1
|
Poprzeczny AJ, Louise J, Deussen AR, Dodd JM. Fetal Growth and Adiposity of Infants Born Large for Gestational Age in Three Harmonized Randomized Trials. Am J Perinatol 2024; 41:e3383-e3390. [PMID: 38134941 PMCID: PMC11150064 DOI: 10.1055/a-2234-7980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 09/26/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVE Infants born large for gestational age (LGA) are at an increased risk of short- and longer-term adverse outcomes. Understanding fetal growth and adiposity and their trajectories may help inform interventions to prevent birth of LGA infants. We aimed to compare fetal growth and adiposity measures of infants born LGA with those born not LGA, to determine whether the discrepancy at birth was primarily due to larger size throughout gestation, or instead to different trajectories of fetal growth. STUDY DESIGN This was a secondary analysis of secondary outcomes of fetal growth and adiposity from three harmonized randomized trials-the LIMIT, GRoW, and Optimise randomized trials. These trials recruited women in early pregnancy, and a singleton gestation, from three major public metropolitan Adelaide maternity hospitals. Maternal body mass index (BMI) ranged from 18.5 to ≥40.0 kg/m2. Data were obtained from enrolled women who underwent research ultrasounds at 28 and 36 weeks' gestation. Outcome measures were ultrasound measures of fetal biometry and adiposity. RESULTS Infants born LGA had larger fetal biometry measures, and higher growth trajectories, from 20 weeks' gestation. Fetal adiposity measures were consistently larger among infants born LGA and these differences increased over time. We did not find evidence that the differences in biometry and adiposity measurements varied according to maternal BMI. CONCLUSION Infants born LGA had larger fetal biometry measures at all time points from 20 weeks' gestation, compared with infants born not LGA suggesting any interventions to prevent LGA likely need to commence earlier in pregnancy or prior to conception. KEY POINTS · Infants born LGA had larger fetal biometry measures from 20 weeks' gestation.. · Infants born LGA had larger fetal adiposity measures.. · Interventions to prevent LGA need to start earlier in pregnancy or prior to conception..
Collapse
Affiliation(s)
- Amanda J. Poprzeczny
- The University of Adelaide, The Robinson Research Institute, and Discipline of Obstetrics and Gynaecology, Adelaide, South Australia, Australia
- Department of Perinatal Medicine, The Women's and Children's Hospital, Women's and Babies Division, Adelaide, South Australia, Australia
| | - Jennie Louise
- The University of Adelaide, The Robinson Research Institute, and Discipline of Obstetrics and Gynaecology, Adelaide, South Australia, Australia
- The University of Adelaide, School of Public Health; Adelaide, South Australia, Australia
| | - Andrea R. Deussen
- The University of Adelaide, The Robinson Research Institute, and Discipline of Obstetrics and Gynaecology, Adelaide, South Australia, Australia
| | - Jodie M. Dodd
- The University of Adelaide, The Robinson Research Institute, and Discipline of Obstetrics and Gynaecology, Adelaide, South Australia, Australia
- Department of Perinatal Medicine, The Women's and Children's Hospital, Women's and Babies Division, Adelaide, South Australia, Australia
| |
Collapse
|
2
|
Zsirai L, Kun A, Visolyi GÁ, Svébis MM, Domján BA, Tabák Á. Birthweight trends and their explanatory factors in Hungary between 1999 and 2018: an analysis of the Hungarian Tauffer registry. Reprod Health 2024; 21:52. [PMID: 38609984 PMCID: PMC11015640 DOI: 10.1186/s12978-024-01787-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 04/05/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND The increasing birthweight trend stopped and even reversed in several high income countries in the last 20 years, however the reason for these changes is not well characterized. We aimed to describe birthweight trends of term deliveries in Hungary between 1999 and 2018 and to investigate potential maternal and foetal variables that could drive these changes. METHODS We analysed data from the Hungarian Tauffer registry, a compulsory anonymized data collection of each delivery. We included all singleton term deliveries in 1999-2018 (n = 1,591,932). We modelled birthweight trends separately in 1999-2008 and 2008-2018 in hierarchical multiple linear regression models adjusted for calendar year, newborn sex, maternal age, gestational age at delivery, and other important determinants. RESULTS Median birthweights increased from 3250/3400 g (girl/boy) to 3300/3440 g from 1999 to 2008 and decreased to 3260/3400 g in 2018. When we adjusted for gestational age at delivery the increase in the first period became more pronounced (5.4 g/year). During the second period, similar adjustment substantially decreased the rate of decline from 2.5 to 1.4 g/year. Further adjustment for maternal age halved the rate of increase to 2.4 g/year in the first period. During the second period, adjustment for maternal age had little effect on the estimate. CONCLUSIONS Our findings of an increasing birthweight trend (mostly related to the aging of the mothers) in 1999-2008 may forecast an increased risk of cardiometabolic diseases in offsprings born in this period. In contrast, the decreasing birthweight trends after 2008 may reflect some beneficial effects on perinatal morbidity. However, the long-term effect cannot be predicted, as the trend is mostly explained by the shorter pregnancies.
Collapse
Affiliation(s)
- László Zsirai
- Department of Gynaecology and Family Planning, Istenhegyi GeneDiagnostic Center, Budapest, Hungary
| | - Attila Kun
- Department of Obstetrics and Gynaecology, Tolna County Balassa János Hospital, Szekszárd, Hungary
- Outpatient Department of Obstetrics and Gynecology, Paks Health Centre, Paks,, Hungary
| | - Gergely Á Visolyi
- Károly Rácz School of PhD Studies, Semmelweis University, Budapest, Hungary
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, 26 Üllői Str., Budapest, H-1085, Hungary
- Bajcsy-Zsilinszky Teaching Hospital, Budapest, Hungary
| | - Márk M Svébis
- Károly Rácz School of PhD Studies, Semmelweis University, Budapest, Hungary
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, 26 Üllői Str., Budapest, H-1085, Hungary
| | - Beatrix A Domján
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, 26 Üllői Str., Budapest, H-1085, Hungary
| | - Ádám Tabák
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, 26 Üllői Str., Budapest, H-1085, Hungary.
- UCL Brain Sciences, University College London, London, UK.
- Department of Public Health, Semmelweis University Faculty of Medicine, Budapest, Hungary.
| |
Collapse
|
3
|
Bonanni G, Airoldi C, Berghella V. Birthweights at term have increased globally: insights from a systematic review of 183 million births. Am J Obstet Gynecol 2024:S0002-9378(24)00431-9. [PMID: 38460833 DOI: 10.1016/j.ajog.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 03/03/2024] [Accepted: 03/04/2024] [Indexed: 03/11/2024]
Abstract
OBJECTIVE This study aimed to assess global trends in mean birthweights at term, as reported in peer-reviewed literature. DATA SOURCES We electronically searched PubMed, Embase, and Web of Science up to September 2023, using combinations of the search terms: "birth weight"; "birth-weight"; "birthweight"; "trend". There were no restrictions based on language or geographic area. STUDY ELIGIBILITY CRITERIA We included all ecological and observational studies reporting mean birthweight at term as a continuous numerical variable over time. METHODS We assessed the quality of included studies using the Dufault and Klar checklist modified by Betran et al. Univariate and multivariate linear models were used to examine the effects of time (years) and geographical origins. Subgroup analyses focused on national data sources and on data collected from 1950 onward. RESULTS Among 6447 reviewed articles, 29 met our criteria, reporting mean birthweight data from over 183 million infants worldwide. Most studies were hospital-based (48.3%), 44.8% used national data, and a minority used municipality, community, or regional data (6.9%). Geographically, North America (31.0%) had the highest representation, followed by Asia and Europe (27.6% each), and South America and Oceania (6.9% each). Our univariate linear regression model (Model 1) revealed a significant increase in mean birthweight at term over time (4.74 g/y; 95% confidence interval, 3.95-5.53; P<.001). Model 2, incorporating continental dummy variables into the first model, confirmed this trend (3.85 g/y; 95% confidence interval, 2.96-4.74; P<.001). Model 3, focusing on available national data, did not find a significant relationship. Model 4 narrowed its focus on records from 1950 onward, reporting a robust annual increase of 7.26 g/y (95% confidence interval, 6.19-8.33; P<.001). Model 5, adjusting for the number of participants included in each study, reported a conclusive mean term birthweight increase of 1.46 g/y (95% confidence interval, 0.74-2.18; P<.001). CONCLUSION This systematic review of 29 studies shows an increase in term birthweights over time, particularly when considering data since 1950. Limitations include study quality variations, data source diversity, and data sparsity, underscoring the need for future research to use precise gestational age distinctions and predetermined time frames to gain a deeper understanding of this trend and its implications for maternal and child health.
Collapse
Affiliation(s)
- Giulia Bonanni
- Maternal Fetal Care Center, Division of Fetal Medicine and Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Women, Children, and Public Health Sciences, IRCCS Agostino Gemelli University Polyclinic Foundation, Catholic University of the Sacred Heart, Rome, Italy; Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Thomas Jefferson University Hospital, Philadelphia, PA.
| | - Chiara Airoldi
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Vincenzo Berghella
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Thomas Jefferson University Hospital, Philadelphia, PA
| |
Collapse
|
4
|
Genowska A, Strukcinskiene B, Bochenko-Łuczyńska J, Motkowski R, Jamiołkowski J, Abramowicz P, Konstantynowicz J. Reference Values for Birth Weight in Relation to Gestational Age in Poland and Comparison with the Global Percentile Standards. J Clin Med 2023; 12:5736. [PMID: 37685803 PMCID: PMC10488537 DOI: 10.3390/jcm12175736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
INTRODUCTION Percentiles of birth weight by gestational age (GA) are an essential tool for clinical assessment and initiating interventions to reduce health risks. Unfortunately, Poland lacks a reference chart for assessing newborn growth based on the national population. This study aimed to establish a national reference range for birth weight percentiles among newborns from singleton deliveries in Poland. Additionally, we sought to compare these percentile charts with the currently used international standards, INTERGROWTH-21 and WHO. MATERIALS AND METHODS All singleton live births (n = 3,745,239) reported in Poland between 2010 and 2019 were analyzed. Using the Lambda Mu Sigma (LMS) method, the Generalized Additive Models for Location Scale, and Shape (GAMLSS) package, smoothed percentile charts (3-97) covering GA from 23 to 42 weeks were constructed. RESULTS The mean birth weight of boys was 3453 ± 540 g, and this was higher compared with that of girls (3317 ± 509 g). At each gestational age, boys exhibited higher birth weights than girls. The weight range between the 10th and 90th percentiles was 1061 g for boys and 1016 g for girls. Notably, the birth weight of Polish newborns was higher compared to previously published international growth standards. CONCLUSION The reference values for birth weight percentiles established in this study for Polish newborns differ from the global standards and are therefore useful for evaluating the growth of newborns within the national population. These findings hold clinical importance in identifying neonates requiring postbirth monitoring.
