Online Program

A Community-Based Investigation into Low Birth Weight Deliveries and Collaboration to Improve Maternal and Infant Outcomes at a Baltimore City Hospital

Tuesday, November 3, 2015

Elizabeth Harvey, MPH, Population, Family and Reproductive Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Mercy Medical Center (MMC), a city community hospital in Baltimore Maryland, aimed to reduce low birth weight (LBW) deliveries by 10% in three years in 2011.  MMC partnered with Johns Hopkins Bloomberg School of Public Health to evaluate characteristics associated with LBW deliveries and formulate strategic collaborations with obstetricians and community services to improve birth outcomes. 

A case control study of LBW included all newborns weighing <2500 grams during June 2010-June 2011 and matched 2:1 of newborns ≥2500 grams (n=862).  Logistic regression models of LBW were informed by maternal characteristics prior to and during pregnancy.  Meetings were held with community organizations and feedback was operationalized into strategies, which were jointly carried out.

Multivariable logistic regression results showed an increased odds of LBW among women with a previous preterm birth (aOR 2.48; 95% CI:1.49-4.13), chronic hypertension (aOR:2.53; 95% CI:1.25-5.10), hospitalization during pregnancy (aOR: 2.27; 95% CI:1.52-3.40), multiple gestation (aOR:12.33; 95% CI:5.49-27.73) and gestational hypertension (aOR:2.81; 95% CI:1.79-4.41).  One strategy to address pregnant women at risk of LBW infants is to improve the intake and referral system to better triage women to appropriate services in the community.

Both maternal pre-existing conditions and those occurring during pregnancy were found to be associated with LBW. In particular, the increased odds of LBW among women with hypertension before and during pregnancy represents a need to focus on maternal chronic conditions at the community level.  Education sessions with providers about the referral system are one ongoing strategy to improve birth outcomes in Baltimore City.

Learning Areas:

Chronic disease management and prevention

Learning Objectives:
Describe an academic and community partnership to improve maternal and infant birth outcomes in Baltimore, Maryland.

Keyword(s): MCH Epidemiology, Community-Based Partnership & Collaboration

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a third year PhD student in perinatal health and epidemiologic research methods and have worked at local and state public health departments. I am a recipient of the Maternal and Child Health Epidemiology Training Grant.
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.