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Effects of behavioral and medical variables on fetal growth retardation
Insights
Maternal behavioral factors like smoking and poor prenatal care significantly increase risks for premature birth and low birth weight infants. These risks rise with more behavioral variables, regardless of socioeconomic status.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Perinatal Medicine
Background:
- Several maternal factors, including lifestyle choices and socioeconomic status, are linked to adverse birth outcomes.
- Behavioral variables such as smoking, drug use, inadequate weight gain, poor prenatal care, and extreme maternal age are associated with premature births and fetal growth retardation.
Purpose of the Study:
- To compare the incidence of adverse birth outcomes among mothers with behavioral variables, medical complications, or neither.
- To investigate the relationship between the number of maternal behavioral variables and the risk of premature birth, short-for-dates term infants, and low-birth-weight infants.
Main Methods:
- A comparative study design was employed, categorizing mothers into three groups: those with behavioral variables, those with medical complications, and a control group with neither.
- Incidences of premature births (<37 weeks), short-for-dates term infants, and low-birth-weight infants were analyzed across the groups.
- The influence of socioeconomic status and the number of behavioral variables on birth outcomes was assessed.
Main Results:
- The control group exhibited low incidences of premature births (1%), short-for-dates infants (1.4%), and low birth weight (1%).
- A significant, proportionate increase in premature births, short-for-dates infants, and low birth weight was observed as the number of maternal behavioral variables increased.
- Adverse birth outcomes were high in mothers with two or more behavioral variables, irrespective of socioeconomic status.
- Mothers with behavioral variables had higher absolute numbers of adverse outcomes than those with medical complications, despite lower incidences.
- Mothers with both medical complications and behavioral variables had more growth-retarded infants than those with medical complications alone.
Conclusions:
- Maternal behavioral variables are significant contributors to premature births and fetal growth retardation.
- The cumulative effect of multiple behavioral variables poses a substantial risk for adverse birth outcomes, overriding socioeconomic factors.
- Interventions targeting maternal behaviors are crucial for improving perinatal health outcomes.
Abstract:
Cigarette smoking, indulging in certain drugs, restricting maternal weight gain in pregnancy, failing to obtain sufficient prenatal care, undertaking pregnancy at too early or too advanced on age, and being underweight for height at conception have in the past been identified with either increased premature births or births of term infants with fetal growth retardation. Each of these seven variables contains an element of maternal choice and has therefore been labeled by us as a behavioral variable. The combined group of mothers having these seven behavior variables was compared to a smaller group of mothers with medical complications and to a control group of mothers with neither behavioral nor medical variables. In the control group, there was a remarkably low incidence of premature births under 37 weeks (1 per cent), of term infants who had short body lengths at birth for their fetal ages (1.4 per cent), and of low-birth-weight infants (1 per cent). As the number of seven behavioral variables increased from none to three or more per pregnancy, the incidences of premature births, of short-for-dates term infants, and of low-birth-weight infants increased proportionately and significantly. The incidences of these seven behavioral variables, occurring either singly or in combination, were inverse to the mothers' socioeconomic status. However, the incidences of premature births, of growth-retarded term infants, and of low-birth-weight infants were high among mothers who had two or more behavioral variables in their pregnancies regardless of the mothers' socioeconomic status. The group of mothers with behavioral variables in comparison to the smaller group of mothers with medical complications had lower incidences but higher absolute numbers of premature infants, of growth-retarded term infants, and of low-birth-weight infants. Mothers who had medical complications as well as behavioral variables had more growth-retarded term infants than mothers with medical complications alone.