Evidence map›Paper›PMID 40604901›Full record

ArticleMaternal health, neonatology and perinatology2025

Does infant birthweight percentile identify mothers at risk of severe morbidity? A Canadian population-based cohort study.

Joel G Ray, Howard Berger, Kazuyoshi Aoyama, Jocelynn L Cook, Kayvan Aflaki, Alison L Park

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Article in Maternal health, neonatology and perinatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Joel G RayDepartments of Medicine and Obstetrics and Gynaecology St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. Joel.Ray@unityhealth.to.
Howard BergerDepartments of Medicine and Obstetrics and Gynaecology St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.
Kazuyoshi AoyamaDepartments of Medicine and Obstetrics and Gynaecology St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.
Jocelynn L CookDepartment of Obstetrics and Gynaecology, University of Ottawa, Ottawa, ON, Canada.
Kayvan AflakiInstitute of Medical Science, University of Toronto, Toronto, ON, Canada.
Alison L ParkDepartments of Medicine and Obstetrics and Gynaecology St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.

Funding

CIHR NA
6 · The paper itself

Abstract

backgroundThere is a reverse J-shaped relation between newborn weight percentile and risk of perinatal mortality. Perinatal mortality itself is associated with severe maternal morbidity and mortality (SMM-M) around the index pregnancy, likely because the two share common etiologies, including placental dysfunction. We evaluated an infant's birthweight percentile and risk of its mother experiencing SMM-M.

methodsThis population-based cohort study was completed within a universal healthcare system in Ontario, Canada. Included were 2,203,490 singleton livebirths between 2002 and 2020. The study exposure was infant birthweight percentile for gestational age and sex. The 25th to 75th percentile served as the referent. The main outcome was SMM-M arising from 23 week's gestation up to 42 days postpartum. Multivariable modified Poisson regression generated relative risks (aRRs) and 95% confidence intervals (CI), adjusted for maternal age, income, rurality, pre-existing diabetes and hypertension.

resultsA J-shaped relation was seen between birthweight and risk of SMM-M. Relative to the 25th to 75th (15.0 per 1000 livebirths), the aRR of SMM-M was 1.27 (95% CI 1.21, 1.32) at 5th to < 10th, 1.40 (95% CI 1.28, 1.53) at 2nd to < 3rd, and 1.48 (95% CI 1.36, 1.62) at < 1st birthweight percentile. At higher birthweights, the aRR was 1.16 (95% CI 1.11, 1.21) at 90th to < 95th, 1.24 (95% CI 1.13, 1.36) at 95th to < 96th, and 1.73 (95% CI 1.60, 1.87) at > 99th percentile.

conclusionThere is a J-shaped relation between infant birthweight and risk of its mother experiencing SMM-M, likely due to shared risk factors and a common pathogenesis.

Indexed as

BirthweightBirthweight percentileFetal growthInfant mortalityMaternal mortalityNeonatal mortalitySevere maternal morbidity

Identifiers

PMID40604901
PMCPMC12225049

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.