title: Association of maternal pre-pregnancy weight, weight gain during pregnancy, and smoking with small-for-gestational-age infants in Japan.
abstract: OBJECTIVE
  The aim of this study was to evaluate the associations of maternal pre-pregnancy body mass index (BMI), weight gain during pregnancy, and smoking, with small-for-gestational-age (SGA) births among Japanese women.
  
  
  METHODS
  Subjects were pregnant women who gave birth to single, term infants (37-42 weeks) at a clinic and hospital in the Nagasaki area between 2012 and 2013. To examine associations with SGA, 49 underweight (BMI<18.5 kg/m(2)) and 579 normal-weight (18.5 ≤ BMI<25.0 kg/m(2)) Japanese women with either appropriate-for-gestational-age or SGA infants were selected and analyzed.
  
  
  RESULTS
  The prevalence of SGA infants was 6.8%. Seven percent of women were current smokers. Prevalence of pre-pregnancy underweight and gestational weight gain less than recommendation were 20.8% and 16.7%, respectively. Multivariate logistic regression was performed to assess factors affecting SGA infants in the pregnant women. After adjusting for covariates, the amount of maternal weight gain below recommendation (odds ratio (OR), 2.72; 95% confidence interval (CI), 1.37-5.39) and maternal smoking status (OR, 2.80; 95% CI, 1.14-6.91) were significantly and independently associated with SGA births. Pre-pregnancy maternal weight status showed a borderline association (OR, 1.91; 95% CI, 0.96-3.83, p=0.067).
  
  
  CONCLUSIONS
  To prevent SGA births, education regarding the adequate nutrition and the adverse effect of maternal smoking is important for the women of reproductive age.
authors.affiliation: Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Akahoshi
authors.affiliation: Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. Electronic address: kzarima-ngs@umin.ac.jp.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Arima
authors.affiliation: Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Kiyonori
authors.initials: K
authors.lastname: Miura
authors.affiliation: Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nishimura
authors.affiliation: Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Yasuyo
authors.initials: Y
authors.lastname: Abe
authors.affiliation: Department of Reproductive Health, Unit of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Yamamoto
authors.affiliation: Department of Reproductive Health, Unit of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Kazuyo
authors.initials: K
authors.lastname: Oishi
authors.affiliation: Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Masuzaki
authors.affiliation: Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Aoyagi
mesh_terms: D001724:Birth Weight; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000254:growth & development*; D007564:Japan; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D015430:Weight Gain
keywords: Pre-pregnancy weight; Small-for-gestational-age; Smoking; Weight gain during pregnancy