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Weighting of risk factors for low birth weight: a linked routine data cohort study in Wales, UK

Bandyopadhyay, Amrita, Jones, Hope, Parker, Michael, Marchant, Emily, Evans, Julie, Todd, Charlotte, Rahman, Muhammad A., Healy, James, Win, Tint Lwin, Rowe, Ben, Moore, Simon ORCID:, Jones, Angela and Brophy, Sinead 2023. Weighting of risk factors for low birth weight: a linked routine data cohort study in Wales, UK. BMJ Open 13 (2) , e063836. 10.1136/bmjopen-2022-063836

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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.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Dentistry
Publisher: BMJ Publishing Group
ISSN: 2044-6055
Date of First Compliant Deposit: 10 February 2023
Date of Acceptance: 28 November 2022
Last Modified: 05 Jan 2024 02:08

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