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Weighting of risk factors for low birth weight: a linked routine data cohort study in Wales, UK
BMJ Open, Volume: 13, Issue: 2, Start page: e063836
Swansea University Authors:
Emily Marchant , Sinead Brophy
, Amrita Bandyopadhyay, Hope Jones, Michael Parker
, James Healy, Tint Win
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DOI (Published version): 10.1136/bmjopen-2022-063836
Abstract
Objective: Globally, 20 million children are born with a birth weight below 2500 g every year, which is considered as a low birthweight (LBW) baby. This study investigates the contribution of modifiable risk factors in a nationally representative Welsh e-cohort of children and their mothers to infor...
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<?xml version="1.0" encoding="utf-8"?><rfc1807 xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema"><bib-version>v2</bib-version><id>61656</id><entry>2022-10-25</entry><title>Weighting of risk factors for low birth weight: a linked routine data cohort study in Wales, UK</title><swanseaauthors><author><sid>d68adb6744707b3bd75e07bd334d0516</sid><ORCID>0000-0002-9701-5991</ORCID><firstname>Emily</firstname><surname>Marchant</surname><name>Emily Marchant</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>84f5661b35a729f55047f9e793d8798b</sid><ORCID>0000-0001-7417-2858</ORCID><firstname>Sinead</firstname><surname>Brophy</surname><name>Sinead Brophy</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>9f1e77f76a83746112ef45709bf83630</sid><ORCID/><firstname>Amrita</firstname><surname>Bandyopadhyay</surname><name>Amrita Bandyopadhyay</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>3fbf9b2f03a3a8f507dd35e9068bd485</sid><firstname>Hope</firstname><surname>Jones</surname><name>Hope Jones</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>a4dfe07a6b18fdf6d537962b8f24fbdf</sid><ORCID>0000-0002-0350-6360</ORCID><firstname>Michael</firstname><surname>Parker</surname><name>Michael Parker</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>7484eeb0206079f3e12242478ab96e2a</sid><firstname>James</firstname><surname>Healy</surname><name>James Healy</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>6f37eb348a9bc7c04a1578b526d133a5</sid><firstname>Tint</firstname><surname>Win</surname><name>Tint Win</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2022-10-25</date><deptcode>EDUC</deptcode><abstract>Objective: Globally, 20 million children are born with a birth weight below 2500 g every year, which is considered as a low birthweight (LBW) baby. This study investigates the contribution of modifiable risk factors in a nationally representative Welsh e-cohort of children and their mothers to inform opportunities to reduce LBW prevalence. Design: A longitudinal cohort study based on anonymously linked, routinely collected multiple administrative data sets.Participants: The cohort, (N=693 377) comprising of children born between 1 January 1998 and 31 December 2018 in Wales, was selected from the National Community Child Health Database.Outcome measures: The risk factors associated with a binary LBW (outcome) variable were investigated with multivariable logistic regression (MLR) and decision tree (DT) models.Results: The MLR model showed that non-singleton children had the highest risk of LBW (adjusted OR 21.74 (95% CI 21.09 to 22.40)), followed by pregnancy interval less than 1 year (2.92 (95% CI 2.70 to 3.15)), maternal physical and mental health conditions including diabetes (2.03 (1.81 to 2.28)), anaemia (1.26 (95% CI 1.16 to 1.36)), depression (1.58 (95% CI 1.43 to 1.75)), serious mental illness (1.46 (95% CI 1.04 to 2.05)), anxiety (1.22 (95% CI 1.08 to 1.38)) and use of antidepressant medication during pregnancy (1.92 (95% CI 1.20 to 3.07)). Additional maternal risk factors include smoking (1.80 (95% CI 1.76 to 1.84)), alcohol-related hospital admission (1.60 (95% CI 1.30 to 1.97)), substance misuse (1.35 (95% CI 1.29 to 1.41)) and evidence of domestic abuse (1.98 (95% CI 1.39 to 2.81)). Living in less deprived area has lower risk of LBW (0.70 (95% CI 0.67 to 0.72)). The most important risk factors from the DT models include maternal factors such as smoking, maternal weight, substance misuse record, maternal age along with deprivation—Welsh Index of Multiple Deprivation score, pregnancy interval and birth order of the child.Conclusion: Resources to reduce the prevalence of LBW should focus on improving maternal health, reducing preterm births, increasing awareness of what is a sufficient pregnancy interval, and to provide adequate support for mothers’ mental health and well-being.