Country of origin, social support and the risk of small for gestational age birth

This study investigates the risk of small for gestational age (SGA) in relation to country of origin of the mother. The of psychosocial resources, socioeconomic and lifestyle factors was examined in different causal models. Methods: all pregnant nulliparous women in the city of Malmo", Sweden, who gave birth in 1991-92, 872 (87.7%) women a questionnaire during their first antenatal visit. The study was carried out among women whose pregnancies in a singleton live birth (n = 826); 22% (n = 182) of these women were foreign-born. Results: Fifty-five (6.7%) of the were classified as SGA, 37 ( 5.7%) of mothers of Swedish origin and 18 ( 9.7%) of foreign origin. SGA deliveries were more prevalent among Middle East-and North Africa-born women ( 22%) and sub-Saharan-born women (15%). In women of foreign origin had increased odds for delivering SGA babies (OR = 1.8, 95% CI = 1.0,3.2). In a multivariate psychosocial and socioeconomic factors explained 30% and 40%, respectively, of the increased SGA risk. factors seemed to be more prominent risk factors for SGA among mothers of foreign origin. A possible relation was demonstrated between foreign origin of the mother and low social anchorage. Conclusions: This showed that psychosocial factors, most probably linked to a disadvantaged social situation, could be the theoretically important focus for preventing SGA in immigrant women. This could also further support a hypothesis of a link psychosocial stress and SGA in general. However, this should not exclude the need for intervention in the antenatal system in terms of specially tailored support and education.