title: Impact of individual and ecological characteristics on small for gestational age births: an observational study in Quebec.
abstract: BACKGROUND
  We evaluated associations between ecological variables and the risk of very small for gestational age (VSGA) birth in Quebec in 2000-2008.
  
  
  METHODS
  Ecological variables came from the Canadian Community Health Survey, the Canadian census and Quebec's birth registry; individual variables also came from Quebec's birth registry. Odds ratios (ORs) adjusted for mother's age, academic qualification, parity, marital status and country of birth were estimated using multilevel logistic regression (generalized estimating equations method).
  
  
  RESULTS
  Births in neighbourhoods with a high proportion of people leading a sedentary lifestyle (OR: 1.07, 95% confidence interval [CI]: 1.01-1.11) and those with a high/middle proportion of residents with food insecurity (OR: 1.09, 95% CI: 1.05-1.15; OR: 1.05, 95% CI: 1.01-1.11) had higher odds of VSGA birth. Those with middle proportion of married residents had lower odds of VSGA birth (OR: 0.94, 95% CI: 0.90-0.98).
authors.affiliation: Department of Social and Preventive Medicine, Université Laval, Québec, Quebec, Canada; Institut national de santé publique du Québec, Québec, Quebec, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Savard
authors.affiliation: Department of Social and Preventive Medicine, Université Laval, Québec, Quebec, Canada; Institut national de santé publique du Québec, Québec, Quebec, Canada; Centre hospitalier universitaire du Québec, Québec, Quebec, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Levallois
authors.affiliation: Department of Mathematics and Statistics, Université Laval, Québec, Quebec, Canada.
authors.forename: L P
authors.initials: LP
authors.lastname: Rivest
authors.affiliation: Institut national de santé publique du Québec, Québec, Quebec, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Gingras
mesh_terms: D000328:Adult; D001724:Birth Weight; D016001:Confidence Intervals; D004522:Educational Status; D005260:Female; D005865:Gestational Age; D015438:Health Behavior; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D008423:Maternal Age; D015999:Multivariate Analysis; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D011792:Quebec; D012189:Retrospective Studies; D018570:Risk Assessment; D057185:Sedentary Behavior; D012931:Social Environment; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: birth weight; fetal health; food insecurity; health behaviour; reproductive health; sedentary lifestyle; social epidemiology