1. Epidemiology of Reproductive and Early Years
Our Healthy Future?
Epidemiology of Reproductive and Early Years
Insert name of presentation on Master Slide
Dr Shantini Paranjothy

2. Overview Teenage pregnancy Risks to a healthy future Birth outcomes
Early years (0 – 2)
Our Healthy Future?

3. Teenage pregnancy Pre-term birth OR 1.2 – 1.9 Low birth weight
Baby at increased risk of
Pre-term birth
OR 1.2 – 1.9
Low birth weight
OR 1.2 – 1.8
Neonatal mortality
OR 1.3 – 2.7
Harm, illness, injuries
Behavioural and emotional complications
2 X more likely to have a teen birth
Source: Paranjothy et al Arch Dis Child :

4. Conception rates E & W
Source: ONS

5. Public Health Wales Observatory

6. Complex social factors
Risks to a healthy future
Complex social factors
Alcohol
Illegal drugs
Environment
Obesity
Smoking

7. Obesity Pre-eclampsia RR 3 Gest diabetes RR 3 Thromboembolism OR 2.6
Baby
Mother
Pre-eclampsia RR 3
Gest diabetes RR 3
Thromboembolism
OR 2.6
Post partum haemorhage RR 4
Stillbirth RR 2
Preterm birth RR 1.2
Intensive care RR 1.5
Large for gestational age RR 2
Source: CEMACE

8. Obesity

9. Cigarette smoking Miscarriage OR 1.5 Stillbirth OR 2.O
Infant mortality OR 1.8
Prematurity RR 1.3

10. Cigarette smoking
Source: Infant Feeding Survey (2005)

11. Smoking data in Wales Powys 150 97% 19% Cwm Taf 3,982 96% 21% BCU
Health Board
Total births
Data completeness (%)
Smoking prevalence (%)
Powys
150
97%
19%
Cwm Taf
3,982
96%
21%
BCU
6,858
89%
17%
Hywel Dda
3,254
86%
11%
ABMU
6,050
27% 2%
CVU
6,031 5%
98% AB
5,928
0.5%
13%
Source: NCCHD 2009

12. Alcohol
Source: Infant Feeding Survey (2005)
Outcomes:
Miscarriage, chromosomal abnormalities, disordered fetal growth,
perinatal death and susceptibility to disease in later life

13. Birth Outcomes
Our Healthy Future?

14. Stillbirth
Our Healthy Future?

15. Cause of stillbirth (AWPS 2005-09)
Antepartum haemorrhage (8.5%)
Congenital anomaly (15.2%)
Maternal disorder (6.1%)
Mechanical (4.8%)
Pre-eclamspia (3.0%)
Unexplained (57.4%)
Our Healthy Future?

16. Preterm birth <36 weeks
Source: AWPS and NCCHD
Our Healthy Future?

17. Inequalities in preterm birth <36 weeks
Source: AWPS and NCCHD
Our Healthy Future?

18. Low birth weight <2500g
Source: AWPS and NCCHD
Our Healthy Future?

19. Birth weight > 4000g
Source: AWPS and NCCHD
Our Healthy Future?

20. Infant mortality
Our Healthy Future?

21. Public Health Wales Observatory

22. Causes of infant mortality
Preterm birth (35%)
Congenital anomaly (21%)
Sudden unexplained death in infancy (11%)
Infection (11%)
Intrapartum events (9%)
Our Healthy Future?

23. 23

24. Early Years (0-2)
Our Healthy Future?

25. Breastfeeding
Our Healthy Future?

27. Complex social factors
Illegal drug use
Benefits
Unemployment
Homeless
Domestic violence
Our Healthy Future?

28. 28

29. Insert name of presentation on Master Slide

30. 30

31. Conclusion Inequalities persist
Some risk factors and outcomes not e-captured
What should be done?
How will we know its making a difference?
Can surveillence make a difference?

32. Is my future bright?