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Estrella CAS, Gatford KL, Xiang R, Javadmanesh A, Ghanipoor-Samami M, Nattrass GS, Shuaib E, McAllister MM, Beckman I, Thomsen DA, Clifton VL, Owens JA, Roberts CT, Hiendleder S, Kind KL. Asymmetric growth-limiting development of the female conceptus. Front Endocrinol (Lausanne) 2024; 14:1306513. [PMID: 38362586 PMCID: PMC10867182 DOI: 10.3389/fendo.2023.1306513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/08/2023] [Indexed: 02/17/2024] Open
Abstract
Introduction Sex differences in prenatal growth may contribute to sex-dependent programming effects on postnatal phenotype. Methods We integrated for the first time phenotypic, histomorphological, clinico-chemical, endocrine and gene expression analyses in a single species, the bovine conceptus at mid-gestation. Results We demonstrate that by mid-gestation, before the onset of accelerated growth, the female conceptus displays asymmetric lower growth compared to males. Female fetuses were smaller with lower ponderal index and organ weights than males. However, their brain:body weight, brain:liver weight and heart:body weight ratios were higher than in males, indicating brain and heart 'sparing'. The female placenta weighed less and had lower volumes of trophoblast and fetal connective tissue than the male placenta. Female umbilical cord vessel diameters were smaller, and female-specific relationships of body weight and brain:liver weight ratios with cord vessel diameters indicated that the umbilico-placental vascular system creates a growth-limiting environment where blood flow is redistributed to protect brain and heart growth. Clinico-chemical indicators of liver perfusion support this female-specific growth-limiting phenotype, while lower insulin-like growth factor 2 (IGF2) gene expression in brain and heart, and lower circulating IGF2, implicate female-specific modulation of key endocrine mediators by nutrient supply. Conclusion This mode of female development may increase resilience to environmental perturbations in utero and contribute to sex-bias in programming outcomes including susceptibility to non-communicable diseases.
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Affiliation(s)
- Consuelo Amor S. Estrella
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Epigenetics and Genetics Group and Davies Research Centre, School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, SA, Australia
| | - Kathryn L. Gatford
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- School of Biomedicine, The University of Adelaide, Adelaide, SA, Australia
| | - Ruidong Xiang
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Epigenetics and Genetics Group and Davies Research Centre, School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, SA, Australia
| | - Ali Javadmanesh
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Epigenetics and Genetics Group and Davies Research Centre, School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, SA, Australia
| | - Mani Ghanipoor-Samami
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Epigenetics and Genetics Group and Davies Research Centre, School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, SA, Australia
| | - Greg S. Nattrass
- South Australian Research and Development Institute, Livestock Systems, Roseworthy, SA, Australia
| | - Entesar Shuaib
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Epigenetics and Genetics Group and Davies Research Centre, School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, SA, Australia
| | - Milton M. McAllister
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, SA, Australia
| | - Ian Beckman
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, SA, Australia
| | - Dana A. Thomsen
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Epigenetics and Genetics Group and Davies Research Centre, School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, SA, Australia
| | - Vicki L. Clifton
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Mater Research Institute, University of Queensland, Brisbane, QLD, Australia
| | - Julie A. Owens
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Deakin University, Geelong, VIC, Australia
| | - Claire T. Roberts
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Flinders University, College of Medicine and Public Health, Adelaide, SA, Australia
| | - Stefan Hiendleder
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Epigenetics and Genetics Group and Davies Research Centre, School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, SA, Australia
| | - Karen L. Kind
- Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Epigenetics and Genetics Group and Davies Research Centre, School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, SA, Australia
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Zhao L, Li T, Wang H, Fan YM, Xiao Y, Wang X, Wang S, Sun P, Wang P, Jiangcuo Z, Tong L, Wang L, Peng W. Association of co-exposure to metal(loid)s during pregnancy with birth outcomes in the Tibetan plateau. CHEMOSPHERE 2023; 342:140144. [PMID: 37704082 DOI: 10.1016/j.chemosphere.2023.140144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/08/2023] [Accepted: 09/09/2023] [Indexed: 09/15/2023]
Abstract
Maternal metal (loid)s exposure has been related to birth outcomes but the results are still inconclusive. Most previous studies have discussed the single metal (loid)s, neglecting the scene of co-exposure. We examined the associations of both single metal (loid)s and metal mixtures with birth outcomes in a birth cohort from the Tibetan Plateau, including body weight, body length, head circumference, small for gestational age (SGA), and Ponderal index (PI). In our analysis of 1069 women, we measured 29 metal (loid)s in urine samples in the third trimester. The associations of single metal (loid)s with categorical or continuous birth outcomes were evaluated using a generalized linear mixed-effects model or linear mixed-effects model, respectively. The least absolute shrinkage and selection operator, Bayesian kernel machine, and Quantile g-computation regression were used to explore the joint association. We also evaluated the interactive effects of ethnicity and altitude on the effect of metal (loid)s on birth outcomes. Copper (Cu) concentration in maternal urine was positively associated with SGA, birth weight, birth length, and head circumference in the single pollutant models. For instance, Cu was associated with an increased risk of SGA [OR (95% CI) = 1.56 (1.23, 1.97); P < 0.001]. We didn't find significant joint association of metal mixtures with birth outcomes except a positive association between the mixture of Cu, Magnesium (Mg), and Iron (Fe) with the risk of SGA when the exposure level was above its 80th percentile, and Cu dominated the adverse association in a non-linear manner. Living altitude modified the associations of Cu with SGA and the positive association was only found in participants living at high altitude. In conclusion, maternal urinary metal (loid)s, especially Cu, was the dominant harmful metal (loid)s when associated with SGA on the Tibetan Plateau.
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Affiliation(s)
- Lei Zhao
- Department of Public Health, Nutrition and Health Promotion Center, Medical College, Qinghai University, Xining, China
| | - Tiemei Li
- Department of Public Health, Nutrition and Health Promotion Center, Medical College, Qinghai University, Xining, China
| | - Haijing Wang
- Department of Public Health, Nutrition and Health Promotion Center, Medical College, Qinghai University, Xining, China
| | - Yue-Mei Fan
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Yuancan Xiao
- Qinghai Provincial Key Laboratory of Tibetan Medicine Pharmacology and Safety Evaluation, Northwest Institute of Plateau Biology, Chinese Academy of Sciences, China
| | - Xuejun Wang
- Department of Anesthesiology, Qinghai Red Cross Hospital, Xining, China
| | - Shulin Wang
- Department of Public Health, Nutrition and Health Promotion Center, Medical College, Qinghai University, Xining, China
| | - Pin Sun
- Department of Occupational Health and Toxicology, School of Public Health, Fudan University, Shanghai, China
| | - Pinhua Wang
- Department of Obstetrics and Gynecology, Qinghai Red Cross Hospital, Xining, China
| | | | - Li Tong
- Department of Traditional Chinese Medicine, Medical College of Qinghai University, Xining, China; Qinghai Provincial Key Laboratory of Traditional Chinese Medicine Research for Glucolipid Metabolic Diseases, Medical College, Qinghai University, Qinghai, China
| | - Liehong Wang
- Department of Obstetrics and Gynecology, Qinghai Red Cross Hospital, Xining, China.
| | - Wen Peng
- Department of Public Health, Nutrition and Health Promotion Center, Medical College, Qinghai University, Xining, China; Qinghai Provincial Key Laboratory of Traditional Chinese Medicine Research for Glucolipid Metabolic Diseases, Medical College, Qinghai University, Qinghai, China.
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Zhang Y, Mustieles V, Williams PL, Souter I, Calafat AM, Demokritou M, Lee A, Vagios S, Hauser R, Messerlian C. Association of preconception mixtures of phenol and phthalate metabolites with birthweight among subfertile couples. Environ Epidemiol 2022; 6:e222. [PMID: 36249269 PMCID: PMC9555928 DOI: 10.1097/ee9.0000000000000222] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 07/07/2022] [Indexed: 11/25/2022] Open
Abstract
Although parental preconception exposure to some phenols and phthalates have been associated with reduced birthweight, few studies have examined these chemicals as complex mixtures.
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Hanratty C, Thyagarajan B, Clarke NM, Aarvold A. There is No Link Between Birth Weight and Developmental Dysplasia of the Hip. Indian J Orthop 2021; 55:1515-1522. [PMID: 34987726 PMCID: PMC8688636 DOI: 10.1007/s43465-021-00465-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/20/2021] [Indexed: 02/04/2023]
Abstract
AIMS Developmental Dysplasia of the Hip (DDH) has been linked to high birth weight and packaging disorders, though the evidence is limited. This has implications on screening strategies. The aim of this study was to establish whether birth weight was truly associated with the incidence of DDH. PATIENTS AND METHODS This cohort study analysed the birth weights of all babies born at our institution over a 24 month period, between 01/01/2017 and 01/01/2019. Babies with DDH and those without DDH were compared. Babies were excluded if born before 38 weeks, had incomplete data or were a non-singleton pregnancy. Sub-analysis was performed for DDH severity (dysplastic versus subluxed/dislocated hips), breech presentation, gestational age, gender and ethnicity. Statistical analysis was performed using SPSS. RESULTS There were 10,113 babies born at our institution during the selected timeframe, of which 884 were excluded for prematurity, 336 for being non-singleton and 19 for incomplete data. This left 8874 for analysis, of which 95 babies had confirmed DDH. Both the Non-DDH and DDH data sets had normal distribution (Shapiro-Wilkes, p = 0.308 and 0.629, respectively), with mean birth weights of 3477.7 g with DDH and 3492.8 g without DDH. No difference in birth weight was found (Independent T test, p = 0.789). Females had a lower birth weight than males (3293.1 g versus 3416.6 g (p < 0.001)) yet have a higher incidence of DDH (ratio 6:1 in this dataset). No significant difference was found between birth weights of females with and without DDH (p = 0.068), nor between males with and without DDH (p = 0.513). There were no significant differences in birth weights even when only displaced hips were analysed (p = 0.543), nor according to breech presentation (p = 0.8). Longer gestation babies weighed more (p < 0.00001), yet showed no increase in DDH incidence (p = 0.64). CONCLUSION This study discredits the belief that DDH may be related to higher birth weight, thus casting doubt on the link to DDH being a packaging problem in utero. This, therefore, allows future research to prioritise the investigation of alternative aetiologies.
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Affiliation(s)
- Charlotte Hanratty
- grid.5491.90000 0004 1936 9297University of Southampton, Southampton, UK
| | - Balamurugan Thyagarajan
- grid.123047.30000000103590315Princess Anne Maternity Hospital, University Hospital Southampton, Southampton, UK
| | - Nicholas M. Clarke
- grid.5491.90000 0004 1936 9297University of Southampton, Southampton, UK
| | - Alexander Aarvold
- grid.5491.90000 0004 1936 9297Department of Paediatric Orthopaedic Surgery, Southampton Children’s Hospital, University Hospitals Southampton NHS Foundation Trust, University of Southampton, Tremona Raod, Southampton, SO16 6YD UK
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Zhao Y, Wang P, Zhou Y, Xia B, Zhu Q, Ge W, Li J, Shi H, Xiao X, Zhang Y. Prenatal fine particulate matter exposure, placental DNA methylation changes, and fetal growth. ENVIRONMENT INTERNATIONAL 2021; 147:106313. [PMID: 33341587 DOI: 10.1016/j.envint.2020.106313] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/26/2020] [Accepted: 11/25/2020] [Indexed: 06/12/2023]
Abstract
This study was designed to examine the impact of prenatal fine particulate matter (PM2.5) exposure on fetal growth and the underlying placental epigenetic mechanism in a cohort of Chinese women. Within the prospective Shanghai Mother-Child Pairs cohort (Shanghai MCPC), 329 women carrying singleton pregnancy with a due date in 2018 were recruited between 2017 and 2018. Maternal PM2.5 exposure levels were estimated using gestational exposure prediction model combining satellite-driven ambient concentrations and personal air sampling. Fetal growth characteristics were evaluated by prenatal ultrasound examinations and anthropometric measurements at birth. In a discovery phase, whole-genome DNA methylation analysis was performed using the Infinium 850 K array. In a validation phase, placental DNA methylation was measured using bisulfite pyrosequencing for five candidate genes that showed the most significant alterations and function relevance in our methylation array screen, including BID (BH3 interacting domain death agonist), FOXN3 (Forkhead box N3), FOXP1 (Forkhead box P1), IGF2 (Insulin-like growth factor 2) and HSD11B2 (Hydroxysteroid 11-beta dehydrogenase 2). Multivariate linear regression models were applied to examine the associations among PM2.5 exposure, fetal growth characteristics and DNA methylation on placental candidate genes. Sobel tests were used to evaluate the mediating role of DNA methylation in multivariable models. After excluding women who withdrew or failed to provide placenta, a total of 287 pregnant women with an average age of 30 entered the final analysis. Increased PM2.5 exposure was significantly associated with reduced biparietal diameter (BPD) (β: -0.136 mm, 95% CI: -0.228 to -0.043), head circumference (HC) (β: -0.462 mm, 95% CI: -0.782 to -0.142), femur length (FL) (β: -0.113 mm, 95% CI: -0.185 to -0.041) and abdominal circumference (AC) (β: -0.371 mm, 95% CI: -0.672 to -0.071) in the second trimester and birth length (β: -0.013 cm, 95% CI: -0.025 to -0.001). Prenatal PM2.5 exposure could lead to aberrant changes in DNA methylation profile of placenta genome, which were mainly enriched in reproductive development, energy metabolism and immune response. DNA methylation of IGF2 and BID showed significant associations with PM2.5 exposures during all exposure windows. In addition, BID methylation was negatively correlated with HC (β: -1.396 mm, 95% CI: -2.582 to -0.209) and BPD (β: -0.330 mm, 95% CI: -0.635 to -0.026) in the second trimester. Further mediation analysis indicated that BID methylation mediated about 30% of the effects of PM2.5 exposure on HC. These findings collectively suggested that prenatal PM2.5 exposure may cause adverse effects on fetal growth by modifying placental DNA methylation.
