ArticleBMC pregnancy and childbirth2026
A Bayesian multilevel joint model for predicting neonatal head circumference and body mass index: a case study in Dalahu County, Iran.
Article in BMC pregnancy and childbirth, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNewborn anthropometry is an essential research tool for assessing newborn growth and studying the factors that influence inadequate or excessive fetal growth. Newborn Body Mass Index (BMI) and Head Circumference (HC) are among the anthropometric measurements that are important to monitor from early infancy. This study aimed to identify the maternal, paternal, and pregnancy-related factors associated with newborn BMI and HC in Dalahoo County, Iran.
methodsThis retrospective cohort study included all pregnant women who attended primary health centers in Dalahoo County, located in the central regions of the western half of Kermanshah Province, Iran, from March 21, 2022, to May 19, 2024. The response variables included newborn HC as a continuous variable and newborn BMI as an ordinal variable. BMI was categorized based on sex-and age-specific reference values provided by World Health Organization (WHO). Newborn BMI and HC were examined concurrently to assess factors influencing newborn development using a Bayesian multilevel joint modeling approach.
resultsFor each additional week of gestation, the odds of being in a higher BMI category increased (OR 1.45; 95% HPD 1.31-1.65). Newborns with smoking fathers had lower odds of being in a higher BMI category than those with non-smoking fathers (OR 0.41; 95% HPD 0.36-0.47). Newborns of mothers with Gestational Diabetes Mellitus (GDM) had higher odds of being in a higher BMI category than those of non-diabetic mothers (OR 2.56; 95% HPD 2.18-2.92). Male newborns had higher odds of being in a higher BMI category than females (OR 1.40; 95% HPD 1.22-1.60). For head circumference, each additional week of gestation increased the mean by 0.44 cm (posterior mean, 0.44; 95% HPD, 0.42-0.45). Male newborns had a larger mean head circumference (posterior mean difference, 0.24 cm; 95% HPD, 0.05-0.38). All associations were interpreted while holding other variables constant.
conclusionsIn this cohort study, gestational age (per week), Gestational Diabetes Mellitus (GDM), and male sex were associated with higher odds of being in a higher newborn BMI category, whereas paternal smoking was associated with lower odds. Gestational age and male sex were associated with a larger mean Head Circumference (HC). Joint modeling of BMI and HC within a Bayesian multilevel framework allowed simultaneous estimation of both outcomes while accounting for outcome correlation, supporting the assessment of BMI and HC together in newborn growth. However, given the limitations of external validity, these findings should be interpreted with caution and are not intended as direct clinical recommendations.
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