ESPE Abstracts (2014) 82 LBP-D--3-1003

Increasing Incidence of Infants Born Small and Large for Gestational Age Over 20 Years

Valentina Chiavarolia, Valeria Castorania, Paola Guidonea, Ilaria Di Giovannia, Marco Liberatia, Francesco Chiarellib & Angelika Mohna


aDepartment of Paediatrics, University of Chieti, Chieti, Italy; bDepartment of Obstetrics and Gynecology, University of Chieti, Chieti, Italy


Background: Infants born small (SGA) and large (LGA) for gestational age have been identified at increased risk of perinatal morbidity and later cardio-metabolic alterations. Nevertheless, the progression over time in incidence of SGA and LGA births is yet to be determined.

Objective and hypotheses: To investigate temporal trends in SGA and LGA infants compared to those born appropriate (AGA), and to identify factors potentially associated over a 20-year period.

Method: A population-based cohort of Caucasian infants born between January 1993 and December 2013 was evaluated. Infants with birth weight and/or length <10th percentile were defined SGA, and those >90th percentile LGA. Incidence rates were compared at 5-year intervals (1993, 1998, 2003, 2008, 2013). Logistic regression was used to identify factors associated with SGA and LGA.

Results: A total of 5533 infants were born in 5-year eras from 1993 to 2013. SGA and LGA incidence increased respectively from 87 and 106 per 1000 live births in 1993 to 137 and 134 per 1000 births in 2013 (Table 1). A temporal change was detected over 20 years in SGA (P=0.003) and LGA (P=0.0003) rates. Maternal height and gestational weight gain were associated with SGA birth, whereas maternal height, pre-pregnancy BMI and gestational weight gain with LGA birth.

Table 1 Annual number of AGA, SGA and LGA births.
1993 (n=857)1998 (n=862)2003 (n=1027)2008 (n=1570)2013 (n=1217)
AGA (%)691 (80.6)697 (80.9)765 (74.5)1151 (73.3)887 (72.9)
SGA (%)75 (8.8)81 (9.4)128 (12.5)153 (9.8)167 (13.7)
LGA (%)91 (10.6)84 (9.7)134 (13.0)266 (16.9)163 (13.4)

Conclusion: SGA and LGA births have substantially increased over the last 20 years, in association with and possibly as consequence of changes in maternal outcomes.

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