Trend and factors associated with adverse birth weight in Uruguayan children between 2009 and 2015

Pereyra, Isabel; Bustos, Patricia

doi:10.1590/1806-93042020000300009

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ORIGINAL ARTICLES • Rev. Bras. Saude Mater. Infant. 20 (3) • Jul-Sep 2020 • https://doi.org/10.1590/1806-93042020000300009 copy

Trend and factors associated with adverse birth weight in Uruguayan children between 2009 and 2015

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objectives:

to identify trendand factors associated with adverse birth weight.

Methods:

cross-sectional design. The analysis uses the 2009-2015 Uruguay Perinatal Computer Systemdata on 303,625 newborns.

Results:

the prevalence of macrosomia (> 3,999g) has increased from 7.0% to 8.4%. The prevalence of low birth weight (LBW) (< 2,500g) decreased, standing at 6.6% in the last year. The factors that determines more possibilities of LBW were preeclampsia (OR = 4.80; CI95%= 4.57-5.05), inadequate controls (OR = 2.29; CI95%= 2.20-2.39), shorter duration of pregnancy (OR = 2.52; CI95%= 2.50-2.55), previous hypertension (OR = 2.11; CI95%= 1.96-2.27), hypertensive disease of pregnancy (OR = 1.82; CI95%= 1.74-1.90), low prematernal maternal weight (OR = 1.65; CI95%= 1.58-1.74). Macrosomia was associated with type 1 diabetes (OR = 2.21; CI95%= 1.86-2.61), Type 2 or Gestational (OR = 1.78; CI95%= 1.70-1.87), obesity maternal (OR = 2.33; CI95%= 2.24-2.43) and longer gestation duration (OR = 2.62; CI95%= 2.53-2.72).

Conclusions:

the LBW decreases while the macrosomia increases. The health and nutritional status of women at the beginning of pregnancy, pathologies of the last trimester, smoking, shorter duration of pregnancy and inadequate controls are associated with BPN. Overweight, obesity and metabolic diseases determine macrosomia.

Key words:
Birth weight; Pregnancy; Uruguay

	Total population
	N	%
Education level
Primary and lower	72.870	24.0
Secondary and university	231.078	76.0
Smoking habit	56.677	18.6
Inadequate controls	20.943	6.9
Anemia
<20 weeks	14.541	5.5
≥20 weeks	28.082	9.3
Preeclampsia	8.648	3.3
Hypertension before pregnancy	5.903	2.2
Hypertensive disease of pregnancy	20.327	6.7
Bacteriuria	38.822	12.8
DMII and DG	16.435	6.2
Pregestational Nutritional Status N=257.501
Low weight	16.616	6.5
Normal	158.878	61.7
Overweight	53.818	20.9
Obesity	28.189	10.9

	Total population (N=303.625)		Girls (N = 148.841)		Boys (N=154.472)		p
	Median (IQR)		Median (IQR)		Median (IQR)		p
Birth weight (kg)	3.32 (3.00-3.63)		3.26 (2.95-3.56)		3.37 (3.05-3.69)		<0.001^a a U-Mann Whitney Test;
Birth length (cm)	49.0 (47.6-50.3)		49.0 (47.5-50.5)		49.5 (48.0-51.0)		<0.001^a a U-Mann Whitney Test;

	N	%	N	%	N	%
Macrosomia	22.095	7.3	8.510	5.7	14.851	9.6	<0.001 ^b b Pearson's Chi-square.
LBW	21.106	6.9	11.101	7.5	9.917	6.4	<0.001 ^b b Pearson's Chi-square.

