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Niknam A, Behboudi-Gandevani S, Rahmati M, Firouzi F, Azizi F, Ramezani Tehrani F. Gestational weight gain as a mediator of the relationship between pre-pregnancy body mass index and the risk of preterm birth: A four-way decomposition analysis. Int J Gynaecol Obstet 2024. [PMID: 39011572 DOI: 10.1002/ijgo.15789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 06/30/2024] [Accepted: 07/02/2024] [Indexed: 07/17/2024]
Abstract
OBJECTIVE The aim of the present study was to examine and quantify whether the association between preterm birth (PTB) and pre-pregnancy body mass index (BMI) is mediated by gestational weight gain (GWG). METHODS This is a secondary analysis of a large randomized community non-inferiority trial using a cohort design. The data of 26 101 pregnant women in their first trimester who sought prenatal care and met eligibility criteria were included. The four-way decomposition method was applied to screen for all types of association effects of pre-pregnancy BMI on the risk of PTB. These effects include the total, direct, and various indirect effects including pure mediation via GWG, interactive effects with GWG, and mediated interaction with GWG, all adjusted for potential confounders. RESULTS Among the study participants, 24 461 (93.7%) had term deliveries, while 1640 (6.3%) experienced PTB. The results of the study showed that there was a positive association between pre-pregnancy BMI among those with BMI more than 25 kg/m2 and the risk of PTB and this association was negatively mediated and interacted by GWG, which differed quantitatively between those who had inadequate, adequate, or excessive GWG. The total association effect showed that the risk was lowest for those who had underweight pre-pregnancy BMI and adequate GWG (excess relative risk [RR]: 0.06, 95% CI: 0.01-0.11, P value: 0.022) and was highest for those who had obese pre-pregnancy BMI and excessive GWG (excess RR: 0.67, 95% CI: 0.35-1.00, P value <0.001). CONCLUSION The findings of the present prospective population-based study demonstrated that pre-pregnancy BMI >25 kg/m2 is directly and positively associated with the risk of preterm birth. The highest risk of preterm birth was observed among individuals with an obese pre-pregnancy BMI who also experienced excessive GWG.
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Affiliation(s)
- Atrin Niknam
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Maryam Rahmati
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Faegheh Firouzi
- Tehran Medical Branch, Islamic Azad University, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- The foundation for research & Education Excellence, Vestaria Hills, Al, USA
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Mansor E, Ahmad N, Mohd Zulkefli NA, Lim PY. Incidence and determinants of low birth weight in Peninsular Malaysia: A multicentre prospective cohort study. PLoS One 2024; 19:e0306387. [PMID: 38995940 PMCID: PMC11244833 DOI: 10.1371/journal.pone.0306387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 06/17/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Pregnant mothers are at risk of many adverse pregnancy outcomes, including infants with low birth weight (LBW). The World Health Organization aimed to achieve a 30% reduction in the number of LBW infants by the year 2025. In this study, we aimed to determine the incidence and determinants of LBW infants among pregnant mothers attending government health clinics in Peninsular Malaysia. MATERIAL AND METHODS A prospective cohort study "Relative Risk of Determinants of Adverse Pregnancy Outcomes Among Pregnant Mothers Attending Government Health Clinics, Peninsular Malaysia, PEN-MUM" was conducted from March 2022 until March 2023 at 20 government health clinics in Peninsular Malaysia that were randomly selected through a multistage sampling method. Malaysian pregnant mothers between 18 and 49 years old were recruited at 12-18 weeks of gestation and followed up at three time points: 1 (24-28 weeks of gestation), 2 (36-40 weeks of gestation), and 3 (post-delivery). Eight exposure factors of LBW were studied: gestational weight gain, dengue infection, urinary tract infection, COVID-19 infection, gestational hypertension, preeclampsia, maternal anemia, and gestational diabetes mellitus (GDM). RESULTS Among 507 participants enrolled in the cohort, 40 were lost to follow-up. A total of 467 were included in the final analysis, giving an attrition rate of 7.9%. The incidence of LBW infants in Peninsular Malaysia was 14.3%. After adjusting for three covariates (ethnicity, employment status, and gestational age at birth), three determinants of LBW were identified. The risk of giving birth to LBW infants was higher among those with inadequate gestational weight gain (aRR = 2.86, 95% CI: 1.12, 7.37, p = 0.03), gestational hypertension (aRR = 4.12; 95% CI: 1.66, 10.43; p = 0.002), and GDM (aRR = 2.21; 95% CI: 1.18, 4.14; p = 0.013) during the second and third trimesters. CONCLUSIONS The incidence of LBW infants in Peninsular Malaysia can be considered high. Having inadequate gestational weight gain, gestational hypertension, and GDM in the second and third trimesters increased the risk of LBW infants by threefold, fivefold, and twofold respectively. Thus, intervention strategies should target prevention, early detection, and treatment of gestational hypertension and GDM, as well as promoting adequate weight gain during antenatal care.
