{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:09:40Z","timestamp":1785409780709,"version":"3.56.0"},"reference-count":28,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010034","name":"Walailak University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100010034","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/04b69g067","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int. J. Environ. Res. Public Health","IJERPH"],"abstract":"<jats:p>Maternal anemia during pregnancy may adversely affect fetal growth, including neonatal head circumference (HC). This retrospective cohort study aimed to identify predictors of small HC among infants born to women with third-trimester anemia. Secondary data were obtained from the HosXP electronic medical database and delivery records of pregnant women who delivered between October 2020 and September 2023. A total of 934 women met the eligibility criteria and were included in the analysis. Maternal characteristics were summarized using descriptive statistics. Associations between maternal factors and neonatal HC were examined using the Chi-square test, Fisher\u2019s exact test or Mann\u2013Whitney U test, and independent predictors were identified using binary logistic regression analysis. The mean neonatal HC was 32.76 \u00b1 1.50 cm, and 43.90% of infants were classified as having a small HC. Gravidity, pre-pregnancy body mass index (BMI), and gestational weight gain (GWG) were significantly associated with neonatal HC. Multivariable analysis revealed that women with two pregnancies (aOR = 0.51, 95% CI: 0.352\u20130.734) and those with three or more pregnancies (aOR = 0.54, 95% CI: 0.373\u20130.773) had lower odds of delivering infants with small HC than primigravida women. Pre-pregnancy overweight or obesity was associated with lower odds of small HC (aOR = 0.59, 95% CI: 0.426\u20130.805), whereas inadequate GWG increased the likelihood of this outcome (aOR = 1.38, 95% CI: 1.010\u20131.894). Maternal gravidity, pre-pregnancy BMI, and GWG may influence neonatal HC. These findings may support nurses in identifying women at risk, monitoring GWG, and providing targeted nutritional counseling during antenatal care.<\/jats:p>","DOI":"10.3390\/ijerph23080964","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T17:16:34Z","timestamp":1785172594000},"page":"964","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictive Factors for Small Head Circumference Among Pregnant Women with Third-Trimester Anemia"],"prefix":"10.3390","volume":"23","author":[{"given":"Rachadaporn","family":"Jantasuwan","sequence":"first","affiliation":[{"name":"Division of Community Nursing, School of Nursing, The Excellence Center of Community Health Promotion, Walailak University, Nakhon Si Thammarat 80161, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2247-4525","authenticated-orcid":false,"given":"Suda","family":"Jaihow","sequence":"additional","affiliation":[{"name":"Division of Maternal-Newborn and Midwifery Nursing, School of Nursing, The Excellence Center of Community Health Promotion, Walailak University, Nakhon Si Thammarat 80161, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4540-3412","authenticated-orcid":false,"given":"Sumoltip","family":"Sontimuang","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nursing, School of Nursing, The Excellence Center of Community Health Promotion, Walailak University, Nakhon Si Thammarat 80161, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanyapak","family":"Pluemjai","sequence":"additional","affiliation":[{"name":"Division of Maternal-Newborn and Midwifery Nursing, School of Nursing, The Excellence Center of Community Health Promotion, Walailak University, Nakhon Si Thammarat 80161, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9624-9481","authenticated-orcid":false,"given":"Hasni","family":"Embong","sequence":"additional","affiliation":[{"name":"Nursing Program, School of Health Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu 16050, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salwismawati","family":"Badrin","sequence":"additional","affiliation":[{"name":"Nursing Program, School of Health Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu 16050, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Campbell, R.K., Tanna, N.K., Hartwig, J., Buhimschi, C.S., and Buhimschi, I.A. (2025). Determinants of the Association Between Maternal Anemia and Neonatal Hemoglobin. Nutrients, 17.","DOI":"10.3390\/nu17142292"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.1007\/s10995-022-03450-1","article-title":"Global Prevalence of Anemia in Pregnant Women: A Comprehensive Systematic Review and Meta-Analysis","volume":"26","author":"Karami","year":"2022","journal-title":"Matern. Child Health J."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Zhou, Y., Lyu, Y., Ye, W., Shi, H., Peng, Y., Wen, Z., Narayan, A., Huang, X., Chang, S., and Yang, Y. (2024). The Prevalence of Anemia among Pregnant Women in China: A Systematic Review and Meta-Analysis. Nutrients, 16.","DOI":"10.3390\/nu16121854"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Kamlungkuea, T., Kaewchung, C., Sublon, N., Tanyongmasakul, N., Butsart, S., Winijchai, P., Jatavan, P., and Tongsong, T. (2025). Pregnancy Outcomes Among Women with Treated Iron Deficiency Anemia: A Retrospective Cohort Study. Nutrients, 17.","DOI":"10.3390\/nu17193168"},{"key":"ref_5","unstructured":"Cunningham, F.G., Leveno, K.J., Dashe, J.S., Hoffman, B.L., Spong, C.Y., and Casey, B.M. (2022). Williams Obstetrics, McGraw-Hill. [26th ed.]."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e487","DOI":"10.61919\/448x3e13","article-title":"Anthropometric Measurements in Term Neonates at Birth in Pregnant Patients with and without Anemia","volume":"3","author":"Anwar","year":"2025","journal-title":"J. Health Wellness Community Res."},{"key":"ref_7","first-page":"162","article-title":"Trimester-Specific Maternal Hemoglobin Levels and Their Association with Neonatal Anthropometric Parameters: A Cross-Sectional Study","volume":"7","author":"Haritash","year":"2026","journal-title":"Int. J. Med. Pharm. