{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T13:42:07Z","timestamp":1786542127779,"version":"build-2736575974"},"reference-count":33,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"S.D. Asfendiyarov Kazakh National Medical University"},{"id":[{"id":"https:\/\/ror.org\/05pc6w891","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Birth size is a population-level marker of fetal growth, maternal health, and perinatal care. In Kazakhstan, long-term national and regional patterns in newborn anthropometry have not been jointly examined across birth weight, birth length, the Rohrer index, low birth weight (LBW), and macrosomia. This study aimed to quantify national annual trends in these five indicators for 2013\u20132022, compare region-specific trajectories, and examine whether the two ends of the birth-weight distribution changed in different directions. Methods: This retrospective ecological time-trend study used de-identified individual newborn records (birth weight, birth length, sex, birth date, and region; 3,483,810 live births, 2013\u20132022) from the Electronic Register of Inpatients of the Ministry of Health of the Republic of Kazakhstan. These individual-level records were used to calculate the Rohrer index and to apply exclusion criteria at the newborn level, but national trend models were deliberately fitted on the 10 annual observations, and regional heterogeneity was tested with a single region \u00d7 year interaction model rather than individual births or independent per-region regressions to avoid pseudoreplication. Results: Mean birth weight increased from 3429.5 g (2013) to 3518.4 g (2022), and mean birth length increased from 52.5 to 53.3 cm. Recorded LBW prevalence declined from 3.09% to 1.46%, while macrosomia increased from 12.59% to 16.02%. Pooled regional birth weight ranged from 3392.6 g to 3548.6 g, LBW from 0.9% to 5.3%, and macrosomia from 11.7% to 18.1%; region-specific trends after false-discovery-rate correction showed that only North Kazakhstan Region had a statistically robust increase in LBW. Conclusions: Official registry data for Kazakhstan, analyzed at the individual level and aggregated for trend modeling, showed a decade-long increase in mean birth weight and length, an observed decline in recorded LBW prevalence, and an increase in macrosomia prevalence, with statistically confirmed heterogeneity in regional trajectories. Because this study lacked gestational age or maternal characteristics, these findings should be interpreted as ecological surveillance patterns that support continued monitoring of both ends of the birth-weight distribution, rather than as evidence of individual-level changes in fetal growth or maternal metabolic risk.<\/jats:p>","DOI":"10.3390\/children13081069","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T12:53:48Z","timestamp":1786539228000},"page":"1069","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nationwide Trends in Newborn Anthropometric Indicators in Kazakhstan, 2013\u20132022: A Population-Level Time-Trend Analysis"],"prefix":"10.3390","volume":"13","author":[{"given":"Marat","family":"Shoranov","sequence":"first","affiliation":[{"name":"Department of Medicine, S.D. Asfendiyarov Kazakh National Medical University, Almaty 050000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anel","family":"Ibrayeva","sequence":"additional","affiliation":[{"name":"Department of Medicine, S.D. Asfendiyarov Kazakh National Medical University, Almaty 050000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yerlan","family":"Ismoldayev","sequence":"additional","affiliation":[{"name":"Department of Medicine, S.D. Asfendiyarov Kazakh National Medical University, Almaty 050000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bolat","family":"Sadykov","sequence":"additional","affiliation":[{"name":"Department of Medicine, S.D. Asfendiyarov Kazakh National Medical University, Almaty 050000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6100-4963","authenticated-orcid":false,"given":"Dimash","family":"Davletov","sequence":"additional","affiliation":[{"name":"Department of Medicine, S.D. Asfendiyarov Kazakh National Medical University, Almaty 050000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shynar","family":"Tanabayeva","sequence":"additional","affiliation":[{"name":"Department of Medicine, S.D. Asfendiyarov Kazakh National Medical University, Almaty 050000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0528-3874","authenticated-orcid":false,"given":"Ildar","family":"Fakhradiyev","sequence":"additional","affiliation":[{"name":"Department of Medicine, S.D. Asfendiyarov Kazakh National Medical University, Almaty 050000, Kazakhstan"},{"name":"College of Medicine, Korea University, Seoul 02841, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.puhe.2021.01.019","article-title":"Trends and predictors of birth weight in Chilean children","volume":"193","author":"Garmendia","year":"2021","journal-title":"Public Health"},{"key":"ref_2","first-page":"S60","article-title":"Neonatal mortality risk of vulnerable newborns by fine stratum of gestational age and birthweight for 230,679 live births in nine low- and middle-income countries, 2000\u20132017","volume":"132","author":"Hazel","year":"2025","journal-title":"BJOG"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"EN-BIRTH Study Group, Kong, S., Day, L.T., Bin Zaman, S., Peven, K., Salim, N., Sunny, A.K., Shamba, D., Rahman, Q.S.