A risk assessment screening test for very low birth weight.
OBJECTIVE
To develop a risk-assessment screening tool for very low birth weight (VLBW) and to compare our empirically derived tool to the nonempirically derived screening tool used by the State of Florida.


METHODS
Birth records from the State of Florida Vital Statistics between 04/01/92 and 12/07/94 were matched with State Healthy Start prenatal records, reported from 04/01/92 through 03/31/94. Known and additional potentially important risk factors were identified from both sources. Generalized Linear Modeling techniques were used to estimate associations between risk factors and VLBW. A risk assessment system was then developed using the estimated model. The resulting screening test was compared with the one used by the Florida State Department of Health in terms of sensitivity and specificity on an independent validation sample.


RESULTS
The proposed screening tool had comparable specificity to the Healthy Start screening tool but significantly better sensitivity. Both instruments are simple and easy to implement.


CONCLUSIONS
Identification of women at high risk for VLBW would be improved using the model-based screening tool developed in this paper. Public health policy makers should use statistical methods in addition to expert opinion to improve existing risk assessment methods. The actual value of an improved screening instrument is dependent on the availability of effective intervention programs.
Gueorguieva
Ralitza V
RV
Department of Epidemiology and Public Health, Yale University, New Haven, Connecticut, USA. ralitza.gueorguieva@yale.edu
Sarkar
Neena P
NP
Carter
Randy L
RL
Ariet
Mario
M
Roth
Jeffrey
J
Resnick
Michael B
MB
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005431:Florida; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D016014:Linear Models; D008403:Mass Screening / Q000379:methods*; D008429:Maternal Welfare / Q000145:classification* / Q000706:statistics & numerical data; D008498:Medical Record Linkage; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity