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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2016

Open Access 01-12-2016 | Research article

Risk factors for small-for-gestational-age and preterm births among 19,269 Tanzanian newborns

Authors: Alfa Muhihi, Christopher R. Sudfeld, Emily R. Smith, Ramadhani A. Noor, Salum Mshamu, Christina Briegleb, Mohamed Bakari, Honorati Masanja, Wafaie Fawzi, Grace Jean-Yee Chan

Published in: BMC Pregnancy and Childbirth | Issue 1/2016

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Abstract

Background

Few studies have differentiated risk factors for term-small for gestational age (SGA), preterm-appropriate for gestational age (AGA), and preterm-SGA, despite evidence of varying risk of child mortality and poor developmental outcomes.

Methods

We analyzed birth outcome data from singleton infants, who were enrolled in a large randomized, double-blind, placebo-controlled trial of neonatal vitamin A supplementation conducted in Tanzania. SGA was defined as birth weight <10th percentile for gestation age and sex using INTERGROWTH standards and preterm birth as delivery at <37 complete weeks of gestation. Risk factors for term-SGA, preterm-AGA, and preterm-SGA were examined independently using log-binomial regression.

Results

Among 19,269 singleton Tanzanian newborns included in this analysis, 68.3 % were term-AGA, 15.8 % term-SGA, 15.5 % preterm-AGA, and 0.3 % preterm-SGA. In multivariate analyses, significant risk factors for term-SGA included maternal age <20 years, starting antenatal care (ANC) in the 3rd trimester, short maternal stature, being firstborn, and male sex (all p < 0.05). Independent risk factors for preterm-AGA were maternal age <25 years, short maternal stature, firstborns, and decreased wealth (all p < 0.05). In addition, receiving ANC services in the 1st trimester significantly reduced the risk of preterm-AGA (p = 0.01). Significant risk factors for preterm-SGA included maternal age >30 years, being firstborn, and short maternal stature which appeared to carry a particularly strong risk (all p < 0.05).

Conclusion

Over 30 % of newborns in this large urban and rural cohort of Tanzanian newborns were born preterm and/or SGA. Interventions to promote early attendance to ANC services, reduce unintended young pregnancies, increased maternal height, and reduce poverty may significantly decrease the burden of SGA and preterm birth in sub-Saharan Africa.

Trial registration

Australian New Zealand Clinical Trials Registry (ANZCTR) – ACTRN12610000636​055, registered on 3rd August 2010.
Appendix
Available only for authorised users
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Metadata
Title
Risk factors for small-for-gestational-age and preterm births among 19,269 Tanzanian newborns
Authors
Alfa Muhihi
Christopher R. Sudfeld
Emily R. Smith
Ramadhani A. Noor
Salum Mshamu
Christina Briegleb
Mohamed Bakari
Honorati Masanja
Wafaie Fawzi
Grace Jean-Yee Chan
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2016
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-016-0900-5

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