-U., and K.C., A. (2021). Birthweight: EN-BIRTH multi-country validation study. BMC Pregnancy Childbirth, 21.","DOI":"10.1186\/s12884-020-03355-3"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"677","DOI":"10.3109\/14767058.2013.829817","article-title":"Determinants of birth size in Northeast Spain","volume":"27","author":"Samper","year":"2014","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Roland, M.C.P., Friis, C.M., Voldner, N., Godang, K., Bollerslev, J., Haugen, G., and Henriksen, T. (2012). Fetal growth versus birthweight: The role of placenta versus other determinants. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0039324"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1991","DOI":"10.1056\/NEJMoa0707943","article-title":"Hyperglycemia and adverse pregnancy outcomes","volume":"358","author":"Metzger","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Engdaw, G.T., Tesfaye, A.H., Feleke, M., Negash, A., Yeshiwas, A., Addis, W., Angaw, D.A., and Engidaw, M.T. (2023). Effect of antenatal care on low birth weight: A systematic review and meta-analysis in Africa, 2022. Front. Public Health, 11.","DOI":"10.3389\/fpubh.2023.1158809"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"010408","DOI":"10.7189\/jogh.08.010408","article-title":"Can facility delivery reduce the risk of intrapartum complications-related perinatal mortality? Findings from a cohort study","volume":"8","author":"Khanam","year":"2018","journal-title":"J. Glob. Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"6492","DOI":"10.1016\/j.vaccine.2017.01.049","article-title":"Low birth weight: Case definition and guidelines for data collection, analysis, and presentation of maternal immunization safety data","volume":"35","author":"Cutland","year":"2017","journal-title":"Vaccine"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1016\/S0140-6736(23)01198-4","article-title":"National, regional, and global estimates of low birthweight in 2020, with trends from 2000: A systematic analysis","volume":"403","author":"Okwaraji","year":"2024","journal-title":"Lancet"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e849","DOI":"10.1016\/S2214-109X(18)30565-5","article-title":"National, regional, and worldwide estimates of low birthweight in 2015, with trends from 2000: A systematic analysis","volume":"7","author":"Blencowe","year":"2019","journal-title":"Lancet Glob. Health"},{"key":"ref_12","first-page":"1","article-title":"Global prevalence of small for gestational age births","volume":"Volume 81","author":"Black","year":"2015","journal-title":"Low-Birthweight Baby: Born Too Soon or Too Small"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"(2020). Macrosomia: ACOG Practice Bulletin, Number 216. Obstet. Gynecol., 135, e18\u2013e35.","DOI":"10.1097\/AOG.0000000000003606"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1097\/OGX.0000000000001253","article-title":"Diagnosis and management of macrosomia and shoulder dystocia: A comprehensive review of major guidelines","volume":"79","author":"Giouleka","year":"2024","journal-title":"Obstet. Gynecol. Surv."},{"key":"ref_15","first-page":"H77","article-title":"Maternal and neonatal outcomes of macrosomic pregnancies","volume":"18","author":"Simchen","year":"2012","journal-title":"Med. Sci. Monit."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/j.genm.2012.09.002","article-title":"Perinatal maternal and neonatal outcomes in women with gestational diabetes mellitus according to fetal sex","volume":"9","author":"Tundidor","year":"2012","journal-title":"Gend. