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Related Experiment Video

Updated: Oct 6, 2025

Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
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Why are babies in Canada getting smaller?

Shiraz El Adam1, Jennifer A Hutcheon2, Chris McLeod3

  • 1School of Population and Public Health, the University of British Columbia, Vancouver, British Columbia, Canada.

Health Reports
|January 20, 2022
PubMed
Summary

Small-for-gestational-age (SGA) births increased in Canada from 2000-2016. While sociodemographic factors partially explain this rise, the increase in SGA births was not fully accounted for by these changes.

Keywords:
Small-for-gestational-age birthsbirth weightinfant healthmaternal and fetal medicine

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Epidemiology
  • Public Health

Background:

  • Recent evidence indicates an unexplained rise in small-for-gestational-age (SGA) births in the US and Canada.
  • SGA births, defined as less than the 10th percentile for gestational age, are associated with increased risks of adverse neonatal and long-term health outcomes.

Purpose of the Study:

  • To investigate the reasons behind the observed increase in SGA births in Canada between 2000 and 2016.
  • To determine the extent to which changes in sociodemographic factors explain the trend in SGA births.

Main Methods:

  • Analysis of Canada's Vital Statistics - Birth Database for singleton live births from 2000 to 2016.
  • Examination of temporal trends in mean birth weight, birth weight z-scores, and SGA prevalence.
  • Application of multivariable logistic regression to assess the impact of sociodemographic factors on SGA risk over time.

Main Results:

  • A total of 5,941,820 singleton live births were included. Mean birth weight decreased, and SGA birth prevalence rose from 7.2% to 8.0% between 2000 and 2016.
  • Higher odds of SGA births were associated with advanced maternal age, unmarried status, nulliparity, and residence in low-income neighborhoods.
  • Adjusting for sociodemographic factors attenuated, but did not eliminate, the increased odds of SGA births over the study period (adjusted OR 1.08).

Conclusions:

  • Fetal size has decreased in Canada between 2000 and 2016, leading to an increase in SGA births.
  • Changes in the demography of childbirth only partially explain the rise in SGA births, indicating other contributing factors require further investigation.