Low Birth Weight, Small for Gestational Age and Preterm Births before and after the Economic Collapse in Iceland: A Population Based Cohort Study

Abstract

ObjectiveInfants born small for gestational age (SGA) or preterm have increased rates of perinatal morbidity and mortality. Stressful events have been suggested as potential contributors to preterm birth (PB) and low birth weight (LBW). We studied the effect of the 2008 economic collapse in Iceland on the risks of adverse birth outcomes.Study designThe study population constituted all Icelandic women giving birth to live-born singletons from January 1st 2006 to December 31st 2009. LBW infants were defined as those weighing <2500 grams at birth, PB infants as those born before 37 weeks of gestation and SGA as those with a birth weight for gestational age more than 2 standard deviations (SD's) below the mean according to the Swedish fetal growth curve. We used logistic regression analysis to estimate odds ratios [OR] and corresponding 95 percent confidence intervals [95% CI] of adverse birth outcomes by exposure to calendar time of the economic collapse, i.e. after October 6th 2008.ResultsCompared to the preceding period, we observed an increased adjusted odds in LBW-deliveries following the collapse (aOR = 1.24, 95% CI [1.02, 1.52]), particularly among infants born to mothers younger than 25 years (aOR = 1.85, 95% CI [1.25, 2.72]) and not working mothers (aOR = 1.61, 95% CI [1.10, 2.35]). Similarly, we found a tendency towards higher incidence of SGA-births (aOR = 1.14, 95% CI [0.86, 1.51]) particularly among children born to mothers younger than 25 years (aOR = 1.87, 95% CI [1.09, 3.23]) and not working mothers (aOR = 1.86, 95% CI [1.09, 3.17]). No change in risk of PB was observed. The increase of LBW was most distinct 6–9 months after the collapse.ConclusionThe results suggest an increase in risk of LBW shortly after the collapse of the Icelandic national economy. The increase in LBW seems to be driven by reduced fetal growth rate rather than shorter gestation.

Pregnancy complications, sick leave and service needs of women who experience perinatal distress, weak social support and dissatisfaction in their partner relationships

“…Perinatal distress was found to be a significant predictor of pelvic girdle pain, consistent with other studies (13,36). Twenty-seven of our participants (5.4%) developed PIH, which is less than the percentage (6.47%) reported in a large Icelandic population-based study (37). Further, in our study, women in the PDG were less likely than those in the NDG to experience PIH.…”

Child health in Iceland before and after the economic collapse in 2008

“…The economic crisis has had no discernible impact on maternal, perinatal, neonatal, infant or child mortality rates 19 34 35. To evaluate the impact of the economic collapse on birth outcome, all singleton births of Icelandic women in the period 2008–2009 were analysed in quartiles for that period 36. The incidence of low-birth weight increased significantly only for women giving birth in the period between April and June 2009, that is, about 6–9 months after the bank collapse.…”

Maternal Prepregnancy Body Mass Index and Small for Gestational Age Births in Chinese Women

“…Chief among these is preterm birth, low birthweight (LBW), and small for gestational age (SGA). SGA refers to babies born with a birthweight less than the tenth percentile for their gestational age and gender; these babies are at higher risk of perinatal morbidity and mortality, and survivors are at increased risk of adult diabetes and cardiovascular disease than those born with appropriate for gestational age births . Maternal age, education, parity, smoking, hypertension and preeclampsia, maternal height, prepregnancy weight and weight gain during pregnancy have all been associated with SGA …”