The contribution of birth defects to preterm birth and low birth weight

Siobhan M. Dolan, Susan J. Gross, Irwin R. Merkatz, Vincent Faber, Lisa M. Sullivan, Fergal D. Malone, T. Flint Porter, David A. Nyberg, Christine H. Comstock, Gary Hankins, Keith Eddleman, Lorraine Dugoff, Sabrina D. Craigo, Ilan Timor-Tritsch, Stephen R. Carr, Honor M. Wolfe, Diana W. Bianchi, Mary E. D'Alton

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

OBJECTIVE: To assess the impact of birth defects on preterm birth and low birth weight. METHODS: Data from a large, prospective multi-center trial, the First and Second Trimester Evaluation of Risk (FASTER) Trial, were examined. All live births at more than 24 weeks of gestation with data on outcome and confounders were divided into two comparison groups: 1) those with a chromosomal or structural abnormality (birth defect) and 2) those with no abnormality detected in chromosomes or anatomy. Propensity scores were used to balance the groups, account for confounding, and reduce the bias of a large number of potential confounding factors in the assessment of the impact of a birth defect on outcome. Multiple logistic regression analysis was applied. RESULTS: A singleton liveborn infant with a birth defect was 2.7 times more likely to be delivered preterm before 37 weeks of gestation (95% confidence interval [CI] 2.3-3.2), 7.0 times more likely to be delivered preterm before 34 weeks (95% CI 5.5-8.9), and 11.5 times more likely to be delivered very preterm before 32 weeks (95% CI 8.7-15.2). A singleton liveborn with a birth defect was 3.6 times more likely to have low birth weight at less than 2,500 g (95% CI 3.0-4.3) and 11.3 times more likely to be very low birth weight at less than 1,500 g (95% CI 8.5-15.1). CONCLUSION: Birth defects are associated with preterm birth and low birth weight after controlling for multiple confounding factors, including shared risk factors and pregnancy complications, using propensity scoring adjustment in multivariable regression analysis. The independent effects of risk factors on perinatal outcomes such as preterm birth and low birth weight, usually complicated by numerous confounding factors, may benefit from the application of this methodology, which can be used to minimize bias and account for confounding. Furthermore, this suggests that clinical and public health interventions aimed at preventing birth defects may have added benefits in preventing preterm birth and low birth weight. LEVEL OF EVIDENCE: II.

Original languageEnglish (US)
Pages (from-to)318-324
Number of pages7
JournalObstetrics and Gynecology
Volume110
Issue number2 I
DOIs
StatePublished - Aug 2007
Externally publishedYes

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Premature Birth
Low Birth Weight Infant
Confidence Intervals
Regression Analysis
Pregnancy
Propensity Score
Very Low Birth Weight Infant
Pregnancy Complications
Live Birth
Second Pregnancy Trimester
First Pregnancy Trimester
Anatomy
Public Health
Chromosomes
Logistic Models

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Dolan, S. M., Gross, S. J., Merkatz, I. R., Faber, V., Sullivan, L. M., Malone, F. D., ... D'Alton, M. E. (2007). The contribution of birth defects to preterm birth and low birth weight. Obstetrics and Gynecology, 110(2 I), 318-324. https://doi.org/10.1097/01.AOG.0000275264.78506.63

The contribution of birth defects to preterm birth and low birth weight. / Dolan, Siobhan M.; Gross, Susan J.; Merkatz, Irwin R.; Faber, Vincent; Sullivan, Lisa M.; Malone, Fergal D.; Porter, T. Flint; Nyberg, David A.; Comstock, Christine H.; Hankins, Gary; Eddleman, Keith; Dugoff, Lorraine; Craigo, Sabrina D.; Timor-Tritsch, Ilan; Carr, Stephen R.; Wolfe, Honor M.; Bianchi, Diana W.; D'Alton, Mary E.

In: Obstetrics and Gynecology, Vol. 110, No. 2 I, 08.2007, p. 318-324.

Research output: Contribution to journalArticle

Dolan, SM, Gross, SJ, Merkatz, IR, Faber, V, Sullivan, LM, Malone, FD, Porter, TF, Nyberg, DA, Comstock, CH, Hankins, G, Eddleman, K, Dugoff, L, Craigo, SD, Timor-Tritsch, I, Carr, SR, Wolfe, HM, Bianchi, DW & D'Alton, ME 2007, 'The contribution of birth defects to preterm birth and low birth weight', Obstetrics and Gynecology, vol. 110, no. 2 I, pp. 318-324. https://doi.org/10.1097/01.AOG.0000275264.78506.63
Dolan SM, Gross SJ, Merkatz IR, Faber V, Sullivan LM, Malone FD et al. The contribution of birth defects to preterm birth and low birth weight. Obstetrics and Gynecology. 2007 Aug;110(2 I):318-324. https://doi.org/10.1097/01.AOG.0000275264.78506.63
Dolan, Siobhan M. ; Gross, Susan J. ; Merkatz, Irwin R. ; Faber, Vincent ; Sullivan, Lisa M. ; Malone, Fergal D. ; Porter, T. Flint ; Nyberg, David A. ; Comstock, Christine H. ; Hankins, Gary ; Eddleman, Keith ; Dugoff, Lorraine ; Craigo, Sabrina D. ; Timor-Tritsch, Ilan ; Carr, Stephen R. ; Wolfe, Honor M. ; Bianchi, Diana W. ; D'Alton, Mary E. / The contribution of birth defects to preterm birth and low birth weight. In: Obstetrics and Gynecology. 2007 ; Vol. 110, No. 2 I. pp. 318-324.
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AU - Malone, Fergal D.

AU - Porter, T. Flint

AU - Nyberg, David A.

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AU - Hankins, Gary

AU - Eddleman, Keith

AU - Dugoff, Lorraine

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AU - Timor-Tritsch, Ilan

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N2 - OBJECTIVE: To assess the impact of birth defects on preterm birth and low birth weight. METHODS: Data from a large, prospective multi-center trial, the First and Second Trimester Evaluation of Risk (FASTER) Trial, were examined. All live births at more than 24 weeks of gestation with data on outcome and confounders were divided into two comparison groups: 1) those with a chromosomal or structural abnormality (birth defect) and 2) those with no abnormality detected in chromosomes or anatomy. Propensity scores were used to balance the groups, account for confounding, and reduce the bias of a large number of potential confounding factors in the assessment of the impact of a birth defect on outcome. Multiple logistic regression analysis was applied. RESULTS: A singleton liveborn infant with a birth defect was 2.7 times more likely to be delivered preterm before 37 weeks of gestation (95% confidence interval [CI] 2.3-3.2), 7.0 times more likely to be delivered preterm before 34 weeks (95% CI 5.5-8.9), and 11.5 times more likely to be delivered very preterm before 32 weeks (95% CI 8.7-15.2). A singleton liveborn with a birth defect was 3.6 times more likely to have low birth weight at less than 2,500 g (95% CI 3.0-4.3) and 11.3 times more likely to be very low birth weight at less than 1,500 g (95% CI 8.5-15.1). CONCLUSION: Birth defects are associated with preterm birth and low birth weight after controlling for multiple confounding factors, including shared risk factors and pregnancy complications, using propensity scoring adjustment in multivariable regression analysis. The independent effects of risk factors on perinatal outcomes such as preterm birth and low birth weight, usually complicated by numerous confounding factors, may benefit from the application of this methodology, which can be used to minimize bias and account for confounding. Furthermore, this suggests that clinical and public health interventions aimed at preventing birth defects may have added benefits in preventing preterm birth and low birth weight. LEVEL OF EVIDENCE: II.

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