Impact of Maternal Age and Previous Caesarean Section on Newborn Size
Author Information
Author(s): Lin Lihua, Sun Bin, Wang Xiaomei, Zhang Ronghua, Lin Juan, Yan Jianying
Primary Institution: Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University
Hypothesis
Does gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) mediate the relationship between maternal advanced age, previous caesarean section, and the risk of small- or large-for-gestational-age newborns?
Conclusion
HDP mediates the impact of maternal advanced age and previous caesarean section on the risk of small-for-gestational-age newborns, while GDM mediates the connection between previous caesarean section and large-for-gestational-age newborns.
Supporting Evidence
- Maternal advanced age was associated with a higher likelihood of gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP).
- Previous caesarean section increased the risk of GDM and HDP.
- GDM was linked to a higher risk of large-for-gestational-age (LGA) infants.
- HDP was significantly associated with small-for-gestational-age (SGA) infants.
- HDP mediated 68.96% of the effect of maternal advanced age on SGA risk.
- GDM mediated 5.62% of the effect of previous caesarean section on LGA risk.
Takeaway
Older moms and those who had a C-section before are more likely to have babies that are either too big or too small, and health issues during pregnancy can make this worse.
Methodology
Data from a prospective multicentre cohort study conducted through China's National Maternal Near-miss Surveillance System from January 2012 to December 2021 was analyzed using logistic regression and mediation analyses.
Potential Biases
Potential bias due to unmeasured confounding factors and the observational nature of the study.
Limitations
Findings may not be generalizable beyond southeastern China, and potential confounding factors like pre-pregnancy BMI and socioeconomic status were not assessed.
Participant Demographics
13.5% of participants were classified as advanced age, 51.4% were multipara, and 16.3% had a history of uterine scarring.
Statistical Information
P-Value
p<0.05
Confidence Interval
95% CI for various odds ratios reported in the study.
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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