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Maternal high-risk factors and severity of growth deficit in small for gestational age infants
A Spinillo1, E Capuzzo, G Piazzi
1Department of Obstetrics and Gynaecology, University of Pavia, IRCCS Policlinico S. Matteo, Italy.
Insights
Preeclampsia is linked to severe fetal growth deficit in small for gestational age (SGA) infants. Other maternal factors and fetal sex are associated with milder forms of SGA.
Area of Science:
- Obstetrics and Gynecology
- Neonatology
- Perinatal Medicine
Background:
- Small for gestational age (SGA) is a significant concern in perinatal health.
- Understanding maternal risk factors associated with SGA severity is crucial for targeted interventions.
- Fetal growth deficit severity can vary widely among SGA infants.
Purpose of the Study:
- To evaluate the relationship between maternal risk factors and the severity of fetal growth deficit in SGA infants.
- To identify specific maternal conditions that correlate with more severe SGA.
- To explore associations between various maternal and fetal characteristics and different strata of SGA severity.
Main Methods:
- A population-based study involving 613 SGA infants and 784 controls.
- Severity of growth deficit quantified using fetal growth ratio (observed/expected birthweight).
- Multivariate statistical models employed to analyze associations between maternal factors and SGA severity.
Main Results:
- Preeclampsia was the sole maternal high-risk factor positively correlated with a more severe growth deficit in SGA infants.
- Chronic maternal cardiac/renal diseases and female fetal sex were associated with milder SGA, showing an inverse relationship with deficit severity.
- Maternal smoking, low maternal weight gain, low pre-pregnancy weight, severe anemia, low education, prior low birthweight infant, recurrent spontaneous abortion, and nulliparity showed associations with SGA that were consistent across severity levels.
Conclusions:
- Preeclampsia is a key maternal risk factor associated with severe fetal growth restriction.
- Certain maternal conditions and fetal sex are linked to milder forms of SGA.
- Several other maternal factors are associated with SGA but not specifically with its severity.
Abstract:
The relationship between maternal risk factors and severity of fetal growth deficit was evaluated in a population of 613 small for gestational age (SGA) infants and 784 appropriately grown controls. The severity of growth deficit among SGA infants was expressed as 'fetal growth ratio' (observed/expected birthweight, where expected birthweight is the mean birthweight of the Italian population for a given gestational age). In multivariate models, preeclampsia was the only maternal high-risk factor positively correlated with a more severe growth deficit among SGA infants. Chronic cardiac or renal maternal diseases and female fetal sex were associated with mild forms of SGA, thus showing an inverse relationship with severity of growth deficit. Finally, the association between maternal smoking in pregnancy, low (< 0.2 kg/week) maternal weight gain, low (< 50 kg) pre-pregnancy weight, severe (Hb, < 8 g/dl) maternal anaemia, low education (< 6th grade), history of a previous low birthweight infant or recurrent spontaneous abortion, nulliparity and SGA was homogeneous across the severity strata of fetal growth deficit.