Self-report measure as a useful tool to identify prenatal substance use and predict adverse birth outcomes

Objectives The purpose of the current study was to examine whether a self-report measure identifies prenatal substance use and predicts resulting adverse birth outcomes in a large cohort using electronic medical records. Methods Pregnant patients who were admitted between 2014 and 2015 at Christiana Care Health System and delivered singleton birth were included in the analyses ( N = 11,020). Participant demographic information, pregnancy comorbidities, self-reported substance use, and birth outcomes were retrieved from electronic medical records. Detailed descriptive analyses of prenatal substance use were conducted, and logistic models were evaluated for the associations between substance use and each birth outcome (preterm birth, low birth weight, neonatal intensive care unit admission). Results The average maternal age was 30 years (standard deviation: 6), 37% receiving Medicaid. Over 58% were White, 26% were Black, and 13% were Hispanic. Cigarette smoking only showed the highest prevalence among substance users (53%). Self-reported cigarette smoking and illicit drug use other than marijuana significantly predicted all three adverse birth outcomes (Adjusted Odds Ratio [AOR] range: 1.33 (95% Confidence Interval [CI]: 1.08–1.64)–3.09 (95% CI: 2.03–4.67)). Nonresponders to the cigarette smoking question also significantly predicted two adverse birth outcomes of preterm birth delivery (AOR: 4.16; 95% CI: 1.27–14.71) and having low birth weight babies (AOR: 3.50; 95% CI: 1.04–12.61). Conclusions/Importance: Prenatal cigarette smoking only had the highest prevalence, and co-use with illicit drugs was also high, leading to significant associations with adverse birth outcomes. The study findings indicate that the self-report measurement is a useful tool to identify prenatal substance use and predict resulting adverse birth outcomes.

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Adolescent Substance Use Screening Integrated With Electronic Medical Records

PsycEXTRA Dataset ◽

10.1037/e520552015-006 ◽

2014 ◽

Author(s):

C. McKenna ◽

B. Gaines ◽

C. Hatfield ◽

S. Helman ◽

L. Meyer ◽

...

Keyword(s):

Substance Use ◽

Electronic Medical Records ◽

Medical Records ◽

Adolescent Substance Use ◽

Adolescent Substance

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Improving Accuracy of a Self-Report Measure of Substance Use

PsycEXTRA Dataset ◽

10.1037/e705922007-001 ◽

2007 ◽

Author(s):

Elizabeth R. Rahdert ◽

David L. Wyrick ◽

Melodie Fearnow-Kenney

Keyword(s):

Substance Use ◽

Self Report ◽

Improving Accuracy ◽

Report Measure

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Mass incarceration and public health: the association between black jail incarceration and adverse birth outcomes among black women in Louisiana

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2690-z ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Lauren Dyer ◽

Rachel Hardeman ◽

Dovile Vilda ◽

Katherine Theall ◽

Maeve Wallace

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Black Women ◽

Low Birth Weight ◽

Racial Disparities ◽

Population Health ◽

Birth Outcomes ◽

Mass Incarceration ◽

Interquartile Range ◽

Adverse Birth Outcomes

Abstract Background A growing body of evidence is beginning to highlight how mass incarceration shapes inequalities in population health. Non-Hispanic blacks are disproportionately affected by incarceration and criminal law enforcement, an enduring legacy of a racially-biased criminal justice system with broad health implications for black families and communities. Louisiana has consistently maintained one of the highest rates of black incarceration in the nation. Concurrently, large racial disparities in population health persist. Methods We conducted a cross-sectional analysis of all births among non-Hispanic black women in Louisiana in 2014 to identify associations between parish-level (county equivalent) prevalence of jail incarceration within the black population and adverse birth outcomes (N = 23,954). We fit a log-Poisson model with generalized estimating equations to approximate the relative risk of preterm birth and low birth weight associated with an interquartile range increase in incarceration, controlling for confounders. In sensitivity analyses, we additionally adjusted for the parish-level index crime prevalence and analyzed regression models wherein white incarceration was used to predict the risk of adverse birth outcomes in order to quantify the degree to which mass incarceration may harm health above and beyond living in a high crime area. Results There was a significant 3% higher risk of preterm birth among black women associated with an interquartile range increase in the parish-level incarceration prevalence of black individuals, independent of other factors. Adjusting for the prevalence of index crimes did not substantively change the results of the models. Conclusion Due to the positive significant associations between the prevalence of black individuals incarcerated in Louisiana jails and estimated risk of preterm birth, mass incarceration may be an underlying cause of the persistent inequities in reproductive health outcomes experienced by black women in Louisiana. Not only are there economic and social impacts stemming from mass incarceration, but there may also be implications for population health and health inequities, including the persistence of racial disparities in preterm birth and low birth weight.

