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Risk Factors for Preterm Birth and Small-for-gestational-age Births among Canadian Women


  • All authors were members of the Maternity Experiences Study Group of the Canadian Perinatal Surveillance System, Public Health Agency of Canada.


Maureen Heaman, Faculty of Nursing, Room 268 Helen Glass Centre for Nursing, 89 Curry Place, University of Manitoba, Winnipeg, MB, Canada R3T 2N2.




Preterm births (PTB) and small-for-gestational-age (SGA) births are distinct but related pregnancy outcomes, with differing aetiologies and short and long-term morbidities. Few studies have compared a broad array of predictors among these two outcomes. The purpose of this study was to compare risk factors for PTB and SGA births using a national sample of Canadian women.


We analysed data from the Canadian Maternity Experiences Survey (n = 6421). Mothers were ≥15 years of age, gave birth to a singleton infant and were living with their infant at the time of the interview (between 5 and 14 months post-partum). Backward stepwise multivariable logistic regression models were constructed for each outcome.


Risk profiles for the two outcomes had both differences and similarities. Risk factors specific to PTB were education less than high school, having a previous medical condition, developing a new medical condition or health problem during pregnancy, being a primigravida, or being a multigravida with a previous PTB or a previous miscarriage or abortion. Risk factors unique to SGA were low pre-pregnancy body mass index (<18 kg/m2), smoking during pregnancy and being a recent immigrant. Risk factors for both outcomes included low weight gain during pregnancy (<9.1 kg), short stature (<155 cm) and reporting life as ‘very stressful’ in the year prior to birth of the baby.


A greater understanding of the risk factors related to PTB and SGA may help to reduce the prevalence of these conditions and the associated risk of infant mortality and morbidity.