Intrauterine growth retardation and preterm delivery: prenatal risk factors in an indigent population

Article Abstract:

Although low birth weight (LBW) is one of the strongest predictors of perinatal morbidity and mortality, there is little data to distinguish between the factors contributing to LBW, preterm delivery and intrauterine growth retardation (IUGR). This is largely due to the inaccuracy associated with estimating gestational age. To identify specific risk factors for preterm delivery and IUGR, data from 17,149 deliveries in Birmingham, Alabama were analyzed. Although the data were analyzed retrospectively, they were collected prospectively, presumably reducing the bias of inaccurate recall after the birth of a LBW infant. The data identify a number of statistically significant risk factors. For intrauterine growth retardation, the risk factors were: smoking, Black race, first birth, maternal age over 25, previous preterm delivery, low maternal weight, low maternal height, and low weight gain during pregnancy. These risk factors were found to be independent of one another. Marital status, educational level, and alcohol or drug consumption were not related to IUGR. Some of the risk factors for low birth weight were the same: Black race, age over 25, smoking, previous preterm delivery, low maternal weight and low weight gain during pregnancy. Single marital status and maternal age under 17 were also risk factors for preterm delivery. It is worth noting that numerous studies, both in the United States and abroad, have found associations between maternal education and preterm delivery or low birth weight. That such an effect was not observed here may be due to the fact that most of the women studied were of low income levels. The effects observed elsewhere may be due to income level, and the educational effect due only to a relation between education and income. Within a population relatively uniform for income, education seems to have little effect on preterm delivery or IUGR. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Smoking, maternal age, fetal growth, and gestational age at delivery

Article Abstract:

The relationship between smoking and low birth weight (LBW) is well established, but the various factors which may contribute to the resulting low birth weight have not been extensively examined. Over a five-year period, 15,539 births were studied for which there was adequate information available on prenatal conditions and hypertension at birth. Among non-smoking women, birth weight increased with the advancing age of the mother. Among smokers, however, no such effect was seen. When the data were examined to determine whether retarded intrauterine growth or decreased gestational age at birth was the primary cause of the observed LBW, it was found that both factors contributed. As maternal age increased among smoking women, intrauterine growth retardation increased. Since the mean, or average, weight did not increase, there must be an as yet unidentified factor contributing to the observed data. Similar effects are seen when gestational age is considered; among 17-year-old women, the preterm delivery rate is 16 percent. This falls to 8 percent in women aged 35. Among women who smoke, the rate of preterm delivery remains high regardless of maternal age. Although the present study cannot elucidate the mechanisms by which smoking elicits these effects, it is clear that smoking in pregnant women over 35 constitutes especially high risk behavior which may warrant extra attention on the part of physicians. (Consumer Summary produced by Reliance Medical Information, Inc.)

Growth, Fetal development, Smoking and women, Women smokers

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Maternal risk factors and their influence on fetal anthropometric measurements

Article Abstract:

Different maternal risk factors and fetal sex may increase the risk of a low birth weight. A study examined the affect of different maternal risk factors and fetal sex on fetal size, weight and proportion in 1,205 fetuses of indigent mothers who were born at term. All the maternal risk factors and female sex increased the risk of a low birth weight. The maternal risk factors that were examined included maternal race, height, body mass index, hypertension, weight gain, smoking and previous low birth weight. The risk factors that had the largest impact on fetal weight were reduced weight gain, low body mass index, short height and smoking. The effect of the different maternal risk factors varied depending on the stage of gestation and the type of measurements that were made.

Sex, Sexual behavior, Birth weight, Birth size

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