Abstract
ABSTRACTObjective:To determine the frequency and risk factors of small-for-gestational-age newborns in a high-risk maternity.Methods:This is an observational, cross-sectional, and case-control study, conducted in a public tertiary care maternity hospital. Data from 998 newborns and their mothers were collected through interviews and review of medical records and prenatal care cards. Some placentas underwent histopathological analysis. The variables of small-for-gestational-age and non-small-for-gestational-age newborns and of their mothers were statistically compared by means of Student's t test, Fisher's exact test, and odds ratio. The significance level used was 0.050.Results:There was a 17.9% frequency of small-for-gestational-age newborns. The statistically significant factors associated with the birth of these babies were female sex (p=0.012); positive history of another small-for-gestational-age child (p=0.006); inadequate prenatal care (p=0.019); smoking (p=0.003); hypertensive disorders of pregnancy (p=0.007); placental bleeding (p=0.009) and infarction (p=0.001).Conclusion:In the population studied, the frequency of small-for-gestational-age newborns was high and associated with sex, inappropriate prenatal care, presence of maternal diseases and addictions, and placental abnormalities.
Highlights
Over 70% of SGA occur due to constitutional factors, such as female sex, ethnicity, parity or maternal body mass index (BMI)
The variables studied in the mothers included age; number of consultations in the prenatal care and GA upon initiating prenatal care; schooling years; number of pregnancies; parity; use of legal and illegal drugs; previous SGA child; weight gain during pregnancy; BMI; family income in minimum wages; number of people living in the same house; serology (toxoplasmosis, rubella, cytomegalovirus, hepatitis B and C, human immunodeficiency virus (HIV) and Venereal Disease Research Laboratory (VDRL)); clinical complications during pregnancy; hypertensive disorders of pregnancy (HDP); GDM; urinary tract infection (UTI); pregestation comorbidities; chronic hypertension (CH); diabetes mellitus, among others
The study started after approval by the Research Ethics Committee of the Hospital Municipal Maternidade Escola de Vila Nova Cachoeirinha “Dr Mario de Moraes Altenfelder Silva”, under the resolution number 528.568, CAAE: 25893114.1.0000.5454, and after having an Informed Consent signed by the mothers, which was designed for the specific purposes of this study
Summary
According to Anderson et al,(1) the interest for smallfor-gestational-age (SGA) newborns began when it was observed that babies classified as SGA, appropriatefor-gestational-age (AGA), or large-for-gestational-age (LGA) had specific morbidity and mortality for each birth weight (BW) class, according to the gestational-age (GA). Over 70% of SGA occur due to constitutional factors, such as female sex, ethnicity, parity or maternal body mass index (BMI) In these situations, the SGA newborns are not at risk of perinatal morbidity and mortality.(4). The data obtained in this study may contribute to the development and implementation of measures that result in reducing the incidence of SGA infants
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