Predictors Of Adverse Birth Outcomes Research Articles

Machine learning-based risk factor analysis of adverse birth outcomes in very low birth weight infants

This study aimed to analyze major predictors of adverse birth outcomes in very low birth weight (VLBW) infants including particulate matter concentration (PM10), using machine learning and the national prospective cohort. Data consisted of 10,423 VLBW infants from the Korean Neonatal Network database during January 2013–December 2017. Five adverse birth outcomes were considered as the dependent variables, i.e., gestational age less than 28 weeks, gestational age less than 26 weeks, birth weight less than 1000 g, birth weight less than 750 g and small-for-gestational age. Thirty-three predictors were included and the artificial neural network, the decision tree, the logistic regression, the Naïve Bayes, the random forest and the support vector machine were used for predicting the dependent variables. Among the six prediction models, the random forest had the best performance (accuracy 0.79, area under the receiver-operating-characteristic curve 0.72). According to the random forest variable importance, major predictors of adverse birth outcomes were maternal age (0.2131), birth-month (0.0767), PM10 month (0.0656), sex (0.0428), number of fetuses (0.0424), primipara (0.0395), maternal education (0.0352), pregnancy-induced hypertension (0.0347), chorioamnionitis (0.0336) and antenatal steroid (0.0318). In conclusion, adverse birth outcomes had strong associations with PM10 month as well as maternal and fetal factors.

Perceived stress and COVID-19-related stressors: the moderating role of social support during pregnancy

ABSTRACT Recent evidence on perceived stress during the COVID-19 pandemic shows that birthing people experienced stress from pandemic-related stressors. While psychosocial stress is a significant predictor of adverse birth outcomes, social support can reduce stress levels during pregnancy. This study examined social support moderation of relationships between COVID-19-related stressors and perceived stress during pregnancy. The analysis included data from publicly insured pregnant participants who were enrolled in a randomized control trial of two enhanced prenatal care models in Fresno, California, and completed a third-trimester questionnaire between April and August 2020 (n = 77). Multivariate linear regression was used to estimate the associations between perceived stress and COVID-19-related stressors and social support moderation. COVID-19-related stressors related to childcare and tension at home remained significantly associated with perceived stress adjusting for sociodemographic characteristics and other COVID-19-related stressors. Social support moderated the relationship between perceived stress and loss of childcare (β = 2.4, 95 percent CI = 0.5–4.3, p = .014). Overall, social support moderated the association between COVID-19 stressors and perceived stress. While social support is commonly conceptualized as protective, the finding of greater stress around childcare among individuals reporting greater social support suggests complexity for leveraging these support networks during the pandemic.

Predictors of adverse birth outcomes among pregnant adolescents in Ashanti Region, Ghana.

Adolescent pregnancy is associated with adverse birth outcomes. However, the determinants of these outcomes are understudied. The present study sought to identify the predictors of adverse birth outcomes among pregnant adolescents in Ghana. In this prospective health centre-based study, 416 pregnant adolescents, aged 13-19 years old, were followed, and 270 birth outcomes were evaluated. We collected data on socio-demographic variables, eating behaviour, household hunger scale (HHS), lived poverty index (LPI) and compliance to antenatal interventions. The prevalence of low birth weight (LBW) and preterm births (PTB) were 15⋅2 and 12⋅5 %, respectively. Pregnant adolescents with no formal education (AOR 9⋅0; P = 0⋅004; 95 % CI 2⋅1, 39⋅8), those who experienced illness (AOR 3⋅0; P = 0⋅011; 95 % CI 1⋅3, 7⋅0), those who experienced hunger (OR 2⋅9; P = 0⋅010; 95 % CI 1⋅3, 6⋅5) and those with high LPI (OR 2⋅5; P = 0⋅014; 95 % CI 1⋅2, 5⋅3) presented increased odds of delivering preterm babies compared with those who have had secondary education, did not experience any illness, were not hungry or having low LPI, respectively. Pregnant adolescents who used insecticide-treated net (ITN) (AOR 0⋅4; P = 0⋅013; 95 % CI 0⋅2, 0⋅9) presented reduced odds LBW children; while those who experienced illness (AOR 2⋅7; P = 0⋅020; 95 % CI 1⋅2, 6⋅0), poorer pregnant adolescents (OR 2⋅5; P = 0⋅014; 95 % CI 1⋅1, 4⋅8) and those who experienced hunger (AOR 3⋅0; P = 0⋅028; 95 % CI 1⋅1, 8⋅1) presented increased odds of LBW children compared with those who used ITN, were not ill, were not poor or did not experience hunger. Adverse birth outcomes were associated with ANC compliance and socioeconomic factors of the pregnant adolescents. Hence, strengthening antenatal uptake and compliance by pregnant adolescents, promoting their livelihood and socioeconomic status, and interventions to prevent teenage pregnancies are strongly recommended.

