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Intrauterine growth and gestational duration determinants
1Maternal and Child Health Unit, World Health Organization, Geneva, Switzerland.
Pediatrics
|October 1, 1987
Summary
Identifying causal factors for low birth weight is complex. This review clarifies which determinants significantly impact birth weight, gestational age, and growth, guiding public health interventions.
Area of Science:
- Epidemiology
- Public Health
- Perinatal Medicine
Background:
- Low birth weight (LBW) is a significant concern with numerous potential causes.
- Previous research on LBW determinants is often conflicting due to methodological limitations.
Purpose of the Study:
- To critically assess and meta-analyze studies on factors affecting intrauterine growth and gestational duration.
- To identify independent causal factors and their quantitative importance for LBW.
Main Methods:
- Systematic review and meta-analysis of 895 English and French studies (1970-1984).
- Inclusion of 43 potential determinants of intrauterine growth or gestational duration.
- Application of a priori methodologic standards to select best studies for causal assessment.
Main Results:
- Identified factors with well-established direct causal impacts on birth weight, gestational age, prematurity, and intrauterine growth retardation.
- Quantified the relative importance of these factors in developing and developed countries.
- Highlighted modifiable factors with large effects for public health interventions.
Conclusions:
- Established direct causal links between specific factors and LBW outcomes.
- Provided evidence-based priorities for public health interventions and future research in perinatal health.