	OR crude	CI95%	OR adjusted ^a a Adjustment for age and maternal education;	CI95%	OR adjusted ^b b Adjustment for age, maternal education and year of birth;	CI95%
Mothers characteristics
Tobacco use	1.41	1.36-1.46	1.36	1.32-1.40	1.36	1.32-1.40
Hypertensive disease of pregnancy (HDP)	2.16	2.05-2.28	1.2	1.74-1.90	1.82	1.75-1.90
Preeclampsia	5.13	4.87-5.40	4.80	4.57-5.05	4.80	4.57-5.03
HTA previa	2.25	2.06-2.46	2.11	1.96-2.27	2.11	1.96-2.26
Bacteriuria	1.08	1.03-1.14	1.00	0.96-1.04	1.00	0.97-1.05
Inadequate controls	2.52	2.42-2.62	2.29	2.20-2.39	2.28	2.19-2.37
Pregnancy consultations (n°)^c c Converted to 1 / OR for better presentation.	1.30	1.29-1.31	1.28	1.28-1.29	1.28	1.28-1.30
Low pre-pregnancy maternal weight	1.63	1.55-1.71	1.65	1.58-1.74	1.65	1.57-1.73

Newborns characteristics
Gestation (weeks) ^c c Converted to 1 / OR for better presentation.	2.44	2.42-2.50	2.52	2.50-2.55	2.50	2.50-2.56
Female	1.14	1.10-1.16	1.19	1.16-1.22	1.19	1.16-1.22
Variable interaction
HDP * pregnancy consultations (n°)^c c Converted to 1 / OR for better presentation.	1.02	1.00-1.03	1.01	1.00-1.03	1.01	0.99-1.03
HDP * gestation (weeks) ^c c Converted to 1 / OR for better presentation.	1.07	1.03-1.12	1.07	1.03-1.11	1.07	1.03-1.10
Preeclampsia * pregnancy consultations (n°) ^c c Converted to 1 / OR for better presentation.	1.03	1.01-1.05	1.04	1.01-1.06	1.04	1.01-1.06
Preeclampsia * gestation (weeks) ^c c Converted to 1 / OR for better presentation.	1.04	1.01-1.11	1.05	1.01-1.11	1.04	1.01-1.11

	OR crude	Cl 9 5 %	OR adjusted ^a a Adjustment for age and maternal education;	Cl 9 5 %	OR adjusted ^b b Adjustment for age, maternal education and year of birth;	Cl 9 5%
Mothers characteristics
DM 1	2.37	2.00-2.81	2.21	1.86-2.61	2.20	1.86-2.62
DMII and DG	1.90	1.82-2.00	1.78	1.70-1.87	1.78	1.70-1.87
Overweight pregestational	1.71	1.69-1.81	1.72	1.66-1.78	1.71	1.66-1.77
Obesidad pregestacional	2.39	2.30-2.48	2.33	2.24-2.43	2.32	2.23-2.42
Hypertensive disease of pregnancy (HDP)	1.12	1.06-1.17	1.08	1.03-1.14	1.08	1.03-1.14
HTA previa	1.03	0.93-1.13	0.94	0.85-1.03	0.94	0.85-1.03
Maternal height (cm)	1.05	1.05-1.06	1.05	1.04-1.05	1.05	1.04-1.05
Gestation greater than 40 weeks	2.54	2.45-2.63	2.62	2.53-2.72	2.62	2.53-2.72
Primigravity	1.10	1.01-1.19	1.08	1.00-1.17	1.10	1.00-1.19
Newborn characteristics
Male	1.74	1.69-1.79	1,76	1.71-1.81	1.76	1.71-1.81
Variable interaction
DMI * pregnancy consultations (n°)^c c Converted to 1 / OR for better presentation.	1.10	1.03-1.16	1.10	1.03-1.16	1.09	1.03-1.16
DMII and DG * pregnancy consultations (n°)^c c Converted to 1 / OR for better presentation.	1.11	1.09-1.12	1.11	1.09-1.12	1.11	1.08-1.12
HDP * pregnancy consultations (n°)^c c Converted to 1 / OR for better presentation.	1.05	1.03-1.07	1.04	1.03-1.07	1.05	1.02-1.07

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[1] Author’s contribution

Pereyra I designed the study, performed the literature review, analyzed the data and wrote the manuscript. Bustos P assisted in the interpretation of the data and participated in the writing and editing of the manuscript. All authors approved the final version of the article.