Influence of maternal lifestyle behaviors on birth weight and Apgar score

IntroductionUnhealthy maternal lifestyles has been found to be associated with various adverse birth outcomes including low birth weight and low Apgar score. Purpose of the studyThe aim was to determine the influence of maternal lifestyle behaviors on birth weight and Apgar score among post-delivery women in Zanzibar. MethodologyA cross-sectional analytical hospital-based study which included 301 post-delivery women was conducted in Zanzibar from May to July 2019. The predictors of adverse birth outcomes (low birth weight and low Apgar score) were determined using Binary Logistic regression under multivariate analysis using SPSS version 23.0. P < 0.05 was considered to be significant. ResultsThe mean age of the post-delivery women was 28.6 ± 6.709 years. Low birth weight and low Apgar score were found in 40.2% and 26.9% of all the newborn, respectively. Passive tobacco smoking during pregnancy had almost a 4-fold increased risk of low birth weight (AOR = 3.77, 95% CI = 2.16–6.58, p = 0.001). Alcoholism during pregnancy had an almost 2-fold increased risk of causing low birth weight (AOR = 1.86, 95% CI = 3.11–5.34, p = 0.023). Inadequate dietary intake during pregnancy had a 1.21-fold increased risk of low birth weight (AOR = 1.21, 95% CI = 0.42–1.21, p = 0.007). ConclusionBeing a passive smoker, alcoholism and inadequate dietary intake during pregnancy may predict low birth weight and low Apgar score. Therefore, education should be given to pregnant women attending antenatal clinics in order to prevent or reduce the number of women giving birth to babies with either low birth weight or low Apgar score.

Birth history as a predictor of adverse birth outcomes: Evidence from state vital statistics data.

One of the most important predictors of preterm births (PTBs) or low-birth-weight births (LBWBs) is whether a mother has had a history of these birth outcomes. This study examined how different characterizations of birth history (e.g., any previous incidence of PTBs or LBWBs, immediate previous birth that was preterm or of low birth weight, and number of previous PTBs or LBWBs) were associated with PTBs or LBWBs. Based on birth records (n = 98,776) reported to the vital statistics electronic registration system in Nebraska from 2005 to 2014, mothers with a history of PTBs or LBWBs were more likely to have recurrences of these outcomes than those who did not have any history of PTBs or LBWBs. The adjusted odds ratios for recurrent PTBs ranged from 2.82 (95% CI: 2.62, 3.04) to 5.54 (95% CI: 4.67, 6.57) depending on how previous incidence of PTBs or LBWBs were characterized. The corresponding adjusted odds ratio for LBWBs ranged from 1.58 (95% CI: 1.43, 1.74) to 6.75 (95% CI: 4.96, 9.17). Relative to other measures used to characterize birth history, the use of number of previous PTBs or LBWBs allows for identifying mothers most vulnerable to recurrences of these birth outcomes. To help identify mothers at risk for future PTBs or LBWBs, it is beneficial to develop state-wide surveillance of reoccurrences for adverse birth outcomes which is feasible by integrating all separated birth records for the same mother using vital statistics data.

