The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62103

Nisha S. Ahamed, MPH¹, Diane J. Abatemarco, MSW, PhD², Edmond S. Malka, MPH³, Judy Donlen, RN, DNSc, JD⁴, and Joy Jensen⁴. (1) NJMS National Tuberculosis Center, UMDNJ, 225 Warren St, Newark, NJ 07102, 973-972-9008, ahamedni@umdnj.edu, (2) Health Education and Behavioral Science, UMDNJ - School of Public Health, 335 George St, Liberty Plaza, Suite 2200, PO BOX 2688, New Brunswick, NJ 08903, (3) UMDNJ-School of Public Health, Liberty Plaza, Suite 2200, PO Box 2688, New Brunswick, NJ 08903-2688, (4) Southern New Jersey Perinatal Cooperative, 2500 McClellan Avenue, Suite 250, Pennsauken, NJ 08109

Evidence suggests that risk behaviors including alcohol tobacco and drug use among pregnant women may result in increased risk for infant morbidity and mortality. This study analyzed Electronic Birth Certificate data from 1997-2001 (n=101,550) to assess the relationship between self reported risk behavior and a variety of birth outcomes in seven counties served by the Southern New Jersey Perinatal Cooperative (SNJPC). Data was analyzed using a forward stepwise logistic regression model that adjusted for alcohol, tobacco, and drug use, race, ethnicity, absence of pre-natal care, mother’s marital status and age, previous small for gestational age babies, and year of birth. Delivery of a low birth weight infant was significantly more likely among women who used any tobacco (OR=1.36, 95% CI=1.27-1.46), alcohol (OR=1.26, 95% CI=1.06-1.48), or drugs (OR=1.6, 95% CI=1.41-1.82). Pre-term delivery was significantly more likely in women who used tobacco (OR=1.10, 95% CI=1.03-1.18) or drugs (OR=1.53, 95% CI=1.35-1.74) and a hospital length of stay (LOS) of greater than four days was more likely for infants of women who used alcohol (OR = 1.21, 95% CI = 1.04-1.42) or drugs (OR=2.83, 95% CI = 2.51-3.20). Infants of women who used drugs were more likely to be admitted to the NICU (OR=1.93, 95% CI 1.69-2.21) and women who used tobacco or drugs were more likely to have certain obstetric complications that lead to pre-term delivery. Increased awareness on the effect of pregnancy risk behaviors on birth outcomes and morbidity may be used by SNJPC to enhance programs serving women in the region.

Learning Objectives:

• Discuss the use of electronic birth certificate data in planning and enhancing maternal and child health programs.
• Discuss three issues involved with a large scale study of electronic birth certificate data.
• Recognize the different categories of maternal and infant outcomes that are influenced by behavioral risk factors.
• Describe the effects of prenatal tobacco, alcohol and drug use on maternal and infant birth outcomes.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.