Low Birth Weight, Small for Gestational Age and Preterm Births before and after the Economic Collapse in Iceland: A Population Based Cohort Study

Author(s)
Eiríksdóttir, V. H., Ásgeirsdóttir, T. L., Bjarnadóttir, R. I., Kaestner, R., Cnattingius, S., and Valdimarsdóttir, U. A.
Publication language
English
Pages
9pp
Date published
01 Dec 2013
Publisher
PLOS ONE
Type
Articles
Keywords
Children & youth, Food and nutrition, Food security, Nutrition, Health
Countries
Iceland
Link
http://www.plosone.org/article/fetchObject.action?uri=info%3Adoi/10.1371/journal…

Objective: Infants born small for gestational age (SGA) or preterm have increased rates of perinatal morbidity and mortality.
Stressful events have been suggested as potential contributors to preterm birth (PB) and low birth weight (LBW). We
studied the effect of the 2008 economic collapse in Iceland on the risks of adverse birth outcomes.
Study design: The study population constituted all Icelandic women giving birth to live-born singletons from January 1st
2006 to December 31st 2009. LBW infants were defined as those weighing ,2500 grams at birth, PB infants as those born
before 37 weeks of gestation and SGA as those with a birth weight for gestational age more than 2 standard deviations
(SD’s) below the mean according to the Swedish fetal growth curve. We used logistic regression analysis to estimate odds
ratios [OR] and corresponding 95 percent confidence intervals [95% CI] of adverse birth outcomes by exposure to calendar
time of the economic collapse, i.e. after October 6th 2008.
Results: Compared to the preceding period, we observed an increased adjusted odds in LBW-deliveries following the
collapse (aOR = 1.24, 95% CI [1.02, 1.52]), particularly among infants born to mothers younger than 25 years (aOR = 1.85,
95% CI [1.25, 2.72]) and not working mothers (aOR = 1.61, 95% CI [1.10, 2.35]). Similarly, we found a tendency towards higher
incidence of SGA-births (aOR = 1.14, 95% CI [0.86, 1.51]) particularly among children born to mothers younger than 25 years
(aOR = 1.87, 95% CI [1.09, 3.23]) and not working mothers (aOR = 1.86, 95% CI [1.09, 3.17]). No change in risk of PB was
observed. The increase of LBW was most distinct 6–9 months after the collapse.
Conclusion: The results suggest an increase in risk of LBW shortly after the collapse of the Icelandic national economy. The
increase in LBW seems to be driven by reduced fetal growth rate rather than shorter gestation.