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Intrauterine growth retardation and preterm delivery: prenatal risk factors in an indigent population
S W Wen1, R L Goldenberg, G R Cutter
1Department of Obstetrics and Gynecology, University of Alabama at Birmingham 35294.
Insights
Identifying maternal risk factors like smoking and low weight gain is crucial for preventing low birth weight, intrauterine growth retardation, and preterm delivery in vulnerable populations.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Public Health
Background:
- Low birth weight (LBW) remains a significant global health concern.
- Intrauterine growth retardation (IUGR) and preterm delivery (PTD) are major contributors to LBW.
- Understanding specific risk factors is essential for targeted interventions.
Purpose of the Study:
- To evaluate prenatal risk factors for LBW.
- To differentiate effects on IUGR versus PTD.
- To inform strategies for reducing LBW prevalence.
Main Methods:
- Univariate and logistic regression analyses were performed.
- A large cohort of 17,000 indigent women was studied.
- Specific risk factors for IUGR and PTD were identified.
Main Results:
- Significant risk factors for IUGR included race, parity, maternal age, prior PTD, smoking, short stature, low pre-pregnancy weight, and low weight gain.
- Significant risk factors for PTD included race, marital status, maternal age, prior PTD, smoking, low pre-pregnancy weight, and abnormal weight gain.
- Smoking, short stature, low weight, and low weight gain were strongly correlated with IUGR; prior PTD and very low maternal weight were strongly correlated with PTD.
Conclusions:
- Specific prenatal risk factors for IUGR and PTD have been identified.
- These findings can guide the development of targeted public health strategies.
- Reducing the prevalence of IUGR and PTD can improve birth outcomes.
Abstract:
Prenatally ascertained risk factors for low birth weight were evaluated in a population of 17,000 indigent women for their specific effect on intrauterine growth retardation and on the rate of preterm delivery. In a univariate analysis, intrauterine growth retardation occurred more frequently in women who were black, single, primiparous, less than 17 or greater than 30 years old, short, thin, had a previous preterm delivery, consumed alcohol, took drugs, or gained limited weight. Preterm delivery occurred significantly more frequently in women who were black, single, thin, less than 17 or greater than 30 years old, had less than a twelfth grade education, or gained limited weight. In logistic regression analyses, race, parity, maternal age, a history of preterm delivery, smoking, short stature, low weight, and low weight gain remained significant risk factors of intrauterine growth retardation. Of these factors, smoking, short stature, low weight, and low weight gain showed the greatest correlation. Factors significantly related to preterm delivery included black race, single marital status, younger or older ages, previous preterm delivery, smoking, low weight, and very low or high weight gain. A previous preterm delivery and very low maternal weight had the greatest correlation. Identification of specific risk factors of both intrauterine growth retardation and preterm delivery should aid in the development of strategies to reduce the prevalence of these conditions.