Collapse
Affiliation(s)
- Agnieszka Genowska
- Department of Public Health, Medical University of Bialystok, 15-295 Bialystok, Poland
| | | | | | - Radosław Motkowski
- Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, University Children′s Hospital, 15-274 Bialystok, Poland; (R.M.); (P.A.); (J.K.)
| | - Jacek Jamiołkowski
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, 15-269 Bialystok, Poland;
| | - Paweł Abramowicz
- Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, University Children′s Hospital, 15-274 Bialystok, Poland; (R.M.); (P.A.); (J.K.)
| | - Jerzy Konstantynowicz
- Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, University Children′s Hospital, 15-274 Bialystok, Poland; (R.M.); (P.A.); (J.K.)
| |
Collapse
|
5
|
Archer E, Hill JO. Body and Fat mass are not Regulated, Controlled, or Defended: An introduction to the Invisible Hand' and 'Competition' Models of Metabolism. Prog Cardiovasc Dis 2023; 79:56-64. [PMID: 36283496 DOI: 10.1016/j.pcad.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022]
Abstract
This paper presents two inter-dependent frameworks for understanding the etiology of obesity and the regain of body and fat mass after weight loss. The 'Invisible Hand of Metabolism' illustrates how physiologic states such as body and fat mass and blood glucose levels arise from the unregulated, uncontrolled, yet competitive behavior of trillions of semi-autonomous cells. The 'Competition Model of Metabolism' is an explanatory (mechanistic) framework that details how organismal and cell-specific behaviors generate the apparent stability of physiologic states despite metabolic perturbations (e.g., weight-loss and exercise). Together, these frameworks show that body and fat mass and blood glucose levels are not regulated, controlled, or defended but emerge from the complexity and functional plasticity of competitive cellular relations. Therefore, we argue that the use of abstract constructs such as 'regulation', 'control', 'glucostats', 'adipostats', and 'set-/settling-points' hinders the understanding of obesity and cardiometabolic diseases in human and nonhuman mammals.
Collapse
Affiliation(s)
| | - James O Hill
- University of Alabama at Birmingham, Birmingham, AL, USA
| |
Collapse
|
6
|
Huda MM, Callaway LK, Jackson G, Fatima Y, Cumming J, Biswas T, Paz GR, Boyle F, Sly PD, Mamun AA. Time trends, projections, and spatial distribution of low birthweight in Australia, 2009-2030: Evidence from the National Perinatal Data Collection. Birth 2023; 50:76-89. [PMID: 36696404 PMCID: PMC10947513 DOI: 10.1111/birt.12708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 11/15/2022] [Accepted: 01/06/2023] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Infants with low birthweight (LBW, birthweight <2500 g) have increased in many high-resource countries over the past two decades. This study aimed to investigate the time trends, projections, and spatial distribution of LBW in Australia, 2009-2030. METHODS We used standard aggregate data on 3 346 808 births from 2009 to 2019 from Australia's National Perinatal Data Collection. Bayesian linear regression model was used to estimate the trends in the prevalence of LBW in Australia. RESULTS Wefound that the prevalence of LBW was 6.18% in 2009, which has increased to 6.64% in 2019 (average annual rate of change, AARC = +0.76%). If the national trend remains the same, the projected prevalence of LBW in Australia will increase to 7.34% (95% uncertainty interval, UI = 6.99, 7.68) in 2030. Observing AARC across different subpopulations, the trend of LBW was stable among Indigenous mothers, whereas it increased among non-Indigenous mothers (AARC = +0.81%). There is also an increase among the most disadvantaged mothers (AARC = +1.08%), birthing people in either of two extreme age groups (AARC = +1.99% and +1.53% for <20 years and ≥40 years, respectively), and mothers who smoked during pregnancy (AARC = +1.52%). Spatiotemporal maps showed that some of the Statistical Area level 3 (SA3) in Northern Territory and Queensland had consistently higher prevalence for LBW than the national average from 2014 to 2019. CONCLUSION Overall, the prevalence of LBW has increased in Australia during 2009-2019; however, the trends vary across different subpopulations. If trends persist, Australia will not achieve the Sustainable Development Goals (SDGs) target of a 30% reduction in LBW by 2030. Centering and supporting the most vulnerable subpopulations is vital to progress the SDGs and improves perinatal and infant health in Australia.
Collapse
Affiliation(s)
- M. Mamun Huda
- Poche Centre for Indigenous HealthThe University of QueenslandQueenslandBrisbaneAustralia
- ARC Life Course CentreThe University of QueenslandQueenslandBrisbaneAustralia
| | - Leonie K. Callaway
- Women's and Newborn ServicesRoyal Brisbane and Women's HospitalQueenslandBrisbaneAustralia
- Faculty of MedicineThe University of QueenslandBrisbaneAustralia
| | - Greg Jackson
- Health Protection Branch, Queensland Department of HealthQueenslandBrisbaneAustralia
- Queensland Alliance for Environmental Health Sciences (QAEHS)The University of QueenslandQueenslandWoolloongabbaAustralia
| | - Yaqoot Fatima
- Poche Centre for Indigenous HealthThe University of QueenslandQueenslandBrisbaneAustralia
- ARC Life Course CentreThe University of QueenslandQueenslandBrisbaneAustralia
- Murtupuni Centre for Rural and Remote HealthJames Cook UniversityQueenslandMount IsaAustralia
| | - Janet Cumming
- Health Protection Branch, Queensland Department of HealthQueenslandBrisbaneAustralia
| | - Tuhin Biswas
- Poche Centre for Indigenous HealthThe University of QueenslandQueenslandBrisbaneAustralia
- ARC Life Course CentreThe University of QueenslandQueenslandBrisbaneAustralia
- Science and Math ProgramAsian University for WomenChattogramBangladesh
| | - Gonzalo R. Paz
- Poche Centre for Indigenous HealthThe University of QueenslandQueenslandBrisbaneAustralia
- ARC Life Course CentreThe University of QueenslandQueenslandBrisbaneAustralia
- Facultad de MedicinaUniversidad del ValleCaliColombia
| | - Fran Boyle
- Poche Centre for Indigenous HealthThe University of QueenslandQueenslandBrisbaneAustralia
| | - Peter D. Sly
- Children's Health Research CentreUniversity of QueenslandSouth BrisbaneAustralia
- WHO Collaborating Centre for Children's Health and EnvironmentQueenslandSouth BrisbaneAustralia
| | - Abdullah Al Mamun
- Poche Centre for Indigenous HealthThe University of QueenslandQueenslandBrisbaneAustralia
- ARC Life Course CentreThe University of QueenslandQueenslandBrisbaneAustralia
- Queensland Alliance for Environmental Health Sciences (QAEHS)The University of QueenslandQueenslandWoolloongabbaAustralia
| |
Collapse
|
7
|
Vilcins D, Baker P, Jagals P, Sly PD. Secular trends of birthweight in a population of live-born, singletons, without congenital anomalies in Queensland, Australia. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-023-01841-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Abstract
Objectives and importance
Maternal and family patterns are changing, and these changes can influence birthweight. Past research and organisational reports focus on short temporal timelines or broad trends, but trends across a longer temporal period are important. The aim of this study is to assess the trends in birthweight and maternal characteristics across a 19-year period using descriptive statistics.
Study type and methods
Birth records (n = 1,166,055) were obtained for a 19-year period (2000–2019) and a descriptive secular trend analysis was performed.
Results and conclusions
Mean birthweight trended down across the study period, while rates of large for gestational age births increased. This appears to be driven by a decrease in gestational age across the period. Maternal factors, such as smoking, BMI and Indigenous status, were found to be linked with changes in mean birthweight and the proportion of small for gestational age or large for gestational age. More babies were born to older women by the end of the study period. There was a sharp rise in gestational diabetes, and more large for gestational age births to these women. Over time, the large for gestational age births started to decline, suggesting better care practices for women with gestational diabetes.
Collapse
|
8
|
Ribas-Prats T, Arenillas-Alcón S, Pérez-Cruz M, Costa-Faidella J, Gómez-Roig MD, Escera C. Speech-Encoding Deficits in Neonates Born Large-for-Gestational Age as Revealed With the Envelope Frequency-Following Response. Ear Hear 2023:00003446-990000000-00115. [PMID: 36759954 DOI: 10.1097/aud.0000000000001330] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
OBJECTIVES The present envelope frequency-following response (FFRENV) study aimed at characterizing the neural encoding of the fundamental frequency of speech sounds in neonates born at the higher end of the birth weight continuum (>90th percentile), known as large-for-gestational age (LGA). DESIGN Twenty-five LGA newborns were recruited from the maternity unit of Sant Joan de Déu Barcelona Children's Hospital and paired by age and sex with 25 babies born adequate-for-gestational age (AGA), all from healthy mothers and normal pregnancies. FFRENVs were elicited to the/da/ syllable and recorded while the baby was sleeping in its cradle after a successful universal hearing screening. Neural encoding of the stimulus' envelope of the fundamental frequency (F0ENV) was characterized through the FFRENV spectral amplitude. Relationships between electrophysiological parameters and maternal/neonatal variables that may condition neonatal neurodevelopment were assessed, including pregestational body mass index (BMI), maternal gestational weight gain and neonatal BMI. RESULTS LGA newborns showed smaller spectral amplitudes at the F0ENV compared to the AGA group. Significant negative correlations were found between neonatal BMI and the spectral amplitude at the F0ENV. CONCLUSIONS Our results indicate that in spite of having a healthy pregnancy, LGA neonates' central auditory system is impaired in encoding a fundamental aspect of the speech sounds, namely their fundamental frequency. The negative correlation between the neonates' BMI and FFRENV indicates that this impaired encoding is independent of the pregnant woman BMI and weight gain during pregnancy, supporting the role of the neonatal BMI. We suggest that the higher adipose tissue observed in the LGA group may impair, via proinflammatory products, the fine-grained central auditory system microstructure required for the neural encoding of the fundamental frequency of speech sounds.
Collapse
Affiliation(s)
- Teresa Ribas-Prats
- Brainlab-Cognitive Neuroscience Research Group. Department of Clinical Psychology and Psychobiology, University of Barcelona, Catalonia, Spain.,Institute of Neurosciences, University of Barcelona, Catalonia, Spain.,Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Catalonia, Spain
| | - Sonia Arenillas-Alcón
- Brainlab-Cognitive Neuroscience Research Group. Department of Clinical Psychology and Psychobiology, University of Barcelona, Catalonia, Spain.,Institute of Neurosciences, University of Barcelona, Catalonia, Spain.,Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Catalonia, Spain
| | - Míriam Pérez-Cruz
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Catalonia, Spain.,BCNatal-Barcelona Center for Maternal Fetal and Neonatal Medicine (Hospital Sant Joan de Déu and Hospital Clínic), University of Barcelona, Barcelona, Catalonia, Spain
| | - Jordi Costa-Faidella
- Brainlab-Cognitive Neuroscience Research Group. Department of Clinical Psychology and Psychobiology, University of Barcelona, Catalonia, Spain.,Institute of Neurosciences, University of Barcelona, Catalonia, Spain.,Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Catalonia, Spain
| | - Maria Dolores Gómez-Roig
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Catalonia, Spain.,BCNatal-Barcelona Center for Maternal Fetal and Neonatal Medicine (Hospital Sant Joan de Déu and Hospital Clínic), University of Barcelona, Barcelona, Catalonia, Spain
| | - Carles Escera
- Brainlab-Cognitive Neuroscience Research Group. Department of Clinical Psychology and Psychobiology, University of Barcelona, Catalonia, Spain.,Institute of Neurosciences, University of Barcelona, Catalonia, Spain.,Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Catalonia, Spain
| |
Collapse
|
9
|
Du Y, Rafferty AR, McAuliffe FM, Mehegan J, Mooney C. Towards an explainable clinical decision support system for large-for-gestational-age births. PLoS One 2023; 18:e0281821. [PMID: 36809384 PMCID: PMC9942967 DOI: 10.1371/journal.pone.0281821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/31/2023] [Indexed: 02/23/2023] Open
Abstract
A myriad of maternal and neonatal complications can result from delivery of a large-for-gestational-age (LGA) infant. LGA birth rates have increased in many countries since the late 20th century, partially due to a rise in maternal body mass index, which is associated with LGA risk. The objective of the current study was to develop LGA prediction models for women with overweight and obesity for the purpose of clinical decision support in a clinical setting. Maternal characteristics, serum biomarkers and fetal anatomy scan measurements for 465 pregnant women with overweight and obesity before and at approximately 21 weeks gestation were obtained from the PEARS (Pregnancy Exercise and Nutrition with smart phone application support) study data. Random forest, support vector machine, adaptive boosting and extreme gradient boosting algorithms were applied with synthetic minority over-sampling technique to develop probabilistic prediction models. Two models were developed for use in different settings: a clinical setting for white women (AUC-ROC of 0.75); and a clinical setting for women of all ethnicity and regions (AUC-ROC of 0.57). Maternal age, mid upper arm circumference, white cell count at the first antenatal visit, fetal biometry and gestational age at fetal anatomy scan were found to be important predictors of LGA. Pobal HP deprivation index and fetal biometry centiles, which are population-specific, are also important. Moreover, we explained our models with Local Interpretable Model-agnostic Explanations (LIME) to improve explainability, which was proven effective by case studies. Our explainable models can effectively predict the probability of an LGA birth for women with overweight and obesity, and are anticipated to be useful to support clinical decision-making and for the development of early pregnancy intervention strategies to reduce pregnancy complications related to LGA.
Collapse
Affiliation(s)
- Yuhan Du
- UCD Perinatal Research Centre, School of Computer Science, University College Dublin, Dublin, Ireland
| | - Anthony R. Rafferty
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Fionnuala M. McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - John Mehegan
- UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Catherine Mooney
- UCD Perinatal Research Centre, School of Computer Science, University College Dublin, Dublin, Ireland
- * E-mail:
| |
Collapse
|
10
|
VURALLI D, SUCU M, TOTİK DOĞAN N. Evaluation of the factors affecting newborn weight. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1053457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
11
|
Sjöholm P, Pahkala K, Davison B, Niinikoski H, Raitakari O, Juonala M, Singh GR. Birth weight for gestational age and later cardiovascular health: a comparison between longitudinal Finnish and indigenous Australian cohorts. Ann Med 2021; 53:2060-2071. [PMID: 34755580 PMCID: PMC8583840 DOI: 10.1080/07853890.2021.1999491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/25/2021] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Small or large birth weight for gestational age has been linked with later cardiovascular disease risk. However, cardiovascular risk markers from childhood to adulthood according to birth weight in diverse longitudinal settings globally have not been extensively studied. OBJECTIVES To examine the relationship between birth weight and cardiovascular risk profile from childhood until young adulthood in two geographically and socioeconomically distinct cohorts. METHODS Data were derived from two longitudinal birth cohort studies; one from southern Finland (Special Turku Coronary Risk Factor Intervention Project, STRIP) and one from northern Australia comprising Indigenous Australians (Aboriginal Birth Cohort, ABC). The sample included 747 Finnish participants and 541 Indigenous Australians with data on birth weight, gestational age and cardiovascular risk factors (body mass index [BMI]), waist-to-height ratio [WHtR], lipid profile, blood pressure) collected at ages 11, 18 and 25 or 26 years. Carotid intima-media thickness (cIMT) was assessed at age 18 or 19 years. Participants were categorised according to birth weight for gestational age (small [SGA], appropriate [AGA] or large [LGA]). Associations between birth weight category and cardiovascular risk markers were studied using a repeated measures ANOVA. RESULTS Higher birth weight category was associated with higher BMI later in life in both cohorts (p=.003 for STRIP and p<.0001 for ABC). In the ABC, higher birth weight category was also associated with higher WHtR (p=.004). In the ABC, SGA participants had lower systolic and diastolic blood pressure than AGA participants (p=.028 for systolic, p=.027 for diastolic) and lower systolic blood pressure than LGA participants (p=.046) at age 25. In the STRIP cohort, SGA participants had lower cIMT than LGA participants (p=.024). CONCLUSIONS Birth weight can predict future cardiovascular risk profile in diverse populations. Thus, it needs to be included in targeted public health interventions for tackling the obesity pandemic and improving cardiovascular health worldwide.Key messagesThe strongest association between birth weight and later cardiovascular risk profile was manifested as differences in body mass index in two culturally and geographically distinct cohorts.Foetal growth is a determinant for later cardiovascular health in diverse populations, indicating a need to focus on maternal and foetal health to improve cardiovascular health worldwide.
Collapse
Affiliation(s)
- Pauline Sjöholm
- Department of Medicine; University of Turku, Turku, Finland
- Division of Perioperative Services, Intensive Care and Pain Medicine, Turku University Hospital, Turku, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
- Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Belinda Davison
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Harri Niinikoski
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
- Department of Pediatrics, Turku University Hospital, Finland
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
- Department Clinical Physiology and Nuclear Medicine, Turku University Hospital, Finland
| | - Markus Juonala
- Department of Medicine; University of Turku, Turku, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | - Gurmeet R. Singh
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Northern Territory Medical Program, Flinders University, Darwin, Australia
| |
Collapse
|
12
|
Moen GH, Beaumont RN, Grarup N, Sommer C, Shields BM, Lawlor DA, Freathy RM, Evans DM, Warrington NM. Investigating the causal effect of maternal vitamin B12 and folate levels on offspring birthweight. Int J Epidemiol 2021; 50:179-189. [PMID: 33347560 PMCID: PMC7938507 DOI: 10.1093/ije/dyaa256] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2020] [Indexed: 11/29/2022] Open
Abstract
Background Lower maternal serum vitamin B12 (B12) and folate levels have been associated with lower offspring birthweight, in observational studies. The aim of this study was to investigate whether this relationship is causal. Methods We performed two-sample Mendelian randomization (MR) using summary data on associations between genotype-B12 (10 genetic variants) or genotype-folate (four genetic variants) levels from: a genome-wide association study of 45 576 individuals (sample 1); and both maternal- and fetal-specific genetic effects on offspring birthweight from the latest Early Growth Genetics consortium meta-analysis with 297 356 individuals reporting their own birthweight and 210 248 women reporting their offspring's birthweight (sample 2). We used the inverse variance weighted method, and sensitivity analyses to account for pleiotropy, in addition to excluding a potentially pleiotropic variant in the FUT2 gene for B12 levels. Results We did not find evidence for a causal effect of maternal or fetal B12 levels on offspring birthweight. The results were consistent across the different methods. We found a positive causal effect of maternal folate levels on offspring birthweight [0.146 (0.065, 0.227), which corresponds to an increase in birthweight of 71 g per 1 standard deviation higher folate]. We found some evidence for a small inverse effect of fetal folate levels on their own birthweight [−0.051 (−0.100, −0.003)]. Conclusions Our results are consistent with evidence from randomized controlled trials that higher maternal folate levels increase offspring birthweight. We did not find evidence for a causal effect of B12 levels on offspring birthweight, suggesting previous observational studies may have been confounded.
Collapse
Affiliation(s)
- Gunn-Helen Moen
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,University of Queensland Diamantina Institute, University of Queensland, Woolloongabba, QLD, Australia.,K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.,Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Robin N Beaumont
- Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, Royal Devon and Exeter Hospital, Exeter, UK
| | - Niels Grarup
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christine Sommer
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Beverley M Shields
- Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, Royal Devon and Exeter Hospital, Exeter, UK
| | - Deborah A Lawlor
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK.,Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,Bristol National Institute of Health Research Biomedical Research Centre, Bristol, UK
| | - Rachel M Freathy
- Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, Royal Devon and Exeter Hospital, Exeter, UK.,Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - David M Evans
- University of Queensland Diamantina Institute, University of Queensland, Woolloongabba, QLD, Australia.,Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Nicole M Warrington
- University of Queensland Diamantina Institute, University of Queensland, Woolloongabba, QLD, Australia.,K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
13
|
Falcão IR, Ribeiro-Silva RDC, de Almeida MF, Fiaccone RL, Silva NJ, Paixao ES, Ichihara MY, Rodrigues LC, Barreto ML. Factors associated with small- and large-for-gestational-age in socioeconomically vulnerable individuals in the 100 Million Brazilian Cohort. Am J Clin Nutr 2021; 114:109-116. [PMID: 33826704 PMCID: PMC8246620 DOI: 10.1093/ajcn/nqab033] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 01/29/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Evidence points to diverse risk factors associated with small- (SGA) and large-for-gestational-age (LGA) births. A more comprehensive understanding of these factors is imperative, especially in vulnerable populations. OBJECTIVES To estimate the occurrence of and sociodemographic factors associated with SGA and LGA births in poor and extremely poor populations of Brazil. METHODS The study population consisted of women of reproductive age (14-49 y), whose last child was born between 2012 and 2015. INTERGROWTH 21st consortium criteria were used to classify weight for gestational age according to sex. Multinomial logistic regression modeling was performed to investigate associations of interest. RESULTS Of 5,521,517 live births analyzed, SGA and LGA corresponded to 7.8% and 17.1%, respectively. Multivariate analysis revealed greater odds of SGA in children born to women who self-reported as black (OR: 1.21; 95% CI: 1.19, 1.22), mixed-race (parda) (OR: 1.08; 95% CI: 1.07, 1.09), or indigenous (OR: 1.11; 95% CI: 1.06, 1.15), were unmarried (OR: 1.08; 95% CI: 1.07, 1.08), illiterate (OR: 1.47; 95% CI: 1.42, 1.52), did not receive prenatal care (OR: 1.57; 95% CI: 1.53, 1.60), or were aged 14-20 y (OR: 1.21; 95% CI: 1.20, 1.22) or 35-49 y (OR: 1.12; 95% CI: 1.10, 1.13). Considering LGA children, higher odds were found in infants born to women living in households with ≥3 inadequate housing conditions (OR: 1.11; 95% CI: 1.10, 1.12), in indigenous women (OR: 1.22; 95% CI: 1.19, 1.25), those who had 1-3 y of schooling (OR: 1.18; 95% CI: 1.17, 1.19), 1-3 prenatal visits (OR: 1.16; CI 95%: 1.14, 1.17), or were older (OR: 1.26; 95% CI: 1.25, 1.27). CONCLUSIONS In poorer Brazilian populations, socioeconomic, racial, and maternal characteristics are consistently associated with the occurrence of SGA births, but remain less clearly linked to the occurrence of LGA births.