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Affiliation(s)
- Elliza Mansor
- Ministry of Health, Putrajaya, Malaysia
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Norliza Ahmad
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Nor Afiah Mohd Zulkefli
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Poh Ying Lim
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Shiraishi M, Kurashima Y, Harada R. Association Between Body Image Before and During Pregnancy and Gestational Weight Gain in Japanese Women: A Prospective Cohort Study. Matern Child Health J 2024; 28:708-718. [PMID: 38051453 DOI: 10.1007/s10995-023-03854-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVES More than half of women do not achieve appropriate gestational weight gain. Maternal body image may be an important factor associated with gestational weight gain. However, this association has not been thoroughly evaluated. We aimed to elucidate whether body image parameters before and during pregnancy are associated with gestational weight gain in Japanese women. METHODS This prospective cohort study was conducted at a hospital in Osaka, Japan from March 2020 to March 2021. We recruited women with singleton pregnancies in their second and third trimesters. Body image was assessed using the Pregnancy and Weight Gain Attitude Scale and additional questions. Gestational weight gain was classified as insufficient, appropriate, or excessive based on recommended ranges in Japan. One-way analysis of variance, chi-square tests, and multinomial logistic regression analyses were performed to identify factors associated with insufficient or excessive weight gain. RESULTS Of 266 enrolled women, 47 had insufficient weight gain and 100 had excessive weight gain during pregnancy. Risk factors for excessive gestational weight gain included a history of dietary restriction before pregnancy, negative attitudes toward gestational weight gain, and perception of body shape as fat and body shape dissatisfaction during pregnancy. Perception of body shape as thin during pregnancy was identified as a risk factor for insufficient gestational weight gain. CONCLUSIONS Body image before and during pregnancy may be an important factor in preventing insufficient or excessive gestational weight gain in Japanese women. Healthcare professionals should consider body image when providing health guidance on weight management to pregnant women.
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Affiliation(s)
- Mie Shiraishi
- Department of Children and Women's Health, Division of Health Sciences, Graduate School of Medicine, Osaka University, 1-7, Yamadaoka, Suita, 565-0871, Osaka, Japan.
| | - Yuki Kurashima
- Department of Children and Women's Health, Division of Health Sciences, Graduate School of Medicine, Osaka University, 1-7, Yamadaoka, Suita, 565-0871, Osaka, Japan
| | - Rio Harada
- Department of Children and Women's Health, Division of Health Sciences, Graduate School of Medicine, Osaka University, 1-7, Yamadaoka, Suita, 565-0871, Osaka, Japan
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Feria-Ramirez C, Gonzalez-Sanz JD, Molina-Luque R, Molina-Recio G. Influence of gestational weight gain on the nutritional status of offspring at birth and at 5 years of age. Midwifery 2024; 129:103908. [PMID: 38142650 DOI: 10.1016/j.midw.2023.103908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 11/24/2023] [Accepted: 12/07/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVE To determine the influence of pre-pregnancy maternal BMI and increases in maternal weight during pregnancy on perinatal and child outcomes at birth and at 5 years. RESEARCH DESIGN/SETTING A prospective cohort study was conducted between November 2016 and December 2021. The participants were a total of 115 women-child dyads, selected from among pregnant women receiving routine prenatal care in different health centres belonging to 2 health districts. Follow-ups were conducted with the women during pregnancy and with their children during the 10 days after birth and at 5 years. FINDINGS The total weight gain during pregnancy is influenced by an inadequate pre-pregnancy BMI (0.03; 95 % CI, 0.004 - 0.25; P=.001) and a greater increase in maternal BMI during the first and second term of pregnancy. A greater increase in BMI during pregnancy was associated with higher breastfeeding rates both in the short term (1.21; 95 % CI, 1.01-1.44; P = 0.04) and the long term (12 months: 1.30; 95 % CI, 1.02 - 1.67; P = 0.04; 24 months: 1.30; 95 % CI, 1.02 - 1.69; P = 0.04). No links were found between gains in maternal weight and the weight of the newborn, nor between maternal weight and/or pre-pregnancy BMI with the nutritional status of the child. KEY CONCLUSIONS After studying these results, it was concluded that promoting and implementing health and education policies focused on enhancing maternal nutritional status is essential to improve the nutritional status of children. IMPLICATIONS FOR PRACTICE Healthy gestational weight gain (GWG) is an important issue to be addressed by the midwife in primary care, both in the preconception period and throughout pregnancy. As a result, it is important that the midwife is trained and has the appropriate resources and tools to work with pregnant women individually and collectively. In addition to paying attention to overweight and obese pregnant women, the midwife should also pay attention to women with a normal BMI, as they seem to have greater difficulty in maintaining a healthy weight gain. Another line of intervention to be addressed is breastfeeding (BF), where the midwife should be the main point of reference from the beginning of this process, taking into account the relationship between BMI and BF.
