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Wojciech Hanke, Jarosław Kalinka, Wojciech Sobala
Med Sci Monit 1998; 4(3): EP505-512
The purpose of this study was to determine the influence of sociodemographic and environmental risk factors on preterm delivery (PD) and small-for-gestational-age (SGA) babies in the population of the Łódz region of Poland. The rapid socio-economic transformations in Poland and the associated behavioral changes of the society seen since the early 1990's may have generated new risk factors or simply intensified the impact of those already known. The study group comprised 987 women from this region who gave birth to a child during the period between June 1, 1996 and November 30, 1996. The enrolment criteria included only singleton, non-malformed pregnancies past the 22nd week. The SGA group comprised 66 women while the comparison group comprised 809 women. The PD group included 52 women with preterm delivery and was compared with the reference group of 824 women with term delivery. Logistic regression models were applied to examine the relationship between the probability of the two pathologies and the risk factors under investigation. The mother's age below 19, marital status described as 'single', 3 prior deliveries or more and a history of unemployment during pregnancy were found to be independent, statistically significant risk factors for preterm delivery. An urban residency, low maternal height (below 1.55 m), marital status described as 'single' and smoking during pregnancy were all found to be independent, significant risk factors for SGA. The women delivering for the second time had a reduced risk of SGA. Among the clinical variables, only first trimester hemorrhage proved to be a significant risk factor of this pathology. The socio-economic and environmental risk factors described in this paper play an important role in the pathogenesis of PD and SGA. The spectrum of risk factors should be periodically re-evaluated in order to determine their significance and to monitor for new hazards.
key words: small-for-gestational-age babies (SGA) • preterm delivery • sociodemographic factors • cigarette smoking • risk factors