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Smallness at Birth and Neonatal Death: Reexamining the Current Indicator Using Sibling Data.
Maya Tabet1, Louise H Flick1, Hong Xian1
1Department of Epidemiology and Biostatistics, Saint Louis University College for Public Health and Social Justice, St. Louis, Missouri.
American Journal of Perinatology
|August 15, 2019
Summary
Sibling birth weight impacts neonatal death risk. Second-born infants with small-for-gestational age (SGA) had higher odds of neonatal death, especially if their elder sibling was also SGA.
Area of Science:
- Perinatal epidemiology
- Neonatal health outcomes
- Birth weight research
Background:
- Sibling birth weight similarity is linked to neonatal outcomes, but US data is scarce.
- Small-for-gestational age (SGA) is a critical indicator of neonatal risk.
- Understanding repeat SGA patterns is crucial for targeted interventions.
Purpose of the Study:
- To investigate the association between small-for-gestational age (SGA) and neonatal death in second births.
- To compare neonatal death risks for second births based on whether the elder sibling also had SGA.
- To explore the predictive value of sibling birth weight in neonatal mortality risk assessment.
Main Methods:
- Population-based retrospective cohort study of 179,436 women with two nonanomalous singleton live births in Missouri (1989-2005).
- Logistic regression analysis to assess the relationship between SGA in second births and neonatal death.
- Stratification of analysis based on the SGA status of the elder sibling.
Main Results:
- A significant interaction (p=0.001) was observed between the birth weight-for-gestational age of first and second births concerning neonatal death.
- Second births with SGA faced 2.15-fold increased odds of neonatal death if they were 'repeaters' (elder sibling also SGA).
- Second births with SGA faced 4.44-fold increased odds of neonatal death if they were 'nonrepeaters' (elder sibling not SGA), compared to non-SGA second births.
Conclusions:
- Sibling birth weight is a relevant factor in assessing neonatal death risk.
- The study highlights the heightened vulnerability of neonates with a history of SGA in the family.
- Referencing sibling birth weight may improve the evaluation of infant size and associated mortality risks.
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