Pre-pregnancy risk factors of small-for-gestational age births among parous women in Scandinavia.

To study the etiology and consequences of intrauterine growth retardation (IUGR), a prospective study was organized by the National Institute of Child Health and Human Development, NIH, with the Universities of Trondheim and Bergen in Norway, Uppsala in Sweden, and Alabama in the United States. This paper reports on the Scandinavian portion of the study. 6,354 women were referred to the study and 5,722 women, who were expecting their second or third child between January 1986 and March 1988, were eligible and made their first appointment for the study. Of these, 1,945 women and their births were selected for follow-up at four prenatal visits, delivery, and during the first year of life. This report analyzes the relative impact of various maternal pre-pregnancy risk factors associated with SGA birth. For example, mothers who smoked cigarettes around the time of conception, but who had none of the other major risk factors, nearly doubled their risk of SGA birth. A previous low birth weight (LBW) delivery increased the risk nearly two and a half times among non-smokers. If a mother both smoked and had a previous LBW, the relative risk rose to nearly five and a half. Low maternal pre-pregnancy weight (< 50 kg) increased the risk of SGA birth almost twofold among non-smokers, while low pre-pregnancy weight and smoking together increased the risk of SGA birth fourfold. A low weight mother who smoked and also had a previous LBW delivery, had a risk of SGA birth that was nearly six times that of a mother without those characteristics.