MOTHER’S PREVIOUS BIRTH EXPERIENCE, BEHAVIOR DURING PREGNANCY AND PREMATURE BIRTHS- AN ANALYSIS OF SOUTH CAROLINA PRAMS 2004-2013
Author(s)
Haider MR, Siddiqi KA, Demir I, Khan MM
University of South Carolina, Columbia, SC, USA
OBJECTIVES Pregnant women’s risky behavior during pregnancy can lead to subsequent adverse birth outcomes. The purpose of this study is to assess the association between mother’s personal and health seeking behavior during pregnancy and having premature birth, giving birth before 37 weeks of gestation. METHODS We performed a multivariate weighted logistic regression using 10 years (2004-2013) of South Carolina Pregnancy Risk Assessment and Monitoring System (PRAMS) data. RESULTS Over the ten-year study period, a total of 550,292 live births were documented. Of those, 55,871 (10.15%) babies born premature. Most mothers were white (59%), Medicaid insured (52%), and Women, Infant, and Children (WIC) enrollees (55%). One-fourth (26%) of mothers had inadequate prenatal care (PNC) visits; 13.5% smoked; and, 7.42% drank alcohol just 3 months before delivery. Odds of having preterm birth decreased with adequacy of PNC. Mothers who had intermediate and adequate PNC visits according to Kotelchuck index had lower odds of premature birth (OR 0.54 95% CI 0.31-0.93 and OR 0.35, 95% CI 0.22-0.56, respectively) than who had inadequate visit. However, mothers who had more than adequate visits had higher likelihood of premature birth (OR 1.98, 95% CI 1.45-2.72). Mothers who experienced premature birth in earlier pregnancies had higher likelihood of having premature birth again (OR 3.72, 95% CI 2.77-4.98), but other previous poor pregnancy outcomes had no significant association with premature birth. While mothers with Medicaid (OR 1.84, 95% CI 1.26-2.70) and hypertension (OR 2.28, 95% CI 1.54-3.38) had higher odds, mothers who were enrolled in WIC (OR 0.50, 95% CI 0.36-0.69) and those who drank during pregnancy had lower likelihood of premature birth. Study found no significant association of household income, maternal race, and smoking with birth outcome. CONCLUSIONS The findings of our study show that the main focus of premature birth reduction programs should be the lower-income pregnant women.
Conference/Value in Health Info
2018-05, ISPOR 2018, Baltimore, MD, USA
Value in Health, Vol. 21, S1 (May 2018)
Code
PHS92
Topic
Health Policy & Regulatory, Health Service Delivery & Process of Care
Topic Subcategory
Health Care Research, Health Disparities & Equity
Disease
Reproductive and Sexual Health, Respiratory-Related Disorders