Assessment of Magnitude and Associated Factors of Adverse Birth Outcomes among Deliveries at Suhul Hospital Shire, Tigray, Ethiopia From September, 2015 to February, 2016

Adverse birth outcome is common phenomena both in developed and underdeveloped countries. Among all these adverse birth outcomes prematurity, low birth weight and still birth are the most common cases . Each year, about 15 million babies in the world, more than one in 10 births, are born too prematurely. More than 7% of those babies die shortly after birth; countless others suffer from lifelong physical, neurological, or educational disabilities, often at great cost to families and societies. Assessment of magnitude and associated factors of neonatal adverse birth outcomes among deliveries at Suhul Hospital, Shire, Tigray, Ethiopia from September, 2015 to February, 2016. An institution based cross sectional study with retrieving of information from cards retrospectively was conducted at maternity ward of Suhul hospital from September, 2015 to February, 2016. Simple random sampling method was used. Data collection was done using structured check list. Logistic regression analyses were used to identify significant predictors of adverse birth outcomes. P-value ≤0.05 was considered as statistically significant. Odds ratio was also used to determine the strength of association between independent variables and the birth outcomes. The magnitude of adverse birth outcome among the study participants was higher than the WHO estimation. Induced onset of labor, hypertensive disorders of pregnancy, ante partum hemorrhage, previous bad obstetric history and multiple pregnancies were the major predictors of adverse birth outcomes and improving of maternal health care service requires strict attention. The result indicates that an intervention is mandatory being the magnitude is higher than the WHO estimation. Keywords: Adverse birth outcome, preterm birth, still birth, low birth weight Cite this Article Tesfay Adhena , Abera Haftu, Gelawdiwos Gebre et al. Assessment of magnitude and associated factors of adverse birth outcomes among deliveries at Suhul Hospital Shire Tigray, Ethiopia from September, 2015 to February, 2016. Research & Reviews: Journal of Medical Science & Technology . 2017; 6(1): 1–10p.

Fathers Count: The Impact of Paternal Risk Factors on Birth Outcomes.

Objective To determine the contribution of paternal factors to the risk of adverse birth outcomes. Methods This is a retrospective cross-sectional analysis using birth certificate data from 2004 to 2015 retrieved from the Finger Lakes Regional Perinatal Data System. Primiparous women with singleton pregnancies were analyzed in the study. Two multivariate logistic regression models were conducted to assess potential paternal risk factors including age, race/ethnicity, and education on four birth outcomes, including preterm birth (PTB), low birthweight (LBW), high birthweight (HBW), and small for gestational age (SGA). Results A total of 36,731 singleton births were included in the analysis. Less paternal education was significantly related to an elevated risk of PTB, LBW, and SGA, even after adjustment for maternal demographic, medical, and lifestyle factors (P < 0.05). Paternal race/ethnicity was also significantly associated with all four birth outcomes (P < 0.05) while controlling for maternal factors. Older paternal age was associated with increased odds (OR 1.012, 95% CI 1.003-1.022) of LBW. Maternal race/ethnicity partially mediated the association of paternal race/ethnicity with HBW and SGA. Maternal education partially mediated the relationship between paternal education and SGA. Conclusion Paternal factors were important predictors of adverse birth outcomes. Our results support the inclusion of fathers in future studies and clinical programs aimed at reducing adverse birth outcomes.

Machine Learning for Social Services: A Study of Prenatal Case Management in Illinois.

To evaluate the positive predictive value of machine learning algorithms for early assessment of adverse birth risk among pregnant women as a means of improving the allocation of social services. We used administrative data for 6457 women collected by the Illinois Department of Human Services from July 2014 to May 2015 to develop a machine learning model for adverse birth prediction and improve upon the existing paper-based risk assessment. We compared different models and determined the strongest predictors of adverse birth outcomes using positive predictive value as the metric for selection. Machine learning algorithms performed similarly, outperforming the current paper-based risk assessment by up to 36%; a refined paper-based assessment outperformed the current assessment by up to 22%. We estimate that these improvements will allow 100 to 170 additional high-risk pregnant women screened for program eligibility each year to receive services that would have otherwise been unobtainable. Our analysis exhibits the potential for machine learning to move government agencies toward a more data-informed approach to evaluating risk and providing social services. Overall, such efforts will improve the efficiency of allocating resource-intensive interventions.

