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      The effect of high altitude and other risk factors on birthweight: independent or interactive effects?

      American Journal of Public Health
      Adult, Altitude, Birth Weight, Colorado, Fathers, statistics & numerical data, Female, Humans, Linear Models, Logistic Models, Male, Mothers, Pregnancy, Pregnancy Complications

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          Abstract

          This study examined whether the decline in birth-weight with increasing altitude is due to an independent effect of altitude or an exacerbation of other risk factors. Maternal, paternal, and infant characteristics were obtained from 3836 Colorado birth certificates from 1989 through 1991. Average altitude of residence for each county was determined. None of the characteristics related to birthweight (gestational age, maternal weight gain, parity, smoking, prenatal care visits, hypertension, previous small-for-gestational-age infant, female newborn) interacted with the effect of altitude. Birthweight declined an average of 102 g per 3300 ft (1000 m) elevation when the other characteristics were taken into account, increasing the percentage of low birthweight by 54% from the lowest to the highest elevations in Colorado. High altitude acts independently from other factors to reduce birthweight and accounts for Colorado's high rate of low birthweight.

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          Most cited references6

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          Studies of Babies Born at High Altitude

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            The quality and completeness of birthweight and gestational age data in computerized birth files.

            Computerized birth files compiled by the State of North Carolina for the years 1975-1977 were analyzed for omissions and inaccuracies. A wide range in the per cent missing values was found for different data items, from essentially none missing (birthweight, sex, race) to about 20 per cent missing (gestational age, paternal social data). Recorded birthweight showed the expected skewing from a normal distribution. The only demonstrable inaccuracy was in the form of digit preference, probably causing errors of +/- 1 oz (28.3 g). Reported gestational ages were more suspect, falling outside the range of biologically plausible gestation length in 2.8 per cent of cases. An additional 1.5 per cent of gestational ages were found to be misdated by four to 20 weeks based on the observed bimodal weight distributions among births of the same reported gestational age. Hospitals of various sizes and administrative affiliations submitted records with missing or inaccurate gestational age data with roughly equal frequency. These records were found to come from a socio-demographically high-risk subpopulation. The implications of elimination of incomplete or erroneous birth record data in perinatal epidemiologic research are discussed.
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              Fetal growth retardation and increased infant mortality at high altitude.

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                Author and article information

                Journal
                9224184
                1380938
                10.2105/AJPH.87.6.1003

                Chemistry
                Adult,Altitude,Birth Weight,Colorado,Fathers,statistics & numerical data,Female,Humans,Linear Models,Logistic Models,Male,Mothers,Pregnancy,Pregnancy Complications

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