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Paternal factors and adverse birth outcomes in Lanzhou, China

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03492-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jing Li ◽

Jie Qiu ◽

Ling Lv ◽

Baohong Mao ◽

Lei Huang ◽

...

Keyword(s):

Birth Outcomes ◽

Medical Records ◽

Paternal Age ◽

Birth Cohort Study ◽

Adverse Birth Outcomes ◽

Care Hospital ◽

Maternal Factors ◽

Heavy Smoking ◽

Paternal Factors ◽

Low Education

Abstract Background Many maternal factors are known to be associated with adverse birth outcomes, but studies about paternal factors yielded inconsistent conclusions. The study was to assess whether paternal factors are associated with low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA). Methods A birth cohort study was conducted in 2010–2012 at the Gansu Provincial Maternity and Child Care Hospital, the largest maternity and childcare hospital in Lanzhou, China. Paternal age, ethnicity, educational level, height, weight, smoking, and drinking were collected. Birth outcomes and pregnancy complications were extracted from the medical records. Results During the study period, 10,121 participants were included; the overall prevalence of LBW, PTB, and SGA was 7.2, 9.9, and 7.8%, respectively. Paternal higher height (OR = 0.64 95%CI: 0.49, 0.83), higher weight (P for trend < 0.001), and higher BMI (P for trend < 0.001) could decrease the rate of LBW. Paternal higher education (OR = 0.55, 95%CI: 0.43, 0.71) and higher weight (P for trend < 0.001,) were associated with lower rate of PTB. Fathers who smoked more than 6 pack-years were associated with PTB (OR = 1.31, 95%CI: 1.07, 1.61). Paternal BMI > 23.9 kg/m2 (P for trend < 0.001,) and paternal education which above college (OR = 0.61, 95%CI: 0.50, 0.82) were associated with a lower rate of SGA. Conclusion Paternal low education is independently associated with PTB and SGA. Paternal heavy smoking is associated with PTB. Low paternal weight/BMI is independently associated with LBW, PTB, and SGA.

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Maternal exposure to airborne polychlorinated biphenyls (PCBs) and risk of adverse birth outcomes

European Journal of Epidemiology ◽

10.1007/s10654-021-00793-x ◽

2021 ◽

Author(s):

Ane Bungum Kofoed ◽

Laura Deen ◽

Karin Sørig Hougaard ◽

Kajsa Ugelvig Petersen ◽

Harald William Meyer ◽

...

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Sex Ratio ◽

Polychlorinated Biphenyls ◽

Birth Outcomes ◽

Gestational Age ◽

Small For Gestational Age ◽

Maternal Exposure ◽

Adverse Birth Outcomes ◽

Secondary Sex Ratio

AbstractHuman health effects of airborne lower-chlorinated polychlorinated biphenyls (LC-PCBs) are largely unexplored. Since PCBs may cross the placenta, maternal exposure could potentially have negative consequences for fetal development. We aimed to determine if exposure to airborne PCB during pregnancy was associated with adverse birth outcomes. In this cohort study, exposed women had lived in PCB contaminated apartments at least one year during the 3.6 years before conception or the entire first trimester of pregnancy. The women and their children were followed for birth outcomes in Danish health registers. Logistic regression was performed to estimate odds ratios (OR) for changes in secondary sex ratio, preterm birth, major congenital malformations, cryptorchidism, and being born small for gestational age. We performed linear regression to estimate difference in birth weight among children of exposed and unexposed mothers. All models were adjusted for maternal age, educational level, ethnicity, and calendar time. We identified 885 exposed pregnancies and 3327 unexposed pregnancies. Relative to unexposed women, exposed women had OR 0.97 (95% CI 0.82, 1.15) for secondary sex ratio, OR 1.13 (95% CI 0.76, 1.67) for preterm birth, OR 1.28 (95% CI 0.81, 2.01) for having a child with major malformations, OR 1.73 (95% CI 1.01, 2.95) for cryptorchidism and OR 1.23 (95% CI 0.88, 1.72) for giving birth to a child born small for gestational age. The difference in birth weight for children of exposed compared to unexposed women was − 32 g (95% CI—79, 14). We observed an increased risk of cryptorchidism among boys after maternal airborne LC-PCB exposure, but due to the proxy measure of exposure, inability to perform dose–response analyses, and the lack of comparable literature, larger cohort studies with direct measures of exposure are needed to investigate the safety of airborne LC-PCB exposure during pregnancy