Collapse
Affiliation(s)
| | - Rita de Cássia Ribeiro-Silva
- The School of Nutrition, Federal University of Bahia, Salvador, Brazil,Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | | | - Rosemeire L Fiaccone
- Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil,Department of Statistics, Federal University of Bahia, Salvador, Brazil
| | - Natanael J Silva
- Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Enny S Paixao
- Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil,Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Maria Yury Ichihara
- Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil,Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Laura C Rodrigues
- Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil,Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mauricio L Barreto
- Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil,Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
| |
Collapse
|
14
|
Vilcins D, Scarth P, Sly PD, Jagals P, Knibbs LD, Baker P. The association of fractional cover, foliage projective cover and biodiversity with birthweight. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 763:143051. [PMID: 33127150 DOI: 10.1016/j.scitotenv.2020.143051] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/18/2020] [Accepted: 10/08/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Environmental exposures can contribute both benefits and risks to human health. Maternal exposure to green space has been associated with improvements in birthweight, among other birth outcomes. Newer measures of green space have been developed, which allows for an exploration of the effect of different ground covers (green, dry and bare earth), as well as measures of biodiversity. This study explores the association of these novel green space measures with birthweight in a large birth cohort in Queensland, Australia. METHODS Birthweight was acquired from the routine health records. Records were allocated green space values for fractional cover, biodiversity and foliage projective cover. Directed acyclic graphs were developed to guide variable selection. Mixed-effects linear regression and generalised linear mixed-effects models were developed, with random intercepts for maternal residential locality and year of birth. Results are presented as standardised beta coefficients or odds ratios, with 95% confidence intervals. RESULTS An IQR increase of green cover (29.6 g, 95% CI 13.8-45.5) and foliage projective cover (26.0 g, 95% CI 10.8-41.3) are associated with birthweight in urban areas. An IQR increase in dry cover -34.4 g, 95% CI -60.4 to -8.4) and bare earth (-17.7 g, 95% CI -32.8 to -2.6) are associated with lower birthweight. Mothers living in rural areas had similar results, with an IQR increase in green cover (17.8 g, 95% CI 2.9-32.7) associated with higher birthweight, and bare earth (-27.7 g, 95% CI -45.7 to -9.7) was associated with lower birthweight. The biodiversity measure used in this study was not associated with any birthweight outcomes. CONCLUSION This study finds that the types of ground cover within the maternal residential locality are associated with small, but significant, changes in estimated birthweight, and these effects are not limited to urban areas.
Collapse
Affiliation(s)
- Dwan Vilcins
- Children's Health and Environment Program, The University of Queensland, L7 Centre for Children's Health Research, 62 Graham St, South Brisbane 4101, QLD, Australia.
| | - Peter Scarth
- School of Earth and Environmental Sciences, L2, Room 210, Steele Building, The University of Queensland, St Lucia, QLD, Australia, 4072.
| | - Peter D Sly
- Children's Health and Environment Program, The University of Queensland, L7 Centre for Children's Health Research, 62 Graham St, South Brisbane 4101, QLD, Australia.
| | - Paul Jagals
- Children's Health and Environment Program, The University of Queensland, L7 Centre for Children's Health Research, 62 Graham St, South Brisbane 4101, QLD, Australia.
| | - Luke D Knibbs
- School of Public Health, Public Health Building, 288 Herston Rd, The University of Queensland, Brisbane 4006, Australia.
| | - Peter Baker
- School of Public Health, Public Health Building, 288 Herston Rd, The University of Queensland, Brisbane 4006, Australia.
| |
Collapse
|
15
|
Gibbons KS, McIntyre HD, Mamun A, Chang AMZ. Development of the Birthweight Appropriateness Quotient: A New Measure of Infant's Size. Matern Child Health J 2020; 24:1202-1211. [PMID: 32794153 DOI: 10.1007/s10995-020-02994-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The customised birthweight model can be used to improve detection of babies that may be at risk of adverse outcomes associated with abnormal growth, however it is currently used in conjunction with either an intrauterine growth standard or the individualised birthweight ratio (IBR), both of which have significant methodological flaws. Our aim was to investigate the statistical validity of the IBR and attempt to develop a new measurement to represent the appropriateness of an infant's size at birth that will support clinicians in identifying infants requiring further attention. METHODS Routinely collected hospital maternity and neonatal data on singleton, term births from a tertiary Australian hospital were extracted for the time period 1998-2009. The relationships between birthweight, customised birthweight and IBR are investigated using correlation, regression analysis and division of births into groups of < 2500 g, 2500-4000 g and > 4000 g. A new measure, the Birthweight Appropriateness Quotient (BAQ), is developed. The utility of the BAQ is compared with IBR and birthweight to identify infants with a composite neonatal morbidity outcome. RESULTS Statistical flaws with the IBR due to significant correlation between birthweight and customised birthweight and a heterogenous relationship between these two measurements across the range of birthweight are present. BAQ is uncorrelated with birthweight. Comparison of BAQ and IBR as indicators of adverse neonatal outcome demonstrates that BAQ identifies babies at risk due to their small size and those babies at risk due to inappropriate size. CONCLUSIONS FOR PRACTICE BAQ is a customised measurement of an infant's size free of the statistical flaws experienced by the IBR with the ability to identify at-risk infants.
Collapse
Affiliation(s)
- Kristen S Gibbons
- Mothers and Babies Research, Mater Research Institute - The University of Queensland, South Brisbane, Australia. .,Level 4, Centre for Children's Health Research, 62 Graham St, South Brisbane, QLD, 4101, Australia.
| | - H David McIntyre
- Mothers and Babies Research, Mater Research Institute - The University of Queensland, South Brisbane, Australia.,UQ/Mater Clinical School, The University of Queensland, Brisbane, Australia
| | - Abdullah Mamun
- Institute for Social Science Research, The University of Queensland, Brisbane, Australia
| | - Allan M Z Chang
- Department of Obstetrics and Gynaecology, Chinese University of Hong Kong, Shatin, Hong Kong
| |
Collapse
|
16
|
Knitza J, Kurmanavicius J, Faschingbauer F, Wisser J. Comparison of Current Swiss Fetal Biometry Reference Charts with Reference Charts from 1999. Are Fetuses Getting Bigger? ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2020; 41:410-417. [PMID: 29797308 DOI: 10.1055/a-0591-3206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE To create current fetal biometry reference ranges and to compare them with references published in 1999, from the same local area in order to generate data for secular trend in fetal size. MATERIALS AND METHODS Applying the same methodology as previously published, we calculated reference ranges for biparietal diameter (BPD), occipitofrontal diameter (OFD), head circumference (HC), abdominal circumference (AC) and femur length (FL) in 7863 patients examined at the obstetric clinics in a cross-sectional, prospective study in a university setting from January 2008 to December 2014. In order to compare the new reference ranges with our previously published data, we used Z-Scores and displayed the pick-up of fetal biometry data below the 5th and above the 95th percentile using the previously published reference charts. RESULTS The comparison of the charts showed a minimal but clinically relevant increase in mean fetal body measures (BPD, HC, AC). Applying the 1999 charts to the new dataset, we would classify only 162 of 339 fetuses (47.8 %) to be correctly below the 5th percentile for AC and only 134 of 349 (38.4 %) fetuses were correctly below the 5th percentile for HC. On the other hand, the 1999 charts classified 426 instead of 332 fetuses to be above the 95th percentile for AC, which means an overestimation of 28.3 %. CONCLUSION Applying a similar methodology, study collective and clinical setting, our new charts showed clinically relevant differences compared to the 1999 charts. The data suggest that within one generation fetuses are getting bigger and regular updates of fetal reference charts are needed.
