Risk factors and adverse perinatal outcomes among term and preterm infants born small-for-gestational-age: secondary analyses of the WHO Multi-Country Survey on Maternal and Newborn Health.

<h4>Background</h4>Small for gestational age (SGA) is not only a major indicator of perinatal mortality and morbidity, but also the morbidity risks in later in life. We aim to estimate the association between the birth of SGA infants and the risk factors and adverse perinatal outcomes am...

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Main Authors: Erika Ota, Togoobaatar Ganchimeg, Naho Morisaki, Joshua P Vogel, Cynthia Pileggi, Eduardo Ortiz-Panozo, João P Souza, Rintaro Mori, WHO Multi-Country Survey on Maternal and Newborn Health Research Network
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2014-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0105155
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author Erika Ota
Togoobaatar Ganchimeg
Naho Morisaki
Joshua P Vogel
Cynthia Pileggi
Eduardo Ortiz-Panozo
João P Souza
Rintaro Mori
WHO Multi-Country Survey on Maternal and Newborn Health Research Network
author_facet Erika Ota
Togoobaatar Ganchimeg
Naho Morisaki
Joshua P Vogel
Cynthia Pileggi
Eduardo Ortiz-Panozo
João P Souza
Rintaro Mori
WHO Multi-Country Survey on Maternal and Newborn Health Research Network
author_sort Erika Ota
collection DOAJ
description <h4>Background</h4>Small for gestational age (SGA) is not only a major indicator of perinatal mortality and morbidity, but also the morbidity risks in later in life. We aim to estimate the association between the birth of SGA infants and the risk factors and adverse perinatal outcomes among twenty-nine countries in Africa, Latin America, the Middle East and Asia in 359 health facilities in 2010-11.<h4>Methods</h4>We analysed facility-based, cross-sectional data from the WHO Multi-country Survey on Maternal and Newborn Health. We constructed multilevel logistic regression models with random effects for facilities and countries to estimate the risk factors for SGA infants using country-specific birthweight reference standards in preterm and term delivery, and SGA's association with adverse perinatal outcomes. We compared the risks and adverse perinatal outcomes with appropriate for gestational age (AGA) infants categorized by preterm and term delivery.<h4>Results</h4>A total of 295,829 singleton infants delivered were analysed. The overall prevalence of SGA was highest in Cambodia (18.8%), Nepal (17.9%), the Occupied Palestinian Territory (16.1%), and Japan (16.0%), while the lowest was observed in Afghanistan (4.8%), Uganda (6.6%) and Thailand (9.7%). The risk of preterm SGA infants was significantly higher among nulliparous mothers and mothers with chronic hypertension and preeclampsia/eclampsia (aOR: 2.89; 95% CI: 2.55-3.28) compared with AGA infants. Higher risks of term SGA were observed among sociodemographic factors and women with preeclampsia/eclampsia, anaemia and other medical conditions. Multiparity (> = 3) (AOR: 0.88; 95% CI: 0.83-0.92) was a protective factor for term SGA. The risk of perinatal mortality was significantly higher in preterm SGA deliveries in low to high HDI countries.<h4>Conclusion</h4>Preterm SGA is associated with medical conditions related to preeclampsia, but not with sociodemographic status. Term SGA is associated with sociodemographic status and various medical conditions.
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spelling doaj-art-235d5cd343ff48bcbffe062644455d522025-08-20T02:22:45ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0198e10515510.1371/journal.pone.0105155Risk factors and adverse perinatal outcomes among term and preterm infants born small-for-gestational-age: secondary analyses of the WHO Multi-Country Survey on Maternal and Newborn Health.Erika OtaTogoobaatar GanchimegNaho MorisakiJoshua P VogelCynthia PileggiEduardo Ortiz-PanozoJoão P SouzaRintaro MoriWHO Multi-Country Survey on Maternal and Newborn Health Research Network<h4>Background</h4>Small for gestational age (SGA) is not only a major indicator of perinatal mortality and morbidity, but also the morbidity risks in later in life. We aim to estimate the association between the birth of SGA infants and the risk factors and adverse perinatal outcomes among twenty-nine countries in Africa, Latin America, the Middle East and Asia in 359 health facilities in 2010-11.<h4>Methods</h4>We analysed facility-based, cross-sectional data from the WHO Multi-country Survey on Maternal and Newborn Health. We constructed multilevel logistic regression models with random effects for facilities and countries to estimate the risk factors for SGA infants using country-specific birthweight reference standards in preterm and term delivery, and SGA's association with adverse perinatal outcomes. We compared the risks and adverse perinatal outcomes with appropriate for gestational age (AGA) infants categorized by preterm and term delivery.<h4>Results</h4>A total of 295,829 singleton infants delivered were analysed. The overall prevalence of SGA was highest in Cambodia (18.8%), Nepal (17.9%), the Occupied Palestinian Territory (16.1%), and Japan (16.0%), while the lowest was observed in Afghanistan (4.8%), Uganda (6.6%) and Thailand (9.7%). The risk of preterm SGA infants was significantly higher among nulliparous mothers and mothers with chronic hypertension and preeclampsia/eclampsia (aOR: 2.89; 95% CI: 2.55-3.28) compared with AGA infants. Higher risks of term SGA were observed among sociodemographic factors and women with preeclampsia/eclampsia, anaemia and other medical conditions. Multiparity (> = 3) (AOR: 0.88; 95% CI: 0.83-0.92) was a protective factor for term SGA. The risk of perinatal mortality was significantly higher in preterm SGA deliveries in low to high HDI countries.<h4>Conclusion</h4>Preterm SGA is associated with medical conditions related to preeclampsia, but not with sociodemographic status. Term SGA is associated with sociodemographic status and various medical conditions.https://doi.org/10.1371/journal.pone.0105155
spellingShingle Erika Ota
Togoobaatar Ganchimeg
Naho Morisaki
Joshua P Vogel
Cynthia Pileggi
Eduardo Ortiz-Panozo
João P Souza
Rintaro Mori
WHO Multi-Country Survey on Maternal and Newborn Health Research Network
Risk factors and adverse perinatal outcomes among term and preterm infants born small-for-gestational-age: secondary analyses of the WHO Multi-Country Survey on Maternal and Newborn Health.
PLoS ONE
title Risk factors and adverse perinatal outcomes among term and preterm infants born small-for-gestational-age: secondary analyses of the WHO Multi-Country Survey on Maternal and Newborn Health.
title_full Risk factors and adverse perinatal outcomes among term and preterm infants born small-for-gestational-age: secondary analyses of the WHO Multi-Country Survey on Maternal and Newborn Health.
title_fullStr Risk factors and adverse perinatal outcomes among term and preterm infants born small-for-gestational-age: secondary analyses of the WHO Multi-Country Survey on Maternal and Newborn Health.
title_full_unstemmed Risk factors and adverse perinatal outcomes among term and preterm infants born small-for-gestational-age: secondary analyses of the WHO Multi-Country Survey on Maternal and Newborn Health.
title_short Risk factors and adverse perinatal outcomes among term and preterm infants born small-for-gestational-age: secondary analyses of the WHO Multi-Country Survey on Maternal and Newborn Health.
title_sort risk factors and adverse perinatal outcomes among term and preterm infants born small for gestational age secondary analyses of the who multi country survey on maternal and newborn health
url https://doi.org/10.1371/journal.pone.0105155
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