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Affiliation(s)
- Carmen Feria-Ramirez
- Department of Nursing, Faculty of Nursing, University of Huelva, Avda. Tres de Marzo, s/n, Huelva 21071, Spain
| | - Juan D Gonzalez-Sanz
- Department of Nursing, Faculty of Nursing, University of Huelva, Avda. Tres de Marzo, s/n, Huelva 21071, Spain; COIDESO Research Center, University of Huelva, Avda. Tres de Marzo, s/n, Huelva 21071, Spain.
| | - Rafael Molina-Luque
- Lifestyles, Innovation and Health Research Associate Group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Avda. Menéndez Pidal, s/n, Córdoba 14004, Spain; Department of Nursing, Pharmacology and Physiotherapy, Faculty of Nursing, University of Cordoba, Avda. Menéndez Pidal, s/n, Córdoba 14004, Spain
| | - Guillermo Molina-Recio
- Lifestyles, Innovation and Health Research Associate Group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Avda. Menéndez Pidal, s/n, Córdoba 14004, Spain; Department of Nursing, Pharmacology and Physiotherapy, Faculty of Nursing, University of Cordoba, Avda. Menéndez Pidal, s/n, Córdoba 14004, Spain
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Du M, Muhuza MPU, Tang Y, Chen Y, Chen D, Zhang L, Liang Z. Maternal Height Is an Independent Risk of Adverse Outcomes in Women with Gestational Diabetes Mellitus. Diabetes Ther 2024; 15:461-472. [PMID: 38104305 PMCID: PMC10838893 DOI: 10.1007/s13300-023-01512-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 11/14/2023] [Indexed: 12/19/2023] Open
Abstract
INTRODUCTION Maternal height has been shown to be associated with adverse outcomes in women with gestational diabetes mellitus (GDM). The aim of this study is to evaluate the association between maternal height and adverse outcomes stratified for gestational weight gain (GWG) and pre-pregnancy body mass index (BMI) in women with GDM. METHODS We conducted a retrospective study that included 2048 women diagnosed with GDM during 24-28 gestational weeks from July 1, 2017, to June 30, 2018, in Zhejiang Province, China. Demographic data, maternal characteristics and pregnancy complications were extracted from medical records. Maternal height was divided into three categories by tertiles. Chi-square was used to evaluate categorical data while one-way ANOVA was utilized to analyze continuous variables. The relationship between maternal height and adverse outcomes was examined using logistic regression. RESULTS We found that shorter women had higher rates of low birth weight (LBW) (p = 0.003) and primary cesarean section (primary CS) (p < 0.001) while taller women had higher rates of abnormal neonatal ponderal index (p < 0.001), postpartum hemorrhage (p = 0.044) and macrosomia (p < 0.001). In taller women who had excess GWG, maternal height was positively associated with the risk of macrosomia (aOR 1.97, 95% CI 0.95-4.10). In shorter women who had inadequate GWG, maternal height was significantly associated with LBW (aOR 2.20, 95% CI 1.13-4.29) and primary CS (aOR 2.08, 95% CI 1.38-3.12). Maternal height was a protective factor of postpartum hemorrhage (aOR 0.15, 95% CI 0.03-0.72) in shorter women with excess GWG. In women with normal pre-pregnancy BMI, maternal height was positively associated with LBW (aOR 2.00, 95% CI 1.15-3.49) and primary CS (aOR 1.71, 95% CI 1.28-2.28) in shorter women while it was negatively associated with the risk of abnormal neonatal ponderal index in both shorter and taller women compared to average height women (aOR 0.71, 95% CI 0.55-0.92; aOR 0.66, 95% CI 0.51-0.85). CONCLUSION The association between maternal height and adverse pregnancy outcomes varies with pre-pregnancy BMI and GWG in GDM women. Taking maternal height, pre-pregnancy BMI and GWG into account and using personalized prenatal management may reduce the risk of adverse pregnancy outcomes in GDM.
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Affiliation(s)
- Mengkai Du
- Obstetrical Department, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, 310006, China
| | | | - Yibo Tang
- Obstetrical Department, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, 310006, China
| | - Yanmin Chen
- Obstetrical Department, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, 310006, China
| | - Danqing Chen
- Obstetrical Department, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, 310006, China
| | - Lixia Zhang
- Obstetrical Department, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, 310006, China.
| | - Zhaoxia Liang
- Obstetrical Department, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, 310006, China.
