Grant: Operating Grant - Secondary Analysis of Databases

Infants born large at birth comprise a growing number of livebirths in Canada. Increased maternal anthropometry, advancing maternal age and education, and decreased smoking rates are at least partly responsible. Little has been documented regarding the health service utilization of infants born at the upper end of the birth weight continuum. As women in Canada continue to delay child-bearing, attain higher levels of education, and reduce their smoking rates, and as conditions such as overweight, obesity, and diabetes continue to rise, it is expected that the proportion of large infants will grow. It is important to understand the implications of size at birth on health and health service utilization. The objective of this study is to examine whether size at birth can be used to predict health status and health service utilization among infants and young children. We hypothesize that larger infants consume greater health services and place children at greater risk for adverse health outcomes compared to infants born at what is considered normal birth weight and/or appropriate size-for-gestational-age. The Longitudinal Pediatric Research Database, comprised of linked birth registration records, mortality records, hospital records, and records on physician visits will be used for the analysis. This population-based study will follow a cohort of children born in the province of Newfoundland and Labrador between 1996 and 2008. The study will examine their health outcomes and health service utilization as they age. Number of hospitalizations, number of physician visits, diagnoses, and length of hospital stay will be analyzed according to size at birth. The study will determine at what birth weight or size-for-gestational-age threshold children are at greatest risk for illness and higher health service utilization. This evidence is vital in reinforcing the need for greater emphasis on promoting healthy birth weight outcomes and in turn improved population health.