1. The risk factors of preterm births and their implication for neonatal deaths in South Carolina during 1998-2003 Joanna Yoon, MSPH Division of Biostatistics and Health GIS PHSIS, SC DHEC

2. Background Congenital malformations and disorders related to short gestation (i.e., Preterm births) are reported as the top leading causes of infant deaths in South Carolina. Also, they primarily result in neonatal deaths. Congenital malformations and disorders related to short gestation (i.e., Preterm births) are reported as the top leading causes of infant deaths in South Carolina. Also, they primarily result in neonatal deaths.

3. Objectives To study the risk factors of preterm births and their implication for neonatal deaths in South Carolina To study the risk factors of preterm births and their implication for neonatal deaths in South Carolina

4. Methods SC 1998-2003 birth and LB/ND data SC 1998-2003 birth and LB/ND data Preterm Preterm  <32 completed wks of gestation  <37 completed wks of gestation Risk factors: Risk factors:  Maternal age  Maternal education  Marital status

5. Methods Risk factors (conti.) Risk factors (conti.)  Number at birth  Smoking during pregnancy  Drinking during pregnancy  Time of onset of prenatal care  Gravidity  Medical risk factors

6. Methods Trends in preterm births Trends in preterm births The prevalence of preterm births The prevalence of preterm births Logistic regression models Logistic regression models  Preterm birth (<37 wks) : outcome variable  Multiple births : excluded  Adjusted OR, 95% CI

7. Methods Neonatal mortality rates for preterm infants and total births Neonatal mortality rates for preterm infants and total births SAS 8.2 SAS 8.2

8. Results

10. The Prevalence of Preterm Births for Selected Risk Factors, SC Residence Data

11. The Prevalence of Preterm Births

12. Adjusted ORs and 95% CIs : 2001-2003 SC Residence Data

14. Neonatal Mortality Rates for Preterm Infants and Total Births: 1998-2003 SC Residence Data

15. Conclusion The percentage of preterm births from 1998 to 2003 in SC is increasing. The percentage of preterm births from 1998 to 2003 in SC is increasing.  The percentage of preterm < 37 wks is increasing.  The percentage of preterm < 32 wks is not much changed.

16. Conclusion All selected risk factors except drinking were significant risk factors of preterm births for white and total mothers. All selected risk factors except drinking were significant risk factors of preterm births for white and total mothers. All selected risk factors except drinking and maternal education were significant for B&O mothers. All selected risk factors except drinking and maternal education were significant for B&O mothers.

17. Conclusion Racial disparity Racial disparity  preterm birth percentages  neonatal mortality rates for preterm births.

18. Limitations Self-reported on the birth certificate Self-reported on the birth certificate Unexplored risk factors for preterm births Unexplored risk factors for preterm births Unexplained factors Unexplained factors

19. Future study To further study about disparity and to identify and develop innovative strategies to prevent preterm births and reduce the neonatal mortality rates for preterm births. To further study about disparity and to identify and develop innovative strategies to prevent preterm births and reduce the neonatal mortality rates for preterm births.

20. Acknowledgements  Office of Public Health Statistics and Information Services, SC DHEC