Adverse Birth Out Comes and Associated Factors among Delivered Mothers in Dessie Referral Hospital, North East Ethiopia

Introduction: Though there are studies on the various forms of adverse birth outcomes particularly in developing countries, there is limited information on determinant maternal and fetal factors of adverse birth outcomes at Dessie referral hospital including north east Ethiopia. Objective: To assess adverse birth outcomes and associated factors among delivered mothers in Dessie referral hospital, Dessie, Ethiopia. Methods: Institutional based cross sectional study design was conducted in Dessie referral hospital from February 30-March 30, 2017. Random sampling technique was used and 462 sample size was deployed. The collected data was checked; coded and entered to Epi info 7.3 and exported to SPSS version 20 for further analysis. Bivariate logistic regression model used to determine the independent association of dependent and independent variables on the bases of COR; 95 percent of confidence level and significance level of 0.25 Those variables which had significance level of less than 0.25 transferred to multivariable logistic regression. Multivariable logistic regression also used to control the possible effects of confounder variables on the basis of AOR; 95 percent of confidence level and significance level of 0.05. Result: A total of 462 delivered mothers participated in this study which yields 100% response rate. The study finding showed that the proportion of adverse birth outcome among the study participants was 32.5%. Out of 462 births 8.2% were still birth, 16.7% were low birth weight, 15.2% preterm and 8.4% were with visible birth defects. Mothers who didn’t attend antenatal care were 4 times more likely to have adverse birth outcome when compared to those who attended antenatal care follow up, [AOR=4.01, 95% CI(2.8,8.3 )]. Similarly, mothers with hemoglobin level less than 11 mg/dl were encountered adverse birth outcomes 3 times more when compared to those with hemoglobin level greater or equal to 11 mg/dl [AOR=3.04, 95% CI(1.62, 5.71)]. The presence of any form of pregnancy complication to current pregnancy were 3 times more likely to result in adverse birth outcomes as compared to no complication [AOR=2.9, 95% CI (1.64, 5.15)]. Conclusion and Recommendation: proportion of adverse birth outcome among the study participants was high. Lack of antenatal care, hemoglobin level, and pregnancy complications, middle upper arm circumference, were predictors of adverse birth outcomes. Increasing antenatal care uptake, prevention and treatment of chronic medical illness, and anemia and improvements in quality of maternal health services require strict attention.

Implementation Of Cambridge Worry Scale As A Psychological Assesment In Antenatal Care Routine

Pregnancy is a transition period in women’s life. In pregnancy, there are physiologic and psychological changes. Enhanced levels of anxiety during pregnancy may affect maternal blood flow and contribute to adverse obstetric, fetal and neonatal outcomes. There are many different reasons why women fell anxious and worry about their pregnancy. However, worries related to the pregnancy can contribute to high levels of pregnancy anxiety that has emerged as one of the most potent psychological predictors of adverse birth outcomes and is also implicated in poorer child and infant development.Pregnancy is a period in a woman’s life filled with pleasant anticipation of a baby, which may be influenced by several psychological stressors. Research on the psychological state in pregnancy indicates that each trimester of pregnancy includes possible stressors that may provoke several worries for pregnant women. Some studies found heightened levels of worries in the first and third trimester of pregnancy whereas others showed that each facet of a pregnant woman’s worries may fluctuate across the course of pregnancy. Several studies indicated that worries about the possibility of losing the baby, baby’s health, and childbirth are common causes of concerns among pregnant women. In addition to this kind of worries, there are other sources of worries in women daily life (e.g., worry about money, job, housing, their health, and marital relationships). Most women experience some mild worries during pregnancy; however, some women may experience pathological worries, defined as uncontrollable negative thoughts and excessive concern about future events in pregnancy which can produce anxiety.

Paternal education and adverse birth outcomes in Canada

BackgroundResearch on predictors of adverse birth outcomes has focused on maternal characteristics. Much less is known about the role of paternal factors. Paternal education is an important socioeconomic marker that...

