Risk factors for singleton full-term small vulnerable newborns: a retrospective analysis of maternal and pregnancy factors (2019-2022).

OBJECTIVE

This study aims to investigate risk factors influencing the occurrence of singleton full-term small vulnerable newborns (SVN), defined as those who are either small for gestational age (SGA) or have low birth weight (LBW).

METHODS

A retrospective analysis of 8,919 singleton full-term deliveries (2019-2022) was conducted. Neonates were classified into SVN and control groups, with comparisons made based on maternal demographics, pregnancy complications, and outcomes. Logistic regression identified factors influencing SVN occurrence and assessed its association with cesarean section rates.

RESULTS

From 2019 to 2022, the incidence rates of SVN, SGA, and LBW in the study population showed a modest increase, with the SVN incidence in the population rising by 0.73 % in 2022 compared with 2019. Statistically significant differences were observed between the SVN and control groups in maternal age, parity, ethnicity, pre-pregnancy BMI, early pregnancy anemia, and pregnancy complications such as pre-eclampsia, oligohydramnios, and placenta previa. Multivariate logistic regression identified advanced maternal age, underweight pre-pregnancy BMI, Zhuang ethnicity, and early pregnancy anemia as independent risk factors for SVN, while multiparity, overweight/obesity, and complications like placenta previa acted as protective factors. Additionally, SGA with LBW was associated with a 1.5 times higher risk of cesarean section (adjusted OR 1.524, 95 % CI: 1.093, 2.125), while SGA without LBW showed a 50 % reduction in C-section risk (adjusted OR 0.501, 95 % CI: 0.409, 0.614).

CONCLUSION

Improving maternal nutritional status and enhancing surveillance of fetal growth in high-risk populations may help reduce the incidence of full-term SVN. Strengthening prevention and optimizing delivery management could contribute to better neonatal health outcomes.