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Tomita H, Iwama N, Hamada H, Kudo R, Tagami K, Kumagai N, Sato N, Izumi S, Sakurai K, Watanabe Z, Ishikuro M, Obara T, Tatsuta N, Hoshiai T, Metoki H, Saito M, Sugawara J, Kuriyama S, Arima T, Yaegashi N. The impact of maternal and paternal birth weights on infant birth weights: the Japan environment and children's study. J Dev Orig Health Dis 2023; 14:699-710. [PMID: 38247363 DOI: 10.1017/s2040174423000387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
This study aimed to evaluate the association between parental and infant birth weights in Japan. In total, 37,504 pregnant Japanese women and their partners were included in this birth cohort study. A multinomial logistic regression model was used to evaluate the associations of parental birth weights with small-for-gestational-age (SGA) or large-for-gestational-age (LGA) infants. Associations between parental birth weight and low birth weight (LBW) infants or macrosomia were also examined, and linear associations between parental birth weight and SGA or LGA were found. The adjusted odds ratios (aORs) for SGA infants per 500 g decrease in maternal and paternal birth weights were 1.50 (95% confidence interval [CI],1.43-1.58) and 1.31 (95% CI, 1.25-1.38), respectively. The aORs for LGA infants per 500 g increase in maternal and paternal birth weights were 1.53 (95% CI, 1.47-1.60) and 1.41 (95% CI, 1.35-1.47), respectively. The association between parental birth weight and LBW infants or macrosomia was also linear. The aORs for LBW infants per 500 g decrease in maternal and paternal birth weights were 1.47 (95% CI, 1.40-1.55) and 1.25 (95% CI, 1.19-1.31), respectively. The aORs for macrosomia per 500 g increase in maternal and paternal birth weights were 1.59 (95% CI, 1.41-1.79) and 1.40 (95% CI, 1.23-1.60), respectively. Parental birth weight was found to be associated with infant birth weight even after adjusting for various parental factors. Furthermore, maternal birth weight was more strongly associated with infant birth weight than with paternal birth weight.
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Affiliation(s)
- Hasumi Tomita
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
| | - Noriyuki Iwama
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
- Division of Molecular Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, MI, Japan
| | - Hirotaka Hamada
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
| | - Rie Kudo
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
| | - Kazuma Tagami
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
| | - Natsumi Kumagai
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
| | - Naoto Sato
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
| | - Seiya Izumi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
| | - Kasumi Sakurai
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
| | - Zen Watanabe
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
| | - Mami Ishikuro
- Division of Molecular Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, MI, Japan
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
| | - Taku Obara
- Division of Molecular Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, MI, Japan
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
| | - Nozomi Tatsuta
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
| | - Tetsuro Hoshiai
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical Pharmaceutical University, Sendai, MI, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, MI, Japan
| | - Masatoshi Saito
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
- Department of Maternal and Fetal Therapeutics, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
| | - Junichi Sugawara
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, MI, Japan
- Suzuki Memorial Hospital, Iwanuma, MI, Japan
| | - Shinichi Kuriyama
- Division of Molecular Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, MI, Japan
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai, MI, Japan
| | - Takahiro Arima
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, MI, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, MI, Japan
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Sato N, Haruyama R, Miyasaka N. Effective gestational weight gain advice to optimize infant birth weight in Japan based on quantile regression analysis. Sci Rep 2023; 13:20954. [PMID: 38017257 PMCID: PMC10684669 DOI: 10.1038/s41598-023-48375-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 11/25/2023] [Indexed: 11/30/2023] Open
Abstract
The optimal range of gestational weight gain (GWG) was recently raised in Japan. This may help reduce small-for-gestational-age (SGA) infants, but may also increase large-for-gestational-age (LGA) infants. This study performed hypothetical experiments to determine effective GWG advice based on quantile regression analysis. In a total of 354,401 singleton pregnancies registered in the perinatal database of the Japan Society of Obstetrics and Gynecology (2013-2017), the proportions of SGA and LGA were 9.33% and 11.13%, respectively. Using regression coefficients of GWG across the birth weight-for-gestational-age quantile distribution, we analyzed changes in their proportions by simulating a uniform 3-kg extra increase in GWG or an increase or decrease based on GWG adequacy. A hypothetical experiment of a uniform increase in GWG resulted in SGA and LGA proportions of 7.26% (95% confidence interval 7.15-7.36) and 14.51% (14.37-14.66), respectively. By contrast, assuming a 3-kg increase in women with inadequate GWG and a 3-kg decrease in women with excessive GWG resulted in SGA and LGA proportions of 8.42% (8.31-8.54) and 11.50% (11.37-11.62), respectively. Our real-world data analysis suggests that careful adjustment of GWG based on GWG adequacy will be effective in optimizing infant birth weight in Japan.
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Affiliation(s)
- Noriko Sato
- Department of Food and Nutrition, Faculty of Human Sciences and Design, Japan Women's University, 2-8-1 Mejirodai, Bunkyo-ku, Tokyo, 112-8681, Japan.
