Short Maternal Stature Increases Risk of Small-for-Gestational-Age and Preterm Births in Low-and Middle-Income Countries: Individual Participant Data Meta-Analysis and Population Attributable Fraction

卷:145

Kozuki, Naoko ; Katz, Joanne ; Lee, Anne C. C. ; Vogel, Joshua P. ; Silveira, Mariangela F. ; Sania, Ayesha ; Stevens, Gretchen A. ; Cousens, Simon ; Caulfield, Laura E. ; Christian, Parul ; Huybregts, Lieven ; Roberfroid, Dominique ; Schmiegelow, Christentze ; Adair, Linda S. ; Barrosi, Fernando C. ; Cowan, Melanie ; Fawzi, Wafaie ; Kolsteren, Patrick ; Merialdi, Mario ; Mongkolchati, Aroonsri ; Saville, Naomi ; Victora, Cesar G. ; Bhutta, Zulfiqar A. ; Blencowe, Hannah ; Ezzati, Majid ; Lawn, Joy E. ; Black, Robert E.

关键词: small-for-gestational-age;    chronic malnutrition;    neonatal health;    maternal health;    maternal height;   

DOI  :  10.3945/jn.115.216374

学科分类：食品科学和技术

【 摘 要 】

Background: Small-for-gestational-age (SGA) and preterm births are associated with adverse health consequences, including neonatal and infant mortality, childhood undernutrition, and adulthood chronic disease. Objectives: The specific aims of this study were to estimate the association between short maternal stature and outcomes of SGA alone, preterm birth alone, or both, and to calculate the population attributable fraction of SGA and preterm birth associated with short maternal stature. Methods: We conducted an individual participant data meta-analysis with the use of data sets from 12 population-based cohort studies and the WHO Global Survey on Maternal and Perinatal Health 113 of 24 available data sets used) from low-and middle-income countries (LMIC). We included those with weight taken within 72 h of birth, gestational age, and maternal height data (n = 177,000). For each of these studies, we individually calculated RRs between height exposure categories of <145 cm, 145 to <150 cm, and 150 to <155 cm (reference: >= 155 cm) and outcomes of SGA, preterm birth, and their combination categories. SGA was defined with the use of both the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) birth weight standard and the 1991 US birth weight reference. The associations were then meta-analyzed. Results: All short stature categories were statistically significantly associated with term SGA, preterm appropriate-for-gestational-age (AGA), and preterm SGA births (reference: term AGA). When using the INTERGROVVTH-21st standard to define SGA, women <145 cm had the highest adjusted risk ratios (aRRs) (term SGA-aRR: 2.03; 95% CI: 1.76, 2.35;