The impact of socio-economic, demographic and medical factors on the morphological development of the fetus and the weight of the newborn

Relevance. The morphological development of the fetus and the weight of the newborn are key indicators of perinatal health, reflecting both the biological, socio-economic, demographic and medical characteristics of the mother. In the context of regional differences and the changing structure of motherhood, it is necessary to comprehensively study the influence of such factors as socio-economic status (income level, education, parity, and smoking status), maternal age, as well as the presence of diseases and anthropometric indicators (BMI) before pregnancy on the outcome of childbirth. The objective of this study was to determine the cumulative effect of socio-economic, demographic and medical factors on the morphometric parameters of the fetus and the weight of the newborn in a regional analysis, as well as to identify optimal parameters for the formation of favorable intrauterine development. Methods and materials. The study conducted a retrospective analysis of the data of 5,161 pregnant women who were observed at the Kirov Regional Clinical Perinatal Center. All data were divided into subgroups by maternal age (younger than 20, 20–30, 31–40, ≥41 years), socio-economic indicators (income level, education, parity, smoking status) and medical characteristics (presence of diseases: hypertension, preeclampsia, diabetes mellitus, SARS-CoV-2, fetoplacental insufficiency; BMI before pregnancy). Methods of descriptive statistics, univariate and multifactorial analysis of variance (ANOVA), post-hoc Tukey test, multiple linear regression and logistic regression were used for statistical processing. The software was SPSS (version 26.0) and R (version 4.0.2). Results. Multifactorial analysis showed that all the studied factors have a statistically significant effect on the weight of the newborn (p<0.001). Optimal indicators were found in mothers aged 20–30 years with a high level of income and education, non–smokers, having a second pregnancy, a normal BMI (18.5–24.9 kg/m2) and the absence of concomitant diseases. Low BMI and the presence of diseases (hypertension, preeclampsia, diabetes mellitus, SARS-CoV-2, fetoplacental insufficiency) lead to a decrease in newborn weight by up to 20 % compared with the control group, while an increased BMI (25.0–29.9 kg/m2) partially compensates for the negative effects of diseases, increasing fetal weight by 8–10 %. Conclusions. The obtained results emphasize the need for an integrated approach in perinatal medicine, taking into account socio-economic, demographic and medical factors. A personalized pregnancy management strategy, including monitoring the state of maternal health, optimizing anthropometric indicators, and correcting social factors, improves birth outcomes and reduces the risk of fetal hypotrophy. The results of the study are of practical importance for the development of programs to support pregnant women in regions with different social structures.