Background
Methods
Data and population
Ethical approval
Variables and definitions
Statistical analyses
Results
Characteristic% or Mean (±SD) | SGA, n = 42,702 (3.1%) | Not SGA, n = 1,347,463 | p value |
---|---|---|---|
Mean maternal age (±SD) (years) | 29.0 (±5.8) | 29.1 (±5.3) | ≤0.001 |
≤19 | 4.2 | 2.7 | ≤0.001 |
20 − 29 | 50.5 | 51.5 | |
30 − 39 | 41.2 | 42.8 | |
≥40 | 4.1 | 3.0 | |
Primiparous women | 59.6 | 40.6 | ≤0.001 |
Multiparous women | 40.4 | 59.4 | |
Mean gestational age (weeks) | 38.5 (±3.1) | 39.8 (±1.7) | ≤0.001 |
<28 | 1.9 | 0.2 | |
28 − 31 + 6 | 2.9 | 0.4 | |
32 − 36 + 6 | 12.7 | 3.5 | |
37 − 39 + 6 | 47.1 | 42.3 | |
40 − 41 + 6 | 32.5 | 48.8 | |
>42 | 2.9 | 4.8 | |
Mode of delivery
| |||
Vaginal delivery | 63.0 | 78.8 | ≤0.001 |
Breech | 1.0 | 0.4 | |
Forceps | 0.1 | 0.1 | |
Vacuum assistance | 5.4 | 5.9 | |
Cesarean section | 30.5 | 14.7 | |
Girl | 48.5 | 48.9 | 0.17 |
Boy | 51.5 | 51.1 | |
Mean birthweight (±SD) (grams) | 2372.3 (±518.2) | 3590.4 (±514.4) | ≤0.001 |
Region (n = 20) range in 1987 − 2010 | 3.1 (2.9 − 3.4) | 96.9 (96.6 − 97.1) | ≤0.001 |
Time periods | |||
1987 − 1991 | 3.0 | 97.0 | ≤0.001 |
1992 − 1996 | 2.9 | 97.1 | |
1997 − 2001 | 3.1 | 96.9 | |
2002 − 2006 | 3.1 | 96.9 | |
2007 − 2010 | 3.3 | 96.7 |
Characteristic% or Mean (±SD) | SGA, n = 42,702 (3.1%) | Not SGA, n = 1,347,463 | p value |
---|---|---|---|
Pregravid BMIa | ≤0.001 | ||
≤24.9 | 72.8 | 66.9 | |
25–29.9 | 17.8 | 21.6 | |
≥30 | 9.4 | 11.5 | |
Non-smoking | 71.1 | 84.9 | ≤0.001 |
Quitted smoking | 4.5 | 3.5 | |
Smoking | 24.3 | 11.6 | |
Married or cohabiting | 93.7 | 95.9 | ≤0.001 |
Mean number of deliveries (±SD) | 0.71 (±1.22) | 1.04 (±1.35) | ≤0.001 |
Mean number of pregnancies (±SD) | 1.18 (±1.63) | 1.48 (±1.70) | ≤0.001 |
Mean number of miscarriages (±SD) | 0.26 (±0.65) | 0.26 (±0.61) | 0.72 |
Mean number of prior terminations (±SD) | 0.14 (±0.45) | 0.12 (±0.41) | ≤0.001 |
IVFb | 1.3 | 1.1 | 0.001 |
Anemia ≤ 100 g/l | 0.6 | 0.6 | 0.28 |
Prior Cesarean section | 7.6 | 8.4 | ≤0.001 |
Chorionic villus biopsy | 1.1 | 0.9 | ≤0.001 |
Amniocentesis | 3.9 | 2.7 | ≤0.001 |
Placenta previa | 0.3 | 0.2 | ≤0.001 |
Placental abruption | 0.6 | 0.2 | ≤0.001 |
Induction | 18.8 | 13.3 | ≤0.001 |
Congenital anomalies | 8.7 | 2.8 | ≤0.001 |
Socioeconomic status | |||
Upper white-collar worker | 5.5 | 6.7 | ≤0.001 |
Lower white-collar worker | 31.2 | 32.6 | |
Blue-collar worker | 15.9 | 13.6 | |
Other | 19.5 | 19.8 | |
Missing | 27.9 | 27.2 |
Number | Hospital district | Number of births, n | % Prevalence of SGA (range in 1987–2010) | p value |
---|---|---|---|---|
