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Open Access Research article

Preconceptional factors associated with very low birthweight delivery in East and West Berlin: a case control study

Ingrid Grimmer1, Christoph Bührer1*, Joachim W Dudenhausen2, Andrea Stroux3, Horst Reiher4, Horst Halle5 and Michael Obladen1

Author Affiliations

1 Department of Neonatology, Charité Virchow Hospital; Humboldt University, Berlin, Germany

2 Department of Obstetrics, Charité Virchow Hospital; Humboldt University, Berlin, Germany

3 Berlin Center Public Health; Department of Medical Informatics, Biometry and Epidemiology, University Hospital Benjamin Franklin, Free University, Berlin, Germany

4 Department of Obstetrics and Gynecology, Friedrichshain Municipal Hospital; Berlin, Germany

5 Department of Obstetrics and Gynecology, Charité Campus Mitte, Humboldt University, Berlin, Germany

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BMC Public Health 2002, 2:10  doi:10.1186/1471-2458-2-10

Published: 24 June 2002

Abstract

Background

Very low birthweight, i.e. a birthweight < 1500 g, is among the strongest determinants of infant mortality and childhood morbidity. To develop primary prevention approaches to VLBW birth and its sequelae, information is needed on the causes of preterm birth, their personal and social antecedents, and on conditions associated with very low birthweight. Despite the growing body of evidence linking sociodemographic variables with preterm delivery, little is known as to how this may be extrapolated to the risk of very low birthweight.

Methods

In 1992, two years after the German unification, we started to recruit two cohorts of very low birthweight infants and controls in East and West Berlin for a long-term neurodevelopmental study. The present analysis was undertaken to compare potential preconceptional risk factors for very low birthweight delivery in a case-control design including 166 mothers (82 East vs. 84 West Berlin) with very low birthweight delivery and 341 control mothers (166 East vs. 175 West).

Results

Multivariate logistic regression analysis was used to assess the effects of various dichotomous parental covariates and their interaction with living in East or West Berlin. After backward variable selection, short maternal school education, maternal unemployment, single-room apartment, smoking, previous preterm delivery, and fetal loss emerged as significant main effect variables, together with living in West Berlin as positive effect modificator for single-mother status.

Conclusion

Very low birthweight has been differentially associated with obstetrical history and indicators of maternal socioeconomic status in East and West Berlin. The ranking of these risk factors is under the influence of the political framework.