The Effect of Structural Gender Inequality Revealed in Small for Gestational Age

BACKGROUND: This study proposes that being small for gestational age (SGA) is not only an important indicator for neonatal health but also could be a consequence of gender inequality. Low birth weight (LBW) has been widely used as a measurement for adverse birth outcomes, whereas much less attention has been given to the use of small for gestational age (SGA). Despite the importance and worldwide acknowledgement of promoting gender equality and women’s empowerment to improve maternal and infant health, previous studies on SGA have focused on nutritional status, social and medical infrastructures, and socioeconomic status. The impact of structural violence against women on SGA has not been explored sufficiently. Therefore, the aim of this study was to examine the effect of gender inequality on SGA, using the Gender Inequality Index (GII). METHODS: A total of 106 low- and middle-income countries (LMICs) from the most recent three global datasets—Institute of Health Metrics and Evaluation (IHME), the UN Development Programme (UNDP), and World Bank—were assessed. RESULTS: Findings from generalized linear model analysis suggest that significant links exist between years of potential life lost (YLL) from SGA and gender inequality, maternal health status, and country level of income. CONCLUSIONS: Our findings advance the understanding of the role of gender inequality on SGA and reiterate the importance of considering structural violence in maternal and infant health research. These associations can support the message of designing public health and socioeconomic development as well as creating campaigns to promote gender equality in efforts to advance maternal and infant health and to prevent adverse birth outcomes across the globe. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40609-022-00245-8.