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1016\/j.jpeds.2008.10.012","article-title":"Use of a body proportionality index for growth assessment of preterm infants","volume":"154","author":"Olsen","year":"2009","journal-title":"J. Pediatr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1093\/oxfordjournals.aje.a115694","article-title":"The ponderal index in term newborn siblings","volume":"132","author":"Khoury","year":"1990","journal-title":"Am. J. Epidemiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3393","DOI":"10.1038\/s41598-018-21771-6","article-title":"Trend and risk factors of low birth weight and macrosomia in south China, 2005\u20132017: A retrospective observational study","volume":"8","author":"Rao","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_20","first-page":"138","article-title":"The impact of birth weight on infant mortality in Kazakhstan","volume":"351","author":"Ailbayeva","year":"2024","journal-title":"Georgian Med. News"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1097\/FM9.0000000000000309","article-title":"Customized birthweight standard for the population in the Republic of Kazakhstan","volume":"7","author":"Sharipova","year":"2025","journal-title":"Matern. Fetal Med."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Zhamantayev, O., Smagulov, N., Tykezhanova, G., Konkabayeva, A., Nukeshtayeva, K., Zhanalina, G., Aldanova, Z., Shintayeva, N., and Kurzhunbaeva, Z. (2025). Relationships between infant mortality and socioeconomic and demographic factors in Kazakhstan: An analysis from a middle-income country in Central Asia. BMC Public Health, 25.","DOI":"10.1186\/s12889-025-23317-8"},{"key":"ref_23","unstructured":"Dayletov, D. (2026). Newborns in Kazakhstan dataset. Zenodo."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Shan, X., Chen, F., Wang, W., Zhao, J., Teng, Y., Wu, M., Teng, H., Zhang, X., Qi, H., and Liu, X. (2014). Secular trends of low birthweight and macrosomia and related maternal factors in Beijing, China: A longitudinal trend analysis. BMC Pregnancy Childbirth, 14.","DOI":"10.1186\/1471-2393-14-105"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e007537","DOI":"10.1136\/bmjgh-2021-007537","article-title":"Preconception and periconception interventions to prevent low birth weight, small for gestational age and preterm birth: A systematic review and meta-analysis","volume":"7","author":"Partap","year":"2022","journal-title":"BMJ Glob. Health"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.1016\/S0140-6736(23)00522-6","article-title":"Small babies, big risks: Global estimates of prevalence and mortality for vulnerable newborns to accelerate change and improve counting","volume":"401","author":"Lawn","year":"2023","journal-title":"Lancet"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Falc\u00e3o, I.R., Ribeiro-Silva, R.C., de Almeida, M.F., Fiaccone, R.L., Dos, S.R.A., Ortelan, N., Silva, N.J., Paixao, E.S., Ichihara, M.Y., and Rodrigues, L.C. (2020). Factors associated with low birth weight at term: A population-based linkage study of the 100 million Brazilian cohort. BMC Pregnancy Childbirth, 20.","DOI":"10.1186\/s12884-020-03226-x"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"640291","DOI":"10.1155\/2014\/640291","article-title":"Maternal obesity and occurrence of fetal macrosomia: A systematic review and meta-analysis","volume":"2014","author":"Gaudet","year":"2014","journal-title":"BioMed Res. Int."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1159\/000371628","article-title":"Gestational diabetes mellitus and macrosomia: A literature review","volume":"66","author":"Kc","year":"2015","journal-title":"Ann. Nutr. Metab."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s00404-015-3825-8","article-title":"Excessive weight gain during pregnancy and risk of macrosomia: A meta-analysis","volume":"293","author":"Tian","year":"2016","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_31","unstructured":"Magliano, D.J., Boyko, E., and Diabetes Atlas 11th Edition Scientific Committee (2026, May 05). Chapter 3, The global picture of diabetes, Diabetes Atlas [Internet], Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK618744."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1001\/jamainternmed.2021.6373","article-title":"Association of antenatal diet and physical activity-based interventions with gestational weight gain and pregnancy outcomes: A systematic review and meta-analysis","volume":"182","author":"Teede","year":"2022","journal-title":"JAMA Intern. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"65","DOI":"10.3399\/bjgp14X676979","article-title":"Ecological studies: Use with caution","volume":"64","author":"Saunders","year":"2014","journal-title":"Br. J. Gen. Pract."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/8\/1069\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T13:21:12Z","timestamp":1786540872000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/8\/1069"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,12]]},"references-count":33,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["children13081069"],"URL":"https:\/\/doi.org\/10.3390\/children13081069","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,12]]}}}