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Maternal Factors for Intrauterine Growth Retardation: Systematic Review and Meta-Analysis of Observational Studies

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Abstract

Intrauterine growth retardation (IUGR) is a major complication of pregnancy and is the second leading cause of perinatal morbidity and mortality. The etiology of IUGR is multifactorial and the maternal factors are easily identifiable and modifiable. The present study aimed to perform a meta-analysis to identify the association between various maternal factors and IUGR. Eight electronic databases (PubMed, Cochrane, Embase, CIHNAL Plus, CNKI, VIP database, CBM, and WanFang database) were searched from their inception until July 2020. Eligibility screening, data extraction, and quality assessment of the retrieved articles were conducted independently by two reviewers. The Newcastle-Ottawa Quality Assessment Form and the Joanna Briggs Institute critical appraisal tool were used to evaluate the quality of included studies. The outcomes of study were calculated by OR with 95%CI. The study protocol was registered with PROSPERO (No. CRD42020210615). A total of 15 studies were included, with a sample size range from 152 to 9372. The quality of included studies ranged from moderate to high. The pooled results identified seven factors: smoking (OR = 1.62, 95%CI 1.38–1.90), primiparity (OR = 1.64, 95%CI 1.20–2.24), and prepregnancy.

BMI < 18.5 (OR = 1.98, 95%CI 1.29–3.03), anemia (OR = 2.01, 95%CI 1.44–2.82), hypoproteinemia (OR = 2.91, 95%CI 1.94–4.36), pregnancy-induced hypertension (OR = 3.45, 95%CI 1.80–6.58), and maternal gestational weight gain (OR = 2.51, 95%CI 1.88–3.35). The present study identified several maternal factors for IUGR: smoking, primiparity, prepregnancy BMI < 18.5, poor gestational weight gain, PIH, anemia, and hypoproteinemia. The result could serve to generate risk factors prediction models, improve the management and education for child-bearing or early pregnant women.

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Acknowledgements

The authors gratefully acknowledge the financial supports by the National Social Science Foundation of China under Grant number No. 19ZDA142.

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Author notes

  1. Liu Yang and Lufang Feng contributed equally to this study.

Authors and Affiliations

  1. School of Nursing, Lanzhou University, Lanzhou, 730011, Gansu, China

    Liu Yang & Haihong Li

  2. Gansu Provincial Maternity and Child-care Hospital, Lanzhou, 730050, Gansu, China

    Liu Yang, Lijuan Huang, Xuejiao Li, Wenwen Qiu, Jie Qiu & Haihong Li

  3. Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, Gansu, China

    Lufang Feng & Kehu Yang

  4. Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, Gansu, China

    Lufang Feng & Kehu Yang

  5. Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, Gansu, China

    Lufang Feng & Kehu Yang

  6. School of Nursing, Gansu University of Chinese Medicine, Lanzhou, 730000, Gansu, China

    Lijuan Huang & Wenwen Qiu

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Liu Yang, Lufang Feng, Lijuan Huang, and Xuejiao Li. The first draft of the manuscript was written by Liu Yang, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Kehu Yang, Jie Qiu or Haihong Li.

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This work was supported by the National Social Science Fund of China (No. 19ZDA142).

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Yang, L., Feng, L., Huang, L. et al. Maternal Factors for Intrauterine Growth Retardation: Systematic Review and Meta-Analysis of Observational Studies. Reprod. Sci. 30, 1737–1745 (2023). https://doi.org/10.1007/s43032-021-00756-3

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