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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
4062.0: Tuesday, December 13, 2005 - 9:40 AM

Abstract #119568

Does it matter how SGA is defined when assessing its association with individual and neighborhood level characteristics?

Jennifer F. Culhane, PhD, MPH, Department of Obstetrics and Gynecology, Drexel University College of Medicine, 245 North 15th St. MS#495, 17th Floor New College Building, Philadelphia, PA 19102, 215-762-2013, jfc92@Drexel.edu, Iliana Kohler, Population Studies Center, University of Pennsylvania, 3718 Locus Walk, Philadelphia, PA 19104, and Irma T. Elo, MPA, PhD, Department of Sociology, University of Pennsylvania, 3718 Locust Walk, Philadelphia, PA 19104.

Small for gestational age (SGA) is defined as birth weight below the 10th percentile at any gestational week. SGA is an important predictor of poor pregnancy outcomes and neonatal mortality and morbidity. There have been several approaches to defining birth weight cut-points for SGA. Introduction of race-specific distributions and birth weight cut-points has raised a question of the most appropriate way to define SGA. The purpose of this analysis is to explore a variety of methodologies to assign SGA-status and to assess the impact of different methodologies on the association between individual and neighborhood level explanatory variables and SGA. We use 2000 national linked birth and infant death records for the United States to explore multiple methodologies for assigning SGA to birth certificate data. We will create sex-specific, race and sex-specific and race-, sex- and parity-specific SGA variables. We then evaluate if the gestational-age specific 10th percentile birth weight cut-points are substantively different by the above specifications. We then apply different SGA-specifications to Philadelphia birth certificate data from 1999-2000. Using Philadelphia data we will examine the association between individual and neighborhood level variables and SGA. We are particularly interested in assessing whether effects of explanatory variables vary depending on how the outcome measure (SGA) is constructed. These analyses are a part of the Multilevel Modeling of Disparities Explaining Preterm Delivery (MODE-PTD) project which is an MCHB-funded collaborative partnership between four universities and their government health departments with the purpose of studying contextual level influences on birth outcomes.

Learning Objectives:

Keywords: 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.

Evaluating Individual and Census Tract Characteristics on Birth Outcomes--a Multi-level Approach

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA