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Epidemiology of Reproductive and Early Years

Epidemiology of Reproductive and Early Years. Our Healthy Future?. Dr Shantini Paranjothy. Overview. Teenage pregnancy Risks to a healthy future Birth outcomes Early years (0 – 2). Teenage pregnancy. Baby at increased risk of. Harm, illness, injuries

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Epidemiology of Reproductive and Early Years

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  1. Epidemiology of Reproductive and Early Years Our Healthy Future? Insert name of presentation on Master Slide Dr Shantini Paranjothy

  2. Overview • Teenage pregnancy • Risks to a healthy future • Birth outcomes • Early years (0 – 2) Our Healthy Future?

  3. Teenage pregnancy Baby at increased risk of Harm, illness, injuries Behavioural and emotional complications 2 X more likely to have a teen birth • Pre-term birth OR 1.2 – 1.9 • Low birth weight OR 1.2 – 1.8 • Neonatal mortality OR 1.3 – 2.7 Source: Paranjothy et al Arch Dis Child 2009 94: 239-245

  4. Conception rates E & W Source: ONS

  5. Public Health Wales Observatory

  6. Risks to a healthy future Complex social factors Alcohol Illegal drugs Environment Obesity Smoking

  7. Obesity Mother Baby Stillbirth RR 2 Preterm birth RR 1.2 Intensive care RR 1.5 Large for gestational age RR 2 • Pre-eclampsiaRR 3 • Gest diabetes RR 3 • Thromboembolism OR 2.6 • Post partum haemorhageRR 4 Source: CEMACE

  8. Obesity

  9. Cigarette smoking • Miscarriage OR 1.5 • Stillbirth OR 2.O • Infant mortality OR 1.8 • Prematurity RR 1.3

  10. Cigarette smoking Source: Infant Feeding Survey (2005)

  11. Smoking data in Wales

  12. Alcohol Source: Infant Feeding Survey (2005) Outcomes: Miscarriage, chromosomal abnormalities, disordered fetal growth, perinatal death and susceptibility to disease in later life

  13. Birth Outcomes Our Healthy Future?

  14. Stillbirth Our Healthy Future?

  15. Cause of stillbirth (AWPS 2005-09) • Antepartum haemorrhage (8.5%) • Congenital anomaly (15.2%) • Maternal disorder (6.1%) • Mechanical (4.8%) • Pre-eclamspia (3.0%) • Unexplained (57.4%) Our Healthy Future?

  16. Preterm birth <36 weeks Source: AWPS and NCCHD Our Healthy Future?

  17. Inequalities in preterm birth <36 weeks Source: AWPS and NCCHD Our Healthy Future?

  18. Low birth weight <2500g Source: AWPS and NCCHD Our Healthy Future?

  19. Birth weight > 4000g Source: AWPS and NCCHD Our Healthy Future?

  20. Infant mortality Our Healthy Future?

  21. Public Health Wales Observatory

  22. Causes of infant mortality • Preterm birth (35%) • Congenital anomaly (21%) • Sudden unexplained death in infancy (11%) • Infection (11%) • Intrapartum events (9%) Our Healthy Future?

  23. Early Years (0-2) Our Healthy Future?

  24. Breastfeeding Our Healthy Future?

  25. Complex social factors • Illegal drug use • Benefits • Unemployment • Homeless • Domestic violence Our Healthy Future?

  26. Insert name of presentation on Master Slide

  27. Conclusion • Inequalities persist • Some risk factors and outcomes not e-captured • What should be done? • How will we know its making a difference? • Can surveillence make a difference?

  28. Is my future bright?

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