Prevalence and associated Factors of Adverse Birth Outcomes among Women Attended Maternity Ward at Negest Elene Mohammed Memorial General Hospital in Hosanna Town, SNNPR, Ethiopia

Background: Throughout the world, approximately 210 million women become pregnant and over 135 million of them deliverr live born infants, while 75 million pregnancies end in stillbirth, preterm or spontaneous or induced abortion. Though there are studies on the various forms of adverse birth outcomes particularly in developing countries and few parts of Ethiopia there is limited data on the adverse birth outcomes at Negest Elene Mohammed memorial general hospital in Hosanna town Sothern Ethiopia. Objective: The aim of the study was to assess the prevalence and associated factors of adverse birth outcomes among deliveries at Negest Elene Mohammed memorial general hospital in Hosanna Town, south west of Ethiopia. Methods: Facility based Cross sectional quantitative study was carried out from March 1 to May 2, 2015 at Negest Elene Mohammed memorial general hospital. A convenient sampling technique was used to select 327 study participants. Data was collected using a pre-tested structured interviewer administered questionnaire and measurements of weight of the new born were taken and client’s chart was reviewed to retrieve medical information. The data was entered into SPSS version 20.0 statistical software for windows for analysis, then, logistic regression analysis was carried out to identify independent predictors of adverse birth outcomes at CI of 95% and significance level of P-value<0.05. Result: The study finding showed that 80 (24.5%) of women had adverse birth outcomes. The common adverse birth outcomes were still birth, preterm, and low birth weight with the proportion of 28 (8.6%), 28(8.6%), and 32 (9.8%), respectively). Being government employee [AOR=4.5,95%CI(1.25,15.9)], lack of antenatal care [AOR=3.2,95%CI(1.27,8.06)], rural residence [AOR=3.5,95%CI(1.57,7.93)], hemoglobin<11 mg/dl [AOR=2.5,95%CI(1.1,5.45)], malarial infection [AOR=8.6,95%CI(2.6,22.62)], age<20 years [AOR=4.9,95%CI(11.29,18.6)], pregnancy complications [AOR=6.3%CI(2.8,13.9)], were associated with adverse birth outcomes. Conclusion: Occupation, residence, age, malarial infection, lack of antenatal care, hemoglobin level, and pregnancy complications were associated with adverse birth outcomes. Increasing antenatal care uptake, prevention and treatment of malarial infection, and anemia and improvements in quality of maternal health services require strict attention.

No Association between Antenatal Common Mental Disorders in Low-Obstetric Risk Women and Adverse Birth Outcomes in Their Offspring: Results from the CDS Study in Ghana and Côte D'Ivoire

BackgroundEvidence linking common mental disorders (CMD) in pregnant women to adverse birth outcomes is inconsistent, and studies often failed to control for pregnancy complications. This study aimed to explore the association between antenatal depression and anxiety symptoms and birth outcomes in a low-obstetric risk sample of mother/child dyads in Ghana and Côte d’Ivoire.MethodsIn 2010-2011, a prospective cohort of 1030 women in their third trimester in Ghana and Côte d’Ivoire was enrolled. Depression and anxiety were assessed in the third trimester using the Patient Health Questionnaire depression module and the 7-item Generalized Anxiety Disorder scale. 719 mother/child dyads were included in the analysis. We constructed multivariate regression models to estimate the association between CMD and low birth weight (LBW), and preterm birth (PTB) to control for potential confounders.ResultsThe prevalence of depression and anxiety symptoms were 28.9% and 14.2% respectively. The mean birth weight was 3172.1g (SD 440.6) and the prevalence of LBW was 1.7%. The mean gestational age was 39.6 weeks and the proportion of PTB was 4%. Multivariate linear regression revealed no significant association between maternal depression (B=52.2, 95% CI -18.2 122.6, p=0.15) or anxiety (B=17.1, 95% CI -74.6 108.7, p=0.72) and birth weight. Yet, low socio-economic status, female sex of the child, and younger maternal age were associated with lower birth weight. Multivariate logistic regression suggested no significant association between maternal depression (OR: 2.1, 95% CI 0.8 5.6, p=0.15) or anxiety (OR: 1.8, 95% CI 0.6 5.5, p=0.29) with PTB.ConclusionsOur data suggests that depression and/or anxiety in the 3rd trimester of pregnancy are not independent predictors of adverse birth outcomes in low obstetric risk women. The role of pregnancy complications as confounders or effect modifiers in studies of maternal CMD and their impact on birth outcomes should be investigated.