1 | South Karelia | 31,106 | 3.3 (2.6 − 3.6) | ≤0.001 |
2 | South Ostrobothnia | 53,413 | 2.4 (2.2 − 2.7) | |
3 | South Savo | 25,525 | 3.1 (3.0 − 3.6) | |
4 | Helsinki and Uusimaa | 397,593 | 3.3 (3.2 − 3.4) | |
5 | East Savo | 10,384 | 3.7 (2.8 − 4.3) | |
6 | Kainuu | 20,602 | 3.4 (3.0 − 4.0) | |
7 | Kanta-Häme | 42,501 | 3.2 (2.9 − 3.4) | |
8 | Middle Ostrobothnia | 21,987 | 2.7 (2.4 − 3.6) | |
9 | Central Finland | 69,985 | 2.9 (2.6 − 3.2) | |
10 | Kymenlaakso | 41,486 | 3.2 (2.9 − 3.9) | |
11 | Lapland | 32,010 | 3.8 (3.5 − 4.8) | |
12 | Länsi-Pohja | 17,950 | 3.2 (2.5 − 3.3) | |
13 | Pirkanmaa | 115,602 | 2.8 (2.5 − 2.9) | |
14 | North Karelia | 43,296 | 3.2 (2.9 − 3.7) | |
15 | Northern Ostrobothnia | 121,927 | 3.1 (2.9 − 3.3) | |
16 | North Savo | 62,892 | 3.4 (3.1 − 3.9) | |
17 | Päijät-Häme | 51,397 | 3.2 (2.7 − 3.9) | |
18 | Satakunta | 60,444 | 2.8 (2.4 − 3.3) | |
19 | Vaasa | 42,718 | 2.4 (2.2 − 2.9) | |
20 | Varsinais-Suomi | 112,131 | 2.7 (2.3 − 3.2) | |
Total | 1,374,458 | 3.1 (2.9 − 3.4) |
Characteristic/risk factors | Unadjusted OR | Adjusted OR |
---|---|---|
Maternal age (years) | ||
≤19 | 1 | 1 |
20-29 | 0.63 (0.60–0.67) | 1.08 (1.04–1.18)** |
30-39 | 0.62 (0.59–0.65) | 1.37 (1.28–1.46)*** |
≥40 | 0.87 (0.81–0.94) | 1.82 (1.66–1.99)*** |
Primiparity | 2.20 (2.15–2.24) | 2.41 (2.33-2.48)*** |
Gestational age (weeks) | ||
<28 | 7.30 (6.70–7.95) | 6.26 (5.65–6.93)*** |
28 − 31 + 6 | 7.35 (6.85–7.89) | 5.90 (5.43–6.40)*** |
32 − 36 + 6 | 3.17 (3.06–3.28) | 2.74 (2.63–2.84)*** |
37 − 39 + 6 | 1 | 1 |
40 − 41 + 6 | 0.59 (0.58–0.61) | 0.59 (0.58–0.61)*** |
>42 | 0.51 (0.47–0.54) | 0.44 (0.41–0.47)*** |
Pregravid BMIa | ||
≤24.9 | 1.32 (1.24–1.41) | 1.38 (1.28–1.48)*** |
25-29.9 | 1.00 (0.93–1.08) | 1.06 (0.98–1.15) |
≥30 | 1 | 1 |
Smoking status | ||
Non-smoking | 1 | 1 |
Quitted smoking | 1.28 (1.20 − 1.36) | 1.07 (1.00 − 1.15)* |
Smoking | 2.45 (2.39–2.51) | 2.34 (2.28–2.42)*** |
Single marital status | 1.58 (1.51–1.64) | 1.09 (1.04–1.15)*** |
Socioeconomic status (SES) | ||
Upper white-collar workers | 1 | 1 |
Lower white-collar workers | 1.16 (1.11–1.21) | 1.11 (1.06–1.17)*** |
Blue-collar workers | 1.42 (1.35–1.49) | 1.24 (1.17–1.30)*** |
Other | 1.19 (1.14–1.25) | 1.13 (1.07–1.19)*** |
Missing | 1.36 (1.29 − 1.43) | 1.15 (1.08 − 1.21)*** |
Prior pregnancies (number) | 0.88 (0.87–0.89) | 0.98 (0.97–0.99)*** |
Prior terminations (number) | 1.11 (1.08–1.13) | 1.00 (0.97–1.03) |
IVFb | 1.19 (1.07–1.32) | 0.83 (0.74–0.92)*** |
Chorionic villus biopsy | 1.22 (1.11–1.34) | 1.08 (0.97–1.21) |
Amniocentesis | 1.44 (1.37–1.51) | 1.30 (1.23–1.38)*** |