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Affiliation(s)
- Yingya Zhao
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Pengpeng Wang
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Yuhan Zhou
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Bin Xia
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China
| | - Qingyang Zhu
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China
| | - Wenzhen Ge
- Regeneron Pharmaceuticals Inc., New York, NY, USA
| | - Jialin Li
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Huijing Shi
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Xirong Xiao
- Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200032, China.
| | - Yunhui Zhang
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
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Ba-Saddik IA, Al-Asbahi TO. Anthropometric measurements of singleton live full-term newborns in Aden, Yemen. Int J Pediatr Adolesc Med 2020; 7:121-126. [PMID: 33094140 PMCID: PMC7568082 DOI: 10.1016/j.ijpam.2019.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 03/27/2019] [Accepted: 08/27/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND Neonatal anthropometry is the single most portable, universally applicable cheap, and non-invasive technique that deals with a variety of human body measurements. The anthropometric data for newborns, infants and children reflect their general health, nutritional status, and future survival by tracking trends in growth and development over time. PATIENTS AND METHODS The present study was conducted on 1000 Yemeni singleton live full-term newborns (37-42 weeks gestation), 488 males and 512 females during first 24 h of delivery at Al-Sadaqa Teaching Hospital, Aden, Yemen during the years 2002-2003. RESULTS The data analysis of seven anthropometric values for 1000 Yemeni term newborns of both sexes revealed the mean birth weight and SD was 3113.04 g (±519.52), crown-heel length, head, chest, mid-arm, abdominal and calf circumferences were 48.91 (1.62), 33.78 (1.13), 32.09 (1.48), 10.09 (1.02), 30.10 (1.92), and 10.94 (1.04) respectively. The Ponderal Index was calculated with mean value of 2.65 (0.40). This study showed significant sex differences in all the anthropometric measurements principally in the birth weight (3187.66 versus 3039.04) and crown-heel length CHL (49.28 versus 48.53). (P < .001). The best cut-off point to determine LBW was calf circumference (8.5 cm), which showed the most significant correlation with birth weight (r = 0.5) followed by chest (r = 0.44) and mid-arm circumference (r = 0.41). CONCLUSIONS This study of normal reference values will provide basic step for future standardization of Yemen anthropometric parameters to be used for accurate assessment, development and maturity of newborn births that would lead to identify newborns at risk and help in better management.
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Affiliation(s)
- Iman Ali Ba-Saddik
- Department of Pediatrics, Faculty of Medicine and Health Sciences, University of Aden, Aden, Yemen
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Rafferty AR, Geraghty AA, Kennelly MA, O'Brien EC, Reji RM, Mehegan J, Segurado R, Smith T, Maguire O, Cronin M, McAuliffe FM. Limited Impact of Fetal Sex and Maternal Body Mass Index on Fetal and Maternal Insulin Resistance and Lipid Metabolism: Findings from the PEARs Study. Reprod Sci 2020; 27:513-522. [PMID: 31925771 DOI: 10.1007/s43032-019-00045-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 09/02/2019] [Indexed: 11/26/2022]
Abstract
The intrauterine environment can have a significant impact on fetal and maternal well-being, both during pregnancy and in later life. We aimed to identify how fetal sex and maternal body mass index (BMI) influence insulin resistance and metabolic function during pregnancy with maternal BMI > 25 kg/m2. This secondary analysis assessed data from the PEARS-randomized controlled trial that recruited pregnant women with body mass indexes 25-39.9 kg/m2. Longitudinal measurements of maternal and fetal insulin resistance and metabolic function were recorded throughout pregnancy. Regression models tested the effects of fetal sex and maternal BMI on markers of metabolic function and insulin regulation. A total of 484 women and their newborns (252 (52%) males vs. 232 (48%) females) were included in the analysis. A total of 333 (69%) women were overweight and 151 (31%) were obese. Male newborns were heavier and larger than females, and had a higher rate of instrumental delivery. Males had a lower LDL, but no other markers of insulin resistance or metabolic function were affected by fetal sex. Women with obesity had elevated markers of insulin resistance and metabolic dysfunction compared with women that were overweight, but maternal BMI did not impact these variables in the fetus. Fetal sex did not impact maternal and fetal metabolic parameters in women with BMI > 25 kg/m2. However, a higher BMI caused increasingly deranged maternal blood lipid concentrations and markers of insulin resistance as pregnancy progressed. Lipid monitoring and interventions to reduce lipids during pregnancy therefore require further evaluation.
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Affiliation(s)
- Anthony R Rafferty
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Aisling A Geraghty
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Maria A Kennelly
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Eileen C O'Brien
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Reshma Merin Reji
- School of Public Health, Physiotherapy and Sports Science, Health Sciences Centre, University College Dublin, Dublin, Ireland
| | - John Mehegan
- School of Public Health, Physiotherapy and Sports Science, Health Sciences Centre, University College Dublin, Dublin, Ireland
| | - Ricardo Segurado
- Centre for Support and Training in Analysis and Research (CSTAR), School of Public Health, Physical & Sports Sciences, Health Sciences Centre, University College Dublin, Dublin, Ireland
| | - Thomas Smith
- Department of Endocrinology, St. Vincent's University Hospital, Dublin, Ireland
| | - Orla Maguire
- Department of Endocrinology, St. Vincent's University Hospital, Dublin, Ireland
| | - Martina Cronin
- Department of Midwifery, National Maternity Hospital, Dublin, Ireland
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.
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Ferguson KK, Kamai EM, Cantonwine DE, Mukherjee B, Meeker JD, McElrath TF. Associations between repeated ultrasound measures of fetal growth and biomarkers of maternal oxidative stress and inflammation in pregnancy. Am J Reprod Immunol 2018; 80:e13017. [PMID: 29984454 PMCID: PMC6160349 DOI: 10.1111/aji.13017] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 06/15/2018] [Indexed: 11/29/2022] Open
Abstract
PROBLEM Perturbations in normal fetal growth during pregnancy are associated with poor child and adult health outcomes. Inflammation and oxidative stress are recognized as important mechanisms in preeclampsia and preterm birth but have been examined less in relation to fetal growth. We hypothesized that maternal inflammation and oxidative stress in pregnancy would be associated with reduced fetal growth and sought to identify windows of vulnerability. METHOD OF STUDY In a secondary analysis of 482 women from the LIFECODES birth cohort study, we measured inflammation (C-reactive protein [CRP] and the cytokines IL-1β, IL-6, IL-10, and TNF-α) and oxidative stress (8-isoprostane and 8-hydroxydeoxyguanosine [8-OHdG]) biomarkers in plasma and urine, respectively, at four time points during pregnancy. We examined associations between repeated measures of each marker and ultrasound (head and abdominal circumference, femur length, and a summary measure of estimated fetal weight) as well as delivery (birthweight) metrics of growth. RESULTS In adjusted repeated-measures models, an interquartile range (IQR) increase in CRP was associated with a 0.12 standard deviation decrease in fetal weight z-score (95% confidence interval, CI, -0.21, -0.02), which corresponds to approximately 50 g at 40-week gestation. The association was greatest in magnitude (ie, most negative) with CRP measured later in pregnancy. Oxidative stress markers were not associated with fetal weight, although both were inversely associated with head circumference and femur length. CONCLUSION Inflammation and oxidative stress markers measured later in pregnancy were associated with reduced fetal growth as measured by repeated ultrasound scans.
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Affiliation(s)
- Kelly K. Ferguson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Elizabeth M. Kamai
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health
| | - David E. Cantonwine
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Harvard Medical School
| | - Bhramar Mukherjee
- Departments of Biostatistics and Epidemiology, University of Michigan School of Public Health
| | - John D. Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health
| | - Thomas F. McElrath
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Harvard Medical School
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Lee E, Kim H, Kim H, Ha EH, Chang N. Association of maternal omega-6 fatty acid intake with infant birth outcomes: Korean Mothers and Children's Environmental Health (MOCEH). Nutr J 2018; 17:47. [PMID: 29679982 PMCID: PMC5911376 DOI: 10.1186/s12937-018-0353-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 04/06/2018] [Indexed: 12/23/2022] Open
Abstract
Background Maternal fatty acids (FAs) intake has an effect on birth weight, birth length, and gestational age, as fetal development is entirely dependent on the maternal essential FA supply. This study aimed to identify the association between the maternal intake of FAs and birth outcomes among pregnant women who participated in the Mothers and Children’s Environmental Health (MOCEH) prospective cohort study in South Korea. Methods A total of 1407 pregnant women, aged 30.2 ± 3.7 years, at 12 to 28 weeks’ gestation were recruited between August 2006 and December 2010. Their dietary intake during pregnancy was investigated by the 1-day 24-h dietary recall method. The pregnancy outcome data—namely infant’s gestational age, birth weight, and birth length—were analyzed for their associations with their mothers’ intake of FAs. Results When adjusted for confounding factors, multiple regression analysis revealed adverse effects on birth weight (P = 0.031) and birth length (P = 0.025) with high maternal intake of omega-6 FAs. In the multiple logistic regression analysis, the odds ratio (OR) for the risk of being below the 10th percentile for birth weight was higher in the highest quintile (Q5) compared to the lowest quintile (Q1) of omega-6 FA intake levels (OR = 2.444; 95% CI = 1.038–5.751; P for trend = 0.010). Also, the OR for being above the 90th percentile of birth length was lower in the highest quintile (Q5) compared to that in the lowest quintile (Q1) of omega-6 FA intake (OR = 0.432; 95% CI = 0.211–0.884; P for trend = 0.020). However, the maternal intake of omega-3 FAs was not related to gestational age, birth weight, or birth length. Conclusions A high maternal omega-6 FA intake was negatively associated with birth weight and birth length.
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Affiliation(s)
- Eunjung Lee
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, South Korea.,Department of Nutrition Consultation, Seoul National University Hospital, Healthcare System Gangnam Center, Seoul, South Korea
| | - Hyesook Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, South Korea
| | - Hyejin Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, South Korea
| | - Eun-Hee Ha
- Department of Occupational and Environmental Medicine, Ewha Womans University, College of Medicine, Seoul, South Korea
| | - Namsoo Chang
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, South Korea.
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Lamichhane DK, Ryu J, Leem JH, Ha M, Hong YC, Park H, Kim Y, Jung DY, Lee JY, Kim HC, Ha EH. Air pollution exposure during pregnancy and ultrasound and birth measures of fetal growth: A prospective cohort study in Korea. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 619-620:834-841. [PMID: 29734629 DOI: 10.1016/j.scitotenv.2017.11.058] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 10/19/2017] [Accepted: 11/06/2017] [Indexed: 05/04/2023]
Abstract
Few studies have examined the effects of air pollution on fetal growth based on ultrasound measures during pregnancy. More data is needed to evaluate the windows of special vulnerability. Our aim was to investigate the association of ambient air pollution during pregnancy with fetal and neonatal characteristics in a cohort of Korean women. Maternal exposure to particulate matter with an aerodynamic diameter<10μm (PM10) and nitrogen dioxide (NO2) was estimated using land-use regression models based on residential address. The biparietal diameter (BPD), abdominal circumference (AC), femur length (FL), and estimated fetal weight (EFW) were evaluated via ultrasonography, and birth weight (BW), birth length (BL), and head circumference at birth (BHC) were obtained from medical records. The multiple linear regression model was used to adjust for confounders, and the mixed-effect model was used to evaluate longitudinal effect. The negative effects for NO2 and PM10 were estimated; in the adjusted analyses the decreases of BPD were -0.26mm (95% confidence interval [CI]=-0.41 to -0.11, with a 10μg/m3 increase) in the second trimester for NO2, and -0.30mm (95% CI=-0.59 to -0.03, with a 10μg/m3 increase) in the third trimester for PM10. Both NO2 and PM10 levels (10μg/m3) during third trimester were inversely associated with BHC, and NO2 level was inversely associated with BL in all exposure windows. No significant associations for AC, FL, and EFW were observed. The longitudinal analyses showed inverse association of NO2 exposure with head and length growth (P<0.001). Our findings suggest that ambient air pollution is associated with impaired fetal head size from mid-gestation onwards.
