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Predictors of size for gestational age in St. Louis City and County.

Xaverius PK, Salas J, Woolfolk CL, Leung F, Yuan J, Chang JJ - Biomed Res Int (2014)

Bottom Line: Among full-term infants, smoking (aOR = 2.08), chronic hypertension (aOR = 1.46), and inadequate prenatal care (aOR = 1.25) had the next most robust and significant impact on SGA.Preeclampsia and inadequate weight gain are significant risk factors for SGA, regardless of gestational age.In this community, disparities in SGA and smoking rates are important considerations for interventions designed to improve birth outcomes.

View Article: PubMed Central - PubMed

Affiliation: Saint Louis University College for Public Health & Social Justice, 3545 Lafayette Avenue, St. Louis, MO 63104, USA.

ABSTRACT

Objective: To identify social, behavioral, and physiological risk factors associated with small for gestational age (SGA) by gestational age category in St. Louis City and County.

Methods: A retrospective cohort study was conducted using birth certificate and fetal death records from 2000 to 2009 (n = 142,017). Adjusted associations of risk factors with SGA were explored using bivariate logistic regression. Four separate multivariable logistic regression analyses, stratified by gestational age, were conducted to estimate adjusted odds ratios.

Results: Preeclampsia and inadequate weight gain contributed significantly to increased odds for SGA across all gestational age categories. The point estimates ranged from a 3.41 increased odds among women with preeclampsia and 1.76 for women with inadequate weight gain at 24-28 weeks' gestational age to 2.19 and 2.11 for full-term infants, respectively. Among full-term infants, smoking (aOR = 2.08), chronic hypertension (aOR = 1.46), and inadequate prenatal care (aOR = 1.25) had the next most robust and significant impact on SGA.

Conclusion: Preeclampsia and inadequate weight gain are significant risk factors for SGA, regardless of gestational age. Education on the importance of nutrition and adequate weight gain during pregnancy is vital. In this community, disparities in SGA and smoking rates are important considerations for interventions designed to improve birth outcomes.

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Related in: MedlinePlus

Small for gestational age.
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fig1: Small for gestational age.

Mentions: Small for gestational age (SGA) is defined as being less than the 10th percentile for birth weight [1]. Research shows that clinical outcomes are significantly worse for babies that are SGA when compared with those that are normal-for-gestational age [2, 3]. For example, children born SGA have different growth patterns [4], increased risk of neurodevelopmental delays [5, 6], and significantly increased risk of death, compared to babies that are not SGA [7]. In St. Louis City and St. Louis County in 2011, 12.0% of singleton births were SGA, with significant differences based upon race (white = 7.8, 95% confidence interval [CI] = [7.2, 8.3] versus black = 17.7, 95% CI = [16.8 18.7]). Alarmingly, the trend for SGA in this urban area has been significantly increasing since the year 2001 (Mann-Kendall S = 48, P < 0.05), with SGA among black babies increasing at a significantly faster rate than among white babies [8] (see Figure 1).


Predictors of size for gestational age in St. Louis City and County.

Xaverius PK, Salas J, Woolfolk CL, Leung F, Yuan J, Chang JJ - Biomed Res Int (2014)

Small for gestational age.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4109607&req=5

fig1: Small for gestational age.
Mentions: Small for gestational age (SGA) is defined as being less than the 10th percentile for birth weight [1]. Research shows that clinical outcomes are significantly worse for babies that are SGA when compared with those that are normal-for-gestational age [2, 3]. For example, children born SGA have different growth patterns [4], increased risk of neurodevelopmental delays [5, 6], and significantly increased risk of death, compared to babies that are not SGA [7]. In St. Louis City and St. Louis County in 2011, 12.0% of singleton births were SGA, with significant differences based upon race (white = 7.8, 95% confidence interval [CI] = [7.2, 8.3] versus black = 17.7, 95% CI = [16.8 18.7]). Alarmingly, the trend for SGA in this urban area has been significantly increasing since the year 2001 (Mann-Kendall S = 48, P < 0.05), with SGA among black babies increasing at a significantly faster rate than among white babies [8] (see Figure 1).

Bottom Line: Among full-term infants, smoking (aOR = 2.08), chronic hypertension (aOR = 1.46), and inadequate prenatal care (aOR = 1.25) had the next most robust and significant impact on SGA.Preeclampsia and inadequate weight gain are significant risk factors for SGA, regardless of gestational age.In this community, disparities in SGA and smoking rates are important considerations for interventions designed to improve birth outcomes.

View Article: PubMed Central - PubMed

Affiliation: Saint Louis University College for Public Health & Social Justice, 3545 Lafayette Avenue, St. Louis, MO 63104, USA.

ABSTRACT

Objective: To identify social, behavioral, and physiological risk factors associated with small for gestational age (SGA) by gestational age category in St. Louis City and County.

Methods: A retrospective cohort study was conducted using birth certificate and fetal death records from 2000 to 2009 (n = 142,017). Adjusted associations of risk factors with SGA were explored using bivariate logistic regression. Four separate multivariable logistic regression analyses, stratified by gestational age, were conducted to estimate adjusted odds ratios.

Results: Preeclampsia and inadequate weight gain contributed significantly to increased odds for SGA across all gestational age categories. The point estimates ranged from a 3.41 increased odds among women with preeclampsia and 1.76 for women with inadequate weight gain at 24-28 weeks' gestational age to 2.19 and 2.11 for full-term infants, respectively. Among full-term infants, smoking (aOR = 2.08), chronic hypertension (aOR = 1.46), and inadequate prenatal care (aOR = 1.25) had the next most robust and significant impact on SGA.

Conclusion: Preeclampsia and inadequate weight gain are significant risk factors for SGA, regardless of gestational age. Education on the importance of nutrition and adequate weight gain during pregnancy is vital. In this community, disparities in SGA and smoking rates are important considerations for interventions designed to improve birth outcomes.

Show MeSH
Related in: MedlinePlus