title: Country of origin, social support and the risk of small for gestational age birth.
abstract: OBJECTIVE
  This study investigates the risk of small for gestational age (SGA) in relation to country of origin of the mother. The role of psychosocial resources, socioeconomic and lifestyle factors was examined in different causal models.
  
  
  METHODS
  Among all pregnant nulliparous women in the city of Malmö, Sweden, who gave birth in 1991--92, 872 (87.7%) women completed a questionnaire during their first antenatal visit. The study was carried out among women whose pregnancies resulted in a singleton live birth (n = 826); 22% (n = 182) of these women were foreign-born.
  
  
  RESULTS
  Fifty-five (6.7%) of the infants were classified as SGA, 37 (5.7%) of mothers of Swedish origin and 18 (9.7%) of foreign origin. SGA deliveries were much more prevalent among Middle East- and North Africa-born women (22%) and sub-Saharan-born women (15%). In all, women of foreign origin had increased odds for delivering SGA babies (OR = 1.8, 95% CI = 1.0,3.2). In a multivariate analysis psychosocial and socioeconomic factors explained 30% and 40%, respectively, of the increased SGA risk. Psychosocial factors seemed to be more prominent risk factors for SGA among mothers of foreign origin. A possible synergistic relation was demonstrated between foreign origin of the mother and low social anchorage.
  
  
  CONCLUSIONS
  This study showed that psychosocial factors, most probably linked to a disadvantaged social situation, could be the theoretically most important focus for preventing SGA in immigrant women. This could also further support a hypothesis of a link between psychosocial stress and SGA in general. However, this should not exclude the need for intervention in the antenatal care system in terms of specially tailored support and education.
authors.affiliation: Department of Nursing, School of Health and Society, Malmö University, Sweden. elisabeth.dejin-karlsson@hs.mah.se
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Dejin-Karlsson
authors.forename: Per-Olof
authors.initials: PO
authors.lastname: Ostergren
mesh_terms: D000328:Adult; D001724:Birth Weight; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D008019:Life Style; D011247:Pregnancy; D037841:Pregnant People / Q000208:ethnology*; D012307:Risk Factors; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology / Q000208:ethnology