Collapse
Affiliation(s)
- Johannes Knitza
- Clinic of Internal Medicine 3, University Hospital Erlangen, Germany
| | | | | | - Josef Wisser
- Clinic of Obstetrics, University Hospital Zurich, Switzerland
| |
Collapse
|
17
|
Castillo CM, Horne G, Fitzgerald CT, Johnstone ED, Brison DR, Roberts SA. The impact of IVF on birthweight from 1991 to 2015: a cross-sectional study. Hum Reprod 2020; 34:920-931. [PMID: 30868153 DOI: 10.1093/humrep/dez025] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 12/14/2018] [Accepted: 02/14/2019] [Indexed: 12/15/2022] Open
Abstract
STUDY QUESTION Has birthweight (BW) changed over time among IVF-conceived singletons? SUMMARY ANSWER Singleton BW has increased markedly over the past 25 years. WHAT IS KNOWN ALREADY IVF conceived singletons have had a higher incidence of low BW compared to spontaneously conceived singletons, and this has raised concerns over long-term increased risks of cardio-metabolic disease. However, few causal links between IVF procedures and BW have been robustly established, and few studies have examined whether BW has changed over time as IVF techniques have developed. STUDY DESIGN, SIZE, DURATION A total of 2780 live born singletons conceived via IVF or ICSI treated in the reproductive medicine department of a single publicly funded tertiary care centre between 1991 and 2015 were included in this retrospective study. The primary outcome measure was singleton BW adjusted for gestational age, maternal parity and child gender. Multivariable linear regression models were used to estimate the associations between patient prognostic factors and IVF treatment procedures with adjusted BW. PARTICIPANTS/MATERIALS, SETTING, METHODS All singletons conceived at the centre following IVF/ICSI using the mother's own oocytes, and non-donated fresh or frozen/thawed embryos with complete electronic data records, were investigated. Available electronic records were retrieved from the Human Fertilization and Embryology Authority for dataset collation. Multiple linear regression analysis was used to evaluate associations between IVF treatment parameters and BW, after adjusting for the year of treatment and patient characteristics and pregnancy factors. MAIN RESULTS AND THE ROLE OF CHANCE In the primary multivariable model, singleton BW increased by 7.4 g per year (95% CI: 3.2-11.6 g, P = 0.001), an increase of close to 180 g throughout the 25-year period after accounting for gestational age, maternal parity, child gender, IVF treatment parameters, patient prognostic characteristics and pregnancy factors. Fresh and frozen embryo transfer-conceived singletons showed a similar increase in BW. Frozen/thawed embryo transfer conceived singletons were on average 53 g heavier than their fresh embryo conceived counterparts (95% CI: 3.7-103.3 g, P = 0.035). LIMITATIONS, REASONS FOR CAUTION The independent variables included in the study were limited to those that have been consistently recorded and stored electronically over the past two decades. WIDER IMPLICATIONS OF THE FINDINGS There has been a progressive BW increase in IVF singletons over time in one large centre with consistent treatment eligibility criteria. Such a change is not seen in the general population of live born singletons in the UK or other developed countries, and seems to be specific to this IVF population. This may be a reflection of changes in practice such as undisturbed extended embryo culture to the blastocyst stage, optimized commercial culture media composition, single embryo transfer and ICSI. Moreover, singletons conceived from frozen/thawed embryos had higher birth weights when compared to their fresh embryo transfer counterparts. The causal pathway is unknown; however, it could be due to the impact on embryos of the freeze/thaw process, self-selection of embryos from couples who produce a surplus of embryos, and/or embryo replacement into a more receptive maternal environment. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the EU FP7 project grant, EpiHealthNet (FP7-PEOPLE-2012-ITN-317146). The authors have no competing interests to declare. TRIAL REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
- Catherine M Castillo
- Maternal & Fetal Health Research Centre, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Sciences Centre, Oxford Rd., Manchester, UK.,Maternal & Fetal Health Research Centre, St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Oxford Rd., Manchester, UK
| | - Gregory Horne
- Department of Reproductive Medicine, Old St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Oxford Rd., Manchester, UK
| | - Cheryl T Fitzgerald
- Maternal & Fetal Health Research Centre, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Sciences Centre, Oxford Rd., Manchester, UK.,Department of Reproductive Medicine, Old St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Oxford Rd., Manchester, UK
| | - Edward D Johnstone
- Maternal & Fetal Health Research Centre, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Sciences Centre, Oxford Rd., Manchester, UK.,Maternal & Fetal Health Research Centre, St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Oxford Rd., Manchester, UK
| | - Daniel R Brison
- Maternal & Fetal Health Research Centre, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Sciences Centre, Oxford Rd., Manchester, UK.,Maternal & Fetal Health Research Centre, St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Oxford Rd., Manchester, UK.,Department of Reproductive Medicine, Old St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Oxford Rd., Manchester, UK
| | - Stephen A Roberts
- Centre for Biostatistics, Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Oxford Rd., Manchester, UK
| |
Collapse
|
18
|
Ibiebele I, Bowen JR, Nippita TA, Morris JM, Ford JB. Childhood health and education outcomes following early term induction for large-for-gestational age: A population-based record linkage study. Acta Obstet Gynecol Scand 2018; 98:423-432. [PMID: 30511739 DOI: 10.1111/aogs.13511] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 11/29/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION There is debate about optimal management of pregnancies with a large-for-gestational age baby. A recent randomized controlled trial reported that early term induction of labor reduced cesarean section rates and infant morbidity. However, long term childhood outcomes have not been assessed. The aim of this study was to assess maternal, neonatal and child health and education outcomes for large-for-gestational age babies induced at 37-38 weeks' gestation. MATERIAL AND METHODS Population-based record linkage study of term (37+ weeks), cephalic-presenting singleton pregnancies with a large-for-gestational age baby in New South Wales, Australia, 2002-2006. Linked birth, hospital, mortality and education data were used with at least 9 years follow up from birth. Exposure was induction of labor at 37-38 weeks, compared to expectant management (spontaneous birth at ≥37 weeks and planned births at ≥39 weeks). Relative risks and 95% confidence intervals were estimated using Modified Poisson regression with robust variance. RESULTS Among 10 174 eligible pregnancies, 412 (4.0%) had an induction at 37-38 weeks. Women in the induction group were less likely to have a cesarean section (RR: 0.65, 95% CI: 0.51-0.82). Infants had higher rates of: low Apgar scores, birth trauma, neonatal jaundice and phototherapy use, and admission to special care nursery or neonatal intensive care than their expectantly managed counterparts. As children, they had higher rates of hospital admission (RR: 1.16, 95% CI: 1.04-1.30) and special needs (RR: 1.98, 95% CI: 1.12-3.50). However, by age 8 there was no difference in overall literacy and numeracy achievement. CONCLUSIONS Although women who had an early term labor induction with large-for-gestational age were less likely to have a cesarean section, the increased risk of neonatal morbidities and additional healthcare utilization suggests the need for caution in early induction of large-for-gestational age babies before 39 weeks' gestation.
Collapse
Affiliation(s)
- Ibinabo Ibiebele
- Clinical and Population Perinatal Health Research, Northern Sydney Local Health District, Kolling Institute, Sydney, NSW, Australia.,Northern Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - Jennifer R Bowen
- Clinical and Population Perinatal Health Research, Northern Sydney Local Health District, Kolling Institute, Sydney, NSW, Australia.,Northern Clinical School, The University of Sydney, Sydney, NSW, Australia.,Department of Neonatology and Pediatrics, Northern Sydney Local Health District, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Tanya A Nippita
- Clinical and Population Perinatal Health Research, Northern Sydney Local Health District, Kolling Institute, Sydney, NSW, Australia.,Northern Clinical School, The University of Sydney, Sydney, NSW, Australia.,Department of Obstetrics and Gynecology, Northern Sydney Local Health District, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Jonathan M Morris
- Clinical and Population Perinatal Health Research, Northern Sydney Local Health District, Kolling Institute, Sydney, NSW, Australia.,Northern Clinical School, The University of Sydney, Sydney, NSW, Australia.,Department of Obstetrics and Gynecology, Northern Sydney Local Health District, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Jane B Ford
- Clinical and Population Perinatal Health Research, Northern Sydney Local Health District, Kolling Institute, Sydney, NSW, Australia.,Northern Clinical School, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
19
|
Influence of maternal adiposity, preterm birth and birth weight centiles on early childhood obesity in an Indigenous Australian pregnancy-through-to-early-childhood cohort study. J Dev Orig Health Dis 2018; 10:39-47. [PMID: 29764530 DOI: 10.1017/s2040174418000302] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Childhood obesity rates are higher among Indigenous compared with non-Indigenous Australian children. It has been hypothesized that early-life influences beginning with the intrauterine environment predict the development of obesity in the offspring. The aim of this paper was to assess, in 227 mother-child dyads from the Gomeroi gaaynggal cohort, associations between prematurity, Gestation Related-Optimal Weight (GROW) centiles, maternal adiposity (percentage body fat, visceral fat area), maternal non-fasting plasma glucose levels (measured at mean gestational age of 23.1 weeks) and offspring BMI and adiposity (abdominal circumference, subscapular skinfold thickness) in early childhood (mean age 23.4 months). Maternal non-fasting plasma glucose concentrations were positively associated with infant birth weight (P=0.005) and GROW customized birth weight centiles (P=0.008). There was a significant association between maternal percentage body fat (P=0.02) and visceral fat area (P=0.00) with infant body weight in early childhood. Body mass index (BMI) in early childhood was significantly higher in offspring born preterm compared with those born at term (P=0.03). GROW customized birth weight centiles was significantly associated with body weight (P=0.01), BMI (P=0.007) and abdominal circumference (P=0.039) at early childhood. Our findings suggest that being born preterm, large for gestational age or exposed to an obesogenic intrauterine environment and higher maternal non-fasting plasma glucose concentrations are associated with increased obesity risk in early childhood. Future strategies should aim to reduce the prevalence of overweight/obesity in women of child-bearing age and emphasize the importance of optimal glycemia during pregnancy, particularly in Indigenous women.
Collapse
|
20
|
Agay-Shay K, Rudolf M, Rubin L, Haklai Z, Grotto I. Trends in Fetal Growth Between 2000 to 2014 in Singleton Live Births from Israel. Sci Rep 2018; 8:1089. [PMID: 29348415 PMCID: PMC5773590 DOI: 10.1038/s41598-018-19396-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 12/28/2017] [Indexed: 12/16/2022] Open
Abstract
Trends in birthweight and abnormal fetal growth, namely term low birthweight (LBW), macrosomia, small-for-gestational age (SGA) and large-for-gestational age (LGA), are important indicators of changes in the health of populations. We performed this epidemiological study to evaluate these trends among 2,039,415 singleton live births from Israel over a period of 15 years. Birth certificate data was obtained from the Ministry of Health. Multivariable linear and logistic regression models were used to evaluate crude and adjusted estimates compared to the baseline of 2000 and polynomial trends. During the study period we observed a significant decrease in the rates of infants born SGA and LGA (10.7% to 9.2%, 10.2% to 9.6% respectively). After adjustment, based on the imputed data set, term mean birthweight increased by 6.0 grams (95% CI: 2.9, 9.1), and term LBW odds decreased by 19% in 2014 compared to 2000 (adj ORs: 0.81; 95% CI: 0.77, 0.85). Significant decreases were also observed for adjusted SGA, LGA and macrosomia rates. The decrease in abnormal fetal growth rates were not entirely explained by changes in sociodemographic characteristics or gestational age and may imply real improvement in child intrauterine growth in Israel during the last 15 years, especially in the Jewish population.
Collapse
Affiliation(s)
- Keren Agay-Shay
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.
| | - Mary Rudolf
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Lisa Rubin
- Department of Maternal and Child Health, Public Health Services, Ministry of Health, Jerusalem, Israel
- School of Public Health, University of Haifa, Haifa, Israel
| | - Ziona Haklai
- Health Information Division, Ministry of Health, Jerusalem, Israel
| | - Itamar Grotto
- Ministry of Health, Jerusalem, Israel
- Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel
| |
Collapse
|
21
|
Khambalia AZ, Algert CS, Bowen JR, Collie RJ, Roberts CL. Long-term outcomes for large for gestational age infants born at term. J Paediatr Child Health 2017; 53:876-881. [PMID: 28868781 DOI: 10.1111/jpc.13593] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 02/01/2017] [Accepted: 03/05/2017] [Indexed: 11/28/2022]
Abstract
AIM Large for gestational age (LGA) babies have increased risks for short-term outcomes such as shoulder dystocia, neonatal hypoglycaemia and longer hospital stay. Little is known of long-term health, development and educational outcomes of LGA babies. The aim of this study was to determine the long-term health, mortality, development and educational outcomes for infants born LGA at term. METHODS A population-based record linkage study of live singletons born at term (37-41 weeks of gestation) in New South Wales, Australia, from 2001 to 2006. RESULTS This study compared 49 439 LGA (>90th percentile for birthweight, gestational age and sex) and 400 418 appropriate size for gestational age (AGA; 10th-90th percentile) infants. LGA infants had increased risk of birth and neonatal outcomes and hospitalisations, for brachial plexus injury after the neonatal period, and for all causes from 1 to 5 years of age. There were no differences in mortality up to 5 years of age or hospitalisations for type 1 diabetes in childhood. LGA infants had lower rates of developmental vulnerability (in kindergarten) and showed a significant trend (χ2 for trend <0.0001) to fewer low scores and more high scores in reading and numeracy (in Year 3) compared with AGA. After adjusting for potential confounders, only the relative risk for higher reading scores was statistically significant. CONCLUSIONS LGA infants show positive long-term health, development and educational outcomes. Concerns for LGA infants still remain in the perinatal period as a result of birth trauma; however, these complications usually do not persist in postnatal and early childhood.
