The Dramatic Increase in the Rate of Low Birthweight in New York City: An Aggregate Time-Series Analysis.

ERIC Educational Resources Information Center

Joyce, Theodore

1990-01-01

Analyzes the incidence of low birth weight in New York City using monthly time-series statistical data from 1968 through 1988. Finds that a downward trend before 1984 for both Blacks and Whites has reversed, with 3,110 additional low birth weight births to Blacks and 1,385 additional low birth weight births to Whites over the numbers expected.…

Working Conditions, Socioeconomic Factors and Low Birth Weight: Path Analysis

PubMed Central

Mahmoodi, Zohreh; Karimlou, Masoud; Sajjadi, Homeira; Dejman, Masoumeh; Vameghi, Meroe; Dolatian, Mahrokh

2013-01-01

Background In recent years, with socioeconomic changes in the society, the presence of women in the workplace is inevitable. The differences in working condition, especially for pregnant women, has adverse consequences like low birth weight. Objectives This study was conducted with the aim to model the relationship between working conditions, socioeconomic factors, and birth weight. Patients and Methods This study was conducted in case-control design. The control group consisted of 500 women with normal weight babies, and the case group, 250 women with low weight babies from selected hospitals in Tehran. Data were collected using a researcher-made questionnaire to determine mothers’ lifestyle during pregnancy with low birth weight with health-affecting social determinants approach. This questionnaire investigated women’s occupational lifestyle in terms of working conditions, activities, and job satisfaction. Data were analyzed with SPSS-16 and Lisrel-8.8 software using statistical path analysis. Results The final path model fitted well (CFI =1, RMSEA=0.00) and showed that among direct paths, working condition (β=-0.032), among indirect paths, household income (β=-0.42), and in the overall effect, unemployed spouse (β=-0.1828) had the most effects on the low birth weight. Negative coefficients indicate decreasing effect on birth weight. Conclusions Based on the path analysis model, working condition and socioeconomic status directly and indirectly influence birth weight. Thus, as well as attention to treatment and health care (biological aspect), special attention must also be paid to mothers’ socioeconomic factors. PMID:24616796

Can Parental Expectations Compensate for the Negative Effects of Low-Birth Weight on Academic Achievement? A Cross-Sectional Analysis of the National PEELS Data

ERIC Educational Resources Information Center

Cormier-Zenon, Dolores E.

2012-01-01

The purpose of this study is to examine the potential impact parental expectations have on the academic achievement of children born with low-birth weight to inform educational leaders. Literature on levels of children born with birth weights as low as 1 LB to as high as 9 LBS were evaluated based on: birth weight, academic achievement, and…

Maternal social support and neighborhood income inequality as predictors of low birth weight and preterm birth outcome disparities: analysis of South Carolina Pregnancy Risk Assessment and Monitoring System survey, 2000-2003.

PubMed

Nkansah-Amankra, Stephen; Dhawain, Ashish; Hussey, James Robert; Luchok, Kathryn J

2010-09-01

Effects of income inequality on health and other social systems have been a subject of considerable debate, but only a few studies have used multilevel models to evaluate these relationships. The main objectives of the study were to (1) Evaluate the relationships among neighborhood income inequality, social support and birth outcomes (low birth weight, and preterm delivery) and (2) Assess variations in racial disparities in birth outcomes across neighborhood contexts of income distribution and maternal social support. We evaluated these relationships by using South Carolina Pregnancy Risk Assessment and Monitoring System (PRAMS) survey for 2000-2003 geocoded to 2000 US Census data for South Carolina. Multilevel analysis was used to simultaneously evaluate the association between income inequality (measured as Gini), maternal social relationships and birth outcomes (low birth weight and preterm delivery). The results showed residence in neighborhoods with medium levels of income inequality was independently associated with low birth weight (OR: 2.00; 95% CI 1.14-3.26), but not preterm birth; low social support was an independent risk for low birth weight or preterm births. The evidence suggests that non-Hispanic black mothers were at increased risks of low birth weight or preterm birth primarily due to greater exposures of neighborhood deprivations associated with low income and reduced social support and modified by unequal income distribution.

Does the impact of a plant-based diet during pregnancy on birth weight differ by ethnicity? A dietary pattern analysis from a prospective Canadian birth cohort alliance.

