Prevalence of adverse outcomes of pregnancy in Sivas-Turkey and their associated factors: A population-based survey

  • Naim Nur Department of Public Health, School of Medicine, Cumhuriyet University of Medical Sciences, Sivas, Turkey
  • Haldun Sumer Department of Public Health, School of Medicine, Cumhuriyet University of Medical Sciences, Sivas, Turkey
Keywords: Women, Pregnancy, Smoking, PTB, LBW


Background & aim: Adverse pregnancy outcomes, including preterm birth (PTB) and low birth weight (LBW) are complications of complex etiology associated with newborn morbidity and mortality. The aims of this study were to explore smoking and other social factors associated with adverse pregnancy outcomes in women of childbearing agesMethods & Materials: The cross-sectional survey involved 1273 women were conducted in Sivas center, Turkey, between September 2013 and May 2014. Multiple linear regression models were performed to demonstrate the significant factors associated with preterm birth (PTB) and low birth weight (LBW).Results: Multivariate analysis significantly showed that having a low educational level (odds ratio, OR = 4.25 for PTB and OR = 4.93 for LBW), being unemployed (OR = 2.08 only for PTB), being a smoker (OR = 1.37 for PTB and OR = 1.67 for LBW), being a multiparous women (OR = 2.59 for PTB and OR = 3.79 for LBW) and having a low income level (OR = 1.53 only for LBW) were the factors associated with the PTB/LBW.Conclusion: Smoking as modifiable risk factors and other socio-economical factors should be addressed for the main goal of improving womens’ health. From this point, health-promoting implementations are important to encourage and support women to stop smoking before or on early stage of their pregnancies especially in those lower educated and those from lower socio-economic conditions to reduce PTB and LBW.Keywords: Women; Pregnancy; Smoking; PTB; LBW


Blencowe H, Cousens S, Chou D, Oestergaard M, Say L, Moller AB, Kinney M, Lawn J. Born too soon: the global epidemiology of 15 million preterm births. Reprod Health. 2013; 10 Suppl 1:S2.

Pattenden S, Dolk H, Vrijheid M. Inequalities in low birth weight:parental social class, area deprivation, and ‘‘lone mother’’ status. J Epidemiol Community Health 1999; 53: 355-358.

Jansen PW, Tiemeier H, Looman CW, Jaddoe VW, Hofman A, Moll HA, Steegers EA, Verhulst FC, Mackenbach JP, Raat H. Explaining educational inequalities in birthweight: the Generation R Study.Paediatr Perinat Epidemiol 2009; 23: 216-228.

Beard JR, Lincoln D, Donoghue D, Taylor D, Summerhayes R, Dunn TM, Earnest A, Morgan G. Socioeconomic and maternal determinants of small-for-gestational age births:patterns of increasing disparity. Acta Obstet Gynecol Scand. 2009; 88: 575-583.

McCowan L, Horgan RP. Risk factors for small for gestational age infants. Best Pract Res Clin Obstet Gynaecol. 2009; 23: 779-793.

Kramer MS, Seguin L, Lydon J, Goulet L. Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly? Paediatr Perinat Epidemiol. 2000; 14: 194-210.

Kallen K The impact of maternal smoking during pregnancy on delivery outcome. Eur J Public Health. 2001; 11: 329-333.

Schiaffino A, Fernandez E, Borrell C, Salto E, Garcia M, Borras JM. Gender and educational differences in smoking initiation rates in Spain from 1948 to 1992. Eur J Public Health. 2003; 13: 56-60.

Gilman SE, Martin LT, Abrams DB, Kawachi I, Kubzansky L, Loucks EB, Rende R, Rudd R, Buka SL. Educational attainment and cigarette smoking: a causal association? Int J Epidemiol. 2008; 37: 615-624.

Nur N. The association of risk factors with smoking during pregnancy among women of childbearing ages: An epidemiologic field study from Turkey. Säo Paulo Med J. 2017;135(2):100-106.

