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Small for Gestational Age Newborns in French Guiana: The Importance of Health Insurance for Prevention
Lindsay Osei1,2,3, Nicolas Vignier2,4,5, Mathieu Nacher2
1Department of Pediatrics, Cayenne Hospital, Cayenne, French Guiana.
Insights
In French Guiana, immigration and precariousness are linked to higher rates of small for gestational age (SGA) newborns. Lack of health insurance and young maternal age were significant risk factors for SGA.
Area of Science:
- Obstetrics and Gynecology
- Neonatology
- Public Health
Background:
- Small for gestational age (SGA) newborns face increased risks of adverse outcomes.
- French Guiana (FG), a South American territory, experiences challenging living conditions.
- Identifying SGA risk factors in FG is crucial for targeted interventions.
Purpose of the Study:
- To investigate and describe the risk factors associated with SGA newborns in French Guiana.
- To analyze a comprehensive birth cohort data from 2013 to 2021.
Main Methods:
- Utilized a birth cohort dataset encompassing all pregnancies in FG from 2013 to 2021.
- Included data on newborns born after 22 weeks gestation or weighing over 500g, and their mothers.
- Performed statistical analysis to identify significant risk factors.
Main Results:
- The study included 67,962 newborns, with 11.7% identified as SGA.
- Maternal factors associated with SGA included young maternal age (<20 years), immigration from Haiti or Guyana, and lack of health insurance.
- Lack of health insurance was a significant predictor (aOR = 1.24 [1.10-1.40]).
Conclusions:
- Immigration and socioeconomic precariousness are identified as key determinants of SGA newborns in FG.
- Targeted public health strategies addressing these factors are recommended.
- Further research is necessary to refine these findings and inform interventions.
Abstract:
Objectives: Small for gestational age (SGA) newborns have a higher risk of poor outcomes. French Guiana (FG) is a territory in South America with poor living conditions. The objectives of this study were to describe risk factors associated with SGA newborns in FG. Methods: We used the birth cohort that compiles data from all pregnancies that ended in FG from 2013 to 2021. We analysed data of newborns born after 22 weeks of gestation and/or weighing more than 500 g and their mothers. Results: 67,962 newborns were included. SGA newborns represented 11.7% of all newborns. Lack of health insurance was associated with SGA newborns (p < 0.001) whereas no difference was found between different types of health insurance and the proportion of SGA newborns (p = 0.86). Mothers aged less than 20 years (aOR = 1.65 [1.55-1.77]), from Haiti (aOR = 1.24 [1.11-1.39]) or Guyana (aOR = 1.30 [1.01-1.68]) and lack of health insurance (aOR = 1.24 [1.10-1.40]) were associated with SGA newborns. Conclusion: Immigration and precariousness appear to be determinants of SGA newborns in FG. Other studies are needed to refine these results.
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