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Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Republic of Korea
| | - Jia Ryu
- Department of Occupational and Environmental Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Jong-Han Leem
- Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Republic of Korea; Department of Environmental and Occupational Medicine, Inha University Hospital, Incheon, Republic of Korea
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyesook Park
- Department of Preventive Medicine and Ewha Medical Research Center, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Dal-Young Jung
- Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Republic of Korea
| | - Ji-Young Lee
- Department of Occupational and Environmental Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Hwan-Cheol Kim
- Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Republic of Korea; Department of Environmental and Occupational Medicine, Inha University Hospital, Incheon, Republic of Korea.
| | - Eun-Hee Ha
- Department of Occupational and Environmental Medicine, Ewha Womans University, Seoul, Republic of Korea; Ewha Institute of Convergence Medicine, Ewha Womans University, Seoul, Republic of Korea; Research Institute for Human Health Information, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea.
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11
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Ferguson KK, Meeker JD, Cantonwine DE, Mukherjee B, Pace GG, Weller D, McElrath TF. Environmental phenol associations with ultrasound and delivery measures of fetal growth. ENVIRONMENT INTERNATIONAL 2018; 112:243-250. [PMID: 29294443 PMCID: PMC5899051 DOI: 10.1016/j.envint.2017.12.011] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 11/09/2017] [Accepted: 12/07/2017] [Indexed: 05/19/2023]
Abstract
Environmental phenols are used commonly in personal care products and exposure is widespread in pregnant women. In this study, we sought to assess the association between maternal urinary phenol concentrations in pregnancy and fetal growth. The study population included 476 mothers who participated in the prospective LIFECODES birth cohort between 2006 and 2008 at Brigham and Women's Hospital in Boston, Massachusetts, USA. Dichlorophenols (DCPs), benzophenone-3, parabens, triclosan, triclocarban, and bisphenol-S were measured in urine from three time points during pregnancy and averaged. Outcome measures were all standardized to create gestational-age specific z-scores and included: 1) birth weight; 2) ultrasound parameters measured at up to two time points in pregnancy (head and abdominal circumference and femur length); and 3) ultrasound estimates of fetal weight from two time points in combination with birth weight. Models were stratified to investigate sex differences. Inverse associations were observed between average 2,4- and 2,5-DCP concentrations and birth weight z-scores in males. For example, an interquartile range difference in 2,4-DCP was associated with a 0.18 standard deviation decrease in birth weight z-score (95% confidence interval [CI]=-0.33, -0.02). These associations were observed in models that included repeated ultrasound estimates of fetal weight during gestation as well. Also in males, we noted inverse associations between average triclosan exposure over pregnancy and estimated fetal weight combined with birth weight in repeated measures models. For females, associations were generally null. However, mothers with a detectable concentration of bisphenol-S at any of the study visits had lower weight females. In conclusion, we observed inverse associations between indicators of maternal phenol exposure during pregnancy and fetal growth, with several differences observed by sex.
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Affiliation(s)
- Kelly K Ferguson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA; Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - David E Cantonwine
- Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School, USA
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | | | | | - Thomas F McElrath
- Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School, USA
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12
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Lee JJ, Kapur K, Rodrigues EG, Ibne Hasan MOS, Quamruzzaman Q, Wright RO, Bellinger DC, Christiani DC, Mazumdar M. Anthropometric measures at birth and early childhood are associated with neurodevelopmental outcomes among Bangladeshi children aged 2-3years. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 607-608:475-482. [PMID: 28704672 PMCID: PMC5587388 DOI: 10.1016/j.scitotenv.2017.06.168] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 06/20/2017] [Accepted: 06/20/2017] [Indexed: 05/31/2023]
Abstract
Among a cohort of children located in rural areas of Bangladesh affected by high levels of exposure to environmental metals, we investigated the associations between anthropometric measures, growth trajectory, and neurodevelopment at age 20-40months. Our study population included mothers and their children who participated in a longitudinal birth cohort study that took in place in the Pabna and Sirajdikhan areas of Bangladesh. Anthropometric measures including weight, length, and head circumference were measured at birth, age 12months, and age 20-40months. Neurodevelopment was assessed using Bayley Scales of Infant and Toddler Development Third Edition (BSID-III) multi-scale at age 20-40months. A total of 777 mother-child pairs were included. Higher anthropometric measures at 20-40months were associated with higher cognitive, language, and motor scores on BSID-III. For example, a 1-kg increment in birthweight was associated with an increase of 2.11 for cognitive score (p<0.0001), 1.63 for language score (p=0.006), and 0.89 for motor scores (p=0.03). Greater positive changes in growth parameters, or growth trajectory, between birth and 20-40months were also associated with higher BSID-III scores. These associations remained significant after adjusting for potential confounders and prenatal exposure to environmental metals. These findings suggest that even when taking into account high environmental metal exposures, prenatal and early childhood growth have strong associations with neurodevelopmental test scores in early childhood.
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Affiliation(s)
- Jane J Lee
- Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
| | - Kush Kapur
- Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Ema G Rodrigues
- Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
| | | | - Quazi Quamruzzaman
- Dhaka Community Hospital, 190/1, Wireless Railgate Bara Moghbazar, Dhaka, 1217, Bangladesh.
| | - Robert O Wright
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, NY, New York, 10029, USA.
| | - David C Bellinger
- Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
| | - David C Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
| | - Maitreyi Mazumdar
- Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
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13
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Smith ER, Shankar AH, Wu LSF, Aboud S, Adu-Afarwuah S, Ali H, Agustina R, Arifeen S, Ashorn P, Bhutta ZA, Christian P, Devakumar D, Dewey KG, Friis H, Gomo E, Gupta P, Kæstel P, Kolsteren P, Lanou H, Maleta K, Mamadoultaibou A, Msamanga G, Osrin D, Persson LÅ, Ramakrishnan U, Rivera JA, Rizvi A, Sachdev HPS, Urassa W, West KP, Zagre N, Zeng L, Zhu Z, Fawzi WW, Sudfeld CR. Modifiers of the effect of maternal multiple micronutrient supplementation on stillbirth, birth outcomes, and infant mortality: a meta-analysis of individual patient data from 17 randomised trials in low-income and middle-income countries. Lancet Glob Health 2017; 5:e1090-e1100. [PMID: 29025632 DOI: 10.1016/s2214-109x(17)30371-6] [Citation(s) in RCA: 140] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 07/24/2017] [Accepted: 08/18/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Micronutrient deficiencies are common among women in low-income and middle-income countries. Data from randomised trials suggest that maternal multiple micronutrient supplementation decreases the risk of low birthweight and potentially improves other infant health outcomes. However, heterogeneity across studies suggests influence from effect modifiers. We aimed to identify individual-level modifiers of the effect of multiple micronutrient supplements on stillbirth, birth outcomes, and infant mortality in low-income and middle-income countries. METHODS This two-stage meta-analysis of individual patient included data from 17 randomised controlled trials done in 14 low-income and middle-income countries, which compared multiple micronutrient supplements containing iron-folic acid versus iron-folic acid alone in 112 953 pregnant women. We generated study-specific estimates and pooled subgroup estimates using fixed-effects models and assessed heterogeneity between subgroups with the χ2 test for heterogeneity. We did sensitivity analyses using random-effects models, stratifying by iron-folic acid dose, and exploring individual study effect. FINDINGS Multiple micronutrient supplements containing iron-folic acid provided significantly greater reductions in neonatal mortality for female neonates compared with male neonates than did iron-folic acid supplementation alone (RR 0·85, 95% CI 0·75-0·96 vs 1·06, 0·95-1·17; p value for interaction 0·007). Multiple micronutrient supplements resulted in greater reductions in low birthweight (RR 0·81, 95% CI 0·74-0·89; p value for interaction 0·049), small-for-gestational-age births (0·92, 0·87-0·97; p=0·03), and 6-month mortality (0·71, 0·60-0·86; p=0·04) in anaemic pregnant women (haemoglobin <110g/L) as compared with non-anaemic pregnant women. Multiple micronutrient supplements also had a greater effect on preterm births among underweight pregnant women (BMI <18·5 kg/m2; RR 0·84, 95% CI 0·78-0·91; p=0·01). Initiation of multiple micronutrient supplements before 20 weeks gestation provided greater reductions in preterm birth (RR 0·89, 95% CI 0·85-0·93; p=0·03). Generally, the survival and birth outcome effects of multiple micronutrient supplementation were greater with high adherence (≥95%) to supplementation. Multiple micronutrient supplements did not significantly increase the risk of stillbirth or neonatal, 6-month, or infant mortality, neither overall or in any of the 26 examined subgroups. INTERPRETATION Antenatal multiple micronutrient supplements improved survival for female neonates and provided greater birth-outcome benefits for infants born to undernourished and anaemic pregnant women. Early initiation in pregnancy and high adherence to multiple micronutrient supplements also provided greater overall benefits. Studies should now aim to elucidate the mechanisms accounting for differences in the effect of antenatal multiple micronutrient supplements on infant health by maternal nutrition status and sex. FUNDING None.
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Affiliation(s)
- Emily R Smith
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA, USA
| | - Anuraj H Shankar
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Summit Institute of Development, Mataram, Indonesia
| | - Lee S-F Wu
- The JiVitA Project, Johns Hopkins University in Bangladesh, Gaibandha, Bangladesh; Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Said Aboud
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Seth Adu-Afarwuah
- Department of Nutrition and Food Science, University of Ghana, Legon, Accra, Ghana
| | - Hasmot Ali
- The JiVitA Project, Johns Hopkins University in Bangladesh, Gaibandha, Bangladesh; Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rina Agustina
- Summit Institute of Development, Mataram, Indonesia; Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Shams Arifeen
- International Centre for Diarrhoeal Diseases Research Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - Per Ashorn
- Centre for Child Health Research and Department of Paediatrics, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland
| | - Zulfiqar A Bhutta
- Center for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada; Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Parul Christian
- The JiVitA Project, Johns Hopkins University in Bangladesh, Gaibandha, Bangladesh; Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Kathryn G Dewey
- Department of Nutrition and Program in International and Community Nutrition, University of California-Davis, Davis, CA, USA
| | - Henrik Friis
- Department of Nutrition Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Exnevia Gomo
- College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Piyush Gupta
- Department of Pediatrics, University College of Medical Sciences, Delhi, India
| | - Pernille Kæstel
- Department of Nutrition Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Patrick Kolsteren
- Nutrition and Child Health Unit, Department of Public Health, Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium; Faculty of Bio-science engineering, Ghent University, Belgium
| | - Hermann Lanou
- Institut de Recherche en Sciences de la Santé, Ministry of Scientific Research and Innovation, Ouagadougou, Burkina Faso
| | - Kenneth Maleta
- School of Public Health and Family Medicine, University of Malawi College of Medicine, Blantyre, Malawi
| | | | - Gernard Msamanga
- Department of Community Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Lars-Åke Persson
- Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden
| | - Usha Ramakrishnan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Juan A Rivera
- Instituto Nacional de Salud Publica, Cuernavaca, Mexico
| | - Arjumand Rizvi
- Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
| | - H P S Sachdev
- Pediatric and Clinical Epidemiology Unit, Sitar am Bhartia Institute of Science and Research, New Delhi, India
| | - Willy Urassa
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Keith P West
- The JiVitA Project, Johns Hopkins University in Bangladesh, Gaibandha, Bangladesh; Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Noel Zagre
- UNICEF Regional Office for West and Central Africa, Dakar, Senegal
| | - Lingxia Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, China
| | - Zhonghai Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, China
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Christopher R Sudfeld
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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14
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Simcox LE, Myers JE, Cole TJ, Johnstone ED. Fractional fetal thigh volume in the prediction of normal and abnormal fetal growth during the third trimester of pregnancy. Am J Obstet Gynecol 2017; 217:453.e1-453.e12. [PMID: 28651860 PMCID: PMC5628948 DOI: 10.1016/j.ajog.2017.06.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 06/09/2017] [Accepted: 06/16/2017] [Indexed: 11/23/2022]
Abstract
Background Currently, 2-dimensional ultrasound estimation of fetal size rather than fetal growth is used to define fetal growth restriction, but single estimates in late pregnancy lack sensitivity and may identify small for gestational age rather than growth restriction. Single or longitudinal measures of 3-dimensional fractional thigh volume may address this problem. Objective We sought to derive normal values for 3-dimensional fractional thigh volume in the third trimester, determine if fractional thigh volume is superior to 2-dimensional ultrasound biometry alone for detecting fetal growth restriction, and determine whether individualized growth assessment parameters have the potential to identify fetal growth restriction remote from term delivery. Study Design This was a longitudinal prospective cohort study of 115 unselected pregnancies in a tertiary referral unit (St Mary’s Hospital, Manchester, United Kingdom). Standard 2-dimensional ultrasound biometry measurements were obtained, along with fractional thigh volume measurements (based on 50% of the femoral diaphysis length). Measurements were used to calculate estimated fetal weight (Hadlock). Individualized growth assessment parameters and percentage deviations in longitudinally measured biometrics were determined using a Web-based system (iGAP; http://iGAP.research.bcm.edu). Small for gestational age was defined <10th and fetal growth restriction <3rd customized birthweight centile. Logistic regression was used to compare estimated fetal weight (Hadlock), estimated fetal weight (biparietal diameter–abdominal circumference–fractional thigh volume), fractional thigh volume, and abdominal circumference for the prediction of small for gestational age or fetal growth restriction at birth. Screening performance was assessed using area under the receiver operating characteristic curve. Results There was a better correlation between fractional thigh volume and estimated fetal weight ((biparietal diameter–abdominal circumference–fractional thigh volume) obtained at 34-36 weeks with birthweight than between 2-dimensional biometry measures such as abdominal circumference and estimated fetal weight (Hadlock). There was also a modest improvement in the detection of both small for gestational age and fetal growth restriction using fractional thigh volume–derived measures compared to standard 2-dimensional measurements (area under receiver operating characteristic curve, 0.86; 95% confidence interval, 0.79–0.94, and area under receiver operating characteristic curve, 0.92; 95% confidence interval, 0.85–0.99, respectively). Conclusion Fractional thigh volume measurements offer some improvement over 2-dimensional biometry for the detection of late-onset fetal growth restriction at 34-36 weeks.
