Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #111031

Marie Lynn Miranda, PhD, Nicholas School of Environment and Earth Sciences, Duke University, PO Box 90328, Durham, NC 27708, 919-613-8023, mmiranda@duke.edu, Geeta Swamy, MD, OB/GYN - Maternal-Fetal Medicine, Duke University Medical Center, Box 3967 Med Ctr, Durham, NC 27710, and Alan Gelfand, PhD, Institute of Statistics and Decision Sciences, Duke University, PO Box 90251, Durham, NC 27708.

Fetal growth restriction exhibits documented disparities across subpopulations. While there are several hypotheses for the etiology of disparities in maternal and fetal outcomes, the joint impact of sociocultural and environmental factors on fetal growth restriction has not been well studied. The Children's Environmental Health Initiative (CEHI) is undertaking a project that spatially links detailed birth record, fetal death certificate, sociodemographic, and environmental exposure data at highly resolved scales for the State of North Carolina from 1990-2003. Innovative methods for georeferencing data at highly resolved spatial scales and spatially linking different datasets allow for more robust statistical analysis. Using high-end Geographic Information Systems (GIS) applications in combination with advanced spatial statistical approaches, we present birthweight-for-gestational-age curves that are adjusted for race, ethnicity, parity, gender, sociodemographics, environmental exposures, geographic location, and season for the State of North Carolina. To examine more outcome-based definitions of fetal growth restriction, we also estimate the relationship between fetal and neonatal morbidity and mortality and birthweight percentile for gestational age across subpopulations. This approach ties the definition of fetal growth restriction to actual health outcomes, rather than arbitrary percentile cutoffs, and thus may serve as the basis for improving clinical practice.

Learning Objectives:

• Discuss the relationship between fetal growth restriction and sociodemographic and environmental factors.
• Analyze how advanced spatial statistical methods can improve understanding of birth outcomes.

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.