Accepted Manuscript Late-Preterm Birth and Neonatal Morbidities: Population-Level and Within-Family Estimates Nancy E. Reichman, Ph.D. Julien O. Teitler, Ph.D. Sophie Moullin, MA Barbara M. Ostfeld, Ph.D. Thomas Hegyi, MD PII:
S1047-2797(14)00458-X
DOI:
10.1016/j.annepidem.2014.10.016
Reference:
AEP 7729
To appear in:
Annals of Epidemiology
Received Date: 27 January 2014 Revised Date:
16 September 2014
Accepted Date: 20 October 2014
Please cite this article as: Reichman NE, Teitler JO, Moullin S, Ostfeld BM, Hegyi T, Late-Preterm Birth and Neonatal Morbidities: Population-Level and Within-Family Estimates, Annals of Epidemiology (2014), doi: 10.1016/j.annepidem.2014.10.016. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
Late-Preterm Birth and Neonatal Morbidities: Population-Level and Within-Family Estimates
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Nancy E. Reichman, Ph.D., Julien O. Teitler, Ph.D., Sophie Moullin, MA, Barbara M. Ostfeld, Ph.D., Thomas Hegyi, MD
SC
Address correspondence to: Nancy E. Reichman, Ph.D., Rutgers University, Robert Wood Johnson Medical School, Child Health Institute of New Jersey, 89 French St., Room 4269, New Brunswick, NJ 08903; phone: 732-235-7977; fax: 925-522-3345; email: [email protected]
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Affiliations: Nancy E. Reichman: Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, US Julien O. Teitler: School of Social Work, Columbia University, New York, NY, US Sophie Moullin: Department of Sociology, Princeton University, Princeton, NJ, US Barbara M. Ostfeld: Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, US Thomas Hegyi: Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, US
Acknowledgements: None
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Running header: Late-Preterm Birth and Neonatal Morbidities
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Word count (abstract): 198 Word count (main text excluding title page, abstract, references, figures, and tables): 2974 Number of tables: 6 Number of figures: 0
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ACCEPTED MANUSCRIPT
ABSTRACT
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PURPOSE. The objective of this study was to compare two salient neonatal outcomes, respiratory disorders and hyperbilirubinemia, between late-preterm (34–36 week) and full-term (37–41 week) singleton infants both at the population level and within families. METHOD. Analyses were based on natality data on all births in the state of New Jersey from 1996 to 2006 linked to newborn hospital discharge records. For population-level models, logistic regression analyses were conducted to estimate unadjusted and adjusted differences in outcomes by gestational age. For within-family analyses, unadjusted and adjusted logistic fixedeffects models were estimated, with the latter including factors that differed across births to the same mother. RESULTS. Late-preterm birth increased the odds of a neonatal respiratory condition by more than four-fold [OR=4.08–4.53] and of neonatal hyperbilirubinemia by more than five-fold [OR=5.11–5.93] even when comparing births to the same mother and controlling for demographic and economic, behavioral, and obstetric factors that may have changed across pregnancies. CONCLUSION. Based on population-level and within-family models, this study provides the strongest evidence to date that late-preterm birth is an important risk factor for adverse neonatal outcomes that other studies have found are associated with cognitive and behavioral disorders in childhood.