</abstract><type>Journal Article</type><journal>BMJ Open</journal><volume>13</volume><journalNumber>2</journalNumber><paginationStart>e063836</paginationStart><paginationEnd/><publisher>BMJ</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>2044-6055</issnPrint><issnElectronic>2044-6055</issnElectronic><keywords/><publishedDay>1</publishedDay><publishedMonth>2</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-02-01</publishedDate><doi>10.1136/bmjopen-2022-063836</doi><url>http://dx.doi.org/10.1136/bmjopen-2022-063836</url><notes/><college>COLLEGE NANME</college><department>Education</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>EDUC</DepartmentCode><institution>Swansea University</institution><apcterm>SU Library paid the OA fee (TA Institutional Deal)</apcterm><funders>Economic and Social Research Council - ES/S007393/1; Nation Institute for Health Research (NIHR) - NIHR133680; Public Health Wales - 105186</funders><projectreference/><lastEdited>2024-01-08T11:58:26.9812834</lastEdited><Created>2022-10-25T11:34:15.4768519</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Amrita</firstname><surname>Bandyopadhyay</surname><orcid>0000-0003-2798-4030</orcid><order>1</order></author><author><firstname>Hope</firstname><surname>Jones</surname><orcid>0000-0003-4312-476x</orcid><order>2</order></author><author><firstname>Michael</firstname><surname>Parker</surname><order>3</order></author><author><firstname>Emily</firstname><surname>Marchant</surname><orcid>0000-0002-9701-5991</orcid><order>4</order></author><author><firstname>Julie</firstname><surname>Evans</surname><order>5</order></author><author><firstname>Charlotte</firstname><surname>Todd</surname><order>6</order></author><author><firstname>Muhammad A</firstname><surname>Rahman</surname><order>7</order></author><author><firstname>James</firstname><surname>Healy</surname><order>8</order></author><author><firstname>Tint Lwin</firstname><surname>Win</surname><order>9</order></author><author><firstname>Ben</firstname><surname>Rowe</surname><order>10</order></author><author><firstname>Simon</firstname><surname>Moore</surname><orcid>0000-0001-5495-4705</orcid><order>11</order></author><author><firstname>Angela</firstname><surname>Jones</surname><order>12</order></author><author><firstname>Sinead</firstname><surname>Brophy</surname><orcid>0000-0001-7417-2858</orcid><order>13</order></author><author><firstname>Amrita</firstname><surname>Bandyopadhyay</surname><orcid/><order>14</order></author><author><firstname>Hope</firstname><surname>Jones</surname><order>15</order></author><author><firstname>Michael</firstname><surname>Parker</surname><orcid>0000-0002-0350-6360</orcid><order>16</order></author><author><firstname>James</firstname><surname>Healy</surname><order>17</order></author><author><firstname>Tint</firstname><surname>Win</surname><order>18</order></author></authors><documents><document><filename>61656__27051__0f5a64936bda492cb7ab531049f82524.pdf</filename><originalFilename>61656.VOR.pdf</originalFilename><uploaded>2023-04-14T15:12:52.0472445</uploaded><type>Output</type><contentLength>736348</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>Distributed under the terms of a Creative Commons Attribution 4.0 License.</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>https://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807> |
