Changing trends of birth weight with maternal age: a cross-sectional study in Xi'an city of Northwestern China

Background: Most studies have shown that maternal age is associated with birth weight. However, the specific relationship between each additional year of maternal age and birth weight remains unclear. The study aimed to analyze the specific association between maternal age and birth weight.Methods: Raw data for all live births from 2015 to 2018 were obtained from the Medical Birth Registry of Xi’an, China. A total of 490143 mother-child pairs with full-term singleton live births and the maternal age ranging from 20 to 40 years old were included in our study. Birth weight, gestational age, neonatal birth date, maternal birth date, residence and ethnicity were collected. Generalized additive model and two-piece wise linear regression model were used to analyze the specific relationships between maternal age and birth weight, risk of low birth weight, and risk of macrosomia.Results: The relationships between maternal age and birth weight, risk of low birth weight, and risk of macrosomia were nonlinear. Birth weight increased 16.204 g per year when maternal age was less than 24 years old (95%CI: 14.323, 18.086), and increased 12.051g per year when maternal age ranged from 24 to 34 years old (95%CI: 11.609, 12.493), then decreased 0.824g per year (95% CI: -3.112, 1.464). The risk of low birth weight decreased with the increase of maternal age until 36 years old (OR= 0.917, 95%CI: 0.903, 0.932 when maternal age was younger than 27 years old; OR= 0.965, 95%CI: 0.955, 0.976 when maternal age ranged from 27 to 36 years old), then increased when maternal age was older than 36 years old (OR=1.133, 95%CI: 1.026, 1.250). The risk of macrosomia increased with the increase of maternal age (OR=1.102, 95%CI: 1.075, 1.129 when maternal age was younger than 24 years old; OR=1.065, 95%CI: 1.060, 1.071 when maternal age ranged from 24 to 33 years old; OR=1.029, 95%CI: 1.012, 1.046 when maternal age was older than 33 years old).Conclusions: For women of childbearing age (20-40 years old), the threshold of maternal age on low birth weight was 36 years old, and the risk of macrosomia increased with the increase of maternal age.