A Cohort Study On The Incidencc Rate And Influencing Factors Of SGA

Objective To investigate the incidence rate and influencing factors of small for gestationalage infants in3cities of Anhui province.Methods By following up the pregnant women who had registered (before16weeks) inthe maternal and child health (MCH) centers in the first trimester in3cities between Oct2008and Oct2010, we collected the information related to the pregnant women and thebaby’s delivery records that including the mother’s socio-demographic characteristics (age,education, family economic status and so on), prior pregnancy history and medical history,and environmental exposure during6months of pre-pregnancy and in the first trimester,mental health in the first trimester. The questionnaires measuring mental health status werepregnancy-related anxiety questionnaire (pregnancy-related anxiety), Self-Rating AnxietyScale (SAS) and Epidemiological Studies-Depression scale (CES-D). We also collectedpregnancy complications in third trimester, such as gestational hypertension, Informationof singleton live births were collected, and the baby’s delivery records including gender,gestational age and birth weight. This study included13121women whose pregnancystarted between October2008and October2010. Exclusions from the analysis include:2543of whom were lost to follow up, women with miscarriage (132), women with stillbirth(40), women with therapeutic induced labor (20), women with neonatal death (4). leavinga final sample size of10269singleton live births，Chi-square analysis and multiplelogistic regression analysis were performed to analyse the effect of socio-demographiccharacteristics and environment factors SGA. Results The incidence rate of SGA was3.2%(332/10269), and we classified SGAaccording ponderal index (PI) as two types,171(51.5%) children were symmetricaltype,161(48.5%) children were asymmetric type.we classified SGA according bodylength to head circumference ratio (BL/HC),208(72%) were symmetrical type,87(0.8%) were asymmetric type. The stepwise multinomial regression analysis showedthat protective factors for SGA were taking trace elements during first trimester andmaintaining more than a month (OR=0.26,95%CI:0.10~0.72), Risk factors for SGAwere pregnant with depression (OR=1.65,95%CI:1.04~2.62), prepregnancy BMI<18.5(OR=1.47,95%CI:1.15~1.89), women with pregnant vomiting in earlypregnancy and need medical treatment (OR=1.93,95%CI:1.20~3.11), women withpregnancy intrahepatic cholestasis syndrome (OR=1.76,95%CI:1.01~3.07)andhypertensive disorders in pregnancy (OR=3.40,95%CI:2.00~5.80).Conclusions The multi-environmental factors in the pre-pregnancy and in the firsttrimester have the impact on SGA, and Chi-square analysis and multiple logisticregression analysis found that low prepregnancy BMI and pregnant vomiting wouldinduce SGA. So pregnant women should pay attention to pregnant vomiting and getprompt medical attention if necessary in order to reduce the incidence rate of SGA.