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Maternal health in pregnancy and associations with adverse birth outcomes: evidence from Growing Up in New Zealand

Maternal health in pregnancy and associations with adverse birth outcomes: evidence from Growing Up in New Zealand
Maternal health in pregnancy and associations with adverse birth outcomes: evidence from Growing Up in New Zealand
Objective: To examine prospectively multiple indicators of pregnancy health and associations with adverse birth outcomes within a large, diverse sample of contemporary women.

Design: A cohort of pregnant women who gave birth during 2009–10.

Population: We enrolled a sample of 6822 pregnant New Zealand (NZ) women: 11% of all births in NZ during the recruitment period.

Methods: We analysed a number of maternal health indicators and behaviours during pregnancy in relation to birth outcomes using multivariable logistic regression. Associations were described using adjusted odds ratios and 95% confidence intervals.

Main outcome measures: Three birth outcomes, low birth weight (LBW), pre-term birth (PTB) and delivery type, were measured via linkage with maternity hospital perinatal databases. Small for gestational age (SGA) was then defined as below the 10th percentile by week of gestation.

Results: Modelling of birth outcomes after adjusting for confounders indicated patterns of increased risk of LBW and PTB for women who smoke, have elevated pre-pregnancy body mass index (BMI), or with insufficient pregnancy weight gain. SGA was associated with maternal smoking, alcohol use, insufficient weight gain and nausea and vomiting during pregnancy. Risk of caesarean section was associated with having a diagnosed illness before pregnancy, elevated BMI, greater pregnancy weight gain and less pregnancy exercise. Number of risk factor variables were then used to model birth outcomes. Women with multiple risk factors were at increased risk compared with those who had no risk factors.

Conclusions: Women with multiple health risks are at particular risk of adverse birth outcomes.
0004-8666
1-9
Bird, A.L.
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Grant, C.C.
cb16f17f-35d7-424b-bc25-01ec286ef395
Bandara, D.K.
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Mohal, J.
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Carr, P.E.A.
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Wise, M.
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Inskip, H.
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Miyahara, M.
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Morton, S.M.B.
a57ae2ff-044b-4c77-ab03-f38af7386c94
Bird, A.L.
df662b7b-4b79-4035-a46c-46b1913d41ad
Grant, C.C.
cb16f17f-35d7-424b-bc25-01ec286ef395
Bandara, D.K.
5c990029-6c8b-48a2-8ef8-71be2495f844
Mohal, J.
7927e24e-f901-4bbd-b143-9eda365a167e
Carr, P.E.A.
6f35862f-0ef7-46f1-bb85-69f1d0138dc7
Wise, M.
4c9966cc-c274-4677-8905-abbd35066e55
Inskip, H.
5fb4470a-9379-49b2-a533-9da8e61058b7
Miyahara, M.
82a3c99c-27e9-44c5-9c39-7e1fcdd95860
Morton, S.M.B.
a57ae2ff-044b-4c77-ab03-f38af7386c94

Bird, A.L., Grant, C.C., Bandara, D.K., Mohal, J., Carr, P.E.A., Wise, M., Inskip, H., Miyahara, M. and Morton, S.M.B. (2016) Maternal health in pregnancy and associations with adverse birth outcomes: evidence from Growing Up in New Zealand. Australian and New Zealand Journal of Obstetrics and Gynaecology, 1-9. (doi:10.1111/ajo.12557). (PMID:27781267)

Record type: Article

Abstract

Objective: To examine prospectively multiple indicators of pregnancy health and associations with adverse birth outcomes within a large, diverse sample of contemporary women.

Design: A cohort of pregnant women who gave birth during 2009–10.

Population: We enrolled a sample of 6822 pregnant New Zealand (NZ) women: 11% of all births in NZ during the recruitment period.

Methods: We analysed a number of maternal health indicators and behaviours during pregnancy in relation to birth outcomes using multivariable logistic regression. Associations were described using adjusted odds ratios and 95% confidence intervals.

Main outcome measures: Three birth outcomes, low birth weight (LBW), pre-term birth (PTB) and delivery type, were measured via linkage with maternity hospital perinatal databases. Small for gestational age (SGA) was then defined as below the 10th percentile by week of gestation.

Results: Modelling of birth outcomes after adjusting for confounders indicated patterns of increased risk of LBW and PTB for women who smoke, have elevated pre-pregnancy body mass index (BMI), or with insufficient pregnancy weight gain. SGA was associated with maternal smoking, alcohol use, insufficient weight gain and nausea and vomiting during pregnancy. Risk of caesarean section was associated with having a diagnosed illness before pregnancy, elevated BMI, greater pregnancy weight gain and less pregnancy exercise. Number of risk factor variables were then used to model birth outcomes. Women with multiple risk factors were at increased risk compared with those who had no risk factors.

Conclusions: Women with multiple health risks are at particular risk of adverse birth outcomes.

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More information

Accepted/In Press date: 12 September 2016
e-pub ahead of print date: 26 October 2016
Organisations: MRC Life-Course Epidemiology Unit

Identifiers

Local EPrints ID: 404623
URI: https://eprints.soton.ac.uk/id/eprint/404623
ISSN: 0004-8666
PURE UUID: 5f81c7d9-4b8b-4407-985d-310348ac67db
ORCID for H. Inskip: ORCID iD orcid.org/0000-0001-8897-1749

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Date deposited: 13 Jan 2017 14:13
Last modified: 11 Apr 2019 04:05

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Contributors

Author: A.L. Bird
Author: C.C. Grant
Author: D.K. Bandara
Author: J. Mohal
Author: P.E.A. Carr
Author: M. Wise
Author: H. Inskip ORCID iD
Author: M. Miyahara
Author: S.M.B. Morton

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