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Determinants of preterm birth in public hospitals in central Ethiopia: an unmatched case-control study

F1000Research ◽

10.12688/f1000research.50974.1 ◽

2021 ◽

Vol 10 ◽

pp. 773

Author(s):

Berhanu Senbeta Deriba ◽

Agumas Fentahun Ayalew ◽

Addis Adera Gebru

Keyword(s):

Preterm Birth ◽

Cigarette Smoking ◽

Birth Outcomes ◽

Case Control Study ◽

Case Control ◽

Public Hospitals ◽

Medical Illness ◽

Adverse Birth Outcomes ◽

Central Ethiopia ◽

Control Study

Background: Around 15 million babies are born prematurely in the world every year. The most common cause of neonatal death in Ethiopia is premature birth. To reduce the rate of preterm delivery by correcting modifiable or preventable causes, the availability of local data is important. Hence, this study aimed to identify the determinants of preterm birth among women who gave birth in public hospitals in central Ethiopia. Methods: An Institutional-based unmatched case-control study was conducted at public hospitals in central Ethiopia to select 170 cases and 340 controls. The collected data were entered into EPI INFO and transferred to SPSS for analysis. Tables, graphs, and proportions were used to present the results. Binary and multiple logistic regressions analysis were computed to identify determinants of preterm birth. Adjusted Odds Ratio (AOR), 95% Confidence Interval (CI), and a p-value < 0.05 were computed to determine the presence of an association between preterm birth and independent variables. Results: A total of 166 cases and 332 controls participated in the study, giving a response rate of 97.6%. Cigarette smoking (AOR=3.77, 95% CI=1.35,10.56), alcohol consumption (AOR=1.85, 95% CI=1.11,3.10), wanted but unplanned pregnancy (AOR=3,95% CI=1.68,5.34), neither wanted nor planned pregnancy(AOR=3.61% CI=1.62,8.06), lack of antenatal care (ANC) visits (AOR=4.13, 95% CI=1.95, 8.74), adverse birth outcomes (AOR=5.66, 95% CI=2.88,11.12), presence of a diagnosed illness (AOR=2.81, 95% CI=1.37, 5.76), presence of one or more of obstetrics complications(AOR=6.44, 95% CI=5.49, 3.35, 9), and hemoglobin level < 11g/dl (AOR=2.78, 95% CI=1.48, 5.22) were determinants of preterm birth. Conclusion:-In this study, cigarette smoking status, alcohol drinking status, pregnancy status, adverse birth outcomes, ANC visits, obstetric complications, presence of medical illness, and anemia were identified as determinants of preterm birth. It is important to encourage such women to attend ANC visits, stop smoking, and abstain from alcohol.

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Paternal age and the risk of low birth weight and preterm delivery: a Finnish register-based study

Journal of Epidemiology & Community Health ◽

10.1136/jech-2017-210170 ◽

2018 ◽

Vol 72 (12) ◽

pp. 1104-1109 ◽

Cited By ~ 6

Author(s):

