Diagnostic Significance of Risk Factors Associated with Birth of Small for Gestational Age Full-Term Newborns

Abstract

Purpose. To analyze the risk factors associated with the birth of small for gestational age full-term newborns. Materials and methods. Examination of 299 full-term newborns was carried out. Children were divided into 2 groups: group 1 (Gr1) – small for gestational age (n=160, body weight (BW) 2463±202 g, percentile BW 4.5±3.9) and the comparison group (Gr2) – newborns with the corresponding gestational age by physical development, appropriate for gestational age (n=139, BW 3360±235 g, BW percentile 54.5±17.5). Results. Established demographic, socio-hygienic, anamnestic and perinatal risk factors for the development of small for gestational age in full-term newborns. Statistically significant relationships were revealed between the height parents, the level of education of a woman, a high mother’s weight at birth, a complicated obstetric history, and a low birth weight. According to the results of logistic regression analysis, the most significant factors associated with pregnancy complications (intrauterine growth restriction (OR=13.21 (95 CI 4.87–35.78)), signs of fetal hypoxia (OR=9.20 (95 CI 1.19–70.94)), amnion fluid abnormalities (OR=5.38 (95 CI 1.90–15.23)), weight gain during pregnancy <7 kg (OR=4.50 (95 CI 1.76–11.52)), placental insufficiency (OR=3.87 (95 CI 2.28–6.56)), anemia of pregnant women (OR=2.40 (95 CI 1.37–4.19). The risk factor was involutional-dystrophic changes in the placenta (OR=3.24 (95 CI (1.99–5.26)). In small for gestational age newborns, postnatal adaptation disorders were significantly more frequent. 79.4% of Gr1 children required transfer to the second stages, which significantly exceeded the same indicator in Gr2 (p<0.001), the duration of medical care at the hospitalization stage was longer (p=0.009). Conclusion. The possibility of their use in diagnostic criteria for predicting a given condition is found. Further prospective studies are needed to develop a multidisciplinary approach to clinical practice in small for gestational age newborns.