Incidence of infants born small- and large-for-gestational-age in an Italian cohort over a 20-year period and associated risk factors.
BACKGROUND
We assessed the incidence of infants born small-for-gestational-age (SGA) and large-for-gestational-age (LGA) in an Italian cohort over 20 years (1993-2013). Furthermore, we investigated maternal factors associated with SGA and LGA births.


METHODS
A retrospective review of obstetric records was performed on infants born in Chieti (Italy) covering every 5(th) year over a 20-year period, specifically examining data for 1993, 1998, 2003, 2008, and 2013. Infants with birthweight <10(th) percentile were defined as SGA, and those with birthweight >90(th) percentile as LGA. Data collected included newborn anthropometry, birth (multiple vs singleton), maternal anthropometry, previous miscarriage, gestational diabetes, hypertension, and smoking during pregnancy.


RESULTS
There were a pooled total of 5896 live births recorded across the 5 selected years. The number of SGA (+60.6 %) and LGA (+90.2 %) births increased considerably between 1993 and 2013. However, there were no marked changes in the incidence of SGA or LGA births (8.3 % and 10.8 % in 1993 versus 7.6 % and 11.7 % in 2013, respectively). Maternal factors associated with increased risk of SGA infants included hypertension, smoking, and previous miscarriage (all p < 0.05), while greater pre-pregnancy BMI and gestational diabetes were risk factors for LGA births (all p < 0.05).


CONCLUSIONS
There was an increase in the number of SGA and LGA births in Chieti over the last two decades, but there was little change in incidence over time. Most maternal factors associated with increased odds of SGA and LGA births were modifiable, thus incidence could be reduced by targeted interventions.
Department of Paediatrics, University of Chieti, Via dei Vestini 5, 66100, Chieti, Italy. valentinachiavaroli@hotmail.it.|Center of Excellence on Aging, "G. d'Annunzio" University Foundation, University of Chieti, Chieti, Italy. valentinachiavaroli@hotmail.it.
Valentina
V
Chiavaroli
Department of Paediatrics, University of Chieti, Via dei Vestini 5, 66100, Chieti, Italy.
Valeria
V
Castorani
Department of Paediatrics, University of Chieti, Via dei Vestini 5, 66100, Chieti, Italy.
Paola
P
Guidone
Liggins Institute, University of Auckland, Auckland, New Zealand.
José G B
JG
Derraik
Department of Obstetrics and Gynaecology, University of Chieti, Chieti, Italy.
Marco
M
Liberati
Department of Paediatrics, University of Chieti, Via dei Vestini 5, 66100, Chieti, Italy.|Center of Excellence on Aging, "G. d'Annunzio" University Foundation, University of Chieti, Chieti, Italy.
Francesco
F
Chiarelli
Department of Paediatrics, University of Chieti, Via dei Vestini 5, 66100, Chieti, Italy.|Center of Excellence on Aging, "G. d'Annunzio" University Foundation, University of Chieti, Chieti, Italy.
Angelika
A
Mohn
D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007558:Italy / Q000453:epidemiology; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors
Birth length; Birth weight; Gestational diabetes; Incidence; LGA; Obesity; SGA; Smoking