Trends and predictors of birth weight in Chilean children.

Abstract

OBJECTIVES\nBirth weight is an important public health indicator that reflects fetal health conditions and predicts future health. Identifying the most important factors related to birth weight would help defining preventive health strategies for both mothers and children. The objectives of this study are i. to describe, using a large birth database from a Chilean hospital, the trend of birth weight during 2002-2015, and ii. to determine factors during prenatal care associated with low and high birth weight.\n\n\nSTUDY DESIGN\nThis study is a secondary analysis of all single birth records at a Chilean Hospital in the southeast district of Santiago, Chile, during 2002-2015 (N\xa0=\xa078,931).\n\n\nMETHODS\nSociodemographic information, clinical and obstetric history, lifestyle, and anthropometric variables were evaluated as potential predictors. Birth weight was categorized into five groups as per percentiles of weight as per gestational age. Data were extracted from clinical records. We used classification and regression tree methodology and logistic regression.\n\n\nRESULTS\nThe average birth weight for the period was 3316\xa0g (SD 566), with little variation across time. Preterm births increased from 7% in 2002 to 10% in 2015, and births >40 weeks decreased from 10.7% in 2002 to 4.4% in 2015. The percentages of small and large for gestational age changed from 10.9% and 12.7% in 2002 to 9.9% and 13.9% in 2015, respectively. The predictors included in the optimal tree were body mass index, gestational weight gain, pre-eclampsia, and gestational diabetes. We found that women with a pregestational body mass index <28\xa0kg/m2, gestational weight gain <17\xa0kg, and preeclampsia had a probability of 41% of having a small for gestational age neonate. Conversely, women with a body mass index ≥28\xa0kg/m2, gestational weight gain ≥17\xa0kg, and gestational diabetes had a probability of 44% of having a large for gestational age neonate.\n\n\nCONCLUSIONS\nThis study showed that the most important variables explaining birth weight are those related to maternal nutritional status. Thus, the strategies to promote a normal birth weight should aim for a normal maternal weight at the beginning of pregnancy, gestational weight gain within the recommendations, and prevention of gestational diabetes and pre-eclampsia.