| | - Rei Haruyama
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan
| | - Naoyuki Miyasaka
- Comprehensive Reproductive Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, 113-8510, Japan
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Okui T. Analysis of the Incidence of Macrosomia in Japan by Parental Nationalities at 5-year Intervals From 1995 to 2020. J Prev Med Public Health 2023; 56:348-356. [PMID: 37551073 PMCID: PMC10415649 DOI: 10.3961/jpmph.23.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/26/2023] [Indexed: 08/09/2023] Open
Abstract
OBJECTIVES We investigated trends in the incidence rate of macrosomia and its association with parental nationalities using Vital Statistics data in Japan. METHODS We used singleton birth data every 5 years from 1995 to 2020. The incidence rate of macrosomia was calculated according to specific attributes (maternal age, infant's sex, parental nationalities, parity, and household occupation) over time (years). In addition, a log-binomial model was used to investigate the relationship between the incidence of macrosomia and the attributes. This study compared Korea, China, the Philippines, Brazil, and other countries with Japan in terms of parental nationalities. "Other countries" indicates countries except for Japan, Korea, China, the Philippines, and Brazil. RESULTS The study included 6 180 787 births. The rate of macrosomia in Japan decreased from 1.43% in 1995 to 0.88% in 2020, and the decrease was observed across all parental nationalities. The rates for Japanese parents were the lowest values among parental nationalities during the timespan investigated. Multivariate regression analysis showed that mothers from Korea, China, the Philippines, Brazil, and other countries had a significantly higher risk of macrosomia than those from Japan (risk ratio, 1.91, 2.82, 1.59, 1.74, and 1.64, respectively). Furthermore, fathers from China, the Philippines, Brazil, and other countries had a significantly higher risk of macrosomia than those from Japan (risk ratio, 1.66, 1.38, 1.88, and 3.02, respectively). CONCLUSIONS The rate of macrosomia decreased from 1995 to 2020 in Japan for parents of all nationalities, and the risk of macrosomia incidence was associated with parental nationality.
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Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
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Mydam J, Mellacheruvu P, Coler B, Chintala S, Depala KS, Sangani S. The Effect of Maternal Race, Ethnicity, and Nativity on Macrosomia Among Infants Born in the United States. Cureus 2023; 15:e39391. [PMID: 37362521 PMCID: PMC10286772 DOI: 10.7759/cureus.39391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
OBJECTIVES This study aims to elucidate the influence of race, ethnicity, and nativity on macrosomia rates, hypothesizing that higher rates are observed among White non-Latina mothers and United States (US)-born mothers. STUDY DESIGN We analyzed data from 1,791,718 US births sourced from the National Center for Health Statistics of the Centers for Disease Control and Prevention. Logistic regression analyses were conducted to examine the associations between macrosomia rates and maternal race, ethnicity, and nativity. RESULTS After excluding non-singleton, preterm, post-term births, and those with missing data, six maternal cohorts were identified: White non-Latina US-born (1,147,096) and foreign-born (75,542), Black non-Latina US-born (174,540) and foreign-born (32,200), and Latina US-born (223,968) and foreign-born (137,515). White non-Latina US-born mothers had the highest rates of excessive gestational weight gain (58.9%). Black non-Latina US-born mothers exhibited the highest rates of pre-pregnancy diabetes (0.7%) and obesity (29.5%). Macrosomia rates were highest among White non-Latina US-born mothers (10.7%) compared to other cohorts. After adjusting for socioeconomic and health-related factors, this group maintained the highest odds of macrosomia (OR: 1.876; 95%CI 1.832-1.922, P<0.001). CONCLUSION Our findings reveal that White non-Latina US-born mothers experience the highest macrosomia rates, which persist after adjusting for known confounders. These results have significant implications for the development of gestational surveillance tools and targeted public health interventions aimed at improving pregnancy outcomes among high-risk cohorts.
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Affiliation(s)
- Janardhan Mydam
- Department of Neonatology, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA
| | - Pranav Mellacheruvu
- Elson S. Floyd College of Medicine, Washington State University, Spokane, USA
| | - Brahm Coler
- Elson S. Floyd College of Medicine, Washington State University, Spokane, USA
| | - Soumini Chintala
- Department of Pediatrics, Phoenix Children's Hospital, Phoenix, USA
| | - Kiran S Depala
- Department of Public Health, Saint Louis University, St Louis, USA
| | - Shreeya Sangani
- Department of Neonatology, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA
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Sohrabi Z, Kazemi A, Farajzadegan Z, Janighorban M. Body perception in pregnant women: a qualitative study. BMC Pregnancy Childbirth 2023; 23:165. [PMID: 36906547 PMCID: PMC10007813 DOI: 10.1186/s12884-023-05467-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 02/23/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Dramatic body changes in pregnancy cause severe concerns among pregnant women about their appearance. Therefore, this study aimed to explore body perception in pregnant women. MATERIALS AND METHODS The qualitative study, using the conventional content analysis approach, was conducted on Iranian pregnant women who were in their second or third trimester of pregnancy. Participants were selected through purposeful sampling method. In-depth and semi-structured interviews were held with 18 pregnant women aged 22 to 36 years, using open-ended questions. Sampling was performed until data saturation was reached. RESULTS Three main categories were extracted from 18 interviews: (1) "symbols," with two subcategories, including 'motherhood' and 'vulnerability,' (2) "feelings toward body changes," with five subcategories, including 'negative feelings toward skin changes,' 'feeling unfit,' 'attention-drawing body shape,' 'the ridiculous body shape' and 'obesity,' and (3) "attraction and beauty," with two subcategories, including 'sexual attraction' and 'facial beauty.' CONCLUSION The results showed that pregnant women's body perception could be described as maternal feelings and feminine attitudes toward changes during pregnancy compared to mental ideals of facial and body beauty. It is recommended that Iranian women's body perception during pregnancy be evaluated using this study results and that counseling interventions be implemented for women with negative body perceptions.
