Browsing by Author "Shour, Abdul"

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    Association of prepregnancy diabetes and average birth-weight infant mortality by pregnancy body mass index: Findings from CDC's national vital statistics system, 2011
    (APHA, 2019) Shour, Abdul; Muehlbauer, Alice; Anguzu, Ronald; Walker, Rebekah; Carter, Catherine; Cassidy, Laura; Egede, Leonard
    Prepregnancy diabetes is associated with neonatal mortality of low birthweight newborns,however, little is known about the association of prepregnancy diabetes and mortality among babies with average birthweight (≥7lbs). We examined Average Birth-Weight Infant Mortality (ABIM), by pregnancy Body Mass Index for women diagnosed with diabetes prior to pregnancy. Data from CDC's NVSS-Linked Birth-Infant Death dataset, 3,638,143 newborns in 2011 were analyzed. The outcome was ABIM, defined as annual deaths per 1,000 live births with birthweight of ≥7pounds. The independent variable was self-reported diabetes (of any type) prior to pregnancy. Covariates were maternal co-morbidities, hospital and infant characteristics. Underlying causes of death (ICD codes 10th Revision) was included. Chi-square tests, stratified models and adjusted logistic regression analysis were conducted using STATA/SE v.15.1. P-values < 0.05 were considered statistically significant. Results: 7,419 average birthweight newborns died before their first birthday. ABIM was prevalent among diabetic mothers (0.3%), women who smoked (0.5%), infants born ≥37 weeks (0.4%) and African Americans (0.3%), with 65% of deaths occurring during post-neonatal period. The leading causes were congenital malformations (25.35%) and SIDS (20.0%). The odds of ABIM were 2 times higher for obese diabetic mothers (95%CI:1.6-2.8) compared to non-diabetic obese mothers. Among infants born ≥37 weeks, the odds of ABIM were 2 times higher for all BMI categories compared to infants born <37 weeks. Obese-diabetic mothers, smokers and full-term infants were at increased risk of ABIM, and particularly congenital malformations and SIDS. Interventions should focus on reducing maternal obesity, smoking and promoting safe sleep.