Identifying determinants of birth outcomes in South America

确定南美洲出生结果的决定因素

• 批准号: 8133789
• 负责人: George L Wehby
• 金额: $ 3.34万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-01 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8133789
• 关键词: Accounting; Affect; Alcohol consumption; American; Behavioral; Behavioral Genetics; Birth; Birth Weight; Caring; Characteristics; Cleaved cell; Cleft Lip; Clinical Trials; Complex; Congenital Abnormality; Country; Data; Data Collection; Data Sources; Demographic Factors; Developed Countries; Developing Countries; Development; Developmental Disabilities; Economic Models; Effectiveness; Endowment; Etiology; Face; Fertility; Fetal Growth; Fetal Growth Retardation; Future; Genetic; Genetic Risk; Gestational Age; Goals; Health; Health Policy; Healthcare; Heterogeneity; Hospitals; Immunization; Individual; Infant; Infant Health; International; Intervention; Life Expectancy; Live Birth; Low Birth Weight Infant; Maternal Health; Measurement; Modeling; Multivitamin; Norway; Outcome; Palate; Play; Policies; Population; Pregnancy; Premature Birth; Prenatal care; Prevalence; Prevention strategy; Preventive Intervention; Production; Productivity; Race; Recording of previous events; Recruitment Activity; Research; Research Infrastructure; Risk; Risk Behaviors; Risk Factors; Role; Sampling; Smoking; Socioeconomic Factors; South America; South American; Spontaneous abortion; Techniques; Time; Trauma; United States; Vitamins; Weight Gain; adverse outcome; behavioral health; case control; cost effective; disability; fetal; genetic variant; health economics; improved; infant outcome; instrument; maternal cigarette smoking; mortality; neonatal death; novel; parent grant; prenatal; public health relevance; racial and ethnic disparities; sample collection; socioeconomics; stillbirth

DESCRIPTION (provided by applicant): Birth weight, gestational age and intrauterine growth (IUG) are important birth outcomes that significantly contribute to future health. Adverse outcomes including low birth weight (LBW), preterm birth and IUG restriction (IUGR) increase substantially the risks of mortality and disability. About 28% of the 4 million neonatal deaths that occur each year worldwide are related to preterm birth, and about 80% occur among LBW infants. LBW and preterm birth are common outcomes and have been on the rise in the past two decades- 16% of babies worldwide are born at LBW. The etiology of these outcomes remains largely unknown but several environmental, behavioral and genetic risks are thought to be involved through both independent and interactive roles. Reliable studies of birth outcomes in South America have been relatively scarce and most previous studies have relied on limited case-control samples as well as fairly simple statistical techniques that are highly vulnerable to bias. This study aims at obtaining reliable estimates of the rates of adverse birth outcomes and identifying health, demographic, behavioral and socioeconomic risk factors that contribute to these outcomes through independent or interactive effects in unique and large birth samples of non-malformed infants from 8 South American countries (more than 100,000 births) recruited through the Latin American Collaborative Study of Congenital Anomalies (ECLAMC). These samples were recruited using the same sampling and data collection strategy in about 90 hospitals that attend about 180,000 births annually and are well representative of large and understudied South American populations. Data is available on maternal health, fertility and behavioral risks as well as on socioeconomic and demographic factors that may play an important role in these outcomes. A health economics model for health production and advanced multivariate techniques will be used to study the contribution of all potentially relevant inputs and characteristics. The study has important implications by providing a reliable assessment of the burden of adverse birth outcomes in several South America populations, identifying risk factors that can be targeted by health policies and interventions to improve birth outcomes and allowing international comparisons of the effects and roles of various risk factors which further help to identify prevention strategies not only in the studied countries but also in other countries including the US. An example would be comparing the effects of infant and maternal ancestry in these highly admixed populations to those in the US where LBW and preterm rates are found to vary significantly by race. The study also provides a key preliminary step to larger studies of interactive effects between relevant risk factors and genetic variants that may also be involved in these outcomes and to clinical trials that study the effectiveness of selected interventions to improve birth outcomes. PUBLIC HEALTH RELEVANCE: This project aims at identifying determinants of adverse birth outcomes including low birth weight, preterm birth and intrauterine growth restriction in several understudied South American populations. Study results are highly relevant for identifying prevention strategies not only for the included countries but also for others including the United States.

描述（由申请人提供）：出生体重，妊娠年龄和宫内生长（IUG）是重要的出生结果，对未来的健康有很大贡献。不利的结果包括低出生体重（LBW），早产和IUG限制（IUGR）大大增加了死亡率和残疾的风险。在全世界每年发生的400万例新生儿死亡中，约有28％与早产有关，而LBW婴儿中约有80％发生。 LBW和早产是共同的结果，在过去的二十年中一直在增长 - 全球16％的婴儿出生于LBW。这些结果的病因仍然很大，但人们认为几种环境，行为和遗传风险都通过独立和互动作用涉及。对南美的出生结果的可靠研究相对较少，大多数以前的研究都依赖有限的病例对照样本以及非常简单的统计技术，这些技术极易受到偏见的影响。 This study aims at obtaining reliable estimates of the rates of adverse birth outcomes and identifying health, demographic, behavioral and socioeconomic risk factors that contribute to these outcomes through independent or interactive effects in unique and large birth samples of non-malformed infants from 8 South American countries (more than 100,000 births) recruited through the Latin American Collaborative Study of Congenital Anomalies (ECLAMC).这些样本是使用相同的抽样和数据收集策略招募的约90家医院，每年约有180,000个出生，并且良好地代表了大型且研究的南美人口。有关孕产妇健康，生育能力和行为风险以及可能在这些结果中起重要作用的社会经济和人口因素的数据。健康生产和先进多元技术的卫生经济学模型将用于研究所有潜在相关投入和特征的贡献。这项研究具有重要的含义，通过对几个南美人口的不良出生结果负担进行可靠的评估，确定了可以通过健康政策和干预措施来针对的风险因素，以改善出生结果，并允许国际上比较各种风险因素的影响和角色，从而进一步确定包括在包括其他国家（包括其他国家）的国家中的预防策略，还可以帮助我们在包括其他国家 /地区进行预防策略。一个例子是将这些高度混杂的人群中婴儿和母亲血统的影响与在美国发现LBW和早产率因种族而有很大差异的美国人群的影响。该研究还为相关风险因素和遗传变异之间的互动效应进行了更大的研究提供了关键的初步步骤，这些研究也可能参与这些结果以及研究所选干预措施以改善出生结果的有效性的临床试验。 公共卫生相关性：该项目旨在确定几个研究研究研究的南美人口的不良出生结果的决定因素，包括低出生体重，早产和宫内生长限制。研究结果与确定所包括国家的预防策略非常相关，而且还针对包括美国在内的其他国家。