Collapse
Affiliation(s)
- Amina Z Khambalia
- Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, Sydney, New South Wales, Australia.,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Charles S Algert
- Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Jennifer R Bowen
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Department of Neonatology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Rebecca J Collie
- School of Education, University of New South Wales, Sydney, New South Wales, Australia
| | - Christine L Roberts
- Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, Sydney, New South Wales, Australia.,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
22
|
Tutlam NT, Liu Y, Nelson EJ, Flick LH, Chang JJ. The Effects of Race and Ethnicity on the Risk of Large-for-Gestational-Age Newborns in Women Without Gestational Diabetes by Prepregnancy Body Mass Index Categories. Matern Child Health J 2017; 21:1643-1654. [PMID: 28092059 DOI: 10.1007/s10995-016-2256-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objectives Children born large for gestational age (LGA) are at risk of numerous adverse outcomes. While the racial/ethnic disparity in LGA risk has been studied among women with Gestational Diabetes Mellitus (GDM), the independent effect of race on LGA risk by maternal prepregnancy BMI is still unclear among women without GDM. Therefore, the objective of this study was to assess the association between maternal race/ethnicity and LGA among women without GDM. Methods This was a population-based cohort study of 2,842,278 singleton births using 2012 U.S. Natality data. We conducted bivariate and multivariate logistic regression analyses to assess the association between race and LGA. Due to effect modification by maternal prepregnancy BMI, we stratified our analysis by four BMI subgroups. Results The prevalence of LGA was similar across the different racial/ethnic groups at about 9%, but non-Hispanic Asian Americans had slightly higher prevalence of 11%. After controlling for potential confounders, minority women had higher odds of birthing LGA babies compared to non-Hispanic white women. Non-Hispanic Asian Americans had the highest odds of LGA babies across all BMI categories: underweight (aOR = 2.67; 95% CI: 2.24, 3.05); normal weight (aOR = 2.53; 2.43, 2.62); overweight (aOR = 2.45; 2.32, 2.60) and obese (aOR = 2.05; 1.91, 2.20). Conclusions for practice Racial/ethnic disparities exist in LGA odds, particularly among women with underweight or normal prepregnancy BMI. Most minorities had higher LGA odds than non-Hispanic white women regardless of prepregnancy BMI category. These racial/ethnic disparities should inform public health policies and interventions to address this problem.
Collapse
Affiliation(s)
- Nhial T Tutlam
- Department of Epidemiology, College for Public Health and Social Justice, St. Louis University, 3545 Lafayette Ave, Saint Louis, MO, 63104, USA.
- Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, Saint Louis, MO, USA.
| | - Yun Liu
- Department of Epidemiology, College for Public Health and Social Justice, St. Louis University, 3545 Lafayette Ave, Saint Louis, MO, 63104, USA
| | - Erik J Nelson
- Department of Epidemiology, College for Public Health and Social Justice, St. Louis University, 3545 Lafayette Ave, Saint Louis, MO, 63104, USA
| | - Louise H Flick
- Department of Epidemiology, College for Public Health and Social Justice, St. Louis University, 3545 Lafayette Ave, Saint Louis, MO, 63104, USA
| | - Jen Jen Chang
- Department of Epidemiology, College for Public Health and Social Justice, St. Louis University, 3545 Lafayette Ave, Saint Louis, MO, 63104, USA
| |
Collapse
|
23
|
Mech P, Hooley M, Skouteris H, Williams J. Parent-related mechanisms underlying the social gradient of childhood overweight and obesity: a systematic review. Child Care Health Dev 2016; 42:603-24. [PMID: 27316858 DOI: 10.1111/cch.12356] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 04/26/2016] [Accepted: 05/02/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Low socio-economic status (SES) is a significant risk factor for childhood overweight and obesity (COWOB) in high-income countries. Parents to young children buffer and accentuate social and cultural influences, and are central to the development of this disease. An understanding of the parent-related mechanisms that underlie the SES-COWOB relationship is needed to improve the efficacy of prevention and intervention efforts. OBJECTIVE A systematic review of relevant literature was conducted to investigate the mechanisms by which levels of SES (low, middle and high) are associated to COWOB, by exploring mediation and interaction effects. METHOD Six electronic databases were searched yielding 5155 initial records, once duplicates were removed. Studies were included if they investigated COWOB, SES, parent-related factors and the multivariate relationship between these factors. Thirty studies were included. Factors found to be mediating the SES-COWOB relationship or interacting with SES to influence COWOB were categorized according to an ecological systems framework, at child, parent, household and social system level factors. RESULTS High parent body mass index, ethnicity, child-care attendance, high TV time (mother and child), breastfeeding (early weaning), food intake behaviours and birthweight potentially mediate the relationship between SES and COWOB. Different risk factors for COWOB in different SES groups were found. For low SES families, parental obesity and maternal depressive symptoms were strong risk factors for COWOB, whereas long maternal working hours and a permissive parenting style were risk factors for higher SES families. None of the studies investigated parental psychological attributes such as attitudes, beliefs, self-esteem and so on as potential mechanisms/risk factors. CONCLUSIONS Families from different SES groups have different risk and protective factors for COWOB. Prevention and intervention efforts may have improved efficacy if they are tailored to address specific risk factors within SES.
Collapse
Affiliation(s)
- P Mech
- School of Psychology, Faculty of Health, Deakin University, Burwood, Vic., Australia
| | - M Hooley
- School of Psychology, Faculty of Health, Deakin University, Burwood, Vic., Australia
| | - H Skouteris
- School of Psychology, Faculty of Health, Deakin University, Burwood, Vic., Australia
| | - J Williams
- School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Vic., Australia
| |
Collapse
|
24
|
Chiavaroli V, Castorani V, Guidone P, Derraik JGB, Liberati M, Chiarelli F, Mohn A. Incidence of infants born small- and large-for-gestational-age in an Italian cohort over a 20-year period and associated risk factors. Ital J Pediatr 2016; 42:42. [PMID: 27117061 PMCID: PMC4845339 DOI: 10.1186/s13052-016-0254-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 04/17/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We assessed the incidence of infants born small-for-gestational-age (SGA) and large-for-gestational-age (LGA) in an Italian cohort over 20 years (1993-2013). Furthermore, we investigated maternal factors associated with SGA and LGA births. METHODS A retrospective review of obstetric records was performed on infants born in Chieti (Italy) covering every 5(th) year over a 20-year period, specifically examining data for 1993, 1998, 2003, 2008, and 2013. Infants with birthweight <10(th) percentile were defined as SGA, and those with birthweight >90(th) percentile as LGA. Data collected included newborn anthropometry, birth (multiple vs singleton), maternal anthropometry, previous miscarriage, gestational diabetes, hypertension, and smoking during pregnancy. RESULTS There were a pooled total of 5896 live births recorded across the 5 selected years. The number of SGA (+60.6 %) and LGA (+90.2 %) births increased considerably between 1993 and 2013. However, there were no marked changes in the incidence of SGA or LGA births (8.3 % and 10.8 % in 1993 versus 7.6 % and 11.7 % in 2013, respectively). Maternal factors associated with increased risk of SGA infants included hypertension, smoking, and previous miscarriage (all p < 0.05), while greater pre-pregnancy BMI and gestational diabetes were risk factors for LGA births (all p < 0.05). CONCLUSIONS There was an increase in the number of SGA and LGA births in Chieti over the last two decades, but there was little change in incidence over time. Most maternal factors associated with increased odds of SGA and LGA births were modifiable, thus incidence could be reduced by targeted interventions.
Collapse
Affiliation(s)
- Valentina Chiavaroli
- Department of Paediatrics, University of Chieti, Via dei Vestini 5, 66100, Chieti, Italy. .,Center of Excellence on Aging, "G. d'Annunzio" University Foundation, University of Chieti, Chieti, Italy.
| | - Valeria Castorani
- Department of Paediatrics, University of Chieti, Via dei Vestini 5, 66100, Chieti, Italy
| | - Paola Guidone
- Department of Paediatrics, University of Chieti, Via dei Vestini 5, 66100, Chieti, Italy
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Marco Liberati
- Department of Obstetrics and Gynaecology, University of Chieti, Chieti, Italy
| | - Francesco Chiarelli
- Department of Paediatrics, University of Chieti, Via dei Vestini 5, 66100, Chieti, Italy.,Center of Excellence on Aging, "G. d'Annunzio" University Foundation, University of Chieti, Chieti, Italy
| | - Angelika Mohn
- Department of Paediatrics, University of Chieti, Via dei Vestini 5, 66100, Chieti, Italy.,Center of Excellence on Aging, "G. d'Annunzio" University Foundation, University of Chieti, Chieti, Italy
| |
Collapse
|
25
|
Gibson KS, Waters TP, Gunzler DD, Catalano PM. A retrospective cohort study of factors relating to the longitudinal change in birth weight. BMC Pregnancy Childbirth 2015; 15:344. [PMID: 26693917 PMCID: PMC4687143 DOI: 10.1186/s12884-015-0777-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 12/04/2015] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Recent reports have shown a decrease in birth weight, a change from prior steady increases. Therefore we sought to describe the demographic and anthropometric changes in singleton term fetal growth. METHODS This was a retrospective cohort analysis of term singleton deliveries (37-42 weeks) from January 1, 1995 to January 1, 2010 at a single tertiary obstetric unit. We included all 43,217 neonates from term, singleton, non-anomalous pregnancies. Data were grouped into five 3-year intervals. Mean and median birth weight (BW), birth length (BL), and Ponderal Index (PI) were estimated by year, race and gestational age. Our primary outcome was change in BW over time. The secondary outcomes were changes in BL and PI over time. RESULTS Mean and median BW decreased by 72 and 70 g respectively (p < 0.0001) over the 15 year period while BL also significantly decreased by 1.0 cm (P < 0.001). This contributed to an increase in the neonatal PI by 0.11 kg/m(3) (P < 0.001). Mean gestational age at delivery decreased while maternal BMI at delivery, hypertension, diabetes, and African American race increased. Adjusting for gestational age, race, infant sex, maternal BMI, smoking, diabetes, hypertension, and parity, year of birth contributed 0.1 % to the variance (-1.7 g/year; 26 g) of BW, 1.8% (-0.06 cm/year; 0.9 cm) of BL, and 0.7% (+0.008 kg/m(3)/year; 0.12 kg/m(3)) of PI. These findings were independent of the proportional change in race or gestational age. CONCLUSIONS We observed a crude decrease in mean BW of 72 g and BL of 1 cm over 15 years. Furthermore, once controlling for gestational age, race, infant sex, maternal BMI, smoking, diabetes, hypertension, and parity, we identified that increasing year of birth was associated with a decrease in BW of 1.7 g/year. The significant increase in PI, despite the decrease in BW emphasizes the limitation of using birth weight alone to define changes in fetal growth.
