RISK-FACTORS FOR SMALL-FOR-GESTATIONAL-AGE BIRTH IN A PRETERM POPULATION

OBJECTIVE: The objective of this study was to discover any distinct risk factors for small-for-gestational-age birth among premature infants. STUDY DESIGN: Demographic and obstetric risk factors were compared for 136 small-for-gestational-age prematures and 636 appropriate-for-gestational-age premature infants. RESULTS: Three significant risk factors for growth retardation among premature infants were found: black maternal race (odds ratio 2.2; 95% confidence interval (1.4 to 3.5); maternal toxemia (odds ratio 3.2; 95% confidence interval 1.7 to 6.1); and either low maternal weight gain (odds ratio 4.0; 95% confidence interval 1.8 to 8.8) or missing information on maternal weight gain, which could be a marker for late or no prenatal care (odds ratio 4.9; 95% confidence interval 1.9 to 12.6). Maternal smoking rates were similar in the small- and appropriate-for-gestational-age groups (42% and 43%, respectively). CONCLUSIONS: Toxemia, weight gain, and race are likely risk factors for small-for-gestational-age birth in both preterm and term populations; within the already high-risk domain of prematurity, maternal smoking did not appear to confer added risk for small-for-gestational-age birth.