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Affiliation(s)
- Louise E Simcox
- Maternal and Fetal Health Research Center, Institute of Human Development, University of Manchester, Manchester, United Kingdom; St Mary's Hospital, Central Manchester University Hospitals National Health Service Foundation Trust, Manchester Academic Health Science Center, Manchester, United Kingdom.
| | - Jenny E Myers
- Maternal and Fetal Health Research Center, Institute of Human Development, University of Manchester, Manchester, United Kingdom; St Mary's Hospital, Central Manchester University Hospitals National Health Service Foundation Trust, Manchester Academic Health Science Center, Manchester, United Kingdom
| | - Tim J Cole
- Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Edward D Johnstone
- Maternal and Fetal Health Research Center, Institute of Human Development, University of Manchester, Manchester, United Kingdom; St Mary's Hospital, Central Manchester University Hospitals National Health Service Foundation Trust, Manchester Academic Health Science Center, Manchester, United Kingdom
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15
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Sinha B, Taneja S, Chowdhury R, Mazumder S, Rongsen-Chandola T, Upadhyay RP, Martines J, Bhandari N, Bhan MK. Low-birthweight infants born to short-stature mothers are at additional risk of stunting and poor growth velocity: Evidence from secondary data analyses. MATERNAL AND CHILD NUTRITION 2017; 14. [PMID: 28840655 PMCID: PMC5763338 DOI: 10.1111/mcn.12504] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 06/05/2017] [Accepted: 07/12/2017] [Indexed: 01/20/2023]
Abstract
Low‐birthweight (LBW) infants are at an increased risk of stunting and poor linear growth. The risk might be additionally higher in these infants when born to short mothers. However, this hypothesis has been less explored. The objective of this secondary data analysis was to determine the risk of linear growth faltering and difference in linear growth velocity in LBW infants born to short mothers (<150 cm) compared to those born to mothers with height ≥150 cm during the first year of life. This analysis uses data from a community‐based randomized controlled trial of 2,052 hospital‐born term infants with birthweight ≤2,500g from urban low–middle socioeconomic neighbourhoods in Delhi, India. Data on maternal height and infant birth length were available from 1,858 (90.5%) of the infants. Infant anthropometry outcomes were measured at birth, 3, 6, 9, and 12 months of age. We found that infants born to short mothers had around twofold higher odds of stunting and lower attained length‐for‐age Z scores compared to infants of mothers with height ≥150 cm, at all ages of assessment. Linear growth velocity was significantly lower in infants of short mothers particularly in the first 6 months of life. We conclude that LBW infants born to short mothers are at a higher risk of stunting and have slower postnatal growth velocity resulting in lower attained length‐for‐age Z scores in infancy. Evidence‐based strategies need to be tested to optimize growth velocity in LBW infants especially those born to short mothers.
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Affiliation(s)
- Bireshwar Sinha
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Sunita Taneja
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Ranadip Chowdhury
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Sarmila Mazumder
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | | | - Ravi Prakash Upadhyay
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Jose Martines
- Independent Consultant, 181, Rue Du Parc Jean Monnet 01630, St Genis Pouilly, France
| | - Nita Bhandari
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Maharaj Kishan Bhan
- Indian Institute of Technology, New Delhi, India.,Knowledge Integration and Translational Platform (KnIT), Biotechnology Industry Research Assistance Council (BIRAC), New Delhi, India
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16
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Ferguson KK, Meeker JD, Cantonwine DE, Chen YH, Mukherjee B, McElrath TF. Urinary phthalate metabolite and bisphenol A associations with ultrasound and delivery indices of fetal growth. ENVIRONMENT INTERNATIONAL 2016; 94:531-537. [PMID: 27320326 PMCID: PMC4980186 DOI: 10.1016/j.envint.2016.06.013] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 05/26/2016] [Accepted: 06/11/2016] [Indexed: 05/17/2023]
Abstract
Growth of the fetus is highly sensitive to environmental perturbations, and disruption can lead to problems in pregnancy as well as later in life. This study investigates the relationship between maternal exposure to common plasticizers in pregnancy and fetal growth. Participants from a longitudinal birth cohort in Boston were recruited early in gestation and followed until delivery. Urine samples were collected at up to four time points and analyzed for concentrations of phthalate metabolites and bisphenol A (BPA). Ultrasound scans were performed at four time points during pregnancy for estimation of growth parameters, and birthweight was recorded at delivery. Growth measures were standardized to a larger population. For the present analysis we examined cross-sectional and repeated measures associations between exposure biomarkers and growth estimates in 482 non-anomalous singleton pregnancies. Cross-sectional associations between urinary phthalate metabolites or BPA and growth indices were imprecise. However, in repeated measures models, we observed significant inverse associations between di-2-ethylhexyl phthalate (DEHP) metabolites and estimated or actual fetal weight. An interquartile range increase in summed DEHP metabolites was associated with a 0.13 standard deviation decrease in estimated or actual fetal weight (95% confidence interval=-0.23, -0.03). Associations were consistent across different growth parameters (e.g., head circumference, femur length), and by fetal sex. No consistent associations were observed for other phthalate metabolites or BPA. Maternal exposure to DEHP during pregnancy was associated with decreased fetal growth, which could have repercussive effects.
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Affiliation(s)
- Kelly K Ferguson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, United States; Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States.
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - David E Cantonwine
- Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Yin-Hsiu Chen
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Thomas F McElrath
- Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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17
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Casas M, Valvi D, Ballesteros-Gomez A, Gascon M, Fernández MF, Garcia-Esteban R, Iñiguez C, Martínez D, Murcia M, Monfort N, Luque N, Rubio S, Ventura R, Sunyer J, Vrijheid M. Exposure to Bisphenol A and Phthalates during Pregnancy and Ultrasound Measures of Fetal Growth in the INMA-Sabadell Cohort. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:521-528. [PMID: 26196298 PMCID: PMC4829997 DOI: 10.1289/ehp.1409190] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 07/17/2015] [Indexed: 05/18/2023]
Abstract
BACKGROUND Prenatal exposure to bisphenol A (BPA) and phthalates may affect fetal growth; however, previous findings are inconsistent and based on few studies. OBJECTIVES We assessed whether prenatal exposure to BPA and phthalates was associated with fetal growth in a Spanish birth cohort of 488 mother-child pairs. METHODS We measured BPA and eight phthalates [four di(2-ethylhexyl) phthalate metabolites (DEHPm), mono-benzyl phthalate (MBzP), and three low-molecular-weight phthalate metabolites (LMWPm)] in two spot-urine samples collected during the first and third trimester of pregnancy. We estimated growth curves for femur length (FL), head circumference (HC), abdominal circumference (AC), biparietal diameter (BPD), and estimated fetal weight (EFW) during pregnancy (weeks 12-20 and 20-34), and for birth weight, birth length, head circumference at birth, and placental weight. RESULTS Overall, results did not support associations of exposure to BPA or DEHPm during pregnancy with fetal growth parameters. Prenatal MBzP exposure was positively associated with FL at 20-34 weeks, resulting in an increase of 3.70% of the average FL (95% CI: 0.75, 6.63%) per doubling of MBzP concentration. MBzP was positively associated with birth weight among boys (48 g; 95% CI: 6, 90) but not in girls (-27 g; 95% CI: -79, 25) (interaction p-value = 0.04). The LMWPm mono-n-butyl phthalate (MnBP) was negatively associated with HC at 12-20 pregnancy weeks [-4.88% of HC average (95% CI: -8.36, -1.36%)]. CONCLUSIONS This study, one of the first to combine repeat exposure biomarker measurements and multiple growth measures during pregnancy, finds little evidence of associations of BPA or phthalate exposures with fetal growth. Phthalate metabolites MBzP and MnBP were associated with some fetal growth parameters, but these findings require replication. CITATION Casas M, Valvi D, Ballesteros-Gomez A, Gascon M, Fernández MF, Garcia-Esteban R, Iñiguez C, Martínez D, Murcia M, Monfort N, Luque N, Rubio S, Ventura R, Sunyer J, Vrijheid M. 2016. Exposure to bisphenol A and phthalates during pregnancy and ultrasound measures of fetal growth in the INMA-Sabadell cohort. Environ Health Perspect 124:521-528; http://dx.doi.org/10.1289/ehp.1409190.
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Affiliation(s)
- Maribel Casas
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Address correspondence to M. Casas, Centre for Research in Environmental Epidemiology, Doctor Aiguader, 88, 08003 Barcelona, Spain. Telephone 34 932 147 364. E-mail:
| | - Damaskini Valvi
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Mireia Gascon
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic–Universitat de Barcelona, Barcelona, Spain
| | - Mariana F. Fernández
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada (Granada.ibs), University of Granada, Granada, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO/CSISP, Valencia, Spain
| | - Raquel Garcia-Esteban
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carmen Iñiguez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO/CSISP, Valencia, Spain
- Universidad de Valencia, Valencia, Spain
| | - David Martínez
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mario Murcia
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO/CSISP, Valencia, Spain
| | - Nuria Monfort
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Noelia Luque
- Department of Analytical Chemistry, University of Cordoba, Cordoba, Spain
| | - Soledad Rubio
- Department of Analytical Chemistry, University of Cordoba, Cordoba, Spain
| | - Rosa Ventura
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Jordi Sunyer
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Martine Vrijheid
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Muller M, Sigurdsson S, Kjartansson O, Gunnarsdottir I, Thorsdottir I, Harris TB, van Buchem M, Gudnason V, Launer LJ. Late-life brain volume: a life-course approach. The AGES-Reykjavik study. Neurobiol Aging 2016; 41:86-92. [PMID: 27103521 DOI: 10.1016/j.neurobiolaging.2016.02.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 01/11/2016] [Accepted: 02/10/2016] [Indexed: 11/30/2022]
Abstract
The "fetal-origins-of-adult-disease" hypothesis proposes that an unfavorable intrauterine environment, estimated from small birth size, may induce permanent changes in fetal organs, including the brain. These changes in combination with effects of (cardiovascular) exposures during adult life may condition the later risk of brain atrophy. We investigated the combined effect of small birth size and mid-life cardiovascular risk on late-life brain volumes. Archived birth records of weight and height were abstracted for 1348 participants of the age, gene/environment susceptibility-Reykjavik study (RS; 2002-2006) population-based cohort, who participated in the original cohort of the RS (baseline 1967). Mid-life cardiovascular risk factors (CVRF) were collected in the RS. As a part of the late-life age, gene/environment susceptibility-RS examination, a brain magnetic resonance imaging was acquired and from it, volumes of total brain, gray matter, white matter, and white matter lesions were estimated. Adjusting for intracranial volume, demographics, and education showed small birth size (low ponderal index [PI]) and increased mid-life cardiovascular risk had an additive effect on having smaller late-life brain volumes. Compared with the reference group (high PI/absence of mid-life CVRF), participants with lower PI/presence of mid-life CVRF (body mass index >25 kg/m(2), hypertension, diabetes, "ever smokers") had smaller total brain volume later in life; B (95% confidence interval) were -10.9 mL (-21.0 to -0.9), -10.9 mL (-20.4 to -1.4), -20.9 mL (-46.9 to 5.2), and -10.8 mL (-19.3 to -2.2), respectively. These results suggest that exposure to an unfavorable intrauterine environment contributes to the trajectory toward smaller brain volume, adding to the atrophy that may be associated with mid-life cardiovascular risk.
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Affiliation(s)
- Majon Muller
- Intramural Research Program, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA; Department of Internal Medicine, VU University Medical Center, the Netherlands
| | | | - Olafur Kjartansson
- The Icelandic Heart Association, Kopavogur, Iceland; Department of Neurology, Landspitali University Hospital, Reykjavik, Iceland; Department of Radiology, Landspitali University Hospital, Reykjavik, Iceland
| | - Ingibjorg Gunnarsdottir
- Unit for Nutrition Research, University of Iceland and Landspitali University Hospital, Reykjavik, Iceland
| | - Inga Thorsdottir
- Unit for Nutrition Research, University of Iceland and Landspitali University Hospital, Reykjavik, Iceland
| | - Tamara B Harris
- Intramural Research Program, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA
| | - Mark van Buchem
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Lenore J Launer
- Intramural Research Program, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA.
