Nutritional and Reproductive Risk Factors for Small for Gestational Age and Preterm Births

Approximately 32.4 million small for gestational age (SGA) babies and 13.7 million preterm babies are born annually in low- and middle-income countries (LMICs), of whom 2.8 million are both SGA and preterm. These newborns who are born too small and/or too soon not only experience heightened risk of neonatal and infant mortality, but also of long-term morbidities, like adulthood chronic disease. In order to reduce these burdens worldwide, it is critical to identify and understand the epidemiology of the risk factors that contribute to SGA and preterm births. As part of the Child Health Epidemiology Reference Group, we explored nutritional and reproductive health-related maternal risk factors associated with SGA and preterm outcomes in LMICs, including short maternal stature, young/advanced maternal age, low/high parity, and short birth interval. In this chapter, we highlight our findings and relevant existing literature, and also summarize literature on how low/high BMI and low weight gain during pregnancy, respectively, are associated with SGA and/or preterm outcomes.