Clark-Sevilla Andrea O, Lin Yun C, Saxena Arnav, Yan Qi, Wapner Ronald, Raja Anita, Pe'er Itsik, Salleb-Aouissi Ansaf
Department of Computer Science, Columbia University, New York, NY 10027, United States.
Department of Data Science, Columbia University, New York, NY 10027, United States.
JAMIA Open. 2024 Mar 20;7(1):ooae024. doi: 10.1093/jamiaopen/ooae024. eCollection 2024 Apr.
Preterm birth (PTB) is a major determinant of neonatal mortality, morbidity, and childhood disability. In this article, we present a longitudinal analysis of the risk factors associated with PTB and how they have varied over the years: starting from 1968 when the CDC first started, reporting the natality data, up until 2021. Along with this article, we are also releasing an RShiny web application that will allow for easy consumption of this voluminous dataset by the research community. Further, we hope this tool can aid clinicians in the understanding and prevention of PTB.
This study used the CDC Natality data from 1968 to 2021 to analyze trends in PTB outcomes across the lens of various features, including race, maternal age, education, and interval length between pregnancies. Our interactive RShiny web application, CDC NatView, allows users to explore interactions between maternal risk factors and maternal morbidity conditions and the aforementioned features.
Our study demonstrates how CDC data can be leveraged to conduct a longitudinal analysis of natality trends in the United States. Our key findings reveal an upward trend in late PTBs, which is concerning. Moreover, a significant disparity exists between African American and White populations in terms of PTB. These disparities persist in other areas, such as education, body-mass index, and access to prenatal care later in pregnancy.
Another notable finding is the increase in maternal age over time. Additionally, we confirm that short interpregnancy intervals (IPIs) are a risk factor for PTBs. To facilitate the exploration of pregnancy risk factors, infections, and maternal morbidity, we developed an open-source RShiny tool called CDC NatView. This software offers a user-friendly interface to interact with and visualize the CDC natality data, which constitutes an invaluable resource.
In conclusion, our study has shed light on the rise of late PTBs and the persistent disparities in PTB rates between African American and White populations in the US. The increase in maternal age and the confirmation of a short IPI as a risk factor for PTB are noteworthy findings. Our open-source tool, CDC NatView, can be a valuable resource for further exploration of the CDC natality data to enhance our understanding of pregnancy risk factors and the interaction of PTB outcomes and maternal morbidities.
早产是新生儿死亡率、发病率和儿童残疾的主要决定因素。在本文中，我们对与早产相关的风险因素及其多年来的变化情况进行了纵向分析：从1968年疾病控制与预防中心（CDC）首次开始报告出生数据起，直至2021年。随本文一同发布的，还有一个RShiny网络应用程序，它将便于研究界使用这一庞大的数据集。此外，我们希望这个工具能够帮助临床医生理解和预防早产。
本研究使用了1968年至2021年CDC的出生数据，从种族、产妇年龄、教育程度以及妊娠间隔时长等多个方面分析早产结局的趋势。我们交互式的RShiny网络应用程序“CDC NatView”，允许用户探究产妇风险因素与产妇发病情况以及上述特征之间的相互作用。
我们的研究展示了如何利用CDC数据对美国的出生趋势进行纵向分析。我们的主要发现揭示了晚期早产呈上升趋势，这令人担忧。此外，非裔美国人和白人在早产方面存在显著差异。这些差异在教育、体重指数以及怀孕后期获得产前护理等其他领域也持续存在。
另一个值得注意的发现是产妇年龄随时间增加。此外，我们证实妊娠间隔时间短是早产的一个风险因素。为便于探究妊娠风险因素、感染及产妇发病情况，我们开发了一个名为“CDC NatView”的开源RShiny工具。该软件提供了一个用户友好的界面，用于与CDC出生数据进行交互并可视化，这些数据是非常宝贵的资源。
总之，我们的研究揭示了晚期早产的增加以及美国非裔美国人和白人在早产率方面持续存在的差异。产妇年龄增加以及确认妊娠间隔时间短是早产的风险因素，这些都是值得关注的发现。我们的开源工具“CDC NatView”对于进一步探索CDC出生数据、增进我们对妊娠风险因素以及早产结局与产妇发病情况之间相互作用的理解可能是一项宝贵资源。
