A comparison of risk assessment models for term and preterm low birthweight.
BACKGROUND
Most epidemiological research dealing with the assessment of risk for low birthweight has focused on all low birthweight births. Studies that have attempted to distinguish between term and preterm low birthweights have tended to examine preterm low birthweight, since the risk of perinatal mortality and morbidity is greatest for this group of infants.


METHODS
This study uses data from 25,408 singleton births in a 20-county region in North Carolina to identify and compare risk factors for term and preterm low birthweights, and also examines the usefulness of separate multivariate risk assessment systems for term and preterm low birthweights that could be used in the clinical setting.


RESULTS
Risk factors that overlap as significant predictors of both types of low birthweight include race, no previous live births, smoking, weight under 100 lb, and previous preterm or low birthweight birth. Age also is a significant predictor of both types of low birthweight, but in opposite directions. Younger age is associated with reduced risk of term low birthweight and increased risk of pattern low birthweight.


CONCLUSIONS
Comparison of all risk factors indicates that different multivariate models are needed to understand the epidemiology of preterm and term low birthweights. In terms of clinical value, a general risk assessment model that combines all low birthweight births is as effective as the separate models.
Michielutte
R
R
Department of Family and Community Medicine, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27157-1084.
Ernest
J M
JM
Moore
M L
ML
Meis
P J
PJ
Sharp
P C
PC
Wells
H B
HB
Buescher
P A
PA
D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D004522:Educational Status; D005069:Evaluation Studies as Topic; D005260:Female; D005865:Gestational Age; D006305:Health Status Indicators; D006801:Humans; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008393:Marriage / Q000706:statistics & numerical data; D008423:Maternal Age; D015233:Models, Statistical; D009657:North Carolina / Q000453:epidemiology; D010298:Parity; D011237:Predictive Value of Tests; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards; D044469:Racial Groups; D015203:Reproducibility of Results; D012307:Risk Factors