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 HealthReportar como inadecuado




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 - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Background

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.

Methods

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.

Results

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.

Conclusion

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.



Autor: Erika Ota , Togoobaatar Ganchimeg , Naho Morisaki, Joshua P. Vogel, Cynthia Pileggi, Eduardo Ortiz-Panozo, João P. Souza, Rintar

Fuente: http://plos.srce.hr/



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