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Cantonwine DE, Ferguson KK, Mukherjee B, Chen YH, Smith NA, Robinson JN, Doubilet PM, Meeker JD, McElrath TF. Utilizing Longitudinal Measures of Fetal Growth to Create a Standard Method to Assess the Impacts of Maternal Disease and Environmental Exposure. PLoS One 2016; 11:e0146532. [PMID: 26731406 PMCID: PMC4701464 DOI: 10.1371/journal.pone.0146532] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 12/19/2015] [Indexed: 11/18/2022] Open
Abstract
Impaired or suboptimal fetal growth is associated with an increased risk of perinatal morbidity and mortality. By utilizing readily available clinical data on the relative size of the fetus at multiple points in pregnancy, including delivery, future epidemiological research can improve our understanding of the impacts of maternal, fetal, and environmental factors on fetal growth at different windows during pregnancy. This study presents mean and standard deviation ultrasound measurements from a clinically representative US population that can be utilized for creating Z-scores to this end. Between 2006 and 2012, 18, 904 non-anomalous pregnancies that received prenatal care, first and second trimester ultrasound evaluations, and ultimately delivered singleton newborns at Brigham and Women's hospital in Boston were used to create the standard population. To illustrate the utility of this standard, we created Z-scores for ultrasound and delivery measurements for a cohort study population and examined associations with factors known to be associated with fetal growth. In addition to cross-sectional regression models, we created linear mixed models and generalized additive mixed models to illustrate how these scores can be utilized longitudinally and for the identification of windows of susceptibility. After adjustment for a priori confounders, maternal BMI was positively associated with increased fetal size beginning in the second trimester in cross-sectional models. Female infants and maternal smoking were associated with consistently reduced fetal size in the longitudinal models. Maternal age had a non-significant association with increased size in the first trimester that was attenuated as gestation progressed. As the growth measurements examined here are widely available in contemporary obstetrical practice, these data may be abstracted from medical records by investigators and standardized with the population means presented here. This will enable easy extension of clinical data to epidemiologic studies investigating novel maternal, fetal, and environmental factors that may impact fetal growth.
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Affiliation(s)
- David E. Cantonwine
- Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- * E-mail:
| | - Kelly K. Ferguson
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
| | - Yin-Hsiu Chen
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
| | - Nicole A. Smith
- Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Julian N. Robinson
- Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Peter M. Doubilet
- Department of Radiology, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - John D. Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
| | - Thomas F. McElrath
- Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
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Bruckner TA, Mayo JA, Gould JB, Stevenson DK, Lewis DB, Shaw GM, Carmichael SL. Heightened risk of preterm birth and growth restriction after a first-born son. Ann Epidemiol 2015; 25:743-7.e1. [DOI: 10.1016/j.annepidem.2015.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 07/07/2015] [Accepted: 07/10/2015] [Indexed: 12/20/2022]
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D'Ovidio F, d'Errico A, Scarinzi C, Costa G. Increased incidence of coronary heart disease associated with “double burden” in a cohort of Italian women. Soc Sci Med 2015; 135:40-6. [DOI: 10.1016/j.socscimed.2015.04.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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23
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Disgust in pregnancy and fetus sex—Longitudinal study. Physiol Behav 2015; 139:177-81. [DOI: 10.1016/j.physbeh.2014.11.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 11/08/2014] [Accepted: 11/10/2014] [Indexed: 01/21/2023]
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Pomeroy E, Wells JCK, Cole TJ, O'Callaghan M, Stock JT. Relationships of maternal and paternal anthropometry with neonatal body size, proportions and adiposity in an Australian cohort. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2014; 156:625-36. [PMID: 25502164 PMCID: PMC4404025 DOI: 10.1002/ajpa.22680] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 10/29/2014] [Accepted: 11/24/2014] [Indexed: 02/04/2023]
Abstract
The patterns of association between maternal or paternal and neonatal phenotype may offer insight into how neonatal characteristics are shaped by evolutionary processes, such as conflicting parental interests in fetal investment and obstetric constraints. Paternal interests are theoretically served by maximizing fetal growth, and maternal interests by managing investment in current and future offspring, but whether paternal and maternal influences act on different components of overall size is unknown. We tested whether parents' prepregnancy height and body mass index (BMI) were related to neonatal anthropometry (birthweight, head circumference, absolute and proportional limb segment and trunk lengths, subcutaneous fat) among 1,041 Australian neonates using stepwise linear regression. Maternal and paternal height and maternal BMI were associated with birthweight. Paternal height related to offspring forearm and lower leg lengths, maternal height and BMI to neonatal head circumference, and maternal BMI to offspring adiposity. Principal components analysis identified three components of variability reflecting neonatal “head and trunk skeletal size,” “adiposity,” and “limb lengths.” Regression analyses of the component scores supported the associations of head and trunk size or adiposity with maternal anthropometry, and limb lengths with paternal anthropometry. Our results suggest that while neonatal fatness reflects environmental conditions (maternal physiology), head circumference and limb and trunk lengths show differing associations with parental anthropometry. These patterns may reflect genetics, parental imprinting and environmental influences in a manner consistent with parental conflicts of interest. Paternal height may relate to neonatal limb length as a means of increasing fetal growth without exacerbating the risk of obstetric complications. Am J Phys Anthropol 156:625–636, 2015.
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Affiliation(s)
- Emma Pomeroy
- Newnham College, University of Cambridge, Cambridge, UK; Division of Biological Anthropology, Department of Archaeology and Anthropology, University of Cambridge, Cambridge, UK
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25
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Christiansen SG. The impact of children's sex composition on parents' mortality. BMC Public Health 2014; 14:989. [PMID: 25246080 PMCID: PMC4179844 DOI: 10.1186/1471-2458-14-989] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 09/15/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study explores the relationship between children's sex composition and parents' mortality in a contemporary western society. It improves on earlier research by using a larger and more representative dataset - constructed from registers and encompassing the entire Norwegian population. METHODS The analysis is based on discrete-time hazard models, estimated for the years 1980-2008 for women and men born after 1935. RESULTS When operationalising sex composition as the "number of boys", coefficients are insignificant in all specifications. However, when considering the three categories "only boys", "only girls" and "mixed sex", I find a small but significant disadvantage of having only girls, compared to having at least one child of each sex, for mothers of two or more children. Having only daughters is associated with a mortality disadvantage compared to having only sons for mothers of two children, but a mortality advantage among mothers with four children. Among women who gave birth to their first child as teenagers, those who have only sons have relatively high mortality. I also find an excess mortality both for mothers of only girls and mothers of only boys in the period 1980-1989. CONCLUSION These results lend some support to the notion that there is a larger benefit of the first son or daughter than the later children of the same sex, and especially in the earliest decade of the study period.
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Pomeroy E, Stock JT, Cole TJ, O'Callaghan M, Wells JCK. Relationships between neonatal weight, limb lengths, skinfold thicknesses, body breadths and circumferences in an Australian cohort. PLoS One 2014; 9:e105108. [PMID: 25162658 PMCID: PMC4146506 DOI: 10.1371/journal.pone.0105108] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 07/17/2014] [Indexed: 12/11/2022] Open
Abstract
Background Low birth weight has been consistently associated with adult chronic disease risk. The thrifty phenotype hypothesis assumes that reduced fetal growth impacts some organs more than others. However, it remains unclear how birth weight relates to different body components, such as circumferences, adiposity, body segment lengths and limb proportions. We hypothesized that these components vary in their relationship to birth weight. Methods We analysed the relationship between birth weight and detailed anthropometry in 1270 singleton live-born neonates (668 male) from the Mater-University of Queensland Study of Pregnancy (Brisbane, Australia). We tested adjusted anthropometry for correlations with birth weight. We then performed stepwise multiple regression on birth weight of: body lengths, breadths and circumferences; relative limb to neck-rump proportions; or skinfold thicknesses. All analyses were adjusted for sex and gestational age, and used logged data. Results Circumferences, especially chest, were most strongly related to birth weight, while segment lengths (neck-rump, thigh, upper arm, and especially lower arm and lower leg) were relatively weakly related to birth weight, and limb lengths relative to neck-rump length showed no relationship. Skinfolds accounted for 36% of birth weight variance, but adjusting for size (neck-rump, thigh and upper arm lengths, and head circumference), this decreased to 10%. There was no evidence that heavier babies had proportionally thicker skinfolds. Conclusions Neonatal body measurements vary in their association with birth weight: head and chest circumferences showed the strongest associations while limb segment lengths did not relate strongly to birth weight. After adjusting for body size, subcutaneous fatness accounted for a smaller proportion of birth weight variance than previously reported. While heavier babies had absolutely thicker skinfolds, this was proportional to their size. Relative limb to trunk length was unrelated to birth weight, suggesting that limb proportions at birth do not index factors relevant to prenatal life.
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Affiliation(s)
- Emma Pomeroy
- Newnham College, University of Cambridge, Cambridge, United Kingdom
- Division of Biological Anthropology, Department of Archaeology and Anthropology, University of Cambridge, Cambridge, United Kingdom
- * E-mail:
| | - Jay T. Stock
- Division of Biological Anthropology, Department of Archaeology and Anthropology, University of Cambridge, Cambridge, United Kingdom
| | - Tim J. Cole
- Population Policy and Practice, UCL Institute of Child Health, London, United Kingdom
| | - Michael O'Callaghan
- School of Medicine, Mater Clinical School, University of Queensland, Brisbane, Queensland, Australia
| | - Jonathan C. K. Wells
- Division of Biological Anthropology, Department of Archaeology and Anthropology, University of Cambridge, Cambridge, United Kingdom
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom
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Reynolds SA, Roberts JM, Bodnar LM, Haggerty CL, Youk AO, Catov JM. Fetal sex and race modify the predictors of fetal growth. Matern Child Health J 2014; 19:798-810. [PMID: 25030701 DOI: 10.1007/s10995-014-1571-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The objective of this study is unknown if fetal sex and race modify the impact of maternal pre-pregnancy body mass index (BMI), and smoking on fetal growth. The authors studied markers of fetal growth in singleton offspring of 8,801 primiparous, normotensive women, enrolled in the Collaborative Perinatal Project. The authors tested for departures from additivity between sex/race and each predictor. The head-to-chest circumference ratio (HCC) decreased more, while birthweight and ponderal index (PI) increased more for each 1 kg/m(2) increase in pre-pregnancy BMI among term females versus males (P = 0.07, P < 0.01 and P = 0.08, interaction respectively). For term offspring of White compared with Black women, smoking independent of "dose" was associated with larger reductions in growth (165 g vs. 68 g reduction in birthweight, P < 0.01, interaction), greater reduction in fetal placental ratio (P < 0.01, interaction), PI (P < 0.01, interaction), and greater increase in HCC (P = 0.02), respectively. The association of BMI and smoking with fetal size appeared to be reversed in term versus preterm infants. Our study provides evidence that the associations of pre-pregnancy BMI and smoking are not constant across sex and race. This finding may be relevant to sex and race differences in neonatal and long term health outcomes.
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Affiliation(s)
- Simone A Reynolds
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA, 15261, USA,
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Jelenkovic A, Silventoinen K, Tynelius P, Helle S, Rasmussen F. Sex of preceding sibling and anthropometrics of subsequent offspring at birth and in young adulthood: A population-based study in Sweden. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2014; 154:471-8. [DOI: 10.1002/ajpa.22534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 04/30/2014] [Indexed: 11/08/2022]
Affiliation(s)
- Aline Jelenkovic
- Department of Genetics; Physical Anthropology and Animal Physiology, University of the Basque Country UPV/EHU; Leioa Spain
- IKERBASQUE, Basque Foundation for Science; Bilbao Spain
- Department of Public Health; Hjelt Institute, University of Helsinki; Helsinki Finland
| | - Karri Silventoinen
- Department of Public Health; Hjelt Institute, University of Helsinki; Helsinki Finland
- Population Research Unit; Department of Social Research; University of Helsinki; Helsinki Finland
| | - Per Tynelius
- Child and Adolescent Public Health Epidemiology; Department of Public Health Sciences; Karolinska Institutet; Stockholm Sweden
| | - Samuli Helle
- Section of Ecology; Department of Biology; University of Turku; Turku Finland
| | - Finn Rasmussen
- Child and Adolescent Public Health Epidemiology; Department of Public Health Sciences; Karolinska Institutet; Stockholm Sweden
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Ritz B, Qiu J, Lee PC, Lurmann F, Penfold B, Erin Weiss R, McConnell R, Arora C, Hobel C, Wilhelm M. Prenatal air pollution exposure and ultrasound measures of fetal growth in Los Angeles, California. ENVIRONMENTAL RESEARCH 2014; 130:7-13. [PMID: 24517884 PMCID: PMC4016959 DOI: 10.1016/j.envres.2014.01.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 12/17/2013] [Accepted: 01/15/2014] [Indexed: 05/20/2023]
Abstract
BACKGROUND Few previous studies examined the impact of prenatal air pollution exposures on fetal development based on ultrasound measures during pregnancy. METHODS In a prospective birth cohort of more than 500 women followed during 1993-1996 in Los Angeles, California, we examined how air pollution impacts fetal growth during pregnancy. Exposure to traffic related air pollution was estimated using CALINE4 air dispersion modeling for nitrogen oxides (NOx) and a land use regression (LUR) model for nitrogen monoxide (NO), nitrogen dioxide (NO2) and NOx. Exposures to carbon monoxide (CO), NO2, ozone (O3) and particles <10μm in aerodynamic diameter (PM10) were estimated using government monitoring data. We employed a linear mixed effects model to estimate changes in fetal size at approximately 19, 29 and 37 weeks gestation based on ultrasound. RESULTS Exposure to traffic-derived air pollution during 29 to 37 weeks was negatively associated with biparietal diameter at 37 weeks gestation. For each interquartile range (IQR) increase in LUR-based estimates of NO, NO2 and NOx, or freeway CALINE4 NOx we estimated a reduction in biparietal diameter of 0.2-0.3mm. For women residing within 5km of a monitoring station, we estimated biparietal diameter reductions of 0.9-1.0mm per IQR increase in CO and NO2. Effect estimates were robust to adjustment for a number of potential confounders. We did not observe consistent patterns for other growth endpoints we examined. CONCLUSIONS Prenatal exposure to traffic-derived pollution was negatively associated with fetal head size measured as biparietal diameter in late pregnancy.
