1. Why is studying this important? Adverse birth outcomes (ABO) can have a large impact on healthcare costs 1 as well as a child’s quality of life 2. A conservative estimate placed the cost to Canadian healthcare system for small-for-gestational age (SGA) and preterm birth (PB) outcomes at over 120 million dollars in the year 2005- 2006 1. Unfavourable birth outcomes not only put a child’s life at risk soon after birth, but can also lead to chronic health issues and functional limitations later in life 2. Maternal factors that influence birth outcomes are variable across time and space, therefore it is important to investigate which factors are most influential now, not decades ago, and in each region. Knowing which maternal factors pose the greatest risk may allow healthcare providers to administer more appropriate care, that is targeted at addressing potential risk factors that mothers may have, in hopes to lower the prevalence of ABO. Research Question + Hypothesis Which maternal factors were the best predictors of PB and SGA in the province of Ontario for the year 2008? The best predictors of PB and SGA in Ontario for the year 2008 will be teen birth rate, mature birth rate, multiple birth rate, smoking rate, rate of no first trimester prenatal visit, and mature nulliparous birth rate. Methodology Searched background literature to find previously identified important maternal factors in other regions and timeframes Cross referenced identified maternal factors with BORN Ontario 2008 regional data reports Extracted data from BORN Ontario 2008 regional reports Statistically analyzed data using ANCOVA models Results Table 1 ANCOVA results for regional maternal factors’ effect on preterm birth rate in Ontario for the year 2008. 1 Maternal Factorp-value Health Unit0.046* Teen Birth Rate0.207 35+ Birth Rate0.120 Nulliparity Rate0.122 Mature and Nulliparous Rate0.357 Multiple Birth Rate0.822 Female Birth Rate0.209 Cesarean Rate0.121 Smoking Rate0.063 No First Trimester Prenatal Visit Rate 2 0.008* 1 Model R Squared = 0.456 2 Sample size reduced to incorporate factor * p-value <0.05 Table 2 ANCOVA results for regional maternal factors ‘effect on SGA birth rate in Ontario for the year 2008. 1 Maternal Factorp-value Health Unit0.581 Teen Birth Rate0.008* 35+ Birth Rate0.898 Nulliparity Rate0.026* Mature and Nulliparous Rate0.075 Multiple Birth Rate0.028* Female Birth Rate0.051 Cesarean Rate0.449 Smoking Rate0.001* No First Trimester Prenatal Visit Rate 2 0.603 1 Model R Squared = 0.559 2 Sample size reduced to incorporate factor * p-value <0.05 Conclusions No maternal factors included in analysis were significant predictors of PB at a regional scale, however individual health units differed significantly in PB rate Several maternal factors were significant predictors of SGA at a regional scale including teen birth rate, nulliparity rate, multiple birth rate, and smoking rate For public health efforts, regions should be evaluated individually for preterm birth risk, and regions with high rates of identified maternal factors should be monitored and targeted for intervention to reduce SGA rates Further research with record-level data is necessary for greater certainty of these factors’ influence in Ontario References 1.Lim, G., Tracey, J., Boom, N., Karmakar, S., Wang, J., Berthelot, JM., Heick, C. 2009. CIHI Survey: Hospital Costs for Preterm and Small-for-Gestational Age Babies in Canada. Healthcare Quarterly, 12(4): 20-24. 2.Das, U.G. and Sysyn. G.D. 2004. Abnormal Fetal Growth: Intrauterine Growth Retardation, Small for Gestational Age, Large for Gestational Age. Pediatric Clinics of North America 51(3): 639-54. OntarioAlgoma SGA Birth Rate Ontario Algoma Preterm Birth Rate 8.3% 10.9% 8.8% 7.9% Maternal Factors Influencing Small-for-Gestational Age and Preterm Birth in Ontario Jordan Robson 1 and Nicola Shaw 1 1 Health Informatics Institute, Algoma University, Sault Ste. Marie, ON, Canada Acknowledgements Authors would like to thank the staff within the Health Informatics Institute for their support during the project. Figure 1 Preterm birth rate and SGA rate for the Province of Ontario and Algoma Public Health Unit for the year 2008.