Gissler M, Merilainen J, Vuori E, Hemminki E. Register based monitoring shows decreasing socioeconomic differences in Finnish perinatal health. J Epidemiology Community Health. 2003; 57: 433-439.

Morgen CS, Bjork C, Andersen PK, Mortensen LH, Nybo Andersen AM. Socioeconomic position and the risk of preterm birth–a study within the Danish National Birth Cohort. International Journal of Epidemiology. 2008; 37: 1109-1120.

Hassoune S, Bassel S, Nani S, Maaroufi A. Prevalence and associated factors of low birth weight in the provincial hospital of Mohammedia-Morocco. Tunis Med. 2015 Jul; 93(7): 440-444.

Shakya KL, Shrestha N, Kisiju P, Onta SR. Association of maternal factors with low birth weight in selected hospitals of Nepal. J Nepal Health Res Counc. 2015; 13(30): 121-5.

Tellapragada C, Eshwara VK, Bhat P, Acharya S, Kamath A, Bhat S, Rao C, Nayak S, Mukhopadhyay C. Risk factors for preterm birth and low birth weight among pregnant ındian women: A hospital-based prospective study. J PrevMed Public Health. 2016; 49(3): 165-175.

Goldenberg RL, Goepfert AR, Ramsey PS. Biochemical markers for the prediction of preterm birth. Am J Obstet Gynecol. 2005; 192(5 Suppl): S36-S46.

Chan RL. Biochemical markers of spontaneous preterm birth in asymptomatic women. Biomed Res Int. 2014; 2014:164081.

Zhang YP, Liu XH, Gao SH, Wang JM, Gu YS, Zhang JY, Zhou X, Li QX. Risk factors for preterm birth in five maternal and child health hospitals in Beijing. PLoS One. 2012;7(12): e52780.

Mumbare SS, Maindarkar G, Darade R, Yenge S, Tolani MK, Patole K. Maternal risk factors associated with term low birth weight neonates: a matched-pair case control study. Indian Pediatr. 2012; 49(1): 25-28.

Chandra SM, Vijaya AN, Maheshwar DM. Factors affecting birth weight of a newborn - a community based study in rural Karnataka, India. PLoS One. 2012;7: 1-4.

Golestan M, Akhavan KS, Fallah R. Prevalence and risk factors for low birth weight in Yazd, Iran. Singapore Med J. 2011; 52:730-733.

Najmi RS. Distribution of birthweights of hospital born Pakistani infants. J Pak Med Assoc. 2000; 50: 121-124.

Slattery MM, Morrison JJ. Preterm delivery. Lancet. 2002; 360(9344): 1489-97.

Palma S, Pérez-Iglesias R, Pardo-Crespo R Llorca J, Mariscal M, Delgado-Rodríguez M. Smoking among pregnant women in Cantabria (Spain): trend and determinants of smoking cessation. BMC Public Health. 2007; 7:65.

Uncu Y, Ozcakir A, Ecran I, Bilgel N, Uncu G. Pregnant women quit smoking: What about fathers? Survey study in Bursa Region, Turkey. Croad Med J. 2005 Oct; 46(5): 832-837.

Office for National Statistics. The Information Centre. Statistics on smoking: England 2006. Office for National Statistics; 2006. Available from: Accessed in 2016 (Aug19).

Villalbí JR, Salvador J, Cano-Serral G, Rodríguez-Sanz MC, Borrell C. Maternal smoking, social class and outcomes of pregnancy. Paediatr Perinat Epidemiol. 2007 sep; 21(5): 441-447.

Kramer MS, Séguin L, Lydon J, Goulet L. Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly? Paediatr Perinat Epidemiol 2000; 14(3): 194-210.

Karim E, Mascie-Taylor CG. The association between birthweight, sociodemographic variables and maternal anthropometry in an urban sample from Dhaka, Bangladesh. Ann Hum Biol. 1997; 24(5): 387-401.

How to Cite
Nur N, Sumer H. Prevalence of adverse outcomes of pregnancy in Sivas-Turkey and their associated factors: A population-based survey. NPT. 5(2):265-71.
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