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Risk Factors for Small-for-Gestational-age and Preterm Births among 19,269 Tanzanian Newborns.

Muhihi, A., Sudfeld, C. R., Smith, E. R., Noor, R. A., Mshamu, S., Briegleb, C., Bakari, M., Masanja, H., Fawzi, W. and Chan, G. J.-Y. (2016) Risk Factors for Small-for-Gestational-age and Preterm Births among 19,269 Tanzanian Newborns. BMC pregnancy and childbirth, 16. p. 110. ISSN 1471-2393

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Abstract

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. 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. 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 3(rd) 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 1(st) 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). 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.

Item Type: Article
Keywords: Risk factors, Birth weight, Term-SGA, Preterm-AGA, Preterm-SGA, Tanzania
Subjects: Maternal & Neonatal Health > Neonatal Health
Divisions: Other
Depositing User: Mr Joseph Madata
Date Deposited: 26 Jun 2016 08:13
Last Modified: 26 Jun 2016 08:13
URI: http://ihi.eprints.org/id/eprint/3771

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