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Affiliation(s)
- Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, UCLA, 650 Charles E. Young Drive, Los Angeles, CA 90095-1772, USA; The David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
| | - Jiaheng Qiu
- Department of Biostatistics, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - Pei-Chen Lee
- Department of Epidemiology, Fielding School of Public Health, UCLA, 650 Charles E. Young Drive, Los Angeles, CA 90095-1772, USA
| | | | | | - Robert Erin Weiss
- Department of Biostatistics, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - Rob McConnell
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Chander Arora
- Department of Obstetrics, Gynecology and Pediatrics, Cedars Sinai Medical Center, Los Angeles, CA, USA; The David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Calvin Hobel
- Department of Obstetrics, Gynecology and Pediatrics, Cedars Sinai Medical Center, Los Angeles, CA, USA; The David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Michelle Wilhelm
- Department of Epidemiology, Fielding School of Public Health, UCLA, 650 Charles E. Young Drive, Los Angeles, CA 90095-1772, USA
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Gaillard R, Steegers EA, de Jongste JC, Hofman A, Jaddoe VW. Tracking of fetal growth characteristics during different trimesters and the risks of adverse birth outcomes. Int J Epidemiol 2014; 43:1140-53. [PMID: 24603318 DOI: 10.1093/ije/dyu036] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Fetal growth characteristics are used to identify influences of several maternal characteristics and to identify individuals at increased risk of adverse outcomes. The extent to which fetal growth characteristics track in different trimesters is not known. METHODS In a population-based prospective cohort study among 8636 pregnant women, we examined the extent to which fetal growth characteristics track, are influenced by maternal socio-demographic and lifestyle related determinants and are associated with birth outcomes. Fetal growth was assessed in each trimester and at birth. RESULTS Correlation coefficient between first-trimester crown-rump length and birthweight was r = 0.12 (P-value < 0.05). Correlation coefficients for fetal-head circumference, (femur) length and (estimated) fetal weight ranged from r = 0.16 to r = 0.30 (all P-values < 0.05) between second trimester and birth and from r = 0.36 to r = 0.58 (all P-values < 0.05) between third trimester and birth, and were highest for (estimated) fetal weight. Correlation coefficients for (estimated) fetal weight tended to be lower among overweight mothers, as compared with normal weight mothers, but were not influenced by other maternal characteristics. First, second and third-trimester fetal growth characteristics were associated with risks of preterm birth and small size for gestational age at birth,with the strongest associations present in third trimester. CONCLUSION Fetal growth characteristics track moderately throughout gestation, with stronger tracking coefficients present in later pregnancy. Tracking coefficients were not materially influenced by maternal socio-demographic and lifestyle characteristics. First, second and third trimester fetal growth characteristics were associated with the risk of adverse birth outcomes.
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Affiliation(s)
- Romy Gaillard
- Generation R Study Group, and Departments of Epidemiology, Paediatrics and Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, The NetherlandsGeneration R Study Group, and Departments of Epidemiology, Paediatrics and Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, The NetherlandsGeneration R Study Group, and Departments of Epidemiology, Paediatrics and Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Eric Ap Steegers
- Generation R Study Group, and Departments of Epidemiology, Paediatrics and Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Johan C de Jongste
- Generation R Study Group, and Departments of Epidemiology, Paediatrics and Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Albert Hofman
- Generation R Study Group, and Departments of Epidemiology, Paediatrics and Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Vincent Wv Jaddoe
- Generation R Study Group, and Departments of Epidemiology, Paediatrics and Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, The NetherlandsGeneration R Study Group, and Departments of Epidemiology, Paediatrics and Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, The NetherlandsGeneration R Study Group, and Departments of Epidemiology, Paediatrics and Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, The Netherlands
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Helle S, Lummaa V. A trade-off between having many sons and shorter maternal post-reproductive survival in pre-industrial Finland. Biol Lett 2013; 9:20130034. [PMID: 23445948 DOI: 10.1098/rsbl.2013.0034] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A bias in reproduction towards sons, which are energetically more costly than daughters, has been suggested to shorten parental lifespan, but previous results have been mixed. Reproductive costs should be most evident in low rather than high resource settings, and are not expected to be severe in men, because women pay higher direct costs of reproduction. We, therefore, used demographic data from pre-industrial Finland to investigate whether the number of sons and daughters born affected their parents' post-reproductive survival and whether this was related to parent's resource availability. Irrespective of access to resources, mothers, but not fathers, with many sons suffered from reduced post-reproductive survival, and this association decreased as mothers aged. Our results provide evidence that Finnish mothers traded long post-reproductive lifespan for giving birth to many sons.
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Affiliation(s)
- Samuli Helle
- Section of Ecology, Department of Biology, University of Turku, Turku 20014, Finland.
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Chakera AJ, Carleton VL, Shields B, Ross GP, Hattersley AT. Response to Comment on: Chakera et al. Antenatal diagnosis of fetal genotype determines if maternal hyperglycemia due to a glucokinase mutation requires treatment. Diabetes Care 2012;35:1832-1834. Diabetes Care 2013; 36:e15. [PMID: 23264298 PMCID: PMC3526246 DOI: 10.2337/dc12-1497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Ali J. Chakera
- From the Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, U.K.; the
- Department of Diabetes and Endocrinology, Royal Devon and Exeter Hospital, Exeter, U.K.; the
| | - Victoria L. Carleton
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, Australia; and
- The University of Sydney, Sydney, Australia
| | - Beverley Shields
- From the Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, U.K.; the
| | - Glynis P. Ross
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, Australia; and
| | - Andrew T. Hattersley
- From the Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, U.K.; the
- Department of Diabetes and Endocrinology, Royal Devon and Exeter Hospital, Exeter, U.K.; the
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Delpisheh A, Brabin L, Brabin BJ. Pregnancy, smoking and birth outcomes. ACTA ACUST UNITED AC 2012; 2:389-403. [PMID: 19803911 DOI: 10.2217/17455057.2.3.389] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This review summarizes the epidemiology and consequences of maternal smoking in pregnancy, with emphasis on the adverse effects on birth outcomes. In developed countries, approximately 15%, and in developing countries, approximately 8% of women smoke cigarettes, and adolescents and women from lower socioeconomic groups are more likely than other women to smoke while pregnant. Maternal smoking during pregnancy is the largest modifiable risk factor for intrauterine growth restriction. A meta-analysis of recent studies showed that the pooled estimate for reduction of mean birthweight was 174 g (95% confidence limits 132-220 g). Other studies confirm a weaker association between maternal smoking and preterm birth. The population attributable risk of low birthweight due to maternal smoking in the UK is estimated to be 29-39%. Tobacco smoke toxins damage the placenta and may lead to placental abruption, abortion or placenta praevia. Infants of mothers who smoke in pregnancy are at an increased risk of respiratory complications including asthma, obesity and, possibly, behavioral disorders. These effects may be dose-related, as there is good evidence that mean birthweight decrements are greater with increased numbers of cigarettes smoked during pregnancy. Cotinine is a useful indicator of tobacco smoke exposure in pregnant women and higher levels in body fluids have been related to lower birthweights. Maternal genetic polymorphisms of the cytochrome P (CYP)450 and glutathione-S-transferase (GST) subfamilies of metabolic genes influence the magnitude of the effect of nicotine exposure on birth outcomes through their influence on nicotine metabolism. Greatly increased risk of cigarette smoke-induced diseases, including low birthweight, has been found in individuals with susceptible genotypes. Interventions to control maternal smoking are also considered.
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Affiliation(s)
- Ali Delpisheh
- Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
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Chakera AJ, Carleton VL, Ellard S, Wong J, Yue DK, Pinner J, Hattersley AT, Ross GP. Antenatal diagnosis of fetal genotype determines if maternal hyperglycemia due to a glucokinase mutation requires treatment. Diabetes Care 2012; 35:1832-4. [PMID: 22773699 PMCID: PMC3425005 DOI: 10.2337/dc12-0151] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE In women with hyperglycemia due to heterozygous glucokinase (GCK) mutations, the fetal genotype determines its growth. If the fetus inherits the mutation, birth weight is normal when maternal hyperglycemia is not treated, whereas intensive treatment may adversely reduce fetal growth. However, fetal genotype is not usually known antenatally, making treatment decisions difficult. HISTORY AND EXAMINATION We report two women with gestational diabetes mellitus resulting from GCK mutations with hyperglycemia sufficient to merit treatment. INVESTIGATION In both women, DNA from chorionic villus sampling, performed after high-risk aneuploidy screening, showed the fetus had inherited the GCK mutation. Therefore, maternal hyperglycemia was not treated. Both offspring had a normal birth weight and no peripartum complications. CONCLUSIONS In pregnancies where the mother has hyperglycemia due to a GCK mutation, knowing the fetal GCK genotype guides the management of maternal hyperglycemia. Fetal genotyping should be performed when fetal DNA is available from invasive prenatal diagnostic testing.
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Affiliation(s)
- Ali J Chakera
- Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, UK
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35
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Ishida M, Monk D, Duncan AJ, Abu-Amero S, Chong J, Ring SM, Pembrey ME, Hindmarsh PC, Whittaker JC, Stanier P, Moore GE. Maternal inheritance of a promoter variant in the imprinted PHLDA2 gene significantly increases birth weight. Am J Hum Genet 2012; 90:715-9. [PMID: 22444668 DOI: 10.1016/j.ajhg.2012.02.021] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 02/17/2012] [Accepted: 02/22/2012] [Indexed: 12/30/2022] Open
Abstract
Birth weight is an important indicator of both perinatal and adult health, but little is known about the genetic factors contributing to its variability. Intrauterine growth restriction is a leading cause of perinatal morbidity and mortality and is also associated with adult disease. A significant correlation has been reported between lower birth weight and increased expression of the maternal PHLDA2 allele in term placenta (the normal imprinting pattern was maintained). However, a mechanism that explains the transcriptional regulation of PHLDA2 on in utero growth has yet to be described. In this study, we sequenced the PHLDA2 promoter region in 263 fetal DNA samples to identify polymorphic variants. We used a luciferase reporter assay to identify in the PHLDA2 promoter a 15 bp repeat sequence (RS1) variant that significantly reduces PHLDA2-promoter efficiency. RS1 genotyping was then performed in three independent white European normal birth cohorts. Meta-analysis of all three (total n = 9,433) showed that maternal inheritance of RS1 resulted in a significant 93 g increase in birth weight (p = 0.01; 95% confidence interval [CI] = 22-163). Moreover, when the mother was homozygous for RS1, the influence on birth weight was 155 g (p = 0.04; 95% CI = 9-300), which is a similar magnitude to the reduction in birth weight caused by maternal smoking.
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Affiliation(s)
- Miho Ishida
- Clinical and Molecular Genetics Unit, Institute of Child Health, University College London, London, UK
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Unger A, Jagsch R, Bäwert A, Winklbaur B, Rohrmeister K, Martin PR, Coyle M, Fischer G. Are male neonates more vulnerable to neonatal abstinence syndrome than female neonates? ACTA ACUST UNITED AC 2011; 8:355-64. [PMID: 22088886 DOI: 10.1016/j.genm.2011.10.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 10/10/2011] [Accepted: 10/10/2011] [Indexed: 11/28/2022]
Abstract
BACKGROUND Prior studies have shown an increased vulnerability among males to adverse outcomes during the postnatal period. Most children exposed to opioids and other medications in utero develop neonatal abstinence syndrome (NAS), yet individual predisposition for NAS is poorly understood. OBJECTIVE This investigation examined the role of neonatal sex in the postnatal period for neonates exposed to standardized opioid maintenance treatment in utero with a focus on NAS regarding severity, medication requirements, and duration. METHODS This was a secondary analysis of data collected in a prospective randomized, double-blind, double-dummy, multicenter trial (MOTHER study) that examined the comparative safety and efficacy of methadone and buprenorphine during pregnancy. A total of 131 neonates born to opioid-dependent women randomized at 6 US sites (n = 74) and 1 European site (n = 37) were analyzed. Sex-based differences in birth weight, length, head circumference, NAS duration, NAS severity, and treatment parameters of full-term neonates were assessed. RESULTS Males had a significantly higher birth weight (P = 0.027) and head circumference (P = 0.017) compared with females, with no significant sex difference in rates of preterm delivery. No significant sex-related differences were found for NAS development, severity, or duration, or medication administered, and there were no significant differences in concomitant drug consumption during pregnancy (P = 0.959). CONCLUSIONS This unique prospective study shows similar postnatal vulnerability for both sexes, suggesting that factors other than sex are the major determinants of clinically significant NAS. ClinicalTrials.gov identifier: NCT 00271219.
