The relationship between small for gestational age infants and maternal health: a meta-analysis

Fetal growth restriction, commonly referred to as small for gestational age (SGA) in academic contexts, is associated with increased mortality rates and significant health risks. Fetal development is influenced by a complex interplay of maternal factors, fetal characteristics, and placenta fiction. This meta-analysis explored the relationship between the prevalence of SGA infants and various maternal conditions, such as overall health, lifestyle choices, and underlying medical conditions.

A comprehensive literature search on maternal factor and SGA was conducted in PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang, and China Biology Medicine (CBM) (SinoMed) databases from 2000 to 2022. The Cochrane Collaboration tool was adopted to assess the quality of the selected literature. STATA 14.0 software was used to perform the statistical analysis and graphic presentation. Meta-analysis was registered with International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) (202410045).

In total, 15 studies with 41,446 infants identified as being SGA were included in this Meta-analysis. SGA occurrence was not associated with maternal age or multi-parameter, but was related to abnormal Body Mass Index (BMI) (RR=2.23, 95% CI [1.24, 4.00]). Smoking was strongly associated with SGA (RR=3.09, 95% CI [1.53, 6.23]), while drinking was not. SGA was negatively correlated with pregestational diabetes (RR=0.59, 95% CI [0.40, 0.88]) and pregnancy complications, including gestational diabetes (RR=0.74, 95% CI [0.56, 0.97]), hypertension (RR=2.84, 95% CI [1.88, 4.29]) and preeclampsia (RR=2.38, 95% CI [1.77, 3.20]).

Maternal risk factors, including BMI, smoking, pregestational diabetes, gestational diabetes, gestational hypertension, and preeclampsia, are associated with SGA.