Weighting of risk factors for low birth weight: a linked routine data cohort study in Wales, UK
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...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-02-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/2/e063836.full |
| _version_ | 1826544458230923264 |
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| author | Amrita Bandyopadhyay Charlotte Todd Sinead Brophy Julie Evans Simon Moore Michael Parker Muhammad A Rahman Emily Marchant Angela Jones Hope Jones James Healy Tint Lwin Win Ben Rowe |
| author_facet | Amrita Bandyopadhyay Charlotte Todd Sinead Brophy Julie Evans Simon Moore Michael Parker Muhammad A Rahman Emily Marchant Angela Jones Hope Jones James Healy Tint Lwin Win Ben Rowe |
| author_sort | Amrita Bandyopadhyay |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-04-10T09:59:21Z |
| format | Article |
| id | doaj.art-dac0774551d04bd4bb498df255c66540 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2025-03-14T05:02:17Z |
| publishDate | 2023-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-dac0774551d04bd4bb498df255c665402025-03-07T04:05:10ZengBMJ Publishing GroupBMJ Open2044-60552023-02-0113210.1136/bmjopen-2022-063836Weighting of risk factors for low birth weight: a linked routine data cohort study in Wales, UKAmrita Bandyopadhyay0Charlotte Todd1Sinead Brophy2Julie Evans3Simon Moore4Michael Parker5Muhammad A Rahman6Emily Marchant7Angela Jones8Hope Jones9James Healy10Tint Lwin Win11Ben Rowe12National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, UKKeir Hardie University Health Park, Public Health Wales, Cardiff, UKData Science, Medical School, Swansea University, Swansea, UKKeir Hardie University Health Park, Public Health Wales, Cardiff, UKSchool of Dentistry, Cardiff University, Cardiff, UKEthox Centre, University of Oxford, Oxford, UKCardiff School of Technologies, Cardiff Metropolitan University, Llandaff Campus, Cardiff, UK2 Swansea University, Swansea, UKMonash Partners, Melbourne, Victoria, Australia1 National Centre for Population Health and Wellbeing Research, Swansea University, Swansea, UKNational Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, West Glamorgan, UKNational Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, West Glamorgan, UKNational Police Chiefs’ Council Lead for Mental Health and Age, London, UKObjective 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.https://bmjopen.bmj.com/content/13/2/e063836.full |
| spellingShingle | Amrita Bandyopadhyay Charlotte Todd Sinead Brophy Julie Evans Simon Moore Michael Parker Muhammad A Rahman Emily Marchant Angela Jones Hope Jones James Healy Tint Lwin Win Ben Rowe Weighting of risk factors for low birth weight: a linked routine data cohort study in Wales, UK BMJ Open |
| title | 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_short | 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 |
| url | https://bmjopen.bmj.com/content/13/2/e063836.full |
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