Risk factors associated with small-for-dates and large-for-dates infants

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Public Health

Background:

• Birth weight extremes, small-for-dates (SFD) and large-for-dates (LFD) infants, pose significant health risks.
• Understanding the multifactorial etiology of these conditions is crucial for effective intervention.

Purpose of the Study:

• To quantify the relative risks of maternal and pregnancy-related factors associated with SFD and LFD infants.
• To estimate the potential reduction in SFD and increase in LFD infants if pathological factors were eliminated.

Main Methods:

• Calculation of relative risks for various maternal and pregnancy factors.
• Analysis of factors including maternal height and weight, smoking, pre-eclampsia, and parity.
• Estimation of attributable risk for pathological factors.

Main Results:

• Maternal height had equal but opposite effects on SFD and LFD risks.
• Maternal weight posed a greater risk for LFD than SFD infants.
• Smoking significantly increased SFD risk (3.5x) and reduced LFD risk by half.
• Pre-eclampsia strongly elevated SFD risk (14.6x) but not LFD risk.
• Increasing parity was associated with higher LFD risk, while SFD risk fluctuated.
• Previous sibling birth weight influenced current SFD/LFD risk in multiparous women.

Conclusions:

• Maternal characteristics and pathological conditions are key determinants of birth weight extremes.
• Eliminating smoking, hypertensive disorders, and congenital abnormalities could substantially reduce SFD incidence and increase LFD incidence.
• Targeted interventions addressing these modifiable risk factors are essential for improving perinatal outcomes.