Int J Fertil Steril. 2018 Jul;12(2):106-113. doi: 10.22074/ijfs.2018.5330. Epub 2018 Mar 18.
Evaluating The Impact of Risk Factors on Birth Weight and Gestational Age: A Multilevel Joint Modeling Approach.
International journal of fertility & sterility
Payam Amini, Abbas Moghimbeigi, Farid Zayeri, Hossein Mahjub, Saman Maroufizadeh, Reza Omani-Samani
Affiliations
Affiliations
- Department of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
- Modeling of Noncomunicable Disease Research Center, Department of Biostatistics, Faculty of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.Electronic Address: [email protected].
- Department of Biostatistics, Proteomics Research Center, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Research Center for Health Sciences, Department of Biostatistics, Faculty of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
PMID: 29707925
PMCID: PMC5936606 DOI: 10.22074/ijfs.2018.5330
Abstract
BACKGROUND: Abnormalities in birth weight and gestational age cause several adverse maternal and infant outcomes. Our study aims to determine the potential factors that affect birth weight and gestational age, and their association.
MATERIALS AND METHODS: We conducted this cross-sectional study of 4415 pregnant women in Tehran, Iran, from July 6-21, 2015. Joint multilevel multiple logistic regression was used in the analysis with demographic and obstetrical variables at the first level, and the hospitals at the second level.
RESULTS: We observed the following prevalence rates: preterm (5.5%), term (94%), and postterm (0.5%). Low birth weight (LBW) had a prevalence rate of 4.8%, whereas the prevalence rate for normal weight was 92.4, and 2.8% for macrosomia. Compared to term, older mother's age [odds ratio (OR)=1.04, 95% confidence interval (CI): 1.02-1.07], preeclampsia (OR=4.14, 95% CI: 2.71-6.31), multiple pregnancy (OR=18.04, 95% CI: 9.75- 33.38), and use of assisted reproductive technology (ART) (OR=2.47, 95% CI: 1.64-33.73) were associated with preterm birth. Better socioeconomic status (SES) was responsible for decreased odds for postterm birth compared to term birth (OR=0.53, 95% CI: 0.37-0.74). Cases with higher maternal body mass index (BMI) were 1.02 times more likely for macrosomia (95% CI: 1.01-1.04), and male infant sex (OR=1.78, 95% CI: 1.21-2.60). LBW was related to multiparity (OR=0.59, 95% CI: 0.42-0.82), multiple pregnancy (OR=17.35, 95% CI: 9.73-30.94), and preeclampsia (OR=3.36, 95% CI: 2.15-5.24).
CONCLUSION: Maternal age, SES, preeclampsia, multiple pregnancy, ART, higher maternal BMI, parity, and male infant sex were determined to be predictive variables for birth weight and gestational age after taking into consideration their association by using a joint multilevel multiple logistic regression model.
Copyright© by Royan Institute. All rights reserved.
Keywords: Birth Weight; Gestational Age; Multilevel; Statistical Model
Conflict of interest statement
The authors declare no conflicts of interest.
References
- Lancet. 2012 Feb 4;379(9814):445-52 - PubMed
- Am J Obstet Gynecol. 2007 Mar;196(3):241.e1-6 - PubMed
- BMC Pregnancy Childbirth. 2015 Dec 15;15:335 - PubMed
- East Mediterr Health J. 2013 Sep;19(9):775-81 - PubMed
- Lancet. 2015 Jan 31;385(9966):430-40 - PubMed
- PLoS One. 2014 Mar 21;9(3):e91198 - PubMed
- Am J Obstet Gynecol. 2000 Sep;183(3):738-45 - PubMed
- Fertil Steril. 2015 Apr;103(4):974-979.e1 - PubMed
- Matern Child Health J. 2012 Nov;16(8):1645-56 - PubMed
- BMC Pregnancy Childbirth. 2014 Mar 27;14:117 - PubMed
- Matern Child Health J. 2015 Nov;19(11):2480-91 - PubMed
- Eur J Obstet Gynecol Reprod Biol. 2009 Oct;146(2):138-48 - PubMed
- Lancet. 2008 Jan 5;371(9606):75-84 - PubMed
- PLoS Med. 2011 Jan 04;8(1):e1000386 - PubMed
- Hypertens Pregnancy. 2016 Nov;35(4):510-519 - PubMed
- Lancet. 2011 Apr 16;377(9774):1331-40 - PubMed
- Eur J Obstet Gynecol Reprod Biol. 2003 Nov 10;111(1):9-14 - PubMed
- Matern Child Health J. 2010 Mar;14(2):215-26 - PubMed
- BJOG. 2013 Oct;120(11):1356-65 - PubMed
- Am J Obstet Gynecol. 2009 Jun;200(6):683.e1-5 - PubMed
- Facts Views Vis Obgyn. 2012;4(3):175-87 - PubMed
- Aust N Z J Obstet Gynaecol. 2009 Oct;49(5):504-9 - PubMed
- Acta Obstet Gynecol Scand. 2008;87(2):134-45 - PubMed
- Lancet. 2012 Jun 9;379(9832):2162-72 - PubMed
- Lancet. 2013 Oct 19;382(9901):1341-9 - PubMed
- Lancet. 2013 Feb 9;381(9865):476-83 - PubMed
- Am J Epidemiol. 2007 Apr 15;165(8):849-57 - PubMed
- Stat Methods Med Res. 2018 Apr;27(4):1187-1201 - PubMed
- Acta Obstet Gynecol Scand. 1977;56(3):247-53 - PubMed
- Acta Obstet Gynecol Scand. 2010 Aug;89(8):1003-10 - PubMed
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