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Affiliation(s)
- Zahra Sohrabi
- Reproductive Health Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Kazemi
- Reproductive Health Department, Isfahan University of Medical Sciences, Isfahan, Iran. .,Reproductive Health Department, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Hezarjerib Av., Isfahan, Iran.
| | - Ziba Farajzadegan
- Community and Preventive Medicine Department, Medicine Faculty, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojgan Janighorban
- Reproductive Health Department, Isfahan University of Medical Sciences, Isfahan, Iran
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11
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Nishihama Y, Nakayama SF, Tabuchi T. Population attributable fraction of risk factors for low birth weight in the Japan Environment and Children's Study. ENVIRONMENT INTERNATIONAL 2022; 170:107560. [PMID: 36240622 DOI: 10.1016/j.envint.2022.107560] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/15/2022] [Accepted: 10/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Low birth weight (LBW), which is considered a birth weight of <2500 g, poses significant health problems for children. However, population attributable fraction (PAF) of risk factors for LBW have not been well studied. OBJECTIVE We aimed to re-evaluate associations between risk factors for LBW reported in previous studies that used the Japan Environment and Children's Study (JECS) data, and to estimate the magnitude of risk using PAF. METHODS Data including 91,559 mother-child dyads were obtained from JECS. Risk factors identified by previous studies that used JECS data were used to calculate odds ratios for LBW using a Bayesian logistic regression model. Based on calculated odds ratios, the PAF was calculated. RESULTS Parity, history of adenomyosis, hypertension disorder of pregnancy, maternal age at birth, prepregnancy body mass index, gestational weight gain (GWG), maternal smoking and lead (Pb) exposure were all significantly associated with LBW. The sum of the PAF of all factors was 79.4 %, with the largest PAF among single risk factors being GWG (16.5 %); the environmental portion of the PAF (Pb exposure, 14.6 % + maternal smoking, 12.1 %) surpassed the PAF of GWG. CONCLUSION Our findings suggest that the number of births classified as LBW can be reduced by approximately 27% if Pb exposure is reduced to the lowest quartile and maternal smoking is eliminated. Further investigations are needed to identify unknown risk factors for LBW.
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Affiliation(s)
- Yukiko Nishihama
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan.
| | - Shoji F Nakayama
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan.
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan.
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Song W, Zhang Z, Zheng W, Gao L, Liang S, Cheng D, Wang X, Guo C, Li G. Patterns of gestational weight gain among women with obesity and its correlation with hypertensive disorders of pregnancy in Chinese women. MATERNAL & CHILD NUTRITION 2022:e13416. [PMID: 36098354 DOI: 10.1111/mcn.13416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/14/2022] [Accepted: 07/18/2022] [Indexed: 12/01/2022]
Abstract
Gestational weight management in obese women is critical in clinical work. Adverse pregnancy outcomes are associated with improper gestational weight gain (GWG). However, the pattern of GWG (PGWG) and its correlation with hypertensive disorders of pregnancy (HDP) in obesity are still unclear in China. This retrospective cohort study evaluates clinical data from 799 women through multivariate analyses and trajectory analyses. All the participants are stratified per first trimester weight gain category into three groups (Inadequate-1st, <0.5 kg; Adequate-1st, 0.5-2.0 kg; Excessive-1st, >2.0 kg) and PGWG refers to the weekly weight gain during each gestational period. GWG is positively associated with first trimester weight gain. 78.4% of the Excessive-1st participants have excessive total GWG, in contrast to Inadequate-1st (32.7%) and Adequate-1st (48.2%). After 20 weeks, the weekly weight gain rapidly accelerates, and 77.3% have a weekly weight gain exceeding the Institute of Medicine recommendations. Trajectory analysis of weekly weight gain based on HDP shows two separate weight gain curves after 20 weeks in women with and without a high risk of HDP. Especially in Excessive-1st participants, weekly weight gain after 20 weeks over 0.32 kg/w is positively related to the risk of HDP (<0.32 kg/w vs. 0.32-0.61 kg/w, adjusted odds ratios [aOR]: 2.999, 95% confidence interval [CI]: 1.054-8.537; <0.32 kg/w vs. >0.61 kg/w, aOR: 5.362, 95% CI: 1.719-16.729). In summary, the first trimester is critical for gestational weight management in obesity. Excessive weight gain during the first trimester and after 20 weeks predicts a high risk of HDP, which should be noted in clinical practice.
