Stunting at 5 Years Among SGA Newborns

Abstract

Objective: To compare risk of stunting at 5 years across etiological subgroups of small for gestational age (SGA) newborns.

Methods: We analyzed data of a subsample (N = 1100) of the Early Childhood Longitudinal Study-Birth Cohort. We defined SGA as birth weight <10th percentile, then classified subjects into etiological subgroups by each of 8 risk factors (ie, maternal prepregnancy underweight, short stature, smoking during pregnancy, alcohol use during pregnancy, inadequate gestational weight gain [GWG], hypertension, genital herpes infection, and multiple births) or by cooccurrence of 2 often intertwined risk factors (smoking and inadequate GWG). We defined stunting as 5 years height-for-age z score below -2. We fitted logistic regression models to test whether the risk of stunting differed across SGA subgroups, adjusting for confounders.

Results: SGA subgroup with maternal short stature (odds ratio [OR] = 3.88; 95% confidence interval [CI] = 2.16-6.96) or inadequate GWG (OR = 2.18; 95% CI = 1.23-3.84) had higher risk of stunting at 5 years, compared with the SGA subgroup without the corresponding risk factor. SGA newborns with both maternal smoking and inadequate GWG during pregnancy had much higher risk of stunting at 5 years (OR = 3.10; 95% CI = 1.21-7.91), compared with SGA newborns without any of these 2 SGA risk factors.

Conclusions: Etiological subgroups of SGA differed in risk of stunting at 5 years. SGA newborns of inadequate GWG mothers who smoke and SGA newborns of short mothers were at particularly high risk of stunting.