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

Amrita Bandyopadhyay Orcid Logo, Hope Jones Orcid Logo, Michael Parker, Emily Marchant Orcid Logo, Julie Evans, Charlotte Todd, Muhammad A Rahman, James Healy, Tint Lwin Win, Ben Rowe, Simon Moore Orcid Logo, Angela Jones, Sinead Brophy Orcid Logo, Amrita Bandyopadhyay, Hope Jones, Michael Parker Orcid Logo, James Healy, Tint Win

BMJ Open, Volume: 13, Issue: 2, Start page: e063836

Swansea University Authors: Emily Marchant Orcid Logo, Sinead Brophy Orcid Logo, Amrita Bandyopadhyay, Hope Jones, Michael Parker Orcid Logo, 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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Published in: BMJ Open
ISSN: 2044-6055 2044-6055
Published: BMJ 2023
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URI: https://cronfa.swan.ac.uk/Record/cronfa61656
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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&#x2009;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&#x2009;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&#x2014;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&#x2019; 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>Social Sciences School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>SOSS</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>
spelling 2024-01-08T11:58:26.9812834 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 SOSS 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 Social Sciences School COLLEGE CODE SOSS 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
format Journal article
container_title BMJ Open
container_volume 13
container_issue 2
container_start_page e063836
publishDate 2023
institution Swansea University
issn 2044-6055
2044-6055
doi_str_mv 10.1136/bmjopen-2022-063836
publisher BMJ
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
url http://dx.doi.org/10.1136/bmjopen-2022-063836
document_store_str 1
active_str 0
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.
published_date 2023-02-01T08:16:10Z
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score 11.04748

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