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Affiliation(s)
- Wei Song
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Zhi Zhang
- Department of Obstetrics, Cangzhou People's Hospital, Cangzhou, China
| | - Wei Zheng
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Lei Gao
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Shengnan Liang
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Dongmei Cheng
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Xiaoxin Wang
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Cuimei Guo
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Guanghui Li
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
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Gestational age, birth weight, and perinatal complications in mothers with diabetes and impaired glucose tolerance: Japan Environment and Children's Study cohort. PLoS One 2022; 17:e0269610. [PMID: 35666987 PMCID: PMC9170270 DOI: 10.1371/journal.pone.0269610] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/24/2022] [Indexed: 12/01/2022] Open
Abstract
We aimed to determine the risk of perinatal complications during delivery in mothers with non-normal glucose tolerance in a large Japanese birth cohort. We analysed data of 24,295 neonate–mother pairs in the Japan Environment and Children’s Study cohort between 2011 and 2014. We included 67 mothers with type 1 diabetes, 102 with type 2 diabetes (determined by questionnaire), 2,045 with gestational diabetes (determined by diagnosis), and 2,949 with plasma glucose levels ≥140 mg/dL (shown by a screening test for gestational diabetes). Gestational age, birth weight, placental weight, and proportions of preterm birth, and labour and neonatal complications at delivery in mothers with diabetes were compared with those in mothers with normal glucose tolerance. Mean gestational age was shorter in mothers with any type of diabetes than in mothers without diabetes. Birth weight tended to be heavier in mothers with type 1 diabetes, and placental weight was significantly heavier in mothers with type 1 and gestational diabetes and elevated plasma glucose levels (all p<0.05). The relative risks of any labour complication and any neonatal complication were 1.49 and 2.28 in type 2 diabetes, 1.59 and 1.95 in gestational diabetes, and 1.22 and 1.30 in a positive screening test result (all p<0.05). The relative risks of preterm birth, gestational hypertension, and neonatal jaundice were significantly higher in mothers with types 1 (2.77; 4.07; 2.04) and 2 diabetes (2.65; 5.84; 1.99) and a positive screening test result (1.29; 1.63; 1.12) than in those without diabetes (all p<0.05). In conclusion, placental weight is heavier in mothers with non-normal glucose tolerance. Preterm birth, gestational hypertension, and jaundice are more frequent in mothers with types 1 and 2 diabetes. A positive result in a screening test for gestational diabetes suggests not only a non-normal glucose tolerance, but also a medium (middle-level) risk of perinatal complications.
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14
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Correspondence on the article "Gestational body weight gain and risk of low birth weight or macrosomia in women of Japan: a nationwide cohort study". Int J Obes (Lond) 2022; 46:1410. [PMID: 35379904 DOI: 10.1038/s41366-022-01112-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/13/2022] [Accepted: 03/16/2022] [Indexed: 11/08/2022]
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Sun Y, Zhang M, Liu R, Wang J, Yang K, Wu Q, Yue W, Yin C. Protective Effect of Maternal First-Trimester Low Body Mass Index Against Macrosomia: A 10-Year Cross-Sectional Study. Front Endocrinol (Lausanne) 2022; 13:805636. [PMID: 35222271 PMCID: PMC8866317 DOI: 10.3389/fendo.2022.805636] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 01/05/2022] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE We aimed to assess whether maternal first-trimester low body mass index (BMI) has a protective effect against macrosomia. METHODS This was a cross-sectional study from January 1, 2011, to June 30, 2021, and 84,900 participants were included. The predictive performance of maternal first-trimester and parental pre-pregnancy BMI for macrosomia was assessed using the area under the receiver-operating characteristics curve (AUC). Multivariate logistic regression analyses were performed to evaluate the independent effect of maternal first-trimester low BMI on macrosomia. Interactions were investigated to evaluate the potential variation of the effect of first-trimester low BMI across different groups. Furthermore, interactions were also examined across groups determined by multiple factors jointly: a) gestational diabetes mellitus (GDM)/GDM history status, parity, and maternal age; and b) GDM/GDM history status, fetal sex, and season of delivery. RESULTS The proportion of macrosomia was 6.14% (5,215 of 84,900). Maternal first-trimester BMI showed the best discrimination of macrosomia (all Delong tests: P < 0.001). The protective effect of maternal first-trimester low BMI against macrosomia remained significant after adjusting for all confounders of this study [adjusted odds ratios (aOR) = 0.37, 95% CI: 0.32-0.43]. Maternal first-trimester low BMI was inversely associated with macrosomia, irrespective of parity, fetal sex, season of delivery, maternal age, and GDM/GDM history status. The protective effect was most pronounced among pregnant women without GDM/GDM history aged 25 to 29 years old, irrespective of parity (multipara: aOR = 0.32, 95% CI: 0.22-0.47; nullipara: aOR = 0.32, 95% CI: 0.24-0.43). In multipara with GDM/GDM history, the protective effect of low BMI was only observed in the 30- to 34-year-old group (aOR = 0.12, 95% CI: 0.02-0.86). For pregnant women without GDM/GDM history, the protective effect of maternal first-trimester low BMI against macrosomia was the weakest in infants born in winter, irrespective of fetal sex (female: aOR = 0.45, 95% CI: 0.29-0.69; male: aOR = 0.39, 95% CI: 0.28-0.55). CONCLUSION Maternal first-trimester low BMI was inversely associated with macrosomia, and the protective effect was most pronounced among 25- to 29-year-old pregnant women without GDM/GDM history and was only found among 30- to 34-year-old multipara with GDM/GDM history. The protective effect of maternal first-trimester low BMI against macrosomia was the weakest in winter among mothers without GDM/GDM history.
