Risk Factors of Small for Gestational Age Babies Born at Term Gestation

Background Small-for-gestational-age is defined as birth weight below the tenth percentile of a birth weight for gestational age and gender specific reference population. The cause of birth of small for gestational age neonates can be due to maternal risk factors, placental factors and fetal risk factors or idiopathic. Objective To evaluate risk factors of full term small for gestational age babies of western Nepal newborns. Method A hospital based case control study was performed in Nepalgunj Medical College from 1st February 2018 to 31st January 2019. The full term small for gestational age babies admitted in neonatal intensive care unit over one year were taken as study group(n=50 cases) and appropriate for gestational babies with matched age and sex were taken as control group(n=50 controls). Binary logistic regression was performed to see the independent predictors of small for gestational age birth and expressed in odds ratio, using 95% confidence interval. Result A total of 50 cases and 50 controls were included in the study. The significant risk factors associated with small for gestational age babies in our study were maternal short stature < 145 cm, maternal post-delivery weight < 51 kg, maternal body mass index < 20 kg/m2, living in rural area, mothers working in farm, heavy work during pregnancy, inadequate antenatal check up and multivitamin intake, maternal hypertension, multiple gestation and oligohydramnios. In binary logistic regression, hypertension during pregnancy, inadequate antenatal visits <4 visits, mothers living in rural area and mothers farmer by occupation were identified as independent predictors after adjusting with confounders. Conclusion This study concludes hypertension during pregnancy, inadequate antenatal visits, mothers living in rural area and working in farm caries highest risk for small for gestational age babies. We recommend adequate antenatal coverage to prevent small for gestational age babies.