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1111\/j.1469-8749.2002.tb00850.x","article-title":"Head Growth and Cranial Assessment at Neurological Examination in Infancy","volume":"44","author":"Gosselin","year":"2002","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"30502225251310538","DOI":"10.1177\/30502225251310538","article-title":"Determinants of Low HCat Birth of New Born in Dessie Comprehensive Specialized Hospital, Northeast Ethiopia: A Case-Control Study","volume":"12","author":"Yimer","year":"2025","journal-title":"SAGE Open Pediatr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"318","DOI":"10.70749\/ijbr.v3i4.1091","article-title":"Association Between Maternal Anemia and the Anthropometric Measurements of Full-Term Newborns","volume":"3","author":"Kiran","year":"2025","journal-title":"Indus J. Biosci. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e020160","DOI":"10.1136\/bmjgh-2025-020160","article-title":"Women with Moderate Anaemia Prior to Conception Benefited Most from Nutrition Interventions: A Secondary Analysis of the Women First Preconception Maternal Nutrition Trial","volume":"11","author":"Kahe","year":"2026","journal-title":"BMJ Glob. Health"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"186","DOI":"10.3126\/jnps.v33i3.8251","article-title":"Effects of Third Trimester Maternal Hemoglobin upon Newborn Anthropometry","volume":"33","author":"Madaan","year":"2013","journal-title":"J. Nepal Paediatr. Soc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"28","DOI":"10.36321\/kjns.vi20252.20334","article-title":"Association Between Maternal Predictors and Neonatal Anthropometric Measurements","volume":"15","author":"Barqi","year":"2025","journal-title":"Kufa J. Nurs. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e000470","DOI":"10.1136\/bmjpo-2019-000470","article-title":"Small HCat Birth: An 8-Year Retrospective Cohort Study in China","volume":"3","author":"Liu","year":"2019","journal-title":"BMJ Paediatr. Open"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"111","DOI":"10.2478\/anre-2018-0009","article-title":"The Impact of Maternal Age on Foetal Growth Patterns and Newborn Size","volume":"81","author":"Kirchweger","year":"2018","journal-title":"Anthropol. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"129","DOI":"10.7762\/cnr.2019.8.2.129","article-title":"Pre-Pregnancy Body Mass Index and Maternal Nutrition in Relation to Infant Birth Size","volume":"8","author":"Bonakdar","year":"2019","journal-title":"Clin. Nutr. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e072249","DOI":"10.1136\/bmj-2022-072249","article-title":"Suboptimal Gestational Weight Gain and Neonatal Outcomes in Low and Middle Income Countries: Individual Participant Data Meta-Analysis","volume":"382","author":"Perumal","year":"2023","journal-title":"BMJ"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1016\/S0895-4356(96)00236-3","article-title":"A Simulation Study of the Number of Events per Variable in Logistic Regression Analysis","volume":"49","author":"Peduzzi","year":"1996","journal-title":"J. Clin. Epidemiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"19","DOI":"10.5505\/ejm.2020.43265","article-title":"Assessment of Maternal and Fetal Outcomes in Adolescent and Non-Adolescent Pregnant Women","volume":"25","author":"Sonkaya","year":"2020","journal-title":"East. J. Med."},{"key":"ref_20","first-page":"QC04","article-title":"Maternal Anaemia and Neonatal Outcome: A Prospective Study on Urban Pregnant Women","volume":"9","author":"Kaur","year":"2015","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/j.placenta.2005.12.006","article-title":"The Uterine Spiral Arteries in Human Pregnancy: Facts and Controversies","volume":"27","author":"Pijnenborg","year":"2006","journal-title":"Placenta"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"S745","DOI":"10.1016\/j.ajog.2017.11.577","article-title":"Pathophysiology of Placental-Derived Fetal Growth Restriction","volume":"218","author":"Burton","year":"2018","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1932","DOI":"10.1007\/s43032-020-00212-8","article-title":"Regulation of Uterine Spiral Artery Remodeling: A Review","volume":"27","author":"Albrecht","year":"2020","journal-title":"Reprod. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1152\/physiol.00033.2008","article-title":"Maternal Uterine Vascular Remodeling During Pregnancy","volume":"24","author":"Osol","year":"2009","journal-title":"Physiology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1126\/science.aaw1300","article-title":"The Immunological Code of Pregnancy","volume":"365","author":"Colucci","year":"2019","journal-title":"Science"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1186\/s12937-024-01042-z","article-title":"Maternal Iron Nutrition During Pregnancy and Fetal Intrauterine Growth","volume":"23","author":"Yang","year":"2024","journal-title":"Nutr. J."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Sontimuang, S., Jantasuwan, R., Jaihow, S., Pluemjai, K., Luksanavimon, L., Badrin, S., and Embong, H. (2026). Relationship Between Pre-Pregnancy Body Mass Index, Gestational Weight Gain, and Perinatal Outcomes Among Women Delivering at a General Hospital, Nakhon Si Thammarat Province. Int. J. Environ. Res. Public Health, 23.","DOI":"10.3390\/ijerph23070924"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1093\/emph\/eoz037","article-title":"The Maternal Nutritional Buffering Model: An Evolutionary Framework for Pregnancy Nutritional Intervention","volume":"2020","author":"Thayer","year":"2020","journal-title":"Evol. Med. Public Health"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/8\/964\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T04:11:27Z","timestamp":1785211887000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/8\/964"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,26]]},"references-count":28,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["ijerph23080964"],"URL":"https:\/\/doi.org\/10.3390\/ijerph23080964","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,26]]}}}