Smallness at Birth and Neonatal Death: Reexamining the Current Indicator Using Sibling Data

2019 ◽  
Vol 38 (01) ◽  
pp. 076-081
Author(s):  
Maya Tabet ◽  
Louise H. Flick ◽  
Hong Xian ◽  
Chang Jen Jen
Keyword(s):  
United States ◽  
Gestational Age ◽  
Neonatal Death ◽  
Retrospective Cohort ◽  
Significant Interaction ◽  
Neonatal Period ◽  
The United States ◽  
Population Based ◽  
Live Births ◽  
Second Births

Abstract Objective The similarity in size among siblings has implications for neonatal death, but research in this area is lacking in the United States. We examined the association between small-for-gestational age (SGA), defined as a birthweight <10th percentile for gestational age, and neonatal death, defined as death within the first 28 days of life, among second births who had an elder sibling with SGA (“repeaters”) versus those whose elder sibling did not have SGA (“nonrepeaters”). Study Design We conducted a population-based retrospective cohort study including 179,436 women who had their first two nonanomalous singleton live births in Missouri (1989–2005). Logistic regression was used to evaluate the association between SGA and neonatal death among second births, stratified by whether the elder sibling was SGA. Results Out of 179,436 second births, 297 died in the neonatal period. There was a significant interaction between birthweight-for-gestational age of first and second births in relation to neonatal death (p = 0.001). Second births with SGA had increased odds of neonatal death by 2.15-fold if they were “repeaters,” and 4.44-fold if they were “nonrepeaters,” as compared with non-SGA second births. Conclusion Our findings suggest that referencing sibling birthweight may be warranted when evaluating infant size in relation to neonatal death.

The Difference in Sibling Birthweight and Neonatal Death: A Population-Based Cohort Study

2018 ◽  
Vol 36 (05) ◽  
pp. 498-504
Author(s):  
Maya Tabet ◽  
Louise Flick ◽  
Hong Xian ◽  
Jen Chang
Keyword(s):  
Logistic Regression ◽  
Cohort Study ◽  
Neonatal Death ◽  
Binary Logistic Regression ◽  
Population Based ◽  
Growth Potential ◽  
Live Births ◽  
The Difference ◽  
Second Births ◽  
Half Sibling

Background There has been a call for customized rather than population-based birthweight standards that would classify smallness based on an infant's own growth potential. Thus, this study aimed to examine the association between the difference in sibling birthweight and the likelihood of neonatal death among second births in a U.S. population. Study Design This was a population-based cohort study including 179,300 women who delivered their first two nonanomalous singleton live births in Missouri (1989–2005). We performed binary logistic regression to evaluate the association between being relatively smaller than the elder full- or half-sibling (i.e., smaller by at least 500 g) and neonatal death (i.e., deaths in the first 28 days of life) among second births after controlling for sociodemographic and pregnancy-related variables in the second pregnancy. Results The adjusted odds of neonatal death were 2.54-times higher among second births who were relatively smaller than their elder sibling. Among relatively small second births, every 100-g increase in the difference in sibling birthweight was associated with a 13% increase in the odds of neonatal death. Conclusion The deviation from the elder sibling's birthweight predicts neonatal death. Taking into consideration the elder sibling's birthweight may be warranted in clinical and research settings.

Will Neonatology Vanish in 1995?

PEDIATRICS ◽  
1986 ◽  
Vol 77 (5) ◽  
pp. 791-792
Author(s):  
HUGH CRAFT ◽  
EARL SIEGEL
Keyword(s):  
United States ◽  
Neonatal Death ◽  
Preventive Measures ◽  
Preterm Births ◽  
The United States ◽  
Dramatic Improvement ◽  
Live Births ◽  
Preventive Effort ◽  
Infant And Child Health ◽  
And Child Health

To the Editor.— It was encouraging to see the results of the recent study from France on the prevention of preterm births published in Pediatrics.1 Pediatricians have long supported preventive measures to improve infant and child health. But, pediatricians, in general, and neonatologists, in particular, have been slow to assume an advocacy position for an obvious, important preventive effort, namely, reducing the incidence of low birth weight. During the last 20 years, the United States has experienced a dramatic improvement in neonatal mortality, from rates of neonatal death of 18 per 1,000 live births in 1965 to 6.8 per 1,000 live births today.2,3

Placenta previa: Neonatal death after live births in the United States

2003 ◽  
Vol 188 (5) ◽  
pp. 1305-1309 ◽  
Author(s):  
Hamisu M. Salihu ◽  
Qing Li ◽  
Dwight J. Rouse ◽  
Greg R. Alexander
Keyword(s):  
United States ◽  
Neonatal Death ◽  
Placenta Previa ◽  
The United States ◽  
Live Births

Regional Contribution of Previable Infant Deaths to Infant Mortality Rates in the United States

