Table 3.
Adjusted Odds of Severe Unexpected Newborn Complications in the Patient-Level Analysis
| Characteristic | aOR (95% CI)a | P Value |
|---|---|---|
| Maternal | ||
| Maternal age, y | ||
| <18 | 0.94 (0.85–1.04) | .28 |
| 18–24 | 1 [Reference] | NA |
| 25–29 | 1.02 (0.98–1.05) | .30 |
| 30–34 | 1.03 (0.99–1.07) | .16 |
| 35–39 | 1.06 (1.01–1.11) | .03 |
| ≥40 | 1.21 (1.10–1.32) | <.001 |
| Maternal race | ||
| White | 1 [Reference] | NA |
| Black | 0.97 (0.93–1.02) | .21 |
| Native American/Alaskan | 0.93 (0.84–1.04) | .22 |
| Asian or Pacific Islander | 0.84 (0.77–0.91) | <.001 |
| Maternal ethnicity | ||
| Non-Hispanic | 1 [Reference] | NA |
| Hispanic | 0.76 (0.73–0.80) | <.001 |
| Maternal educational level | ||
| Less than high school | 1.02 (0.97–1.06) | .45 |
| High school | 1 [Reference] | NA |
| Any postsecondary | 0.93 (0.90–0.96) | <.001 |
| Payer at time of delivery | ||
| Private | 1 [Reference] | NA |
| Medicaid | 1.17 (1.13–1.21) | <.001 |
| Self-pay | 1.25 (1.16–1.36) | <.001 |
| Other | 1.11 (1.03–1.19) | .004 |
| Maternal comorbidities | ||
| Diabetes | ||
| Pregestational | 2.97 (2.73–3.24) | <.001 |
| Gestational | 1.36 (1.29–1.43) | <.001 |
| Hypertension | ||
| Chronic | 1.47 (1.35–1.59) | <.001 |
| Pregnancy-related | 1.51 (1.44–1.59) | <.001 |
| Tobacco use | 1.31 (1.26–1.36) | <.001 |
| Parity | ||
| Nulliparous | 1 [Reference] | NA |
| Multiparous | 0.70 (0.68–0.72) | <.001 |
| Delivery | ||
| Gestational age at delivery, wk | 0.94 (0.93–0.95) | <.001 |
| Delivery mode | ||
| Vaginal | 1 [Reference] | NA |
| Cesarean | 2.10 (2.05–2.16) | <.001 |
| Induction of labor | 0.90 (0.87–0.93) | <.001 |
| Infant birth weight, g | 1.00 (1.00–1.00) | .08 |
| Hospital | ||
| Delivery volume | 1.00 (1.00–1.00) | .002 |
| Medicaid-covered deliveries, % | 0.91 (0.68–1.21) | .51 |
| County population in rural areas, % | 1.00 (1.00–1.01) | .02 |
| Level of neonatal care | ||
| High | 1 [Reference] | NA |
| Low | 1.55 (1.38–1.74) | <.001 |
Abbreviations: aOR, adjusted odds ratio; NA, not applicable.
a
Accounts for the random effect of the hospital, the fixed effect of year, and for all covariates listed. The reference category for the maternal comorbidities includes women without those individual conditions.