AbstractsMedical & Health Science

RISK FACTORS ASSOCIATED WITH PRETERM BIRTH IN THE UNITED STATES

by Napatsawan Kaewluang




Institution: Case Western Reserve University
Department: Nursing
Degree: PhD
Year: 2015
Keywords: Nursing; Preterm birth, United States birth certificate, Risk factors
Record ID: 2058032
Full text PDF: http://rave.ohiolink.edu/etdc/view?acc_num=case1417796797


Abstract

The United States is one of three countries with the highest number of pretermbirths per year. Of 3, 953,591 infants born in 2011 in the United States, 11.72% werepremature. The increasing incidence of preterm birth infants in the United States indicates thatfactors predicting preterm birth have not been sufficiently minimized or eliminated. One reasonthe factors may not have diminished could be a lack of identification of the risk factorsand a lack of knowledge as to which factors make the greatest contribution to pretermbirth.The purpose of a cross-sectional descriptive secondary analysis of the UnitedStates birth certificate data of 2011 was to determine how maternal and infantphysiologic and socio-demographic risk factors contribute to preterm birth. The multipleregression analysis was to identify women who delivered infants with a gestational age <37 weeks; women who gave birth with a gestational age < 32 weeks; women who gavebirth with gestational age between 32 and 36 weeks; women who gave birth to male andfemale infants. Then, an analysis was conducted in which the two factors that were thestrongest predictors, infant birth weight and pregnancy weight gain were omitted fromanalyses to statistically control for the two strongest predictors.The strongest risk factors that contributed to preterm birth in the United States in2011 was infant birth weight. When infant birth weight and pregnancy weight gain werexvexcluded from the analysis, the strongest risk factor was maternal race. The largestdifferences in predictive ability for preterm birth in <32 weeks GA vs 32-36 weeks GAsubgroups was gestational hypertension. When infant birth weight and pregnancy weightgain were omitted from analyses, the largest difference in predictive ability for pretermbirth in <32 weeks GA vs 32-36 weeks GA subgroups was cervical cerclage. For themales vs female subgroups, the largest difference in predictive ability for preterm birthwere eclampsia. When infant birth weight and pregnancy weight gain were omitted fromanalyses, the largest differences in predictive ability for preterm birth was also eclampsia.