PERINATOLOGY • Vol 24 • No. 1 • May–Aug 2023 • 35 Original Article Mohite RV. Effect of Maternal and Obstetric Factors and Placental Weight on Neonatal Birth Weight Conclusion: Several maternal and obstetric factors and placental weight contributed to the birth of LBW neonates. Thus, controlling and modifying these risk factors can lead to the birth of normal-birth-weight neonates. Key Words: Maternal age, gestational age, obstetric complications, placental weight, macrosomia, normal birth weight, low birth weight, parity, anemia Introduction Birth weight is the most accessible epidemiologic variable and the single most important marker of perinatal, neonatal, and infantile outcomes.1 Although there is no universal agreement on birth weight classification,2 the commonly used classification is as follows: • Macrosomia: Birth weight ≥ 4000 g • Normal birth weight (NBW): Between 2500 and 3999 g • Low birth weight (LBW): < 2500 g • Very low birth weight: < 1500 g • Extremely low birth weight: < 1000 but > 500 g There is no other indicator in human biology that can shed light about past events and the future trajectory of life as much as a neonate’s birth weight. The in utero environment is crucial to the growth and development of the fetus, and several maternal nutrition- and metabolism-related factors influence the in utero environment. Nutritional factors from the maternal circulation can enter the fetal circulation only after passing through the placenta; hence, the placenta plays a vital role in fetal growth and nutrition. Besides, the placenta itself metabolizes some of the nutrients it takes up, which means that it is beyond just a channel of nutrient passage.3 Placental weight is not only an indicator of fetal growth at birth but is also associated with early childhood development in term neonates.4 The determinants of LBW can be associated with (i) fetal factors such as congenital or chromosomal abnormalities, multiple gestations, and fetal intrauterine infections; (ii) maternal factors such as age extremes, preeclampsia, chronic medical illnesses, and obstetric complications; and (iii) placental factors such as early aging, placenta previa, abruption, and anomalous cord insertion.5 The birth weight, percentage of body fat of the neonate, and risk of macrosomia are directly related to maternal plasma glucose, BMI, and other metabolic markers. The findings of large cohort studies such as the Hyperglycemia and Adverse Outcome Study (HAPO) validate this.6 Despite the implementation of several national health programs, achieving the objective of NBW neonates has been a challenge in India. This study was conducted to understand the correlation between the birth weight of neonates and fetal, maternal, and placental factors. Aim The aim of this study was to determine the association of maternal and obstetric factors and placental weight with the birth weight of neonates Materials and Methods Study design This was a prospective, cross-sectional study conducted at Krishna Institute of Medical Sciences (Karad, Maharashtra, India), a tertiary care hospital. All neonates delivered at the hospital between January 2018 and December 2018 were considered for the study. Institutional ethics committee approval and parental consent were obtained for this study. Inclusion and exclusion criteria Rural inhabitants who delivered live neonates at our hospital were included for this study. Extremely lowbirth-weight neonates or neonates born at < 20 weeks of gestational age were excluded.
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