Key words: late preterm; near term; neonatal morbidities; neonatal respiratory conditions; neonatal jaundice; neonatal hyperbilirubinemia; within-family analyses
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Abbreviations: Electronic Birth Certificate (EBC); Last menstrual period (LMP); Low birthweight (LBW); National Institute of Child Health and Human Development (NICHD); Neonatal Intensive Care Unit (NICU); Respiratory Distress Syndrome/Hyaline Membrane Disease (RDS/HMD); Small for Gestational Age (SGA); Transient Tachypnea of the Newborn (TTN)
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ACCEPTED MANUSCRIPT
INTRODUCTION Late-preterm infants, those born at 34–36 weeks of gestation, accounted for 9.1% of all births in the U.S. in 2006, up from 7.3% in 1990 [1]. Whereas 69% of all preterm births (
S1047-2797(14)00458-X
DOI:
10.1016/j.annepidem.2014.10.016
Reference:
AEP 7729
To appear in:
Annals of Epidemiology
Received Date: 27 January 2014 Revised Date:
16 September 2014
Accepted Date: 20 October 2014
Please cite this article as: Reichman NE, Teitler JO, Moullin S, Ostfeld BM, Hegyi T, Late-Preterm Birth and Neonatal Morbidities: Population-Level and Within-Family Estimates, Annals of Epidemiology (2014), doi: 10.1016/j.annepidem.2014.10.016. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
Late-Preterm Birth and Neonatal Morbidities: Population-Level and Within-Family Estimates
RI PT
Nancy E. Reichman, Ph.D., Julien O. Teitler, Ph.D., Sophie Moullin, MA, Barbara M. Ostfeld, Ph.D., Thomas Hegyi, MD
SC
Address correspondence to: Nancy E. Reichman, Ph.D., Rutgers University, Robert Wood Johnson Medical School, Child Health Institute of New Jersey, 89 French St., Room 4269, New Brunswick, NJ 08903; phone: 732-235-7977; fax: 925-522-3345; email: [email protected]
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Affiliations: Nancy E. Reichman: Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, US Julien O. Teitler: School of Social Work, Columbia University, New York, NY, US Sophie Moullin: Department of Sociology, Princeton University, Princeton, NJ, US Barbara M. Ostfeld: Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, US Thomas Hegyi: Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, US
Acknowledgements: None
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Running header: Late-Preterm Birth and Neonatal Morbidities
AC C
EP
Word count (abstract): 198 Word count (main text excluding title page, abstract, references, figures, and tables): 2974 Number of tables: 6 Number of figures: 0
1
ACCEPTED MANUSCRIPT
ABSTRACT
M AN U
SC
RI PT
PURPOSE. The objective of this study was to compare two salient neonatal outcomes, respiratory disorders and hyperbilirubinemia, between late-preterm (34–36 week) and full-term (37–41 week) singleton infants both at the population level and within families. METHOD. Analyses were based on natality data on all births in the state of New Jersey from 1996 to 2006 linked to newborn hospital discharge records. For population-level models, logistic regression analyses were conducted to estimate unadjusted and adjusted differences in outcomes by gestational age. For within-family analyses, unadjusted and adjusted logistic fixedeffects models were estimated, with the latter including factors that differed across births to the same mother. RESULTS. Late-preterm birth increased the odds of a neonatal respiratory condition by more than four-fold [OR=4.08–4.53] and of neonatal hyperbilirubinemia by more than five-fold [OR=5.11–5.93] even when comparing births to the same mother and controlling for demographic and economic, behavioral, and obstetric factors that may have changed across pregnancies. CONCLUSION. Based on population-level and within-family models, this study provides the strongest evidence to date that late-preterm birth is an important risk factor for adverse neonatal outcomes that other studies have found are associated with cognitive and behavioral disorders in childhood.
Key words: late preterm; near term; neonatal morbidities; neonatal respiratory conditions; neonatal jaundice; neonatal hyperbilirubinemia; within-family analyses
AC C
EP
TE D
Abbreviations: Electronic Birth Certificate (EBC); Last menstrual period (LMP); Low birthweight (LBW); National Institute of Child Health and Human Development (NICHD); Neonatal Intensive Care Unit (NICU); Respiratory Distress Syndrome/Hyaline Membrane Disease (RDS/HMD); Small for Gestational Age (SGA); Transient Tachypnea of the Newborn (TTN)
2
ACCEPTED MANUSCRIPT
INTRODUCTION Late-preterm infants, those born at 34–36 weeks of gestation, accounted for 9.1% of all births in the U.S. in 2006, up from 7.3% in 1990 [1]. Whereas 69% of all preterm births (
