Impact of maternal and antenatal factors on small-for-gestational-age outcome among infants in Anuradhapura district, Sri Lanka:

Abstract

Abstract, Johanna Enberg Background: Intrauterine growth restriction (IUGR) is a common diagnosis in obstetrics and carries an increased risk of neonatal morbidity and mortality, especially in developing countries. Because valid assessment of IUGR often is unavailable in low-resource settings, small-for-gestational-age (SGA) has been used as a proxy for IUGR. Several risk factors for SGA/IUGR outcome are recognized. However, the important risk factors in a specific area depend on the prevalence and pathology within the population of interest. Aims: Primary aim was to identify risk factors for SGA infants in Anuradhapura district, Sri Lanka. Secondary aim was to investigate if these infants have an increased risk of neonatal adverse outcomes and whether SGA outcome is related to a specific mode of delivery. Methods: The present study was a retrospective case-control study carried out in two demographically different areas in Anuradhapura district. SGA infants were identified by a population-based “weight-for-gestational-age” chart. The study sample was matched with two controls (2 n=272) for each case (n=136). Maternal, antenatal and postnatal information were collected from pregnancy records during the data collection period and later analysed. Results: Logistic regression analysis identified four significant factors; maternal pre-pregnancy weight <50 kg (OR 2.18), BMI <18.5 (OR 2.24) respectively ≥ 25 (OR 1.95), maternal height ≤150 cm (OR 1.98) and previous low birth weight (LBW) child (OR 3.87). Conclusion: The significant maternal factors observed in this study may be a result of physiological or/and pathological influences and depending on which, modifiable or not. Further studies regarding this matter and studies including socioeconomic confounders are needed to determine the underlying cause of SGA infants in Anuradhapura district.