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Risk factors for small-for-gestational-age birth in a preterm population

  • Author Footnotes
    a From the Epidemiology and Biostatistics Section, Boston University School of Public Health
    Janet M. Lang
    Correspondence
    Reprint requests: Janet M. Lang, PhD, ScD, Epidemiology and Biostatistics Section, Boston University School of Public Health, 80 E. Concord St., Boston, MA 02118.
    Footnotes
    a From the Epidemiology and Biostatistics Section, Boston University School of Public Health
    Affiliations
    Boston, Massachusetts
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  • Author Footnotes
    b the Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School
    Amy Cohen
    Footnotes
    b the Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School
    Affiliations
    Boston, Massachusetts
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  • Author Footnotes
    b the Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School
    ,
    Author Footnotes
    c the Department of Maternal and Child Health, Harvard School of Public Health.
    Ellice Lieberman
    Footnotes
    b the Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School
    c the Department of Maternal and Child Health, Harvard School of Public Health.
    Affiliations
    Boston, Massachusetts
    Search for articles by this author
  • Author Footnotes
    a From the Epidemiology and Biostatistics Section, Boston University School of Public Health
    b the Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School
    c the Department of Maternal and Child Health, Harvard School of Public Health.
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      Objective: The objective of this study was to discover any distinct risk factors for small-for-gestational-age birth among premature infants.
      Study Design: Demographic and obstetric risk factors were compared for 136 small-for-gestational-age prematures and 636 appropriate-for-gestational-age premature infants.
      Results: Three significant risk factors for growth retardation among premature infants were found: black maternal race (odds ratio 2.2; 95% confidence interval (1.4 to 3.5); maternal toxemia (odds ratio 3.2; 95% confidence interval 1.7 to 6.1); and either low maternal weight gain (odds ratio 4.0; 95% confidence interval 1.8 to 8.8) or missing information on maternal weight gain, which could be a marker for late or no prenatal care (odds ratio 4.9; 95% confidence interval 1.9 to 12.6). Maternal smoking rates were similar in the small- and appropriate-for-gestational-age groups (42% and 43%, respectively).
      Conclusions: Toxemia, weight gain, and race are likely risk factors for small-for-gestational-age birth in both preterm and term populations; within the already high-risk domain of prematurity, maternal smoking did not appear to confer added risk for small-for-gestational-age birth.

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