Prevalence, characteristics and maternal risk factors of small for gestational age fetuses in a tertiary care center from Kerala

Abstract

Objectives: This study was conducted to determine the prevalence and to understand the maternal characteristics and risk factors of small for gestational age (SGA) fetuses among booked antenatal mothers in the third trimester in a tertiary care hospital. Methods: 250 consecutive booked and singleton mothers at or above 28 weeks gestation were screened for SGA. Those who were diagnosed so, were matched 1:2 ratio with age matched controls and compared. Results: The prevalence of SGA was 13.6% (95% CI 9.4-17.8). Fifty-three percent were in the age group of 20-24 years, 68% were primigravida and 75% of multigravida women had previous history of SGA child. Mothers of SGA fetuses had median BMI of 22.4 kg/m2 and gained 8 kg in pregnancy. Each kilogram gain in pre-pregnancy weight reduces the risk of having SGA fetus by 0.8%. Each earlier week of delivery increased the risk of LBW by 20%. Each gram of low hemoglobin increased the risk of having SGA fetus by 7.6%. Mothers with previous history of SGA had odds of 36 times to have SGA fetus in the current pregnancy. Conclusions: Apart from knowing the prevalence, this study also sheds light into fact that several social, educational and nutritional factors play a role in causation of a SGA fetus. Health policies aimed in improving adolescent health and education could be one of the primary preventive strategies.

Keywords

• fetal growth restriction
• intrauterine growth restriction
• south india