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Low birth weight, small for gestational age and preterm births before and after the economic collapse in Iceland: a population based cohort study.

ABSTRACT: OBJECTIVE:Infants born small for gestational age (SGA) or preterm have increased rates of perinatal morbidity and mortality. Stressful events have been suggested as potential contributors to preterm birth (PB) and low birth weight (LBW). We studied the effect of the 2008 economic collapse in Iceland on the risks of adverse birth outcomes. STUDY DESIGN:The study population constituted all Icelandic women giving birth to live-born singletons from January 1(st) 2006 to December 31(st) 2009. LBW infants were defined as those weighing <2500 grams at birth, PB infants as those born before 37 weeks of gestation and SGA as those with a birth weight for gestational age more than 2 standard deviations (SD's) below the mean according to the Swedish fetal growth curve. We used logistic regression analysis to estimate odds ratios [OR] and corresponding 95 percent confidence intervals [95% CI] of adverse birth outcomes by exposure to calendar time of the economic collapse, i.e. after October 6(th) 2008. RESULTS:Compared to the preceding period, we observed an increased adjusted odds in LBW-deliveries following the collapse (aOR?=?1.24, 95% CI [1.02, 1.52]), particularly among infants born to mothers younger than 25 years (aOR?=?1.85, 95% CI [1.25, 2.72]) and not working mothers (aOR?=?1.61, 95% CI [1.10, 2.35]). Similarly, we found a tendency towards higher incidence of SGA-births (aOR?=?1.14, 95% CI [0.86, 1.51]) particularly among children born to mothers younger than 25 years (aOR?=?1.87, 95% CI [1.09, 3.23]) and not working mothers (aOR?=?1.86, 95% CI [1.09, 3.17]). No change in risk of PB was observed. The increase of LBW was most distinct 6-9 months after the collapse. CONCLUSION:The results suggest an increase in risk of LBW shortly after the collapse of the Icelandic national economy. The increase in LBW seems to be driven by reduced fetal growth rate rather than shorter gestation.

SUBMITTER: Eiriksdottir VH

PROVIDER: S-EPMC3851132 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Low birth weight, small for gestational age and preterm births before and after the economic collapse in Iceland: a population based cohort study.

Eiríksdóttir Védís Helga VH Ásgeirsdóttir Tinna Laufey TL Bjarnadóttir Ragnheiður Ingibjörg RI Kaestner Robert R Cnattingius Sven S Valdimarsdóttir Unnur Anna UA

PloS one 20131204 12

<h4>Objective</h4>Infants born small for gestational age (SGA) or preterm have increased rates of perinatal morbidity and mortality. Stressful events have been suggested as potential contributors to preterm birth (PB) and low birth weight (LBW). We studied the effect of the 2008 economic collapse in Iceland on the risks of adverse birth outcomes.<h4>Study design</h4>The study population constituted all Icelandic women giving birth to live-born singletons from January 1(st) 2006 to December 31(st ...[more]

PMID: 24324602

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Project description:OBJECTIVE:To produce current data on survival of preterm infants. DESIGN:Retrospective population based study. SETTING:Trent health region. SUBJECTS:All European and Asian live births, stillbirths, and late fetal losses from 22 to 32 weeks' gestation, excluding those with major congenital malformations, in women resident in the Trent health region between 1 January 1994 and 31 December 1997. MAIN OUTCOME MEASURES:Birth weight and gestational age specific survival for both European and Asian infants (a) known to be alive at the onset of labour, and (b) admitted for neonatal care. RESULTS:738 deaths occurred in 3760 infants born between 22 and 32 weeks' gestation during the study period, giving an overall survival rate of 80.4%. The survival rate for the 3489 (92.8%) infants admitted for neonatal care was 86.6%. For European infants known to be alive at the onset of labour, significant variations in gestation specific survival by birth weight emerged from 24 weeks' gestation: survival ranged from 9% (95% confidence interval 7% to 13%) for infants of birth weight 250-499 g to 21% (16% to 28%) for those of 1000-1249 g. At 27 weeks' gestation, survival ranged from 55% (49% to 61%) for infants of birth weight 500-749 g (below the 10th centile) to 80% (76% to 85%) for those of 1250-1499 g. Infants who were large for dates (>/=27 weeks' gestation) had a slightly reduced, but not significant, predicted survival. Similar survival rates were observed for Asian infants. The odds ratio for the survival of infants from a multiple birth compared with singleton infants was 1.4 (1.1 to 1.8). Survival graphs for infants admitted for neonatal care are presented by sex. CONCLUSION:Easy to use birth weight and gestational age specific predicted survival graphs for preterm infants facilitate decision making for clinicians and parents. It is important that these graphs are representative, are produced for a geographically defined population, and are not biased towards the outcomes of particular centres. Such graphs, produced in two stages, allow for the changing pattern of survival of infants from the start of the intrapartum period to immediately after admission for neonatal care.

Dataset Information

Low birth weight, small for gestational age and preterm births before and after the economic collapse in Iceland: a population based cohort study.

Publications

Low birth weight, small for gestational age and preterm births before and after the economic collapse in Iceland: a population based cohort study.

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