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Affiliation(s)
- Yongqing Sun
- Prenatal Diagnosis Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Man Zhang
- Beijing Maternal and Child Health Care Hospital, Beijing, China
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Ruixia Liu
- Beijing Maternal and Child Health Care Hospital, Beijing, China
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Jingjing Wang
- Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Kai Yang
- Prenatal Diagnosis Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Qingqing Wu
- Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- *Correspondence: Chenghong Yin, ; Wentao Yue, ; Qingqing Wu,
| | - Wentao Yue
- Beijing Maternal and Child Health Care Hospital, Beijing, China
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- *Correspondence: Chenghong Yin, ; Wentao Yue, ; Qingqing Wu,
| | - Chenghong Yin
- Prenatal Diagnosis Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
- *Correspondence: Chenghong Yin, ; Wentao Yue, ; Qingqing Wu,
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16
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Yan H, Zhai B, Feng R, Wang P, Zhang Y, Wang Y, Hou Y, Zhou Y. Prevalence of Congenital Heart Disease in Chinese Children With Different Birth Weights and Its Relationship to the Neonatal Birth Weight. Front Pediatr 2022; 10:828300. [PMID: 35664878 PMCID: PMC9160328 DOI: 10.3389/fped.2022.828300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 04/06/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study aimed to examine the prevalence and the related risk factors of congenital heart disease (CHD) in children with different birth weights in China and the relationship between the subtypes of CHD and birth weight (BW). METHODS This study conducted a cross-sectional survey on the data collected in the children's congenital heart disease database (CHDD) established in China. This database contained data from one Grade A, Level III Children's Public Hospital in Zhengzhou, Henan. The study included all the children and their parents in the database from 2014 to 2020 as the study subjects, and the missing data were processed by means of imputation. Diagnoses of CHD were coded using the International Classification of Diseases version 10 (ICD-10), and subtypes were classified by the codes Q20 to Q26. We reported the prevalence of CHD based on birth weight and gestational age and analyzed the related risk factors for children with CHD in different birth weight groups and factors for children of the same birth weight groups between the CHD groups and the non-CHD groups. The generalized linear model was used to assess the association between the subtypes of CHD and BW by establishing three adjusting models, and the data were stratified for further analysis by urban-rural and infant gender. RESULTS A total of 42,814 children were identified as having CHD among 5,071,799 live children; the overall prevalence of CHD was 8.44 per 1,000 live births during 2014-2020; and the three subtypes with the highest prevalence of CHD were atrial septal defect (ASD) (2.75‰), ventricular septal defect (VSD) (2.57‰), and patent foramen ovale (PFO) (1.12‰). The prevalence of CHD was 18.87‰ in the group with BW <1,500 g, 12.84‰ in the group with BW 1,500-2,500 g, 8.24‰ in the group with BW 2,500-4,000 g, and 4.80‰ in the group with BW ≥4,000 g. The prevalence of CHD was 16.62‰ in the small for gestational age (SGA) group, 6.99‰ in the appropriate for gestational age (AGA) group, and 6.40‰ in the larger for gestational age (LGA) group. Parental factors such as drinking, smoking, viral infections, peri-pregnancy exposure to radioactive substances, low family monthly expenditure, and low Apgar scores at 1 and 5 min were related to the increased risk of CHD in the offspring. Parental supplementation of folic acid and exercise during the peri-pregnancy period could reduce the risk of CHD in the offspring. The results of Model 3 adjusting for confounding variables showed that infants with ASD had a birth weight 461 g lower (95% CI: -1,085, -128), infants with VSD had a birth weight 426 g lower (95% CI: -932, -120), infants with tetralogy of Fallot (TOF) had a birth weight 532 g lower (95% CI: -987, -168), and without classification, infants with CHD had a birth weight 973 g lower (95% CI: -1,502, -204). CONCLUSION In very low birth weight (VLBW) and low birth weight (LBW) infants, CHDs are more prevalent than in the general live-born population. Moreover, some peri-pregnancy factors of parents are closely related to the occurrence of CHD in offspring; different types of heart defects can lead to LBW. Therefore, if the fetus is found to have a heart defect during the prenatal examination, the mother should pay more attention to maintaining weight and ensuring that the fetus is within the normal weight range, thereby increasing the postpartum survival rate, reducing complications, and promoting children's health.
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Affiliation(s)
- Hui Yan
- Henan Provincial Clinical Research Center for Pediatric Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Bo Zhai
- Department of Cardiothoracic Surgery, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Ruiling Feng
- Department of Cardiothoracic Surgery, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Penggao Wang
- Department of Cardiothoracic Surgery, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Yaodong Zhang
- Henan Provincial Clinical Research Center for Pediatric Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Yiran Wang
- Henan Provincial Clinical Research Center for Pediatric Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Yuwei Hou
- Henan Provincial Clinical Research Center for Pediatric Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Yang Zhou
- Henan Provincial Clinical Research Center for Pediatric Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China.,Department of Cardiothoracic Surgery, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
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