Data-Driven Birth Outcomes Objectives for a Community Health Improvement Plan

Purpose: To identify factors associated with poor birth outcomes in four Montgomery County, Ohio zip codes identified as priority areas for public health intervention. Methods: A cross-sectional study was conducted using data from zip codes 45415 (N=267), 45416 (N=158), 45417 (N=1,104) & 45426 (N=571) in Montgomery County, Ohio from 2013 – 2015. The outcome was birth weight. Predictor variables included maternal demographics and behavioral variables. Multiple linear regression was used to test for associations. Results: Children of White mothers had greater mean birth weight compared to children of non-White mothers in all four zip codes; it was statistically significant in three of the zip codes (45415, 45416, 45417). A greater mean number of cigarettes smoked during pregnancy was relatively associated with a decrease in mean birth weight across the four zip codes; this association was statistically significant in zip code 45417. Although Apgar scores and breastfeeding status were statistically significantly associated with changes in mean birth weight, they were found to be un-fit predictors of birth weight as they both occur after a child’s birth. Maternal age, education level, marital status, WIC participation, payment method for birth of child, month prenatal care began and type of doctor attending to birth were not significantly associated with birth weight. Conclusion: Maternal race and smoking are significantly associated with changes in birth weight; these significant associations can be used to guide the development of birth outcomes-related Community Health Improvement Plan (CHIP) objectives and funding allocations to improve birth outcomes