Birth Size and Maternal, Social, and Environmental Factors in the Province of Jujuy, Argentina

Abstract

Introduction: birth size is affected by diverse maternal, environmental, social, and economic factors. Aim: analyze the relationships between birth size—shown by the indicators small for gestational age (SGA) and large for gestational age (LGA)—and maternal, social, and environmental factors in the Argentine province of Jujuy, located in the Andean foothills. Methods: data was obtained from 49,185 mother-newborn pairs recorded in the Jujuy Perinatal Information System (SIP) between 2009 and 2014, including the following: newborn and maternal weight, length/height, and body mass index (BMI); gestational age and maternal age; mother’s educational level, nutritional status, marital status and birth interval; planned pregnancy; geographic-linguistic origin of surnames; altitudinal place of birth; and unsatisfied basic needs (UBN). The dataset was split into two groups, SGA and LGA, and compared with adequate for gestational age (AGA). Bivariate analysis (ANOVA) and general lineal modeling (GLM) with multinomial distribution were employed. Results: for SGA newborns, risk factors were altitude (1.43 [1.12–1.82]), preterm birth (5.33 [4.17–6.82]), older maternal age (1.59 [1.24–2.05]), and primiparous mothers (1.88 [1.06–3.34]). For LGA newborns, the risk factors were female sex (2.72 [5.51–2.95]), overweight (1.33 [1.22–2.46]) and obesity (1.85 [1.66–2.07]). Conclusions: the distribution of birth size and the factors related to its variability in Jujuy are found to be strongly conditioned by provincial terrain and the clinal variation due to its Andean location.

Insights into Prevention of Health Complications in Small for Gestational Age (SGA) Births in Relation to Maternal Characteristics: A Narrative Review

“…Similarly, an opposite tendency is recorded in women aged 35 years and older [ 35 ]. Nevertheless, considering both maternal age and parity jointly provides a more comprehensive and justified approach, that is, it seems to be more reliable and accurate in predicting adverse birth outcomes [ 35 , 36 , 37 ]. Multiparous (parity 2–4), grand multiparous (parity 5–8), and great grand multiparous (parity > 8) women are thought to have a lower risk of all adverse birth outcomes regardless of the age, comparing with primiparous women, whereas a significant decrease in birth weight is observed in primigravidas ≥30 years old and multigravidas ≥35 years old, compared with women aged 25–29 years [ 35 , 38 ].…”

Higher free testosterone in the third trimester was associated with lower abdominal circumference at birth in boys: Odense child cohort

“…All results are reported as adjusted values. All regression models were adjusted for maternal age, 25 parity, 25 smoking status 26 and educational level 26 . Higher maternal age and primiparity are risk factors for offspring being small‐for‐gestational‐age (SGA) 25 and smoking in pregnancy and lower educational level are associated with reduced BW 26 .…”

“…All regression models were adjusted for maternal age, 25 parity, 25 smoking status 26 and educational level 26 . Higher maternal age and primiparity are risk factors for offspring being small‐for‐gestational‐age (SGA) 25 and smoking in pregnancy and lower educational level are associated with reduced BW 26 . According to the DAG, testosterone and maternal BMI may mediate the associations between PCOS and birth anthropometrics.…”

“…Therefore, we used mediation analysis to estimate total, direct and indirect effect between PCOS and birth anthropometrics. Because impaired placental function and adverse pregnancy outcomes could affect birth anthropometrics, sensitivity analyses were performed by omitting women with early DM (before the third trimester), GDM, 27 fertility treatment, pregnancy‐induced hypertension and/or pre‐eclampsia 28 and preterm birth 25 from the regression analyses. The mediation and sensitivity analyses were also adjusted for maternal age, parity, smoking status and educational level.…”