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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neonatal sex and maternal factors associated with small-for-gestational-age neonates: A nationwide population-based
Pei-Han Fu1, Chia-Hung Yu1,2, Hao-Wei Chung3,4,5
1Department of Anaesthesiology Chi Mei Medical Centre Tainan Taiwan.
Insights
Small-for-gestational-age (SGA) newborns face increased risks. Key determinants include young maternal age, female sex, socioeconomic factors, and maternal health conditions like hypertension and pre-eclampsia.
Area of Science:
- Perinatal epidemiology
- Maternal-fetal medicine
- Public health
Background:
- Small-for-gestational-age (SGA) newborns are at higher risk of morbidity and mortality.
- Identifying SGA risk factors is crucial for early awareness and intervention.
- Understanding determinants informs healthcare providers and pregnant women.
Purpose of the Study:
- To identify independent risk factors for SGA using population-based data in Taiwan.
- To provide insights into the determinants of SGA for clinical and public health applications.
Main Methods:
- Nationwide case-control study utilizing Taiwanese National Health Insurance, Birth Reporting, and Maternal and Child Health databases (2005-2014).
- Inclusion of live births between 20-44 weeks gestation, linked to maternal conditions.
- Multivariable logistic regression analysis with matched controls to determine adjusted odds ratios (aORs) and 95% confidence intervals (CIs).
Main Results:
- Identified 158,405 SGA births and 623,584 controls.
- Independent risk factors for SGA included maternal age <20 years (aOR 1.68), female newborn sex (aOR 1.28), socioeconomic deprivation (aOR 1.29), hypertension (aOR 1.6), kidney disorders (aOR 1.29), thyroid disorders (aOR 1.13), systemic lupus erythematosus (aOR 2.59), antiphospholipid syndrome (aOR 2.08), gestational hypertension (aOR 1.69), pre-eclampsia (aOR 3.12), and antepartum hemorrhage (aOR 1.05).
Conclusions:
- SGA is associated with younger maternal age, female newborns, maternal comorbidities, and obstetric complications.
- Gestational hypertension and pre-eclampsia are significant risk factors, potentially masking other influences.
Background And Aims:
Small-for-gestational-age (SGA) newborns have a higher risk of morbidity and mortality. Recognizing the risk factors for SGA helps raise early awareness of the issue and provides valuable insights for both healthcare providers and pregnant women. We aimed to identify determinants of SGA using population-based databases in Taiwan.
Methods:
Data were retrieved from the National Health Insurance, Birth Reporting, and Maternal and Child Health databases for this nationwide case-control study. Live births between 20 and 44 weeks of gestation from 2005 to 2014 were enrolled and linked to their mothers to determine maternal conditions during pregnancy. For every SGA newborn, four controls matched by gestational age and birth year were randomly selected. Multivariable logistic regression was used to identify risk factors for SGA, with adjusted odds ratios (aORs) and 95% confidence intervals (CIs) accounting for potential confounders and interaction terms.
Results:
A total of 158,405 live SGA births were identified, with 623,584 controls randomly selected. Independent risk factors for SGA included maternal age <20 years (aOR 1.68, 95% CI 1.62, 1.75); female sex in newborns (aOR 1.28, 95% CI 1.27, 1.30); socioeconomic deprivation (aOR 1.29, 95% CI 1.21, 1.38); hypertension (aOR 1.6, 95% CI 1.52, 1.67); kidney disorders (aOR 1.29, 95% CI 1.16, 1.44); thyroid disorders (aOR 1.13, 95% CI 1.09, 1.17); systemic lupus erythematosus (aOR 2.59, 95% CI 2.33, 2.89); antiphospholipid syndrome (aOR 2.08, 95% CI 1.64, 2.64); gestational hypertension (aOR 1.69, 95% CI 1.61, 1.76); pre-eclampsia (aOR 3.12, 95% CI 3.01, 3.25); and antepartum hemorrhage (aOR 1.05, 95% CI 1.03, 1.07) after adjustment for other covariates.
Conclusions:
SGA was associated with younger maternal age, female newborns, underlying comorbidities, and obstetric conditions. Gestational hypertension and pre-eclampsia were significant risk factors affecting infants of both sexes and all age groups and could mask the effects of maternal age and infant sex.