2019 ◽  
Author(s):  
MacKenzie Lee ◽  
Eric S. Hall ◽  
Meredith Taylor ◽  
Emily A. DeFranco
Keyword(s):  
United States ◽  
Infant Mortality ◽  
Infant Death ◽  
The United States ◽  
Mortality Rates ◽  
Population Based ◽  
Infant Mortality Rate ◽  
Infant Deaths ◽  
Live Births ◽  
Healthy People 2020

Objective Lack of standardization of infant mortality rate (IMR) calculation between regions in the United States makes comparisons potentially biased. This study aimed to quantify differences in the contribution of early previable live births (<20 weeks) to U.S. regional IMR. Study Design Population-based cohort study of all U.S. live births and infant deaths recorded between 2007 and 2014 using Centers for Disease Control and Prevention's (CDC's) WONDER database linked birth/infant death records (births from 17–47 weeks). Proportion of infant deaths attributable to births <20 vs. 20 to 47 weeks, and difference (ΔIMR) between reported and modified (births ≥20 weeks) IMRs were compared across four U.S. census regions (North, South, Midwest, and West). Results Percentages of infant deaths attributable to birth <20 weeks were 6.3, 6.3, 5.3, and 4.1% of total deaths for Northeast, Midwest, South, and West, respectively, p < 0.001. Contribution of < 20-week deaths to each region's IMR was 0.34, 0.42, 0.37, and 0.2 per 1,000 live births. Modified IMR yielded less regional variation with IMRs of 5.1, 6.2, 6.6, and 4.9 per 1,000 live births. Conclusion Live births at <20 weeks contribute significantly to IMR as all result in infant death. Standardization of gestational age cut-off results in more consistent IMRs among U.S. regions and would result in U.S. IMR rates exceeding the healthy people 2020 goal of 6.0 per 1,000 live births.

Trends in Multiple Births Conceived Using Assisted Reproductive Technology, United States, 1997–2000

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_1) ◽  
pp. 1159-1162 ◽  
Author(s):  
Meredith A. Reynolds ◽  
Laura A. Schieve ◽  
Joyce A. Martin ◽  
Gary Jeng ◽  
Maurizio Macaluso
Keyword(s):  
United States ◽  
Assisted Reproductive Technology ◽  
The United States ◽  
Population Based ◽  
Reproductive Technology ◽  
Multiple Births ◽  
Multiple Gestation ◽  
Birth Rates ◽  
Live Births ◽  
Natural Conception

Objective. To examine trends in multiple births conceived using assisted reproductive technology (ART) in the United States between 1997 and 2000 and to estimate the proportion of all US multiple births attributable to ART use. Methods. We analyzed population-based data of 109 519 live-born infants who were conceived in the United States using ART and born between 1997 and 2000 and population-based data of 15 856 809 live-born infants who were delivered in the United States between 1997 and 2000. Multiple birth rates (the number of live-born infants delivered in multiple gestation pregnancies per 1000 live births) and the proportion of all US multiple births attributable to ART were evaluated. Results. The twin rate for ART patients increased between 1997 and 2000, reaching 444.7 per 1000 live births in 2000, whereas the triplet/+ rate declined substantially from 134.3 to 98.7 per 1000 live births from 1997–2000. From 1997–2000, the proportion of multiple births in the United States attributable to ART increased from 11.2% to 13.6%, whereas the proportion attributable to natural conception decreased from 69.9% to 64.5%. In 2000, the proportion of triplet/+ births attributable to ART and to natural conception was 42.5% and 17.7%, respectively. The contribution of ART to multiple births increased substantially with maternal age, from 11.6% for triplet/+ infants born to women aged 20 to 24 to 92.8% for women aged 45 to 49 years. Conclusions. The contribution of ART to twin birth rates continues to increase, but the contribution of ART to triplet/+ birth rates has declined.

scholarly journals Maternal Hepatitis B Infection and Pregnancy Outcomes in the United States: A Population-Based Cohort Study

2018 ◽  
Vol 5 (6) ◽  
Author(s):  
Kristina L Bajema ◽  
Helen C Stankiewicz Karita ◽  
Mark W Tenforde ◽  
Stephen E Hawes ◽  
Renee Heffron
Keyword(s):  
United States ◽  
Cohort Study ◽  
Hepatitis B ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Placenta Previa ◽  
The United States ◽  
Population Based ◽  
Large For Gestational Age ◽  
Hepatitis B Infection

