142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Early term births in rural Appalachia

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 1:30 PM - 1:50 PM

Beth Bailey, PhD , Department of Family Medicine, East Tennessee State University, Johnson City, TN
Judy McCook, PhD, CNS, RN-BC , College of Nursing, East Tennessee State University, Johnson City, TN
Purpose: Infants delivered at 37 weeks gestation or later have been considered full term, but recent research demonstrates those born at 37-38 weeks (early term) have higher risk for poor birth outcomes than deliveries at 39-41 weeks (full term). Despite this, a high percentage of deliveries still occur electively (scheduled with no medical indication) prior to 39 weeks. This study examined these risks in a disadvantaged, rural sample, particularly among those who electively delivered early term, and compared these results to national findings. Methods: Data were available for 1772 women, recruited prenatally, from three counties in rural, Southern Appalachia who delivered at 37+ weeks. Findings: Compared with full term infants, those delivered early term were significantly smaller, had longer hospital stays with higher rates of NICU admission and were more likely to develop jaundice. Similarly, among those with elective deliveries, compared with full term infants, those born early were 7.7 times more likely to be low birth weight, 4.4 times more likely to have a NICU admission, and 2.5 times more likely to develop jaundice. While the rate of elective deliveries <39 weeks in this sample was similar to the national rate, the associated adjusted odds of NICU admission was substantially higher (OR=4.4 vs OR=2.2). Finally, those living furthest from their delivery hospital were most likely to have elective deliveries prior to 39 weeks. Conclusions: Results demonstrate that recent efforts in large population centers to end elective early term deliveries are also needed in rural, disadvantaged regions.

Learning Areas:

Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
Describe the negative consequences of elective early term deliveries in a rural disadvantaged population

Keyword(s): Birth Outcomes, Prenatal Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal investigator of multiple federally funded grants focusing on pregnancy health and prenatal care issues. I have over 70 peer reviewed papers in this field, and have written several invited chapters on prenatal care practice standards.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.