title: Maternal and placental risk factors for light-for-gestational-age births.
abstract: OBJECTIVE
  We conducted a cross-sectional study to investigate risk factors for births of light-for-gestational-age (LGA) infants.
  
  
  METHODS
  A survey was conducted at the Department of Obstetrics and Gynecology at Sapporo Medical University Hospital in Sapporo, Japan from 2013 to 2014. LGA and appropriate for gestational age (AGA) are defined as having a birthweight below the 10th percentile and between the 10th percentile and 90th percentile for gestational age at birth in the population standard of gestational age, sex, and parity, respectively. An odds ratio (OR) and its 95% confidence interval (95%CI) for LGA were calculated by analysis using the logistic regression model.
  
  
  RESULTS
  In total, 307 inpatients (94.2%) participated in the study out of 326 consecutive post-partum inpatients. Among them, 37 infants and 237 infants were classified into the LGA and AGA groups, respectively. As a result of multivariable analysis, prevalence of gestational hypertension (OR = 8.96, 95%CI 1.81-44.35) and the presence of placental infarction (OR = 9.65, 95%CI 1.76-53.01) were significantly associated with an increased risk of LGA. Placentas weighing 510-603 g and ≥604 g were significantly associated with reduced risk of LGA (OR = 0.04, 95%CI 0.01-0.29 and OR = 0.03, 95%CI 0.01-0.32, respectively), and higher placental weights were significantly observed in the trend for reduced LGA risk (P for trend < 0.001).
  
  
  CONCLUSIONS
  We found that the prevalence of gestational hypertension, lower placental weight, and the presence of placental infarctions were all independently associated with the risk of LGA. Placental abnormalities may be etiologically important for LGA risk, though further research is necessary.
authors.affiliation: Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Aoyama
authors.affiliation: Department of Obstetrics and Gynecology, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Endo
authors.affiliation: Department of Obstetrics and Gynecology, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Saito
authors.affiliation: Department of Nursing, Sapporo Medical University School of Health Sciences, Sapporo, Japan.
authors.forename: Hisako
authors.initials: H
authors.lastname: Izumi
authors.affiliation: Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Sumiyo
authors.initials: S
authors.lastname: Asakura
authors.affiliation: Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Mori
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology*; D007230:Infant, Low Birth Weight; D007238:Infarction / Q000453:epidemiology; D000068097:Maternal Health; D009929:Organ Size; D010922:Placenta Diseases / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012307:Risk Factors
keywords: cross-sectional study; gestational hypertension; light for gestational age; multivariable analysis; placental infarction; weight of placenta