Elevated Amniotic Fluid Stromal Cell-derived Factor-1α (SDF-1α) Concentration in Mid-gestation as a Predictor of Adverse Birth Outcomes

This study aimed to predict maternal and neonatal outcomes by measuring mid-trimester amniotic fluid stromal cell-derived factor-1alpha (SDF-1alpha) concentration in healthy women. Mid-trimester amniotic fluid samples from healthy women with a singleton pregnancy were obtained at the time of genetic amniocenteses. SDF-1alpha concentrations were determined by enzyme-linked immunosorbent assay. Maternal and neonatal characteristics were recorded. A total of 210 samples were collected. According to the SDF-1alpha cutoff value established by the receiver operating characteristic curve analysis (< 6.42 vs. > or = 6.42 pg/mL), there was a trend toward higher preterm birth rate, lower birth weight and lower 1-minute and 5-minute Apgar scores when SDF-1alpha levels increased (p < 0.05). The pair comparison between normal and selected pregnancy disorders (gestational diabetes, pre-eclampsia, and abnormal placentation) showed no statistical significance (p > 0.05). Pearson's correlations of SDF-1alpha to gestational age at delivery (r = -0.151) and birth weight (r = -0.194) were significant (p < 0.05). In the multivariate analysis on mid-trimester SDF-1alpha levels, maternal age at sampling (regression coefficient = -0.163) and 1-minute Apgar score (< 7 vs. > or = 7, regression coefficient = 2.028) were both significant (p < 0.05). Increased SDF-1alpha levels in mid-trimester amniotic fluid suggest a possible role in predicting pregnant women at risk of adverse neonatal outcomes including higher preterm birth rate, lower birth weight, and lower Apgar scores.

Late recognition of pregnancy as a predictor of adverse birth outcomes

We examined the relationship between the time of recognition of pregnancy and birth outcomes, such as premature births, low birthweight (LBW), admission to the neonatal intensive care unit (NICU), and infant mortality. A secondary analysis was performed using the Pregnancy Risk Assessment and Monitoring System (PRAMS) multistate data from 2000-2004. The sample consisted of 136,373 women who had a live childbirth. Analysis involved multiple logistic regression models, appropriately weighted for point and variance estimation to reflect the complex survey design of the PRAMS using STATA 9.2 (Stata Corp, College Station, TX). Approximately 27.6% recognized their pregnancy late (after 6 weeks of gestation). Late recognition was significantly associated with an increased odds of having premature births (odds ratio [OR], 1.09; 99% confidence interval [CI], 1.01-1.19), LBW (OR, 1.08; 99% CI, 1.01-1.15), and NICU admissions (OR, 1.12; 99% CI, 1.03-1.21). These results provide a rationale and an impetus for developing interventions that promote early recognition of pregnancy.

Adverse birth outcomes among Korean Americans: The impactof nativity and social proximity to other Koreans

In the past two decades, the size of the Korean American population has notably increased. Despite this, there has been little research on the perinatal health of this population. This paper examines which and to what extent maternal risk factors are associated with birth outcomes (prematurity and intrauterine growth retardation [IUGR]) among Korean Americans, particularly focusing on maternal nativity and residential proximity to other Koreans. The authors employ the National Center for Health Statistics Linked Birth/Infant Death Files for 1995–1997, pooled and linked with contextual information obtained from the 2000 Census Summary File 1 for seven selected states. Major findings, based on multinomial logistic regression models, suggest that maternal educational attainments and the status of prenatal care are strong predictors of adverse birth outcomes among this population. Although descriptive analysis indicates an elevated risk of adverse birth among U.S.-born Korean women, compared to their foreign-born counterparts, the control of prenatal care eliminates the effect of maternal nativity. Social proximity to co-ethnics, measured by the population size of Koreans in counties, has little influence on birth outcomes among Korean Americans.