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v2 61656 2022-10-25 Weighting of risk factors for low birth weight: a linked routine data cohort study in Wales, UK d68adb6744707b3bd75e07bd334d0516 0000-0002-9701-5991 Emily Marchant Emily Marchant true false 84f5661b35a729f55047f9e793d8798b 0000-0001-7417-2858 Sinead Brophy Sinead Brophy true false 9f1e77f76a83746112ef45709bf83630 Amrita Bandyopadhyay Amrita Bandyopadhyay true false 3fbf9b2f03a3a8f507dd35e9068bd485 Hope Jones Hope Jones true false a4dfe07a6b18fdf6d537962b8f24fbdf 0000-0002-0350-6360 Michael Parker Michael Parker true false 7484eeb0206079f3e12242478ab96e2a James Healy James Healy true false 6f37eb348a9bc7c04a1578b526d133a5 Tint Win Tint Win true false 2022-10-25 EDUC Objective: Globally, 20 million children are born with a birth weight below 2500 g every year, which is considered as a low birthweight (LBW) baby. This study investigates the contribution of modifiable risk factors in a nationally representative Welsh e-cohort of children and their mothers to inform opportunities to reduce LBW prevalence. Design: A longitudinal cohort study based on anonymously linked, routinely collected multiple administrative data sets.Participants: The cohort, (N=693 377) comprising of children born between 1 January 1998 and 31 December 2018 in Wales, was selected from the National Community Child Health Database.Outcome measures: The risk factors associated with a binary LBW (outcome) variable were investigated with multivariable logistic regression (MLR) and decision tree (DT) models.Results: The MLR model showed that non-singleton children had the highest risk of LBW (adjusted OR 21.74 (95% CI 21.09 to 22.40)), followed by pregnancy interval less than 1 year (2.92 (95% CI 2.70 to 3.15)), maternal physical and mental health conditions including diabetes (2.03 (1.81 to 2.28)), anaemia (1.26 (95% CI 1.16 to 1.36)), depression (1.58 (95% CI 1.43 to 1.75)), serious mental illness (1.46 (95% CI 1.04 to 2.05)), anxiety (1.22 (95% CI 1.08 to 1.38)) and use of antidepressant medication during pregnancy (1.92 (95% CI 1.20 to 3.07)). Additional maternal risk factors include smoking (1.80 (95% CI 1.76 to 1.84)), alcohol-related hospital admission (1.60 (95% CI 1.30 to 1.97)), substance misuse (1.35 (95% CI 1.29 to 1.41)) and evidence of domestic abuse (1.98 (95% CI 1.39 to 2.81)). Living in less deprived area has lower risk of LBW (0.70 (95% CI 0.67 to 0.72)). The most important risk factors from the DT models include maternal factors such as smoking, maternal weight, substance misuse record, maternal age along with deprivation—Welsh Index of Multiple Deprivation score, pregnancy interval and birth order of the child.Conclusion: Resources to reduce the prevalence of LBW should focus on improving maternal health, reducing preterm births, increasing awareness of what is a sufficient pregnancy interval, and to provide adequate support for mothers’ mental health and well-being. Journal Article BMJ Open 13 2 e063836 BMJ 2044-6055 2044-6055 1 2 2023 2023-02-01 10.1136/bmjopen-2022-063836 http://dx.doi.org/10.1136/bmjopen-2022-063836 COLLEGE NANME Education COLLEGE CODE EDUC Swansea University SU Library paid the OA fee (TA Institutional Deal) Economic and Social Research Council - ES/S007393/1; Nation Institute for Health Research (NIHR) - NIHR133680; Public Health Wales - 105186 2024-01-08T11:58:26.9812834 2022-10-25T11:34:15.4768519 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Amrita Bandyopadhyay 0000-0003-2798-4030 1 Hope Jones 0000-0003-4312-476x 2 Michael Parker 3 Emily Marchant 0000-0002-9701-5991 4 Julie Evans 5 Charlotte Todd 6 Muhammad A Rahman 7 James Healy 8 Tint Lwin Win 9 Ben Rowe 10 Simon Moore 0000-0001-5495-4705 11 Angela Jones 12 Sinead Brophy 0000-0001-7417-2858 13 Amrita Bandyopadhyay 14 Hope Jones 15 Michael Parker 0000-0002-0350-6360 16 James Healy 17 Tint Win 18 61656__27051__0f5a64936bda492cb7ab531049f82524.pdf 61656.VOR.pdf 2023-04-14T15:12:52.0472445 Output 736348 application/pdf Version of Record true Distributed under the terms of a Creative Commons Attribution 4.0 License. true eng https://creativecommons.org/licenses/by/4.0/ |
title |
Weighting of risk factors for low birth weight: a linked routine data cohort study in Wales, UK |
spellingShingle |
Weighting of risk factors for low birth weight: a linked routine data cohort study in Wales, UK Emily Marchant Sinead Brophy Amrita Bandyopadhyay Hope Jones Michael Parker James Healy Tint Win |
title_short |
Weighting of risk factors for low birth weight: a linked routine data cohort study in Wales, UK |
title_full |
Weighting of risk factors for low birth weight: a linked routine data cohort study in Wales, UK |
