Preterm and term births of small for gestational age infants: a population-based study of risk factors among nulliparous women
Abstract
OBJECTIVE: To study risk factors for small for gestational age (SGA) infants by gestational age among nulliparous women and to estimate mortality rates among SGA and appropriate-for-gestational-age (AGA) infants by gestational age. DESIGN: A population-based study from the Swedish Medical Birth Register. Setting Sweden 1992 1993. POPULATION: Liveborn singleton infants to nulliparous women (n = 96,662). MAIN OUTCOME MEASURES: Crude and adjusted odds ratios of risk factors for SGA by gestational age. Rates of neonatal and postneonatal mortality. RESULTS: Older maternal age (> or = 30 years) was foremost associated with increased risks of very and moderately preterm SGA (> or = 32 weeks and 33-36 weeks, respectively), but also with term SGA (> or = 37 weeks). Risks of SGA increased with decreasing maternal height at all gestational ages. Smoking increased the risks of moderately preterm and term SGA. Short maternal education increased the risk of preterm SGA and low pre-pregnancy body mass index slightly increased the risk of term SGA. Pre-eclampsia and essential hypertension foremost increased the risk of very preterm SGA (OR = 40.5 and 32.4, respectively) and moderately preterm SGA (OR = 17.4 and 10.6, respectively), but also increased the risk of term SGA. Neonatal and postneonatal mortality rates of SGA infants were substantially influenced by gestational age, and mortality rates were consistently higher among preterm SGA infants compared with AGA infants. CONCLUSIONS: Risk factors for SGA and mortality rates among SGA infants vary by gestational age. A subdivision of risk factors by gestational age adds knowledge, particularly about risks of preterm SGA, where the highest rates of mortality were observed.
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Birth weight is dependent on gestational age at delivery, maternal characteristics, and placental volume, vasculature and function.
“Birth weight is dependent upon numerous factors including gestational age at the time of delivery [1]; maternal characteristics [1–3]; and placental volume, vasculature and function [4].”
From Volume and vascularity: Using ultrasound to unlock the secrets of the first trimester placenta (2019) · cites this paper as [3]
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- Authors
- Clausson, B., Cnattingius, S., & Axelsson, O.
- Affiliations
- Uppsala University (SE)
- Karolinska Institutet (SE)
- Corresponding author
- Clausson, Britt
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 1998-09
- Volume
- 105
- Issue
- 9
- Pages
- 1011-1017
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- 1471-0528
- OpenAlex
- W2037402080
- Cited by
- 192
- References
- 20
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 4 · 2022: 3 · 2021: 9 · 2020: 10 · 2019: 10 · 2018: 13 · 2017: 8 · 2016: 12 · 2015: 6 · 2014: 10 · 2013: 16 · 2012: 12
- FWCI
- 11.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Keywords
- small for gestational age, preterm birth, term birth, nulliparous women, risk factors, maternal age, maternal height, maternal smoking, maternal education, pre-pregnancy body mass index, preeclampsia, essential hypertension, neonatal mortality, postneonatal mortality, gestational age, singleton live births
- MeSH terms
- Adolescent, Adult, Child, Female, Gestational Age, Humans, Hypertension, Infant, Newborn, Infant, Small for Gestational Age, Obstetric Labor, Premature, Maternal Age, Parity, Population Surveillance, Pregnancy, Pregnancy Complications, Cardiovascular, Risk Factors, Sweden, Body Mass Index, Survival Rate, Odds Ratio
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