Collapse
Affiliation(s)
- Kelly S Gibson
- Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 Metrohealth Drive, Cleveland, OH, 44109, USA.
| | - Thaddeus P Waters
- Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL, 60153, USA.
| | - Douglas D Gunzler
- Center for Health Care Research & Policy, Case Western Reserve University School of Medicine, 2500 Metrohealth Drive, Cleveland, OH, 44109, USA.
| | - Patrick M Catalano
- Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 Metrohealth Drive, Cleveland, OH, 44109, USA.
| |
Collapse
|
26
|
Jeyaseelan L, Yadav B, Silambarasan V, Vijayaselvi R, Jose R. Large for Gestational Age Births Among South Indian Women: Temporal Trend and Risk Factors from 1996 to 2010. J Obstet Gynaecol India 2015; 66:42-50. [PMID: 27651576 DOI: 10.1007/s13224-015-0765-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 08/13/2015] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND/PURPOSE Mean birth weight is a good health indicator for any population. In the recent past, there have been many reports in the West indicating that there has been an increase in the proportion of large for gestational age (LGA) babies. The objective is to describe the change in the incidence of LGA babies from 1996 to 2010 in South India and the maternal risk factors. METHODS A rotational sampling scheme was used, i.e., the 12 months of the year were divided into 4 quarters and a month was from each quarter was selected rotationally. All deliveries for that month were considered. Only deliveries that occurred between 28 and 42 weeks of pregnancy were considered. The association between risk variables was studied using multivariable logistic regression. RESULTS There were 35,718 deliveries that occurred during these 15-year-study period in the gestational age 28-42 weeks were registered through the outpatient clinics. The incidence of LGA was 9.4 % that has mostly remained at the same level. The incidence of LGA in mothers with gestational diabetes was 6.7, 3 and 17.6 % in overweight, obese and gestational l diabetes mothers. Overweight, obesity in pregnant women and cesarean section were significant risk factors. CONCLUSION Unlike in Western countries, where the incidence of LGA babies has spiraled upward, has remained nearly at the same level over one and a half decades, in South India. The risk factors for giving birth to LGA babies in South India were similar to other studies.
Collapse
Affiliation(s)
| | - Bijesh Yadav
- Department of Biostatistics, Christian Medical College, Vellore, 632002 India
| | | | - Reeta Vijayaselvi
- Obstetrics and Gynaecology Unit IV, Christian Medical College, Vellore, 632002 India
| | - Ruby Jose
- Obstetrics and Gynaecology Unit IV, Christian Medical College, Vellore, 632002 India ; Department of Obstetrics and Gynecology Unit IV, Christian Medical College, Vellore, 632004 India
| |
Collapse
|
27
|
The intergenerational effects on birth weight and its relations to maternal conditions, São Paulo, Brazil. BIOMED RESEARCH INTERNATIONAL 2015; 2015:615034. [PMID: 25710010 PMCID: PMC4330948 DOI: 10.1155/2015/615034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 10/16/2014] [Accepted: 10/21/2014] [Indexed: 11/17/2022]
Abstract
Background and Objectives. Parents' birth weight acts as a predictor for the descendant birth weight, with the correlation more strongly transmitted through maternal line. The present research aims to study the correlation between the child's low or increased birth weight, the mother's birth weight, and maternal conditions. Methods. 773 mother-infant binomials were identified with information on both the baby's and the mother's birth weight recorded. Group studies were constituted, dividing the sample according to birth weight (<2,500 grams (g) and ≥3,500 grams (g)). The length at birth was also studied in children ≤47.5 cm (lower quartile). Chi2 test or Fisher's exact test, Spearman's Rho, and odds ratio were performed in order to investigate the relation between the children's weight and length at birth and the mothers' and children's variables. Results. The girls were heavier at birth than their mothers, with an average increase at birth weight between the generations of 79 g. The child's birth weight <2,500 g did not show any correlation with maternal birth weight <2,500 g (Fisher 0.264; Spearman's Rho 0.048; OR 2.1 and OR lower 0.7) or with maternal stature below the lower quartile (<157 cm) (Chi2 sig 0.323; with Spearman's Rho 0.036; OR 1.5 and OR lower 0.7). The child's low birth weight (<2,500 g) was lightly correlated with drug use by the mother during pregnancy (Fisher 0.083; Spearman's Rho 0.080; OR 4.9 and OR lower 1.0). The child's birth weight <2,500 g showed increased correlation with gestational age lower than 38 weeks and 3 days (Chi2 sig 0.002; Spearman's Rho 0.113; OR 3.2 and OR lower 1.5). The child's weight at birth ≥3,500 g showed strong correlation with maternal weight at birth ≥3,500 g (Chi2 sig 0; Spearman's Rho +0.142; OR 0.5 and OR upper 0.7). It was also revealed that the higher the maternal prepregnancy BMI, the stronger the correlation with child's birth weight ≥3,500 g ((maternal prepregnancy BMI > 25.0 with Chi2 sig 0.013; Spearman's Rho 0.09; OR 1.54 and OR upper 2.17) and (maternal prepregnancy BMI > 30.0 with Chi2 sig 0 Spearman's Rho 0.137; OR 2.58 and OR upper 4.26)). The child's length at birth in the lower quartile (≤47.5 cm) showed strong correlation with drug use by the mother during pregnancy (Chi2 sig 0.004; Spearman's Rho 0.105; OR 4.3 and OR lower 1.5). Conclusions. The mother's increased weight at birth and the prenatal overweight or obesity were correlated with increased weight and length at birth of the newborn, coupled with the tendency of increasing birth weight between generations of mothers and daughters. Also, descendants with smaller length at birth are the children of women with the lowest statures.
Collapse
|
28
|
Ojha S, Saroha V, Symonds ME, Budge H. Excess nutrient supply in early life and its later metabolic consequences. Clin Exp Pharmacol Physiol 2014; 40:817-23. [PMID: 23350968 DOI: 10.1111/1440-1681.12061] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 01/17/2013] [Accepted: 01/20/2013] [Indexed: 12/20/2022]
Abstract
Suboptimal nutrition in early life, both in utero and during infancy, is linked to increased risk of adult obesity and its associated adverse metabolic health problems. Excess nutrient supply during early life can lead to metabolic programming in the offspring. Such overnutrition can occur in the offspring of obese mothers, the offspring of mothers who gain excess weight during gestation, infants of diabetic mothers and infants who undergo rapid growth, particularly weight gain, during early infancy. Postnatal overnutrition is particularly detrimental for infants who are born small for gestational age, who are overfed to attain 'catch-up growth'. Potential mechanisms underlying metabolic programming that results from excess nutrition during early life include resetting of hypothalamic energy sensing and appetite regulation, altered adipose tissue insulin sensitivity and impaired brown adipose tissue function. More detailed understanding of the mechanisms involved in metabolic programming could enable the development of therapeutic strategies for ameliorating its ill effects. Research in this field could potentially identify optimal and appropriate preventative interventions for a burgeoning population at risk of increased mortality and morbidity from obesity and its concomitant metabolic conditions.
Collapse
Affiliation(s)
- Shalini Ojha
- The Early Life Nutrition Research Unit, Academic Division of Child Health, School of Clinical Sciences, University Hospital, The University of Nottingham, Nottingham, UK
| | | | | | | |
Collapse
|
29
|
Bisson M, Alméras N, Plaisance J, Rhéaume C, Bujold E, Tremblay A, Marc I. Maternal fitness at the onset of the second trimester of pregnancy: correlates and relationship with infant birth weight. Pediatr Obes 2013; 8:464-74. [PMID: 23281128 DOI: 10.1111/j.2047-6310.2012.00129.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Revised: 11/01/2012] [Accepted: 11/04/2012] [Indexed: 10/27/2022]
Abstract
UNLABELLED What is already known about this subject A healthy life begins in utero and a healthy pregnancy requires a fit and healthy mother. Physical activity during pregnancy provides a stimulation that is essential for promoting optimal body oxygenation and composition as well as metabolic fitness during pregnancy. Although a higher maternal fitness is expected to provide a beneficial fetal environment, it is still unclear whether physical fitness during pregnancy contributes to perinatal health. What this study adds Participation in sports and exercise previously and at the beginning of pregnancy can benefit maternal health by improving cardiorespiratory fitness during pregnancy, irrespective of maternal body mass index. Maternal strength, an indicator of muscular fitness, is an independent determinant of infant fetal growth and can positively influence birth weight. BACKGROUND It is still unclear whether maternal physical activity and fitness during pregnancy contributes to perinatal health. OBJECTIVES The aims of this study were to characterize maternal physical fitness at 16 weeks of pregnancy and to examine its effects on infant birth weight. METHODS Maternal anthropometry (body mass index [BMI] and skin-folds), physical activity, cardiorespiratory fitness (VO2 peak) and muscular fitness (handgrip strength) were assessed at 16 weeks of gestation in 65 healthy pregnant women. Offspring birth weight was collected from maternal charts after delivery. RESULTS A higher VO2 peak was associated with physical activity spent at sports and exercise before and in early pregnancy (P = 0.0005). Maternal BMI was negatively associated with cardiorespiratory fitness (P < 0.0001) but positively related to muscular strength (P = 0.0001). Unlike maternal cardiorespiratory fitness, handgrip strength was positively associated with infant birth weight (r = 0.34, P = 0.0068) even after adjustment for confounders (adjusted r = 0.27, P = 0.0480). CONCLUSION A positive relationship between maternal muscular fitness and infant birth weight highlighted maternal strength in pregnancy as a new determinant of infant birth weight.
Collapse
Affiliation(s)
- M Bisson
- Department of Pediatrics, Centre Hospitalier Universitaire de Quebec, Laval University, Quebec City, QC, Canada
| | | | | | | | | | | | | |
Collapse
|
30
|
Wen LM, Simpson JM, Rissel C, Baur LA. Maternal "junk food" diet during pregnancy as a predictor of high birthweight: findings from the healthy beginnings trial. Birth 2013; 40:46-51. [PMID: 24635424 DOI: 10.1111/birt.12028] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/17/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND A high infant birthweight is associated with future risk of a range of adverse health consequences. This study sought to determine whether maternal "junk food" diet (energy-dense, nutrient-poor) predicts high birthweight in first-time mothers in southwest Sydney, Australia. METHODS A community-based longitudinal study was conducted with a total of 368 first-time mothers and their newborns. Information about maternal "junk food" diet, including high consumption of soft drink, fast food, and/or processed meat and chips, and self-reported prepregnant weight and height of first-time mothers was collected by a face-to-face interview with mothers between 24 and 34 weeks of pregnancy. Birthweight was measured in hospital and reported by the mother, together with gestational age, when the baby was 6 months old. Logistic regression modeling was used to determine the factors predicting birthweight greater than 4.0 kg. RESULTS Eleven percent of newborns weighed more than 4.0 kg (12% boys, 9% girls). Compared with mothers who had a "junk food" diet, mothers who had not consumed "junk food" during pregnancy were significantly less likely to have a newborn weighing more than 4.0 kg, with adjusted odds ratio (AOR) 0.36, 95 percent confidence interval (CI) 0.14-0.91, p = 0.03, after adjusting for maternal weight status and gestational age. Compared with healthy and underweight mothers, overweight or obese mothers were more likely to have a newborn weighing more than 4.0 kg (AOR overweight 3.03, 95% CI 1.35-6.80; obese 3.79, 95% CI 1.41-10.25) after allowing for "junk food" diet and gestational age. CONCLUSIONS Maternal "junk food" diet during pregnancy and prepregnant overweight and obesity were independent predictors of high infant birthweight. Early childhood obesity interventions should consider addressing these factors.