PubMed

Zulyniak, Michael A; de Souza, Russell J; Shaikh, Mateen; Desai, Dipika; Lefebvre, Diana L; Gupta, Milan; Wilson, Julie; Wahi, Gita; Subbarao, Padmaja; Becker, Allan B; Mandhane, Piush; Turvey, Stuart E; Beyene, Joseph; Atkinson, Stephanie; Morrison, Katherine M; McDonald, Sarah; Teo, Koon K; Sears, Malcolm R; Anand, Sonia S

2017-11-14

Birth weight is an indicator of newborn health and a strong predictor of health outcomes in later life. Significant variation in diet during pregnancy between ethnic groups in high-income countries provides an ideal opportunity to investigate the influence of maternal diet on birth weight. Four multiethnic birth cohorts based in Canada (the NutriGen Alliance). 3997 full-term mother-infant pairs of diverse ethnic groups who had principal component analysis-derived diet pattern scores-plant-based, Western and health-conscious-and birth weight data. No associations were identified between the Western and health-conscious diet patterns and birth weight; however, the plant-based dietary pattern was inversely associated with birth weight (β=-67.6 g per 1-unit increase; P<0.001), and an interaction with non-white ethnicity and birth weight was observed. Ethnically stratified analyses demonstrated that among white Europeans, maternal consumption of a plant-based diet associated with lower birth weight (β=-65.9 g per 1-unit increase; P<0.001), increased risk of small-for-gestational age (SGA; OR=1.46; 95% CI 1.08 to 1.54;P=0.005) and reduced risk of large-for-gestational age (LGA; OR=0.71; 95% CI 0.53 to 0.95;P=0.02). Among South Asians, maternal consumption of a plant-based diet associated with a higher birth weight (β=+40.5 g per 1-unit increase; P=0.01), partially explained by cooked vegetable consumption. Maternal consumption of a plant-based diet during pregnancy is associated with birth weight. Among white Europeans, a plant-based diet is associated with lower birth weight, reduced odds of an infant born LGA and increased odds of SGA, whereas among South Asians living in Canada, a plant-based diet is associated with increased birth weight. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A population-level analysis of birth weight indices in Peel Region, Ontario: the impact of ethnic diversity.

PubMed

Ramuscak, Nancy L; Jiang, Depeng; Dooling, Kathleen L; Mowat, David L

2012-07-18

The purpose of this paper is to examine whether the elevated rate of low birth weight (LBW) in the Region of Peel, Ontario can be attributed to the high proportion of immigrants in the population. In addition, we examined how the infant birth weight distribution in Peel differs by maternal region of birth. Provincial live birth registration data were used to compare rates of LBW, preterm birth and small-for-gestational-age (SGA) births in Peel and Ontario for the years 2002 through 2006 by maternal region of birth. Birth weight for gestational age curves were developed for singletons and were specific for infant sex and maternal region of birth using the lambda-mu-sigma (LMS) method. Quantile regression was used to examine whether the median birth weight at term (37 to 42 weeks) differed by maternal region of birth. The rate of LBW was higher in Peel than in Ontario (6.8% and 6.0%, respectively). This is the result of a higher SGA rate and not due to differences in rates of preterm birth. Infants of immigrant mothers had significantly lower median birth weights at all gestations, showing that the birth weight distribution among infants of immigrant mothers is shifted towards lower birth weights. At the population level, the shifted birth weight distribution among singleton infants of immigrant mothers has significant impact on the LBW rate observed in Peel.

[Joint effect of birth weight and obesity measures on abnormal glucose metabolism at adulthood].