title_fullStr |
Weighting of risk factors for low birth weight: a linked routine data cohort study in Wales, UK |
title_full_unstemmed |
Weighting of risk factors for low birth weight: a linked routine data cohort study in Wales, UK |
title_sort |
Weighting of risk factors for low birth weight: a linked routine data cohort study in Wales, UK |
author_id_str_mv |
d68adb6744707b3bd75e07bd334d0516 84f5661b35a729f55047f9e793d8798b 9f1e77f76a83746112ef45709bf83630 3fbf9b2f03a3a8f507dd35e9068bd485 a4dfe07a6b18fdf6d537962b8f24fbdf 7484eeb0206079f3e12242478ab96e2a 6f37eb348a9bc7c04a1578b526d133a5 |
author_id_fullname_str_mv |
d68adb6744707b3bd75e07bd334d0516_***_Emily Marchant 84f5661b35a729f55047f9e793d8798b_***_Sinead Brophy 9f1e77f76a83746112ef45709bf83630_***_Amrita Bandyopadhyay 3fbf9b2f03a3a8f507dd35e9068bd485_***_Hope Jones a4dfe07a6b18fdf6d537962b8f24fbdf_***_Michael Parker 7484eeb0206079f3e12242478ab96e2a_***_James Healy 6f37eb348a9bc7c04a1578b526d133a5_***_Tint Win |
author |
Emily Marchant Sinead Brophy Amrita Bandyopadhyay Hope Jones Michael Parker James Healy Tint Win |
author2 |
Amrita Bandyopadhyay Hope Jones Michael Parker Emily Marchant Julie Evans Charlotte Todd Muhammad A Rahman James Healy Tint Lwin Win Ben Rowe Simon Moore Angela Jones Sinead Brophy Amrita Bandyopadhyay Hope Jones Michael Parker James Healy Tint Win |
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e063836 |
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2044-6055 2044-6055 |
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10.1136/bmjopen-2022-063836 |
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Faculty of Medicine, Health and Life Sciences |
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http://dx.doi.org/10.1136/bmjopen-2022-063836 |
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description |
Objective: Globally, 20 million children are born with a birth weight below 2500 g every year, which is considered as a low birthweight (LBW) baby. This study investigates the contribution of modifiable risk factors in a nationally representative Welsh e-cohort of children and their mothers to inform opportunities to reduce LBW prevalence. Design: A longitudinal cohort study based on anonymously linked, routinely collected multiple administrative data sets.Participants: The cohort, (N=693 377) comprising of children born between 1 January 1998 and 31 December 2018 in Wales, was selected from the National Community Child Health Database.Outcome measures: The risk factors associated with a binary LBW (outcome) variable were investigated with multivariable logistic regression (MLR) and decision tree (DT) models.Results: The MLR model showed that non-singleton children had the highest risk of LBW (adjusted OR 21.74 (95% CI 21.09 to 22.40)), followed by pregnancy interval less than 1 year (2.92 (95% CI 2.70 to 3.15)), maternal physical and mental health conditions including diabetes (2.03 (1.81 to 2.28)), anaemia (1.26 (95% CI 1.16 to 1.36)), depression (1.58 (95% CI 1.43 to 1.75)), serious mental illness (1.46 (95% CI 1.04 to 2.05)), anxiety (1.22 (95% CI 1.08 to 1.38)) and use of antidepressant medication during pregnancy (1.92 (95% CI 1.20 to 3.07)). Additional maternal risk factors include smoking (1.80 (95% CI 1.76 to 1.84)), alcohol-related hospital admission (1.60 (95% CI 1.30 to 1.97)), substance misuse (1.35 (95% CI 1.29 to 1.41)) and evidence of domestic abuse (1.98 (95% CI 1.39 to 2.81)). Living in less deprived area has lower risk of LBW (0.70 (95% CI 0.67 to 0.72)). The most important risk factors from the DT models include maternal factors such as smoking, maternal weight, substance misuse record, maternal age along with deprivation—Welsh Index of Multiple Deprivation score, pregnancy interval and birth order of the child.Conclusion: Resources to reduce the prevalence of LBW should focus on improving maternal health, reducing preterm births, increasing awareness of what is a sufficient pregnancy interval, and to provide adequate support for mothers’ mental health and well-being. |
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2023-02-01T11:58:28Z |
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11.021648 |