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Affiliation(s)
- Annemarie Unger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
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O'Connell BA, Moritz KM, Roberts CT, Walker DW, Dickinson H. The placental response to excess maternal glucocorticoid exposure differs between the male and female conceptus in spiny mice. Biol Reprod 2011; 85:1040-7. [PMID: 21795670 DOI: 10.1095/biolreprod.111.093369] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
The placenta is the intermediary between the mother and fetus, and its primary role is to provide for the appropriate growth of the fetus. A suboptimal in utero environment has been shown to differentially affect the health of offspring, depending on their sex. Here we show that excess maternal glucocorticoids administered in midgestation (Day 20, 0.5 gestation in the spiny mouse) for 60 h, have persisting effects on the placenta that differ by fetal sex, placental region, and time after glucocorticoid exposure. Dexamethasone (DEX) exposure altered placental structure and mRNA expression from male and female fetuses both immediately (Day 23) and 2 wk posttreatment (Day 37). The immediate consequences (Day 23) of DEX were similar between males and females, with reductions in the expression of IGF1, IGF1R, and SLC2A1 in the placenta. However, by Day 37, the transcriptional and structural response of the placenta was dependent on the sex of the fetus, with placentas of male fetuses having an increase in GCM1 expression, a decrease in SLC2A1 expression, and an increase in the amount of maternal blood sinusoids in the DEX-exposed placenta. Female placentas, on the other hand, showed increased SLC2A1 and MAP2K1 expression and a decrease in the amount of maternal blood sinusoids in response to DEX exposure. We have shown that the effect of a brief glucocorticoid exposure at midgestation has persisting effects on the placenta, and this is likely to have ongoing and dynamic effects on fetal development that differ for a male and female fetus.
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Affiliation(s)
- Bree A O'Connell
- The Ritchie Centre, Monash Institute of Medical Research, Clayton, Victoria, Australia
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Cha ES, Kong KA, Moon EK, Khang YH, Lee WJ. Childhood cancer mortality and birth characteristics in Korea: a national population-based birth cohort study. J Korean Med Sci 2011; 26:339-45. [PMID: 21394300 PMCID: PMC3051079 DOI: 10.3346/jkms.2011.26.3.339] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Accepted: 01/10/2011] [Indexed: 11/20/2022] Open
Abstract
To examine the relationship between birth characteristics and childhood cancer mortality, a retrospective cohort study of Korean children was conducted using data collected by the national birth register between 1995 and 2006, which were then individually linked to death data. A cohort of 6,479,406 children was followed from birth until their death or until December 31, 2006. Poisson regression analyses were used to calculate rate ratios of childhood cancer deaths according to birth characteristics. A total of 1,469 cancer deaths were noted and the childhood cancer mortality rate was found to be 3.43 per 100,000 person-years in Korea during the period of 1995-2006. The birth characteristics examined in this study (i.e. , birth weight, gestational age, multiple births, parental ages, and number of siblings) were generally found to be not significantly associated with childhood cancer mortality, and the associations did not vary meaningfully with gender nor with cancer sites. However, among children aged 5-11 yr, higher birth weight was associated with elevated childhood cancer mortality (rate ratio = 1.28, 95% confidence interval 1.04-1.58). Our results offer no overall associations between childhood cancer mortality and birth characteristics, but suggest that the association may be specific to age group.
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Affiliation(s)
- Eun Shil Cha
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Kyoung Ae Kong
- Division of Chronic Disease Surveillance, Korea Center for Disease Control and Prevention, Cheongwon, Korea
| | - Eun Kyeong Moon
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Young-Ho Khang
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Jin Lee
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
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Sonographic Maturation of the Placenta at 30 to 34 Weeks Is Not Associated With Second Trimester Markers of Placental Insufficiency in Low-risk Pregnancies. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2010; 32:1134-1139. [DOI: 10.1016/s1701-2163(16)34736-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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40
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Hindmarsh PC, Bryan S, Geary MPP, Cole TJ. Effects of current size, postnatal growth, and birth size on blood pressure in early childhood. Pediatrics 2010; 126:e1507-13. [PMID: 21078732 DOI: 10.1542/peds.2010-0358] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE In a prospective study, we investigated the impact of early growth on blood pressure at 3 years of age. METHODS We measured systolic blood pressure (SBP) and diastolic blood pressure (DBP) for 590 children 3 years of age and related measurements to current size and size at birth, 6 months, 1 year, and 2 years of age. RESULTS SBP was related positively to weight at 3 and 2 years and, after adjustment for current size, negatively to weight at birth and 6 months but not at 1 or 2 years. No effect was observed for DBP. A family history of hypertension was associated with higher maternal blood pressure, greater weight, and gestational hypertension (P = .05). Mothers with a history of gestational hypertension had higher SBP and DBP values (P < .001). In multivariate linear regression analyses, SBP was influenced positively by weight at 3 years and family history of hypertension and negatively by weight at 6 months. None of the factors was associated with DBP. CONCLUSIONS For 3-year-old children, current weight was a determinant of SBP and postnatal growth to 6 months of age was more predictive than birth weight. A family history of hypertension is important in determining maternal blood pressure. These observations suggest a window in which postnatal growth might be modified.
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Affiliation(s)
- Peter C Hindmarsh
- UCL Institute of Child Health, Developmental Endocrinology Research Group, Clinical and Molecular Genetics Unit, 30 Guilford St, London WC1N 1EH, United Kingdom.
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The NS, Adair LS, Gordon-Larsen P. A study of the birth weight-obesity relation using a longitudinal cohort and sibling and twin pairs. Am J Epidemiol 2010; 172:549-57. [PMID: 20688900 DOI: 10.1093/aje/kwq169] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Sibling and twin study designs provide control for confounding factors that are typically unmeasured in traditional cohort studies. Using nationally representative data from the National Longitudinal Study of Adolescent Health collected at 3 visits during 1994-2002, the authors evaluated the longitudinal association between birth weight and later obesity in a traditional cohort study (n = 13,763; ages 11-21 years at baseline), controlling for sex, age, race/ethnicity, and parental education. Among persons with a nonobese mother, high birth weight (>4 kg) participants were more likely than normal birth weight (>/=2.5-</=4 kg) participants to become obese later in life (incidence rate ratio = 1.46, 95% confidence interval: 1.28, 1.67). In a matched sibling pair sample (full siblings: n = 513; monozygotic twins: n = 207; dizygotic twins: n = 189), the authors examined longitudinal within-pair differences. Birth weight difference was positively associated with body mass index difference later in life for female monozygotic pairs only (beta = 2.67, 95% confidence interval: 0.99, 4.35). Given the null associations observed in the sibling sample, the commonly observed positive association between birth weight and later obesity from cohort analyses may be attributed to confounding by maternal characteristics. Further research is needed to identify specific factors that contribute to the birth weight-obesity relation.
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Affiliation(s)
- Natalie S The
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27516-3997, USA
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Aguilera I, Garcia-Esteban R, Iñiguez C, Nieuwenhuijsen MJ, Rodríguez À, Paez M, Ballester F, Sunyer J. Prenatal exposure to traffic-related air pollution and ultrasound measures of fetal growth in the INMA Sabadell cohort. ENVIRONMENTAL HEALTH PERSPECTIVES 2010; 118:705-11. [PMID: 20103496 PMCID: PMC2866689 DOI: 10.1289/ehp.0901228] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2009] [Accepted: 01/26/2010] [Indexed: 05/17/2023]
Abstract
BACKGROUND Few studies have used longitudinal ultrasound measurements to assess the effect of traffic-related air pollution on fetal growth. OBJECTIVE We examined the relationship between exposure to nitrogen dioxide (NO2) and aromatic hydrocarbons [benzene, toluene, ethylbenzene, m/p-xylene, and o-xylene (BTEX)] on fetal growth assessed by 1,692 ultrasound measurements among 562 pregnant women from the Sabadell cohort of the Spanish INMA (Environment and Childhood) study. METHODS We used temporally adjusted land-use regression models to estimate exposures to NO2 and BTEX. We fitted mixed-effects models to estimate longitudinal growth curves for femur length (FL), head circumference (HC), abdominal circumference (AC), biparietal diameter (BPD), and estimated fetal weight (EFW). Unconditional and conditional SD scores were calculated at 12, 20, and 32 weeks of gestation. Sensitivity analyses were performed considering time-activity patterns during pregnancy. RESULTS Exposure to BTEX from early pregnancy was negatively associated with growth in BPD during weeks 20-32. None of the other fetal growth parameters were associated with exposure to air pollution during pregnancy. When considering only women who spent < 2 hr/day in nonresidential outdoor locations, effect estimates were stronger and statistically significant for the association between NO2 and growth in HC during weeks 12-20 and growth in AC, BPD, and EFW during weeks 20-32. CONCLUSIONS Our results lend some support to an effect of exposure to traffic-related air pollutants from early pregnancy on fetal growth during mid-pregnancy..
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Affiliation(s)
- Inmaculada Aguilera
- Centre for Research in Environmental Epidemiology, Barcelona, Spain
- Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
- Address correspondence to I. Aguilera, Centre for Research in Environmental Epidemiology (CREAL), Barcelona Biomedical Research Park, Doctor Aiguader 88, Barcelona, Spain 08003. Telephone: 34-932147300. Fax: 34-932147301. E-mail:
| | - Raquel Garcia-Esteban
- Centre for Research in Environmental Epidemiology, Barcelona, Spain
- Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Barcelona, Spain
| | - Carmen Iñiguez
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Barcelona, Spain
- Centre for Public Health Research, Conselleria de Sanitat, Generalitat Valenciana, Valencia, Spain
| | - Mark J. Nieuwenhuijsen
- Centre for Research in Environmental Epidemiology, Barcelona, Spain
- Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Barcelona, Spain
| | - Àgueda Rodríguez
- Servei de Ginecologia i Obstetrícia, Hospital Parc Taulí, Sabadell, Spain
| | | | - Ferran Ballester
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Barcelona, Spain
- Centre for Public Health Research, Conselleria de Sanitat, Generalitat Valenciana, Valencia, Spain
| | - Jordi Sunyer
- Centre for Research in Environmental Epidemiology, Barcelona, Spain
- Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
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Sifianou P. Approaching the diagnosis of growth-restricted neonates: a cohort study. BMC Pregnancy Childbirth 2010; 10:6. [PMID: 20122167 PMCID: PMC2830965 DOI: 10.1186/1471-2393-10-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2009] [Accepted: 02/01/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The consequences of in utero growth restriction have been attracting scholarly attention for the past two decades. Nevertheless, the diagnosis of growth-restricted neonates is as yet an unresolved issue. Aim of this study is the evaluation of the performance of simple, common indicators of nutritional status, which are used in the identification of growth-restricted neonates. METHODS In a cohort of 418 consecutively born term and near term neonates, four widely used anthropometric indices of body proportionality and subcutaneous fat accretion were applied, singly and in combination, as diagnostic markers for the detection of growth-restricted babies. The concordance of the indices was assessed in terms of positive and negative percent agreement and of Cohen's kappa. RESULTS The agreement between the anthropometric indices was overall poor with a highest positive percent agreement of 62.5% and a lowest of 27.9% and the kappa ranging between 0.19 and 0.58. Moreover, 6% to 32% of babies having abnormal values in just one index were apparently well-grown and the median birth weight centile of babies having abnormal values of either of two indices was found to be as high as the 46th centile for gestational age (95%CI 35.5 to 60.4 and 29.8 to 63.9, respectively). On the contrary, the combination of anthropometric indices appeared to have better distinguishing properties among apparently and not apparently well-grown babies. The median birth weight centile of babies having abnormal values in two (or more) indices was the 11th centile for gestational age (95%CI 6.3 to 16.3). CONCLUSIONS Clinical assessment and anthropometric indices in combination can define a reference standard with better performance compared to the same indices used in isolation. This approach offers an easy-to-use tool for bedside diagnosis of in utero growth restriction.
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Affiliation(s)
- Popi Sifianou
- Department of Neonatology, General & Maternity Hospital Elena Venizelou, Athens, Greece.