Placenta previa | 1.47 (1.23–1.75) | 0.75 (0.61–0.91)** |
Placental abruption | 3.36 (2.94–3.83) | 1.41 (1.22–1.64)*** |
Major congenital anomaly | 3.19 (3.08–3.32) | 2.51 (2.40–2.62)*** |
Prior Cesarean section | 0.89 (0.86–0.93) | 1.26 (1.21–1.29)*** |
Time periods | ||
1991 − 1996 | 1 | 1 |
1997 − 2001 | 1.05 (1.02 − 1.08) | 1.04 (1.00 − 1.07)* |
2002 − 2006 | 1.07 (1.04 − 1.10) | 1.08 (1.04 − 1.11)*** |
2007 − 2010 | 1.14 (1.11 − 1.18) | 1.17 (1.13 − 1.21)*** |
Place of residence grouped by hospital districts | ||
1 | 1.40 (1.27 − 1.53) | 1.29 (1.17 − 1.42)*** |
2 | 1 | 1 |
3 | 1.29 (1.17 − 1.43) | 1.20 (1.08 − 1.34)*** |
4 | 1.38 (1.29 − 1.47) | 1.21 (1.13 − 1.30)*** |
5 | 1.64 (1.44 − 1.86) | 1.51 (1.32 − 1.73)*** |
6 | 1.45 (1.31 − 1.61) | 1.38 (1.24 − 1.54)*** |
7 | 1.36 (1.25 − 1.48) | 1.18 (1.08 − 1.30)*** |
8 | 1.13 (1.02 − 1.26) | 1.17 (1.05 − 1.32)** |
9 | 1.19 (1.10 − 1.28) | 1.11 (1.02 − 1.21)* |
10 | 1.35 (1.24 − 1.47) | 1.21(1.10 − 1.32)*** |
11 | 1.66 (1.52 − 1.81) | 1.54 (1.40 − 1.70)*** |
12 | 1.31 (1.17 − 1.46) | 1.13 (1.00 − 1.28)* |
13 | 1.14 (1.06 − 1.23) | 1.05 (0.97 − 1.14) |
14 | 1.33 (1.22 − 1.45) | 1.27 (1.16 − 1.40)*** |
15 | 1.31 (1.22 − 1.54) | 1.32 (1.22 − 1.42)*** |
16 | 1.43 (1.32 − 1.54) | 1.34 (1.23 − 1.45)*** |
17 | 1.35 (1.25 − 1.47) | 1.21(1.11 − 1.32)*** |
18 | 1.15 (1.06 − 1.25) | 1.04 (0.96 − 1.14) |
19 | 1.02 (0.93 − 1.11) | 1.00 (0.91 − 1.10) |
20 | 1.15 (1.07 − 1.23) | 0.97 (0.89 − 1.05) |
Model 1 | Model 2 | Model 3 | Model A | Model B | Model C | Model D | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
SES | OR (95% CI) | OR (95% CI) | OR (95% CI) | Diff. with 2 (%)* | OR (95% CI) | Diff. with 3 (%)* | OR (95% CI) | Diff. with 3 (%)* | OR (95% CI) | Diff. with 3 (%)* | OR (95% CI) | Diff. with 3 (%)* |
Upper white-collar | 1 | 1 | 1 | 1 | 1 | 1 | 1 | |||||
Lower white-collar | 1.16 (1.11 − 1.21) | 1.24 (1.18 − 1.29) | 1.14 (1.09 − 1.20) | 41.7 | 1.14 (1.09 − 1.19) | - | 1.14 (1.09 − 1.20) | - | 1.14 (1.09 − 1.19) | - | 1.14 (1.09 − 1.19) | - |
Blue-collar | 1.42 (1.35 − 1.48) | 1.57 (1.49 − 1.64) | 1.28(1.21 − 1.34) | 50.9 | 1.28 (1.22 − 1.35) | - | 1.27 (1.21 − 1.34) | 3.6 | 1.27 (1.21 − 1.34) | 3.6 | 1.27 (1.21 − 1.33) | 3.6 |
Other | 1.19 (1.14 − 1.25) | 1.28 (1.22 − 1.34) | 1.19 (1.14 − 1.25) | 32.1 | 1.18 (1.13 − 1.24) | 5.3 | 1.18 (1.13 − 1.24) | 5.3 | 1.19 (1.13 − 1.25) | - | 1.18 (1.12 − 1.24) | 5.3 |
Missing | 1.36 (1.19 − 1.30) | 1.39 (1.32 − 1.46) | 1.24 (1.18 − 1.31) | 38.5 | 1.25 (1.19 − 1.32) | - | 1.23 (1.17 − 1.29) | 4.2 | 1.24 (1.18 − 1.30) | - | 1.22 (1.16 − 1.29) | 8.3 |