Risk factors for small-for-gestational-age and preterm births among 19,269 Tanzanian newborns

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Risk factors for small-for-gestational-age and preterm births among 19,269 Tanzanian newborns

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Title: Risk factors for small-for-gestational-age and preterm births among 19,269 Tanzanian newborns
Author: Muhihi, Alfa; Sudfeld, Christopher R.; Smith, Emily R.; Noor, Ramadhani A.; Mshamu, Salum; Briegleb, Christina; Bakari, Mohamed; Masanja, Honorati; Fawzi, Wafaie; Chan, Grace Jean-Yee

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Citation: Muhihi, Alfa, Christopher R. Sudfeld, Emily R. Smith, Ramadhani A. Noor, Salum Mshamu, Christina Briegleb, Mohamed Bakari, Honorati Masanja, Wafaie Fawzi, and Grace Jean-Yee Chan. 2016. “Risk factors for small-for-gestational-age and preterm births among 19,269 Tanzanian newborns.” BMC Pregnancy and Childbirth 16 (1): 110. doi:10.1186/s12884-016-0900-5. http://dx.doi.org/10.1186/s12884-016-0900-5.
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Abstract: Background: Few studies have differentiated risk factors for term-small for gestational age (SGA), preterm-appropriate for gestational age (AGA), and preterm-SGA, despite evidence of varying risk of child mortality and poor developmental outcomes. Methods: We analyzed birth outcome data from singleton infants, who were enrolled in a large randomized, double-blind, placebo-controlled trial of neonatal vitamin A supplementation conducted in Tanzania. SGA was defined as birth weight <10th percentile for gestation age and sex using INTERGROWTH standards and preterm birth as delivery at <37 complete weeks of gestation. Risk factors for term-SGA, preterm-AGA, and preterm-SGA were examined independently using log-binomial regression. Results: Among 19,269 singleton Tanzanian newborns included in this analysis, 68.3 % were term-AGA, 15.8 % term-SGA, 15.5 % preterm-AGA, and 0.3 % preterm-SGA. In multivariate analyses, significant risk factors for term-SGA included maternal age <20 years, starting antenatal care (ANC) in the 3rd trimester, short maternal stature, being firstborn, and male sex (all p < 0.05). Independent risk factors for preterm-AGA were maternal age <25 years, short maternal stature, firstborns, and decreased wealth (all p < 0.05). In addition, receiving ANC services in the 1st trimester significantly reduced the risk of preterm-AGA (p = 0.01). Significant risk factors for preterm-SGA included maternal age >30 years, being firstborn, and short maternal stature which appeared to carry a particularly strong risk (all p < 0.05). Conclusion: Over 30 % of newborns in this large urban and rural cohort of Tanzanian newborns were born preterm and/or SGA. Interventions to promote early attendance to ANC services, reduce unintended young pregnancies, increased maternal height, and reduce poverty may significantly decrease the burden of SGA and preterm birth in sub-Saharan Africa. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR) – ACTRN12610000636055, registered on 3rd August 2010.
Published Version: doi:10.1186/s12884-016-0900-5
Other Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4869183/pdf/
Terms of Use: This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:27320410
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