Alice Goisis ◽

Hanna Remes ◽

Kieron Barclay ◽

Pekka Martikainen ◽

Mikko Myrskylä

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Delivery ◽

Birth Outcomes ◽

Conclusive Evidence ◽

Paternal Age ◽

Adverse Birth Outcomes ◽

Maternal Characteristics ◽

Parental Characteristics ◽

Increased Risk

BackgroundBased on existing studies, there is no conclusive evidence as to whether and why paternal age matters for birth outcomes.MethodsWe used Finnish population registers on 106 652 children born 1987–2000. We first document the unadjusted association between paternal age and the risk of low birth weight (LBW; <2500 g) and preterm birth (<37 weeks’ gestation). Second, we investigate whether the unadjusted association is attenuated on adjustment for child’s, maternal and parental socioeconomic characteristics. Third, by adopting a within-family design which involves comparing children born to the same father at different ages, we additionally adjust for unobserved parental characteristics shared between siblings.ResultsThe unadjusted results show that being born to a father aged 40+, as opposed to a father aged 30–34, is associated with an increased risk of LBW of 0.96% (95% CI 0.5% to 1.3%) and to a younger father (<25) with a 1% (95% CI 0.6% to 1.3%) increased risk. The increased risk at younger paternal ages is halved on adjustment for the child’s characteristics and fully attenuated on adjustment for child/parental characteristics. The increased risk at paternal ages 40+ is partially attenuated on adjustment for maternal characteristics (β=0.62%; 95% CI 0.13% to 1.1%). Adjustment for unobserved parental characteristics shared by siblings further attenuates the 40+ coefficient (β=0.4%; 95% CI −0.5% to −1.2%). Results for preterm delivery are similar.ConclusionsThe results underscore the importance of considering paternal age as a potential risk factor for adverse birth outcomes and of expanding research on its role and the mechanisms linking it to birth outcomes.

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Association of US state policy orientation with adverse birth outcomes: a longitudinal analysis

Journal of Epidemiology & Community Health ◽

10.1136/jech-2020-214858 ◽

2021 ◽

pp. jech-2020-214858

Author(s):

Alicia R Riley ◽

Daniel Collin ◽

Jacob M Grumbach ◽

Jacqueline M Torres ◽

Rita Hamad

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Birth Outcomes ◽

State Policy ◽

Fixed Effects ◽

State Policies ◽

Adverse Birth Outcomes ◽

Lower Odds ◽

Policy Orientation

BackgroundThe current US context is marked by extreme right–left partisanship, which means that state policies tend to bundle together and are not experienced in isolation. While prior work has leveraged abrupt shifts in single policies to examine the effects of state policy on birth outcomes, we examined a holistic measure that captures political polarisation.MethodsData were drawn from national birth certificates for 2003–2017 (N=56 770 470). Outcomes included preterm birth, low birth weight, small-for-gestational age and other perinatal health measures. The primary exposure was a composite index of right–left state policy orientation, generated from historical data on 135 state policies. Multivariable regressions were used to estimate the association between state policy orientation and each outcome, adjusting for relevant covariates.ResultsCompared with infants born in states with right-leaning policy orientations, those born in left-leaning states had lower odds of adverse birth outcomes (eg, low birth weight: OR 0.95 (0.93, 0.97), preterm birth: OR 0.94 (0.92, 0.95)). Subgroup analyses revealed stronger associations for US-born and White mothers. With the inclusion of state fixed effects, left-leaning policy orientation was no longer associated with lower odds of adverse birth outcomes. Models were otherwise robust to alternative specifications.ConclusionWhile left-leaning state policy orientation has protective associations with a range of birth outcomes, the associations may be explained by stable characteristics of states, at least during the study period. Future studies should examine state policy orientation in association with other health outcomes and study periods.

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Geospatial analysis of exposure to violent crime during pregnancy and adverse birth outcomes: Evidence from São Paulo’s Western Region Birth Cohort

10.21203/rs.3.rs-33991/v1 ◽

2020 ◽

Author(s):

Angelica Carreira dos Santos ◽

Alexandra Brentani ◽

Günther Fink

Keyword(s):