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Hinde K. Richer milk for sons but more milk for daughters: Sex-biased investment during lactation varies with maternal life history in rhesus macaques. Am J Hum Biol 2009; 21:512-9. [PMID: 19384860 DOI: 10.1002/ajhb.20917] [Citation(s) in RCA: 118] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Lactation represents the greatest postnatal energetic expenditure for human and non-human primate females, and the ability to sustain the costs of lactation is influenced by a mother's physical condition. This is especially true for young mothers that initiate reproduction shortly after adolescence. These mothers have fewer bodily reserves available for lactation and face tradeoffs between reproduction and their own growth. Milk synthesis among captive rhesus macaques (Macaca mulatta) was investigated at the California National Primate Research Center from 2005 to 2007 (N = 114). Rhesus macaques produced low energy density milk typical of the primate order, but there was substantial individual variation among mothers in both milk energy density and yield. As a consequence, the available milk energy (AME), the product of milk energy density and milk yield, to support infant growth, development, and activity, varied tenfold among mothers. Primiparous mothers (N = 40) had fewer bodily resources, as measured by mass and body mass index, available for lactation than did multiparous mothers (N = 74) and showed poorer lactational performance. Mothers of sons produced milk of higher energy density, especially primiparous mothers, but lower milk yield, such that AME was the same for sons and daughters. Although AME from the mother was the same for sons and daughters, there was significant sexual dimorphism in infant mass. These data indicate that selection has likely favored sex-specific regulation of growth and development that is not necessarily contingent on greater maternal investment.
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Affiliation(s)
- Katherine Hinde
- Department of Anthropology, UC Santa Barbara, California 93106-3210, USA.
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Moyer-Mileur LJ, Slater H, Thomson JA, Mihalopoulos N, Byrne J, Varner MW. Newborn adiposity measured by plethysmography is not predicted by late gestation two-dimensional ultrasound measures of fetal growth. J Nutr 2009; 139:1772-8. [PMID: 19640967 PMCID: PMC3151022 DOI: 10.3945/jn.109.109058] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Noninvasive measures of fetal and neonatal body composition may provide early identification of children at risk for obesity. Air displacement plethysmography provides a safe, precise measure of adiposity and has recently been validated in infants. Therefore, we explored relationships between term newborn percent body fat (%BF) measured by air displacement plethysmography to 2-dimensional ultrasound (2-D US) biometric measures of fetal growth and maternal and umbilical cord endocrine activity. A total of 47 mother/infant pairs were studied. Fetal biometrics by 2-D US and maternal blood samples were collected during late gestation (35 wk postmenstrual age); infants were measured within 72 h of birth. Fetal biometrics included biparietal diameter, femur length, head circumference, abdominal circumference (AC), and estimated fetal weight (EFW). Serum insulin, insulin-like growth factor (IGF) 1, IGF binding protein-3, and leptin concentrations were measured in umbilical cord and maternal serum. The mean %BF determined by plethysmography was 10.9 +/- 4.8%. EFW and fetal AC had the largest correlations with newborn %BF (R(2) = 0.14 and 0.10, respectively; P < 0.05); however, stepwise linear regression modeling did not identify any fetal biometric parameters as a significant predictor of newborn %BF. Newborn mid-thigh circumference (MTC; cm) and ponderal index (PI; weight, kg/length, cm(3)) explained 21.8 and 14.4% of the variability in %BF, respectively, and gave the best stepwise linear regression model (%BF = 0.446 MTC + 0.347 PI -29.692; P < 0.001). We conclude that fetal growth biometrics determined by 2-D US do not provide a reliable assessment of %BF in term infants.
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Affiliation(s)
- Laurie J. Moyer-Mileur
- Center for Pediatric Nutrition Research and Division of General Pediatrics, Department of Pediatrics, and Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT 84158,To whom correspondence should be addressed. E-mail:
| | - Hillarie Slater
- Center for Pediatric Nutrition Research and Division of General Pediatrics, Department of Pediatrics, and Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT 84158
| | - J. Anne Thomson
- Center for Pediatric Nutrition Research and Division of General Pediatrics, Department of Pediatrics, and Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT 84158
| | - Nicole Mihalopoulos
- Center for Pediatric Nutrition Research and Division of General Pediatrics, Department of Pediatrics, and Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT 84158
| | - Jan Byrne
- Center for Pediatric Nutrition Research and Division of General Pediatrics, Department of Pediatrics, and Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT 84158
| | - Michael W. Varner
- Center for Pediatric Nutrition Research and Division of General Pediatrics, Department of Pediatrics, and Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT 84158
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46
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Sankaran S, Kyle PM. Aetiology and pathogenesis of IUGR. Best Pract Res Clin Obstet Gynaecol 2009; 23:765-77. [PMID: 19666240 DOI: 10.1016/j.bpobgyn.2009.05.003] [Citation(s) in RCA: 120] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2008] [Revised: 04/02/2009] [Accepted: 05/04/2009] [Indexed: 01/06/2023]
Abstract
Intrauterine growth restriction (IUGR) is a major cause of perinatal mortality and morbidity. A complex and dynamic interaction of maternal, placental and fetal environment is involved in ensuring normal fetal growth. An imbalance or lack of coordination in this complex system may lead to IUGR. Animal studies have given us an insight into some aspects of the basic pathophysiology of IUGR, and recent technologies such as Doppler studies of maternal and fetal vessels have added further information. The aetiologies of IUGR are diverse, involving multiple complex mechanisms, which make understanding of the pathophysiology difficult. However, particular focus is placed on the mechanisms involved in uteroplacental insufficiency as a cause of IUGR, as (1) it is common, (2) outcome can be good if timing of delivery is optimal and (3) it may be amenable to therapy in the future. While the research into the pathophysiology of IUGR continues, there have been interesting discoveries related to the genetic contribution to IUGR and the intrauterine programming of adult-onset diseases attributed to IUGR.
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Affiliation(s)
- Srividhya Sankaran
- Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK
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Dirix CEH, Kester AD, Hornstra G. Associations between term birth dimensions and prenatal exposure to essential and trans fatty acids. Early Hum Dev 2009; 85:525-30. [PMID: 19477608 DOI: 10.1016/j.earlhumdev.2009.05.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2008] [Revised: 05/01/2009] [Accepted: 05/01/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Certain essential long-chain polyunsaturated fatty acids (LCPUFAs) are considered important for fetal growth and brain development, whereas industrial trans fatty acids (mainly 18:1trans) have been associated with negative effects. The aim of this study was to investigate associations between term birth dimensions and prenatal exposure to some of these fatty acids, reflected by neonatal fatty acid concentrations at birth. METHODS Data of up to 700 infant-mother pairs from the Maastricht Essential Fatty Acid Birth Cohort were used for the present study. Unadjusted and multivariable-adjusted linear regression analyses were performed to investigate associations between birth weight, birth length or head circumference and relative concentrations of docosahexaenoic acid (DHA), arachidonic acid (AA), dihomo-gamma-linolenic acid (DGLA) and trans-octadecenoic acids (18:1t) measured in phospholipids of the walls of umbilical arteries and veins, and in umbilical cord plasma and erythrocytes. RESULTS After optimal adjustment, a significant negative association was observed between birth weight and umbilical plasma DHA concentrations. Negative associations were also found for AA concentrations measured in umbilical plasma and in arterial and venous vessel walls. Birth length was negatively related to arterial vessel wall AA concentrations only. A significant negative association was observed for the relationship between 18:1t in cord erythrocytes and birth weight. For DGLA no significant associations were observed. CONCLUSIONS Results seem to preclude a role of DHA and AA as growth factors per se. Their negative relationships with birth dimensions may result from a limited maternal-fetal LCPUFA transfer capacity. Potential effects of 18:1t and DGLA on birth dimensions are probably small or non-existing.
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Affiliation(s)
- Chantal E H Dirix
- Department of Human Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, Maastricht, The Netherlands
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Le Clair C, Abbi T, Sandhu H, Tappia PS. Impact of maternal undernutrition on diabetes and cardiovascular disease risk in adult offspring. Can J Physiol Pharmacol 2009; 87:161-79. [PMID: 19295658 DOI: 10.1139/y09-006] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Epidemiological, clinical, and experimental observations have led to the hypothesis that the risk of developing chronic diseases in adulthood is influenced not only by genetic and adult lifestyle factors, but also by environmental factors during early life. Low birth weight, a marker of intrauterine stress, has been linked to predisposition to cardiovascular disease (CVD) and diabetes. The compelling animal evidence and significant human data to support this conclusion are reviewed. Specifically, the review discusses the role of maternal nutrition before and during pregnancy, placental insufficiencies and epigenetic changes in the increased predisposition to diabetes and CVD in adult life. The impact of low birth weight and catch-up growth as they pertain to risk of disease in adult life is also discussed. In addition, adult disease risk in the overnourished fetus is also mentioned. Reference is made to some of the mechanisms of the induction of diabetes and CVD phenotype. It is proposed that fetal nutrition, growth and development through efficient maternal nutrition before and during pregnancy could constitute the basis for nutritional strategies for the primary prevention of diabetes and CVD.
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Affiliation(s)
- Caroline Le Clair
- I.H. Asper Clinical Research Institute, St. Boniface Hospital Research Centre, and Department of Human Nutritional Sciences, Faculty of Human Ecology, University of Manitoba, Winnipeg, MB R2H2A6, Canada
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Coall DA, Charles AK, Salafia CM. Gross placental structure in a low-risk population of singleton, term, first-born infants. Pediatr Dev Pathol 2009; 12:200-10. [PMID: 19007303 DOI: 10.2350/08-02-0413.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2008] [Accepted: 10/19/2008] [Indexed: 11/20/2022]
Abstract
Suboptimal fetal growth has been associated with an increased risk of adult disease, which may be exacerbated by an increased placental weight-to-fetal weight ratio. Placental weight is a summary measure of placental growth and development throughout pregnancy. However, measures of placental structure, including the chorionic disk surface area and thickness and eccentricity of the umbilical cord insertion, have been shown to account for additional variance in birth weight beyond that explained by placental weight. Little is known of the variability of these placental parameters in low-risk populations; their association with maternal, pregnancy, and neonatal characteristics; and the agreement between manual and digital measures. This study used manual and digital image analysis techniques to examine gross placental anatomy in 513 low-risk, singleton, term, first-born infants. Parametric methods compared groups and examined relationships among variables. Maternal birth weight, prepregnancy weight, and body mass index were associated with increased placental and birth weight (all P < 0.005), but only maternal birth weight was associated with increased placental surface area (P < 0.0005) and thickness (P = 0.005). Smoking during pregnancy reduced birth weight and increased the eccentricity of umbilical cord insertion (P = 0.012 and 0.034, respectively). The variability in these placental parameters was consistently lower than that reported in the literature, and correlations between digital and manual measurements were reasonable (r = .87-.71). Detailed analyses of gross placental structure can provide biologically relevant information regarding placental growth and development and, potentially, their consequences.
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Affiliation(s)
- David A Coall
- Center for Cognitive and Decision Sciences, Institute of Psychology, University of Basel, Missionsstrasse 64a, 4055 Basel, Switzerland.
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Veena SR, Krishnaveni GV, Wills AK, Hill JC, Fall CH. A principal components approach to parent-to-newborn body composition associations in South India. BMC Pediatr 2009; 9:16. [PMID: 19236724 PMCID: PMC2649926 DOI: 10.1186/1471-2431-9-16] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2008] [Accepted: 02/24/2009] [Indexed: 11/21/2022] Open
Abstract
Background Size at birth is influenced by environmental factors, like maternal nutrition and parity, and by genes. Birth weight is a composite measure, encompassing bone, fat and lean mass. These may have different determinants. The main purpose of this paper was to use anthropometry and principal components analysis (PCA) to describe maternal and newborn body composition, and associations between them, in an Indian population. We also compared maternal and paternal measurements (body mass index (BMI) and height) as predictors of newborn body composition. Methods Weight, height, head and mid-arm circumferences, skinfold thicknesses and external pelvic diameters were measured at 30 ± 2 weeks gestation in 571 pregnant women attending the antenatal clinic of the Holdsworth Memorial Hospital, Mysore, India. Paternal height and weight were also measured. At birth, detailed neonatal anthropometry was performed. Unrotated and varimax rotated PCA was applied to the maternal and neonatal measurements. Results Rotated PCA reduced maternal measurements to 4 independent components (fat, pelvis, height and muscle) and neonatal measurements to 3 components (trunk+head, fat, and leg length). An SD increase in maternal fat was associated with a 0.16 SD increase (β) in neonatal fat (p < 0.001, adjusted for gestation, maternal parity, newborn sex and socio-economic status). Maternal pelvis, height and (for male babies) muscle predicted neonatal trunk+head (β = 0. 09 SD; p = 0.017, β = 0.12 SD; p = 0.006 and β = 0.27 SD; p < 0.001). In the mother-baby and father-baby comparison, maternal BMI predicted neonatal fat (β = 0.20 SD; p < 0.001) and neonatal trunk+head (β = 0.15 SD; p = 0.001). Both maternal (β = 0.12 SD; p = 0.002) and paternal height (β = 0.09 SD; p = 0.030) predicted neonatal trunk+head but the associations became weak and statistically non-significant in multivariate analysis. Only paternal height predicted neonatal leg length (β = 0.15 SD; p = 0.003). Conclusion Principal components analysis is a useful method to describe neonatal body composition and its determinants. Newborn adiposity is related to maternal nutritional status and parity, while newborn length is genetically determined. Further research is needed to understand mechanisms linking maternal pelvic size to fetal growth and the determinants and implications of the components (trunk v leg length) of fetal skeletal growth.
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Affiliation(s)
- Sargoor R Veena
- Epidemiology Research Unit, Holdsworth Memorial Hospital, Mysore, South India.
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