{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T03:20:53Z","timestamp":1783826453946,"version":"3.55.0"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,11,17]],"date-time":"2024-11-17T00:00:00Z","timestamp":1731801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015060","name":"Nagasaki University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Post\u2010term pregnancy, defined as reaching or exceeding 42\u2009+\u20090\u2009weeks of gestation, is known to be associated with unfavourable birth outcomes. High\u2010income countries have responded to this risk by widely adopting labour induction protocols in late\u2010term, but many low\u2010 and middle\u2010income countries have not. However, understanding underlying mechanisms linking post\u2010term births to adverse newborn and infant outcomes remains limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the (a) prevalence of post\u2010term, (b) the risk factors associated with post\u2010term (c) the association between post\u2010term births and the risk of small\u2010for\u2010gestational\u2010age (SGA) neonates and of infant mortality in middle\u2010income settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used existing electronic datasets from the general population of Brazil, Mexico, and Palestinian refugees. Regression models were used to explore the associations between post\u2010term birth and SGA and infant mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We analysed 21,335,033 live births in Brazil (2011\u20132018), 23,416,126 in Mexico (2008\u20132019), and 966,102 in Palestinian refugees (2010\u20132020) (<jats:italic>N<\/jats:italic>\u2009=\u200945,717,261). Post\u2010term deliveries accounted for 3.1% of births in Brazil, 1.2% in Mexico, and 2.1% in Palestinian refugees. Post\u2010term births had approximately three times the risk of resulting in SGA neonates compared to term births. Additionally, post\u2010term neonates exhibited a 15% to 40% increased risk of infant mortality compared to term infants. Notably, post\u2010term SGA neonates faced a significantly increased risk of infant mortality compared to term appropriate for gestational age neonates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These findings emphasise the critical significance of implementing induction strategies to prevent post\u2010term pregnancies and mitigate the associated risks of SGA neonates and subsequent infant mortality. Moreover, the study highlights the importance of accurately determining gestational age and using INTERGROWTH\u201021st charts to improve the identification of SGA cases, enabling targeted interventions. This is especially relevant because post\u2010term SGA neonates may not exhibit low birthweight (a commonly used risk marker) and, therefore, may miss out on required specialised attention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.13137","type":"journal-article","created":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T06:54:55Z","timestamp":1731912895000},"page":"149-158","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Post\u2010term births as a risk factor for small for gestational age births and infant mortality in Brazil, Mexico, and Palestinian refugees: An analysis of electronic birth records"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2074-9329","authenticated-orcid":false,"given":"Zeina","family":"Jamaluddine","sequence":"first","affiliation":[{"name":"Faculty of Epidemiology and Population Health London School of Hygiene &amp; Tropical Medicine  London UK"},{"name":"School of Tropical Medicine and Global Health Nagasaki University  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0909-7737","authenticated-orcid":false,"given":"Lorena","family":"Suarez Idueta","sequence":"additional","affiliation":[{"name":"Mexican Society of Public Health  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4797-908X","authenticated-orcid":false,"given":"Enny S.","family":"Paixao","sequence":"additional","affiliation":[{"name":"Faculty of Epidemiology and Population Health London School of Hygiene &amp; Tropical Medicine  London UK"},{"name":"Centre for Data and Knowledge Integration for Health (CIDACS) Funda\u00e7\u00e3o Oswaldo Cruz  Salvador Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8711-9589","authenticated-orcid":false,"given":"Julia M.","family":"Pescarini","sequence":"additional","affiliation":[{"name":"Faculty of Epidemiology and Population Health London School of Hygiene &amp; Tropical Medicine  London UK"},{"name":"Centre for Data and Knowledge Integration for Health (CIDACS) Funda\u00e7\u00e3o Oswaldo Cruz  Salvador Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8864-3374","authenticated-orcid":false,"given":"Hala","family":"Ghattas","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Education, and Behavior University of South Carolina  Columbia South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miho","family":"Sato","sequence":"additional","affiliation":[{"name":"School of Tropical Medicine and Global Health Nagasaki University  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0674-1371","authenticated-orcid":false,"given":"Akihiro","family":"Seita","sequence":"additional","affiliation":[{"name":"United Nations Relief and Works Agency for Palestinian Refugees in the Near East  Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7550-7867","authenticated-orcid":false,"given":"Luis A.","family":"Martinez\u2010Juarez","sequence":"additional","affiliation":[{"name":"Mexican Society of Public Health  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0215-4930","authenticated-orcid":false,"given":"Mauricio L.","family":"Barreto","sequence":"additional","affiliation":[{"name":"Centre for Data and Knowledge Integration for Health (CIDACS) Funda\u00e7\u00e3o Oswaldo Cruz  Salvador Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3116-2593","authenticated-orcid":false,"given":"Eric O.","family":"Ohuma","sequence":"additional","affiliation":[{"name":"Faculty of Epidemiology and Population Health London School of Hygiene &amp; Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0038-0002","authenticated-orcid":false,"given":"Louise T.","family":"Day","sequence":"additional","affiliation":[{"name":"Faculty of Epidemiology and Population Health London School of Hygiene &amp; Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9311-0115","authenticated-orcid":false,"given":"Oona M. 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