Socioeconomic Status ◽

Birth Weight ◽

Low Birth Weight ◽

Violent Crime ◽

Birth Outcomes ◽

Gestational Age ◽

Violence Exposure ◽

Western Region ◽

Adverse Birth Outcomes ◽

Violent Crimes

Abstract Background Low birth weight and prematurity remain leading causes of infant mortality and morbidity globally. Although an extensive literature has highlighted the importance of socioenvironmental characteristics for birth outcomes, the role of indirect violence on health remains fairly understudied. Methods Using geocoded birth records from the ongoing Western Region Birth Cohort ( Região Oeste Coorte – ROC-Cohort) of infants born between 2012-2014 and geocoded crime reports, we assessed the associations between exposure to violent crimes during pregnancy within a 1-km radius of mother’s residence and low birth weight, preterm delivery, and being born small-for-gestational-age. Violent crime exposure was categorized into quintiles. Multivariate logistic regressions were used to examine the associations between violence exposure and birth outcomes. Models were adjusted for sex, maternal age and education, socioeconomic status, and risk factors such as hypertension, diabetes, smoking, and drinking during pregnancy. ResultsAmong the 5,268 infants included, the average crime exposure during the first two trimesters of pregnancy ranged from 0.44 violent crimes in the least exposed quintile to 12.74 crimes in the most exposed. Compared to children with the lowest violence exposure, children in the highest exposure quintile were at higher odds of being born small-for-gestational-age (1.41[1.06-1.89]), preterm (1.35[1.01-1.80]), and low birth weight (1.42[1.03-1.98]). While socioeconomic status and maternal education were positively associated with lower violence exposure, no associations were found between these characteristics and the birth outcomes. Conclusions Higher exposure to external violent crimes in the close vicinity are associated with substantial increases in the odds of adverse birth outcomes. Policies to improve neighborhood safety can contribute not only to the short-term well-being of populations but may also have large social, economic, and health benefits in the long run.

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The Association Between State-Level Racial Attitudes Assessed From Twitter Data and Adverse Birth Outcomes: Observational Study (Preprint)

10.2196/preprints.17103 ◽

2019 ◽

Author(s):

Thu T Nguyen ◽

Nikki Adams ◽

Dina Huang ◽

M Maria Glymour ◽

Amani M Allen ◽

...

Keyword(s):

Machine Learning ◽

Birth Weight ◽

Ethnic Minorities ◽

Birth Outcomes ◽

Black People ◽

State Level ◽

Adverse Birth Outcomes ◽

White People ◽

Machine Learning Model ◽

Hispanic White

BACKGROUND In the United States, racial disparities in birth outcomes persist and have been widening. Interpersonal and structural racism are leading explanations for the continuing racial disparities in birth outcomes, but research to confirm the role of racism and evaluate trends in the impact of racism on health outcomes has been hampered by the challenge of measuring racism. Most research on discrimination relies on self-reported experiences of discrimination, and few studies have examined racial attitudes and bias at the US national level. OBJECTIVE This study aimed to investigate the associations between state-level Twitter-derived sentiments related to racial or ethnic minorities and birth outcomes. METHODS We utilized Twitter’s Streaming application programming interface to collect 26,027,740 tweets from June 2015 to December 2017, containing at least one race-related term. Sentiment analysis was performed using support vector machine, a supervised machine learning model. We constructed overall indicators of sentiment toward minorities and sentiment toward race-specific groups. For each year, state-level Twitter-derived sentiment data were merged with birth data for that year. The study participants were women who had singleton births with no congenital abnormalities from 2015 to 2017 and for whom data were available on gestational age (n=9,988,030) or birth weight (n=9,985,402). The main outcomes were low birth weight (birth weight ≤2499 g) and preterm birth (gestational age <37 weeks). We estimated the incidence ratios controlling for individual-level maternal characteristics (sociodemographics, prenatal care, and health behaviors) and state-level demographics, using log binomial regression models. RESULTS The accuracy for identifying negative sentiments on comparing the machine learning model to manually labeled tweets was 91%. Mothers living in states in the highest tertile for negative sentiment tweets referencing racial or ethnic minorities had greater incidences of low birth weight (8% greater, 95% CI 4%-13%) and preterm birth (8% greater, 95% CI 0%-14%) compared with mothers living in states in the lowest tertile. More negative tweets referencing minorities were associated with adverse birth outcomes in the total population, including non-Hispanic white people and racial or ethnic minorities. In stratified subgroup analyses, more negative tweets referencing specific racial or ethnic minority groups (black people, Middle Eastern people, and Muslims) were associated with poor birth outcomes for black people and minorities. CONCLUSIONS A negative social context related to race was associated with poor birth outcomes for racial or ethnic minorities, as well as non-Hispanic white people.

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