title: Low birth weight, small for gestational age and preterm births before and after the economic collapse in Iceland: a population based cohort study.
abstract: OBJECTIVE
  Infants born small for gestational age (SGA) or preterm have increased rates of perinatal morbidity and mortality. Stressful events have been suggested as potential contributors to preterm birth (PB) and low birth weight (LBW). We studied the effect of the 2008 economic collapse in Iceland on the risks of adverse birth outcomes.
  
  
  METHODS
  The study population constituted all Icelandic women giving birth to live-born singletons from January 1(st) 2006 to December 31(st) 2009. LBW infants were defined as those weighing <2500 grams at birth, PB infants as those born before 37 weeks of gestation and SGA as those with a birth weight for gestational age more than 2 standard deviations (SD's) below the mean according to the Swedish fetal growth curve. We used logistic regression analysis to estimate odds ratios [OR] and corresponding 95 percent confidence intervals [95% CI] of adverse birth outcomes by exposure to calendar time of the economic collapse, i.e. after October 6(th) 2008.
  
  
  RESULTS
  Compared to the preceding period, we observed an increased adjusted odds in LBW-deliveries following the collapse (aOR = 1.24, 95% CI [1.02, 1.52]), particularly among infants born to mothers younger than 25 years (aOR = 1.85, 95% CI [1.25, 2.72]) and not working mothers (aOR = 1.61, 95% CI [1.10, 2.35]). Similarly, we found a tendency towards higher incidence of SGA-births (aOR = 1.14, 95% CI [0.86, 1.51]) particularly among children born to mothers younger than 25 years (aOR = 1.87, 95% CI [1.09, 3.23]) and not working mothers (aOR = 1.86, 95% CI [1.09, 3.17]). No change in risk of PB was observed. The increase of LBW was most distinct 6-9 months after the collapse.
  
  
  CONCLUSIONS
  The results suggest an increase in risk of LBW shortly after the collapse of the Icelandic national economy. The increase in LBW seems to be driven by reduced fetal growth rate rather than shorter gestation.
authors: Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland.
authors: Védís Helga
authors: VH
authors: Eiríksdóttir
authors: Tinna Laufey
authors: TL
authors: Ásgeirsdóttir
authors: Ragnheiður Ingibjörg
authors: RI
authors: Bjarnadóttir
authors: Robert
authors: R
authors: Kaestner
authors: Sven
authors: S
authors: Cnattingius
authors: Unnur Anna
authors: UA
authors: Valdimarsdóttir
mesh_terms: D000328:Adult; D001724:Birth Weight; D015331:Cohort Studies; D057172:Economic Recession; D005260:Female; D005865:Gestational Age; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D016015:Logistic Models; D008297:Male; D009035:Mothers / Q000523:psychology*; D016017:Odds Ratio; D011247:Pregnancy; D047928:Premature Birth / Q000191:economics* / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D012959:Socioeconomic Factors