Abstract Background Hepatitis B virus (HBV) infection in pregnancy has been associated with risk of adverse maternal and infant outcomes in highly endemic settings, but this association is not well characterized in the United States. Methods We conducted a retrospective population-based cohort study in Washington State using linked birth certificate and hospital discharge records from 1992–2014. Among pregnant women with hepatitis B (n = 4391) and a hepatitis B–negative group (n = 22 410), we compared the risk of gestational diabetes, pre-eclampsia, eclampsia, placenta previa, preterm delivery, low birthweight, small for gestational age, and large for gestational age using multivariate logistic regression. Results Hepatitis B–infected pregnant women were more likely to be Asian (61% vs 8%, P &lt; .001), foreign-born (76% vs 23%, P &lt; .001), and older in age (77% vs 64% ≥26 years, P &lt; .001). They were less commonly overweight or obese (33% vs 50%, P &lt; .001). There was a lower risk of small for gestational age infants among HBV-infected women (adjusted RR [aRR], 0.79; 95% confidence interval [CI], 0.67–0.93). The risk of other adverse outcomes was not significantly different between hepatitis B–infected and –negative women (gestational diabetes: aRR, 1.11; 95% CI, 0.92–1.34; pre-eclampsia: aRR, 1.06; 95% CI, 0.82–1.35; eclampsia: aRR, 2.31; 95% CI, 0.90–5.91; placenta previa: aRR, 1.16; 95% CI, 0.35–3.84; preterm delivery: aRR, 1.15; 95% CI, 0.98–1.34; low birth weight: aRR, 1.08; 95% CI, 0.90–1.29; large for gestational age: aRR, 1.01; 95% CI, 0.82–1.24). Conclusions In a low-burden setting in the United States, hepatitis B infection was not associated with adverse pregnancy outcomes.

P–773 Infertility treatment and the risk of small for gestational age births: a population-based study in the United States

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
H Glatthorn ◽  
M Sauer ◽  
J Brandt ◽  
C Ananth
Keyword(s):  
United States ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
The United States ◽  
Infertility Treatment ◽  
Unmeasured Confounding ◽  
Live Births ◽  
The Us ◽  
Infertility Treatments ◽  
The Impact

Abstract Study question What is the association between infertility treatments and small for gestational age (SGA) births? Summary answer Women who conceived pregnancies with any infertility treatment had a decreased risk of SGA &lt;10th, &lt;5th and &lt;3rd percentiles compared to naturally conceived pregnancies. What is known already Assisted reproductive technology (ART) and other infertility treatments have long been associated with an increased risk of SGA births, which confers a greater risk of perinatal morbidity and mortality compared to appropriate for gestational age births. Study design, size, duration This is a cross-sectional study of 16,836,228 births in the United States (US) between 2015–2019. The exposure group included women who underwent any infertility treatment, including ART and prescribed fertility enhancing medications. The comparison group included those who had naturally conceived pregnancies. The primary outcome was SGA birth, defined as sex-specific birthweight &lt;10th percentile for gestational age. Secondary outcomes included SGA &lt;5th and &lt;3rd percentile births. Participants/materials, setting, methods Pregnant subjects (n = 16,836,228) in the US who delivered non-malformed, singleton live births between 24–44 weeks’ gestational age. We estimated risk of SGA births in relation to any infertility treatment from fitting log-linear Poisson regression models with robust variance. Risk ratios (RR) and 95% confidence intervals (CI) were estimated as the effect measure before and after adjusting for confounders. We also performed a sensitivity analysis to correct for potential non-differential exposure misclassification and unmeasured confounding biases. Main results and the role of chance During the study period, 1.4% (n = 231,177) of non-malformed singleton live births resulted from infertility treatments (0.8% ART and 0.6% fertility enhancing medications). Of these, 9.4% (n = 21,771) of pregnancies conceived with infertility treatment were complicated by SGA &lt;10th percentile compared to 11.9% (n = 1,755,925) of naturally conceived pregnancies. For pregnancies conceived with infertility treatment versus naturally conceived pregnancies, the adjusted RR for SGA &lt;10th percentile was 1.07 (95% CI 1.06, 1.08). However, after correction for misclassification bias and unmeasured confounding, infertility treatment was found to be protective for SGA and conferred a 27% reduced risk of SGA &lt;10th percentile (bias-corrected RR 0.73, 95% CI 0.53, 0.85). These trends were similar for analyses stratified by exposure to ART and fertility enhancing medications and secondary SGA outcomes, including SGA &lt;5th and &lt;3rd percentile. Limitations, reasons for caution All information collected on infertility treatment relies on self-reporting by patients and recording by hospital staff at the time of delivery, which likely resulted in underreporting of infertility treatments. Additionally, we cannot determine the impact of interventions that were not recorded, such as intrauterine insemination (IUI). Wider implications of the findings: Compared to naturally conceived pregnancies, exposure to infertility treatment is associated with reduction in the risk of SGA births. These findings, which are contrary to some published reports, likely reflect changes in the modern practice of infertility care in the US, and importantly, robust analysis of the national data. Trial registration number Not applicable

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