Collapse
Affiliation(s)
- Li Ming Wen
- School of Public Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | | | | | | |
Collapse
|
31
|
Lee YY, Roberts CL, Dobbins T, Stavrou E, Black K, Morris J, Young J. Incidence and outcomes of pregnancy-associated cancer in Australia, 1994-2008: a population-based linkage study. BJOG 2012; 119:1572-82. [PMID: 22947229 PMCID: PMC3533794 DOI: 10.1111/j.1471-0528.2012.03475.x] [Citation(s) in RCA: 135] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objective To determine trends in pregnancy-associated cancer and associations between maternal cancer and pregnancy outcomes. Design Population-based cohort study. Setting New South Wales, Australia, 1994–2008. Population A total of 781 907 women and their 1 309 501 maternities. Methods Cancer and maternal information were obtained from linked cancer registry, birth and hospital records for the entire population. Generalised estimating equations with a logit link were used to examine associations between cancer risk factors and pregnancy outcomes. Main outcome measures Incidence of pregnancy-associated cancer (diagnosis during pregnancy or within 12 months of delivery), maternal morbidities, preterm birth, and small- and large-for-gestational-age (LGA). Results A total of 1798 new cancer diagnoses were identified, including 499 during pregnancy and 1299 postpartum. From 1994 to 2007, the crude incidence rate of pregnancy-associated cancer increased from 112.3 to 191.5 per 100 000 maternities (P < 0.001), and only 14% of the increase was explained by increasing maternal age. Cancer diagnosis was more common than expected in women aged 15–44 years (observed-to-expected ratio 1.49; 95% CI 1.42–1.56). Cancers were predominantly melanoma (33.3%) and breast cancer (21.0%). Women with cancer diagnosed during pregnancy had high rates of labour induction (28.5%), caesarean section (40.0%) and planned preterm birth (19.7%). Novel findings included a cancer association with multiple pregnancies (adjusted odds ratio 1.52, 95% CI 1.13–2.05) and LGA (aOR 1.47, 95% CI 1.14–1.89). Conclusions Pregnancy-associated cancers have increased, and this increase is only partially explained by increasing maternal age. Pregnancy increases women’s interaction with health services and the possibility for diagnosis, but may also influence tumour growth.
Collapse
Affiliation(s)
- Y Y Lee
- Clinical and Population Perinatal Health Research, Kolling Institute of Medical Research, University of Sydney, Sydney, NSW, Australia
| | | | | | | | | | | | | |
Collapse
|
32
|
Dobbins TA, Sullivan EA, Roberts CL, Simpson JM. Australian national birthweight percentiles by sex and gestational age, 1998–2007. Med J Aust 2012; 197:291-4. [DOI: 10.5694/mja11.11331] [Citation(s) in RCA: 270] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Elizabeth A Sullivan
- Perinatal and Reproductive Epidemiology Research Unit, University of New South Wales, Sydney, NSW
| | - Christine L Roberts
- Clinical and Population Perinatal Health Research, Kolling Institute, University of Sydney, Sydney, NSW
| | - Judy M Simpson
- Sydney School of Public Health, University of Sydney, Sydney, NSW
| |
Collapse
|
33
|
Abstract
OBJECTIVES Rates of high birth weight infants, overweight and obese children and adults are increasing. The associations between birth weight and adult weight may have consequences for the obesity epidemic across generations. We examined the association between mothers' birth weight for gestational age and adult body mass index (BMI) and these factors' joint effect on risk of having a large-for-gestational-age (LGA) offspring (>+2 s.d. above the mean). DESIGN A cohort of 162 676 mothers and their first-born offspring with birth information recorded on mothers and offspring in the nation-wide Swedish Medical Birth Register 1973-2006. RESULTS Compared with mothers with appropriate birth weight for gestational age (AGA; -1 to +1 s.d.), mothers born LGA had increased risks of overweight (BMI 25.0-29.9; odds ratio (OR), 1.50; 95% CI 1.39-1.61), obesity class I (BMI 30.0-34.9; OR 1.77; 95% CI 1.59-1.98), obesity class II (BMI 35.0-39.9; OR 2.77; 95% CI 2.37-3.24) and obesity class III (BMI ≥40.0; OR 2.04; 95% CI 1.49-2.80). In each stratum of mother's birth weight for gestational age, risk of having an LGA offspring increased with mother's BMI. The risk of an LGA offspring was highest among women with a high (≥30) BMI who also had a high birth weight for gestational age (>+1 s.d.). In these groups, the ORs for LGA offspring ranged from 5 to 14 when compared with mothers born AGA with normal BMI (≤24.9). However, the strongest increase in risk by BMI was seen among mothers born SGA: the OR of having an LGA offspring was 13 times as high among SGA mothers with BMI ≥35.0 compared with the OR among SGA mothers with normal BMI (ORs=4.61 and 0.35, respectively). CONCLUSIONS Prenatal conditions are important for the obesity epidemic. Prevention of LGA births may contribute to curtail the intergenerational vicious cycle of obesity.
Collapse
|
34
|
Low and high birth weight as risk factors for obesity among 4 to 5-year-old Australian children: does gender matter? Eur J Pediatr 2011; 170:899-906. [PMID: 21174121 DOI: 10.1007/s00431-010-1375-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Accepted: 12/01/2010] [Indexed: 12/20/2022]
Abstract
UNLABELLED Studies testing whether birth weight and childhood obesity differ by gender are lacking. We aimed to describe the relationship between birth weight and childhood overweight/obesity and investigate the influence that gender has on this relationship among 4 to 5-year-old children. We performed a secondary analysis of an Australian nationally representative cross-sectional study in 4 to 5-year-old children. The main outcome measure was child overweight and obesity. We found that low birth weight (LBW) was associated with lower risk of overweight/obesity among girls at 4-5 years before (OR 0.50, 95%CI 0.32, 0.77) and after adjusting for socio-demographic factors (OR 0.51 95% CI 0.33, 0.80) and ethnicity (OR 0.52, 95%CI 0.33, 0.81) but was not associated with child overweight/obesity among boys before or after adjustment. High birth weight (HBW) was associated with a higher risk of overweight/obesity among both girls (adjusted OR: 1.76, 95% CI 1.12, 2.78) and boys (adjusted OR: 2.42 95% CI 2.06, 2.86). CONCLUSION There are gender differences in the association of birth weight with child overweight/obesity. HBW was associated with a higher risk of child overweight/obesity in boys and girls before and after adjustment for socio-demographic factors. However, LBW was associated with a lower risk of child overweight/obesity in girls but not in boys. These gender differences need to be considered when planning interventions to reduce child overweight/obesity.
Collapse
|
35
|
Çamurdan MO, Çamurdan AD, Polat S, Beyazova U. Growth patterns of large, small, and appropriate for gestational age infants: impacts of long-term breastfeeding: a retrospective cohort study. J Pediatr Endocrinol Metab 2011; 24:463-8. [PMID: 21932583 DOI: 10.1515/jpem.2011.168] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND In several studies, since high and low birth weights are demonstrated as associated with obesity in childhood, these values should be followed up and documented carefully. OBJECTIVE The aim of this retrospective cohort study is to demonstrate the variation on body mass index outcomes of large (LGA), small (SGA), appropriate (AGA) for gestational age infants from birth to the end of fourth year of age and the effects of breastfeeding duration on these outcomes. METHODS AND RESULTS Four hundred and seven infants were recruited in the study (304AGA, 85 LGA, 18 SGA infants). LGA was frequent in boys and SGA in girls (p = 0.001). The mothers with gestational diabetes mellitus did have LGA infants (10.0% vs. 3.3%) (p = 0.022). The SGA infants performed rapid catch-up growth in the second month while the LGA infants performed catch-down growth in the ninth month. After the first 4 months, there was no difference on the values of BMI depending on breastfeeding time, less or more than 4 months, on the basis of the AGA and LGA infants. However, the body mass index (BMI) of LGA infants breastfed more than 12 months were not different from the AGA; unless the breastfeeding ceased earlier, the means of BMI remained significantly higher until 3 years. CONCLUSION Consequently, long duration of breastfeeding might protect LGA infants from childhood obesity risk.
Collapse
Affiliation(s)
- M Orhun Çamurdan
- Department of Pediatric Endocrinology, Gazi University School of Medicine, Ankara, Turkey
| | | | | | | |
Collapse
|
36
|
Ng SK, Olog A, Spinks AB, Cameron CM, Searle J, McClure RJ. Risk factors and obstetric complications of large for gestational age births with adjustments for community effects: results from a new cohort study. BMC Public Health 2010; 10:460. [PMID: 20687966 PMCID: PMC2921393 DOI: 10.1186/1471-2458-10-460] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Accepted: 08/06/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND High birth weight has serious adverse impacts on chronic health conditions and development in children. This study identifies the social determinants and obstetric complications of high birth weight adjusted for gestational age and baby gender. METHODS Pregnant women were recruited from three maternity hospitals in South-East Queensland in Australia during antenatal clinic visits. A questionnaire was completed by each participant to elicit information on eco-epidemiological exposures. Perinatal information was extracted from hospital birth records. A hierarchical mixture regression model was used in the analysis to account for the heterogeneity of birth weights and identify risk factors and obstetric complications of births that were large for gestational age. A generalized linear mixed model was used to adjust for (random) "community" effects. RESULTS Pre-pregnancy obesity (adjusted OR = 2.73, 95% CI = 1.49-5.01), previous pregnancy (adjusted OR = 2.03, 95% CI = 1.08-3.81), and married mothers (adjusted OR = 1.85, 95% CI = 1.00-3.42) were significantly associated with large for gestational age babies. Subsequent complications included the increased need for delivery by caesarean sections or instrumental procedures (adjusted OR = 1.98, 95% CI = 1.10-3.55), resuscitation (adjusted OR = 2.52, 95% CI = 1.33-4.79), and transfer to intensive/special care nursery (adjusted OR = 3.76, 95% CI = 1.89-7.49). Communities associated with a higher proportion of large for gestational age births were identified. CONCLUSIONS Pre pregnancy obesity is the principal modifiable risk factor for large for gestational age births. Large for gestational age is an important risk factor for the subsequent obstetric complications. The findings improve the evidence-base on which to base preventive interventions to reduce the impact of high birth weight on maternal and child health.
Collapse
Affiliation(s)
- Shu-Kay Ng
- School of Medicine, Griffith University Logan Campus, Meadowbrook, QLD 4131, Australia
| | | | | | | | | | | |
Collapse
|
37
|
Abstract
PURPOSE OF REVIEW This review is an update on recent findings regarding early growth patterns and later obesity. These data are important because the potential programming of obesity in early life provides hope for new prevention strategies targeting early growth for long-term benefits. RECENT FINDINGS Recent findings regarding the association of childhood or adulthood obesity with fetal growth, gestational weight gain, maternal diabetes, or infancy weight gain are reviewed. Some related outcomes and potential mechanisms are also described. Most studies remain observational and confirm previous findings, but some intervention studies have begun to appear in the recent literature and support some, but not other, observed associations. SUMMARY Past and recent findings confirm the association of early growth patterns with obesity. However, causality must be demonstrated and safety must be established before translating these findings into public health recommendations.
Collapse
Affiliation(s)
- Nicolas Stettler
- The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
| | | |
Collapse
|