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

Abstract #71897

Birgit Reime, DSc MPH¹, Clarissa Schwarz, MPH², Paul Wenzlaff, MSc³, and Beate Schuecking, MD². (1) Dept. of Health Care and Epidemiology, University of British Columbia, 5804 Fairview Ave, Vancouver, BC V6T 1Z3, Canada, (604) 806 9119, breime@cw.bc.ca, (2) Dept. Health and Illness Research, Osnabrueck University, Albrechtstr. 28, Osnabrueck, Germany, (3) Center of Quality Management, Physician's chamber of Lower Saxony, PB 4749, Hannover, Germany

Background: Past studies from Germany about the relationship between single parenthood and birth weight are restricted to small samples or regions. We analyzed the relationship between single parenthood and low birth weight in the federal state of Lower Saxony, Germany, for 1999. Methods: This is a retrospective cohort study restricted to singletons (n=70,701). The sample consists of routine perinatal data from Lower Saxony, Germany, for 1999 (97% hospital participation rate). Information about socio-demographic, behavioral, and pregnancy- and birth-related medical factors were collected by obstetricians and midwives during antenatal visits and at birth. Using logistic regression models the associations between low birth weight (< 2500g) and single parenthood were tested in four steps: (1) crude analyses, (2) adjusting for socio-demographic variables, (3) adjusting for these and behavioral variables such as smoking and prenatal visits, (4) adjusting for all these additional to medical confounder such as prematurity and maternal diseases. Results: The crude relationship between low birth weight and single parenthood is significant (OR=1.84, 95%-CI=1.65-2.04). The result remained stable after adjusting for socio-demographic (OR=1.71, 95%-CI=1.52-1.94), socio-demographic and behavioral (OR=1.25, 95%-CI=1.08-1.44), socio-demographic, behavioral and medical confounders (OR=1.15, 95%-CI=0.99-1.34). Conclusions: Single parenthood seems to be an independent risk factor for low birth weight. Although 45% of single mothers in this sample consumed tobacco, adjustment of smoking did not eliminate the association. Further studies should examine the pathways between birth weight and partner status. Prevention strategies in the community like telephone crisis intervention and improving socioeconomic conditions are discussed. Limitations of the study are mentioned.

Learning Objectives:

• To identify single motherhood as an independent risk factor for low birth weight.
• To discuss prevention strategies for single mothers-to-be in the community such as telephone crisis line, home visitation by nurse-midwives and improving social and economic conditions.

Keywords: Underserved Populations, Low Birthweight

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.