title: Maternal health in pregnancy and associations with adverse birth outcomes: Evidence from Growing Up in New Zealand.
abstract: OBJECTIVE
  To examine prospectively multiple indicators of pregnancy health and associations with adverse birth outcomes within a large, diverse sample of contemporary women.
  
  
  METHODS
  A cohort of pregnant women who gave birth during 2009-10.
  
  
  METHODS
  We enrolled a sample of 6822 pregnant New Zealand (NZ) women: 11% of all births in NZ during the recruitment period.
  
  
  METHODS
  We analysed a number of maternal health indicators and behaviours during pregnancy in relation to birth outcomes using multivariable logistic regression. Associations were described using adjusted odds ratios and 95% confidence intervals.
  
  
  METHODS
  Three birth outcomes, low birth weight (LBW), pre-term birth (PTB) and delivery type, were measured via linkage with maternity hospital perinatal databases. Small for gestational age (SGA) was then defined as below the 10th percentile by week of gestation.
  
  
  RESULTS
  Modelling of birth outcomes after adjusting for confounders indicated patterns of increased risk of LBW and PTB for women who smoke, have elevated pre-pregnancy body mass index (BMI), or with insufficient pregnancy weight gain. SGA was associated with maternal smoking, alcohol use, insufficient weight gain and nausea and vomiting during pregnancy. Risk of caesarean section was associated with having a diagnosed illness before pregnancy, elevated BMI, greater pregnancy weight gain and less pregnancy exercise. Number of risk factor variables were then used to model birth outcomes. Women with multiple risk factors were at increased risk compared with those who had no risk factors.
  
  
  CONCLUSIONS
  Women with multiple health risks are at particular risk of adverse birth outcomes.
authors: Growing Up in New Zealand, The University of Auckland, Auckland, New Zealand.|Department of General Practice and Primary Health Care, The University of Auckland, Auckland, New Zealand.
authors: Amy L
authors: AL
authors: Bird
authors: Growing Up in New Zealand, The University of Auckland, Auckland, New Zealand.|Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand.|Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand.|Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand.
authors: Cameron C
authors: CC
authors: Grant
authors: Growing Up in New Zealand, The University of Auckland, Auckland, New Zealand.
authors: Dinusha K
authors: DK
authors: Bandara
authors: Growing Up in New Zealand, The University of Auckland, Auckland, New Zealand.
authors: Jatender
authors: J
authors: Mohal
authors: Growing Up in New Zealand, The University of Auckland, Auckland, New Zealand.|Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand.|National Institute of Demographic and Economic Analysis, University of Waikato, Hamilton, New Zealand.
authors: Polly E
authors: PE
authors: Atatoa-Carr
authors: Department of Obstetrics & Gynaecology, University of Auckland, Auckland, New Zealand.
authors: Michelle R
authors: MR
authors: Wise
authors: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors: Hazel
authors: H
authors: Inskip
authors: School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand.
authors: Motohide
authors: M
authors: Miyahara
authors: Growing Up in New Zealand, The University of Auckland, Auckland, New Zealand.|Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand.
authors: Susan M B
authors: SM
authors: Morton
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology; D015992:Body Mass Index; D002585:Cesarean Section / Q000706:statistics & numerical data*; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006305:Health Status Indicators; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D000068097:Maternal Health; D048968:Morning Sickness / Q000453:epidemiology; D009520:New Zealand / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications; D047928:Premature Birth / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D015430:Weight Gain
keywords: antenatal health; caesarean; low birth weight; pre-term birth; small for gestational age