The influence of maternal complications on small for gestational age in very preterm, late preterm and term pregnancies: a Chinese study
- 1Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University
- 2Dong Fureng Institute of Economic and Social Development, Wuhan University
- 3Global Health Institute, School of Public Health, Wuhan University
Abstract
Background This study aimed to assess the association between single or combined maternal complications and small-for-gestational-age (SGA) birth among very preterm, late preterm, and term births and to evaluate whether this association varied across gestational periods. Methods This retrospective cross-sectional study included 46,829 singleton pregnancies. The maternal complications considered were gestational hypertension (GH), preeclampsia (PE), and gestational diabetes mellitus (GDM). The potential nonlinear association between gestational age and the risk of SGA birth was assessed using restricted cubic spline analysis. Binary logistic regression models were used to assess the associations between single or combined maternal complications and SGA birth within the very preterm, late preterm, and term groups. Results were reported as odds ratios (ORs) with 95% confidence intervals (CIs). Additionally, effect modification by gestational age was assessed by incorporating interaction terms into the regression models. Results Among the 46,829 women with singleton pregnancies, the mean maternal age was 31.7 years (SD, 3.8 years). Restricted cubic spline analysis revealed a significant nonlinear inverse association between gestational age and SGA risk, with the odds of SGA being higher at earlier gestational ages and gradually decreasing toward term. PE showed the strongest association with SGA across all gestational periods, particularly in the very preterm group. In contrast, GDM was associated with lower odds of SGA, although the co-occurrence of PE and GDM was associated with an increased risk of SGA. GH was associated with an increased risk of SGA in the very preterm group (OR = 2.430; 95% CI, 1.156–5.111) but not in the late preterm or term groups. Interaction analysis indicated that the association between maternal complications and SGA weakened with advancing gestational age, with substantially weaker associations observed in term pregnancies. Conclusions In contrast to GDM, PE and GH were associated with an increased risk of SGA, particularly in preterm pregnancies. These findings underscore the importance of early identification, close monitoring, and individualized management of women with PE or GH, particularly among pregnancies resulting in preterm birth.
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BibTeX
@article{ma2026influence,
title = {{The influence of maternal complications on small for gestational age in very preterm, late preterm and term pregnancies: a Chinese study}},
author = {Yingxuan Ma and Zhihao Xu and Jian Wang and Hao Li and Can Wang and Jixuan Wang and Jialong Tan},
journal = {BMC Pregnancy and Childbirth},
year = {2026},
month = aug,
doi = {10.1186/s12884-026-09785-9},
url = {https://doi.org/10.1186/s12884-026-09785-9},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - The influence of maternal complications on small for gestational age in very preterm, late preterm and term pregnancies: a Chinese study
AU - Yingxuan Ma
AU - Zhihao Xu
AU - Jian Wang
AU - Hao Li
AU - Can Wang
AU - Jixuan Wang
AU - Jialong Tan
PY - 2026
DA - 2026/08/01
JO - BMC Pregnancy and Childbirth
DO - 10.1186/s12884-026-09785-9
UR - https://doi.org/10.1186/s12884-026-09785-9
AB - Background This study aimed to assess the association between single or combined maternal complications and small-for-gestational-age (SGA) birth among very preterm, late preterm, and term births and to evaluate whether this association varied across gestational periods. Methods This retrospective cross-sectional study included 46,829 singleton pregnancies. The maternal complications considered were gestational hypertension (GH), preeclampsia (PE), and gestational diabetes mellitus (GDM). The potential nonlinear association between gestational age and the risk of SGA birth was assessed using restricted cubic spline analysis. Binary logistic regression models were used to assess the associations between single or combined maternal complications and SGA birth within the very preterm, late preterm, and term groups. Results were reported as odds ratios (ORs) with 95% confidence intervals (CIs). Additionally, effect modification by gestational age was assessed by incorporating interaction terms into the regression models. Results Among the 46,829 women with singleton pregnancies, the mean maternal age was 31.7 years (SD, 3.8 years). Restricted cubic spline analysis revealed a significant nonlinear inverse association between gestational age and SGA risk, with the odds of SGA being higher at earlier gestational ages and gradually decreasing toward term. PE showed the strongest association with SGA across all gestational periods, particularly in the very preterm group. In contrast, GDM was associated with lower odds of SGA, although the co-occurrence of PE and GDM was associated with an increased risk of SGA. GH was associated with an increased risk of SGA in the very preterm group (OR = 2.430; 95% CI, 1.156–5.111) but not in the late preterm or term groups. Interaction analysis indicated that the association between maternal complications and SGA weakened with advancing gestational age, with substantially weaker associations observed in term pregnancies. Conclusions In contrast to GDM, PE and GH were associated with an increased risk of SGA, particularly in preterm pregnancies. These findings underscore the importance of early identification, close monitoring, and individualized management of women with PE or GH, particularly among pregnancies resulting in preterm birth.
SN - 1471-2393
ER -