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Trends and predictors of birth weight in Chilean children
M L Garmendia1, S Mondschein2, B Montiel3
1Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile.
Insights
Maternal nutritional status, including pre-pregnancy body mass index and gestational weight gain, significantly impacts birth weight. Strategies focusing on healthy maternal weight and preventing gestational diabetes and pre-eclampsia are crucial for normal birth outcomes.
Area of Science:
- Public Health
- Obstetrics
- Neonatology
Background:
- Birth weight is a critical indicator of fetal health and future well-being.
- Identifying factors influencing birth weight is essential for developing effective maternal and child health strategies.
Purpose of the Study:
- To analyze birth weight trends in a Chilean hospital from 2002 to 2015.
- To identify prenatal care factors associated with low and high birth weight.
Main Methods:
- Secondary analysis of 78,931 single birth records from a Santiago, Chile hospital (2002-2015).
- Evaluation of sociodemographic, clinical, obstetric, lifestyle, and anthropometric variables.
- Classification and regression tree methodology and logistic regression were employed.
Main Results:
- Average birth weight was 3316g; preterm births increased, while post-term births decreased.
- Key predictors for small for gestational age neonates included pregestational BMI <28 kg/m², gestational weight gain <17 kg, and pre-eclampsia.
- Predictors for large for gestational age neonates included BMI ≥28 kg/m², gestational weight gain ≥17 kg, and gestational diabetes.
Conclusions:
- Maternal nutritional status is the most significant factor influencing birth weight.
- Interventions should focus on achieving normal pre-pregnancy maternal weight, recommended gestational weight gain, and managing gestational diabetes and pre-eclampsia.
Objectives:
Birth weight is an important public health indicator that reflects fetal health conditions and predicts future health. Identifying the most important factors related to birth weight would help defining preventive health strategies for both mothers and children. The objectives of this study are i. to describe, using a large birth database from a Chilean hospital, the trend of birth weight during 2002-2015, and ii. to determine factors during prenatal care associated with low and high birth weight.
Study Design:
This study is a secondary analysis of all single birth records at a Chilean Hospital in the southeast district of Santiago, Chile, during 2002-2015 (N = 78,931).
Methods:
Sociodemographic information, clinical and obstetric history, lifestyle, and anthropometric variables were evaluated as potential predictors. Birth weight was categorized into five groups as per percentiles of weight as per gestational age. Data were extracted from clinical records. We used classification and regression tree methodology and logistic regression.
Results:
The average birth weight for the period was 3316 g (SD 566), with little variation across time. Preterm births increased from 7% in 2002 to 10% in 2015, and births >40 weeks decreased from 10.7% in 2002 to 4.4% in 2015. The percentages of small and large for gestational age changed from 10.9% and 12.7% in 2002 to 9.9% and 13.9% in 2015, respectively. The predictors included in the optimal tree were body mass index, gestational weight gain, pre-eclampsia, and gestational diabetes. We found that women with a pregestational body mass index <28 kg/m2, gestational weight gain <17 kg, and preeclampsia had a probability of 41% of having a small for gestational age neonate. Conversely, women with a body mass index ≥28 kg/m2, gestational weight gain ≥17 kg, and gestational diabetes had a probability of 44% of having a large for gestational age neonate.
Conclusions:
This study showed that the most important variables explaining birth weight are those related to maternal nutritional status. Thus, the strategies to promote a normal birth weight should aim for a normal maternal weight at the beginning of pregnancy, gestational weight gain within the recommendations, and prevention of gestational diabetes and pre-eclampsia.
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