 2.14), Apgar score-1 minute <7 (aOR 2.14, 95%CI 1.53, 3.03), and Apgar score-5 Minutes <7 (aOR 2.8, 95%CI 1.91, 4.17). Infants born to pregnant women with COVID-19 infection were more likely to have low birth weight and low Apgar scores than those born to uninfected mothers.

Maternal food insecurity and low birth weight: A hospital-based case–control study in Eastern India

Abstract Background: As household food insecurity is directly connected with the amount and quality of nutrition available to a person, maternal food insecurity, therefore, might have a role to play in poor pregnancy outcomes such as low birth weight (LBW). Objectives: To find out whether maternal food insecurity was associated with LBW among infants born between May and June of 2020 in a tertiary care hospital of Eastern India. Materials and Methods: The study was a case–control design, conducted among a set of sex-matched cases and controls. 105 LBW infants were taken as cases and 105 infants with birth weight ≥2500 g were taken as controls. Multivariable logistic regression analysis was done to ascertain the relationship between the independent and dependent variables and crude and adjusted odds ratios (AOR) were calculated to find out the association between the exposure and the outcome. Results: The cases and controls were statistically comparable with respect to baseline characteristics. Univariable analysis showed that the odds of LBW were 7.77 (95% confidence interval [CI]: 3.73–16.16) times more in food-insecure households. After adjusting for other variables included in the analysis, the AOR for food insecurity was 8.04 (95% CI: 3.81–16.94). Conclusion: The odds of giving birth to a LBW infant were higher in mothers belonging to food-insecure households. Addressing the prevalent barriers to accessibility, affordability, and adequacy of nutrition can be effective in mitigating this problem.

Moving to opportunity? Low birth weight outcomes among Southern-born Black mothers during the Great Migration

ObjectiveThe Great Migration was a mass movement in the United States during the twentieth century of roughly eight million Black Southerners to the Northeast, Midwest, and West. Despite its significance, little is known about the health outcomes associated with this internal migration. This study assessed the relationship between migration and low birth weight among mothers born in the South between 1950 and 1969. MethodsWe used approximately 1.4 million birth records of Black infants maintained by the US National Center for Health Statistics. To tease out the roles of the healthy migrant bias and of destination contexts, we compared two migration groups to Southern non-migrators: (1) migrators moving to the North and (2) migrators moving within the South. Non-migrants were matched to migrants using coarsened exact matching. We estimated the relationship between migration status and low birth weight stratified by birth year cohorts using logistic regression models. ResultsThere was positive selection in education and marriage among migrants moving out of the South and within the South. Results showed lower odds of low birth weight in both migration groups compared to Southern non-migrants. The odds ratios of low birth weight were similar in both comparisons. ConclusionWe found evidence consistent with a healthy migrant bias in infant health among mothers during the last decades of the Great Migration. Despite better economic opportunity, migrating to the North may not have offered additional protection for infant birth weight outcomes.