ABSTRACT
Low birth weight (LBW) and preterm birth are adverse perinatal outcomes that pose a significant risk to a child's healthy beginning. While antenatal care (ANC) is an established intervention for pregnancy care, little is understood about how the number and timing of ANC visits can impact these adverse health outcomes. This study aimed to examine the impact of the number and timing of ANC visits on LBW and preterm birth in a regional setting. A decade-long perinatal dataset related to singleton live births that took place in the Southern New South Wales Local Health District (SNSWLHD) was utilized. The outcomes of interest were LBW and preterm birth, and the exposure variables were based on the Australian pregnancy guidelines on the number and timing of ANC visits. A multivariable logistic regression was performed to measure the association between outcome and exposure while adjusting for potential confounders. A greater level of protection against LBW and preterm birth was observed among mothers who had an adequate number of visits, with early entry (first trimester) into ANC. The protective effect of an adequate number of ANC visits against LBW and preterm birth among mothers with late entry into ANC (third trimester) was found to be statistically non-significant.
Subject(s)
Premature Birth , Prenatal Care , Child , Infant, Newborn , Pregnancy , Female , Humans , Premature Birth/epidemiology , New South Wales/epidemiology , Australia , ParturitionABSTRACT
Smoking during pregnancy is a modifiable risk behavior of adverse health outcomes including low birth weight (LBW), and LBW is a key marker of newborns immediate and future health. This study aimed to examine the association between smoking cessation during the second half of pregnancy and LBW among babies born in Southern New South Wales Local Health District (SNSWLHD). Routinely collected perinatal data on singleton live births for the period 2011-2019 in five public hospitals of SNSWLHD were utilized. Multivariate logistic regression models were fitted to examine the association between smoking cessation during the second half of pregnancy and LBW. Analyses showed that mothers who ceased smoking during the second half of pregnancy were 44% less likely to have LBW babies (adjusted odds ratio (aOR) = 0.56; 95% confidence interval (CI): 0.34, 0.94) compared to those who continued smoking throughout pregnancy. Mothers who reported an average daily dose of 1-10 or >10 cigarettes during the second half of pregnancy were significantly more likely to have babies with LBW than those who ceased smoking during the second half of pregnancy. Early identification of smoking behavior and promotion of smoking-cessation intervention for risk populations including pregnant women within the older age bracket (35-49 years) is imperative to reduce LBW.
Subject(s)
Smoking Cessation , Aged , Australia , Birth Weight , Female , Humans , Infant, Low Birth Weight , Infant, Newborn , New South Wales/epidemiology , Parturition , Pregnancy , Risk FactorsABSTRACT
As the majority of the determinants of health are controlled outside the health system, the challenge for promoting health is to find a way of influencing these determinants. Health impact assessment was used in Bungendore, NSW, in an attempt to influence decisions relating to scenarios for urban development. Twelve months after the project was completed, interim evaluation has revealed evidence that the health impact assessment has had a positive effect on preliminary land-use planning work.
