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Am J Perinatol 2010; 27(1): 001-007
DOI: 10.1055/s-0029-1223268
© Thieme Medical Publishers

Risk Factors for Recurrent Small-for-Gestational-Age Birth

Felix A. Okah1 , Jinwen Cai2 , Paul C. Dew3 , Gerald L. Hoff2
  • 1Department of Pediatrics, Children's Mercy Hospitals and Clinics/University of Missouri, Kansas City School of Medicine, Kansas City, Missouri
  • 2Office of Epidemiology and Community Health Monitoring, Health Department, Kansas City, Missouri
  • 3Kansas City University of Medicine and Biosciences, Kansas City, Missouri
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Publication History

Publication Date:
20 May 2009 (online)

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ABSTRACT

The factors associated with recurrent small-for-gestational-age birth (R-SGA) have not been previously studied in a multiracial population. This is a retrospective cohort study of 5932 black and white women who had consecutive singleton first and second births in a Midwestern metropolis, from 1995 through 2004, to measure the risk and determine the factors associated with R-SGA. The rates for second-born small-for-gestational-age birth and R-SGA were 10.3% and 4.0%, respectively. Compared with mothers of firstborns who were appropriate for gestational age, mothers of firstborns who were small for gestation age had a higher risk of second-born small-for-gestational-age infants (relative risk [RR] = 3.93; 95% confidence interval [95% CI] = 3.36 to 4.59). Among those with firstborns who were small for gestational age, the odds ratio (OR) and 95% CI of R-SGA were higher for lean body mass index + poor gain (2.83; 1.20 to 6.69), blacks (1.58; 1.09 to 2.29), and smokers (1.61; 1.05 to 2.47). R-SGA occurs in 4% of second births and is responsible for 40% of second-born small-for-gestational-age infants. R-SGA is potentially preventable because of its association with potentially modifiable factors such as smoking and weight gain in pregnancy.

KEYWORDS

Small for gestational age - race - smoking - weight gain

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Felix A OkahM.D. M.S. 

Children's Mercy Hospitals and Clinics, Department of Pediatrics

2401 Gillham Road, Kansas City, MO 64108

Email: faokah@cmh.edu