PubMed

Xi, Bo; Cheng, Hong; Chen, Fangfang; Zhao, Xiaoyuan; Mi, Jie

2016-01-01

To investigate the joint effect of birth weight and each of obesity measures (body mass index (BMI) and waist circumference (WC)) on abnormal glucose metabolism (including diabetes) at adulthood. Using the historical cohort study design and the convenience sampling method, 1 921 infants who were born in Beijing Union Medical College Hospital from June 1948 to December 1954 were selected to do the follow-up in 1995 and 2001 respectively. Through Beijing Household Registration and Management System, they were invited to participate in this study. A total of 972 subjects (627 were followed up in 1995 and 345 were followed up in 2001) with complete information on genders, age, birth weight, family history of diabetes, BMI, WC, fasting plasma glucose (FPG) and 2-hour plasma glucose (2 h PG) met the study inclusion criteria at the follow-up visits. In the data analysis, they were divided into low, normal, and high birth weight, respectively. The ANOVA and Chi-squared tests were used to compare the differences in their characteristics by birth weight group. In addition, multiple binary Logistic regression model was used to investigate the single effect of birth weight, BMI, and waist circumference on abnormal glucose metabolism at adulthood. Stratification analysis was used to investigate the joint effect of birth weight and each of obesity measures (BMI and WC) on abnormal glucose metabolism. There were 972 subjects (males: 50.7%, mean age: (46.0±2.2) years) included in the final data analysis. The 2 h PG in low birth weight group was (7.6±3.2) mmol/L , which was higher than that in normal birth weight group (6.9±2.1) mmol/L and high birth weight group (6.4±1.3) mmol/L (F=3.88, P=0.021). After adjustment for genders, age, body length, gestation age, family history of diabetes, physical activity, smoking and alcohol consumption, and duration of follow-up, subjects with overweight and obesity at adulthood had 2.73 (95% confidence interval (CI) =2.06- 3.62) times risk to develop abnormal glucose metabolism when compared with norm weight ones. Likewise, subjects with central obesity were more likely to develop abnormal glucose metabolism than ones with normal waist (odds ratio (OR)=3.35, 95%CI=2.49-4.50). In addition, compared to subjects with normal birth weight and normal BMI at adulthood, ones with normal birth weight and overweight (including obesity) at adulthood were more likely to have abnormal glucose metabolism (OR= 2.60, 95%CI=1.94-3.49); subjects with low birth weight and overweight (including obesity) at adulthood had the highest risk for abnormal glucose metabolism (OR=4.70, 95% CI=1.84- 11.99). The attributable proportion of interaction between low birth weight and overweight (including obesity) at adulthood was 48.5%. In addition, compared to subjects with normal birth weight and normal WC at adulthood, one with normal birth weight and central obesity at adulthood were more likely to have abnormal glucose metabolism (OR=3.18, 95% CI=2.33- 4.32); subjects with low birth weight and central obesity at adulthood had the highest risk for abnormal glucose metabolism (OR=4.78, 95% CI=2.01- 11.38); subjects with high birth weight and central at adulthood also had high risk for abnormal glucose metabolism (OR=4.35, 95%CI=1.38- 13.65). We found that the attributable proportion of interaction between low birth weight and central obesity at adulthood was 38.5% , and was 28.3% for interaction between high weight and central obesity. There was strong interaction effect between birth weight and overweight (especially central obesity) at adulthood on abnormal glucose metabolism at adulthood. Effective measures should be adopted to prevent and control adult obesity in order to offset the adverse effect of birth weight on long-term health risk.

Maternal education, birth weight, and infant mortality in the United States.

PubMed

Gage, Timothy B; Fang, Fu; O'Neill, Erin; Dirienzo, Greg

2013-04-01

This research determines whether the observed decline in infant mortality with socioeconomic level, operationalized as maternal education (dichotomized as college or more, versus high school or less), is due to its "indirect" effect (operating through birth weight) and/or to its "direct" effect (independent of birth weight). The data used are the 2001 U.S. national African American, Mexican American, and European American birth cohorts by sex. The analysis explores the birth outcomes of infants undergoing normal and compromised fetal development separately by using covariate density defined mixture of logistic regressions (CDDmlr). Among normal births, mean birth weight increases significantly (by 27-108 g) with higher maternal education. Mortality declines significantly (by a factor of 0.40-0.96) through the direct effect of education. The indirect effect of education among normal births is small but significant in three cohorts. Furthermore, the indirect effect of maternal education tends to increase mortality despite improved birth weight. Among compromised births, education has small and inconsistent effects on birth weight and infant mortality. Overall, our results are consistent with the view that the decrease in infant death by socioeconomic level is not mediated by improved birth weight. Interventions targeting birth weight may not result in lower infant mortality.

Use of birth weight threshold for macrosomia to identify fetuses at risk of shoulder dystocia among Chinese populations.

PubMed

Cheng, Yvonne K-Y; Lao, Terence T; Sahota, Daljit S; Leung, Viola K-T; Leung, Tak Y

2013-03-01

To assess the incidence of macrosomia and the influence of birth weight on shoulder dystocia risk among a cohort of Chinese women. A retrospective analysis was conducted of 80953 singleton deliveries recorded at the Prince of Wales Hospital, Hong Kong, between 1995 and 2009. The incidences of macrosomia (birth weight ≥ 4000 g) and shoulder dystocia were assessed by birth weight; risk factors for shoulder dystocia were examined by multiple logistic regression analysis. The incidence of macrosomia was 3.4%. The overall incidence of shoulder dystocia was 0.3%; however, the incidence rose with increasing birth weight. The odds ratio (OR) for a birth weight of 4000-4199 g was 22.40, while the OR for a birth weight of 4200 g or above was 76.10. Other independent risk factors for shoulder dystocia included instrumental delivery (OR 12.11), short stature (OR 2.16), maternal diabetes mellitus (OR 1.78), and obesity (OR 1.58). Although the overall incidences of macrosomia and shoulder dystocia were low, the risk of shoulder dystocia was strongly linked to increasing birth weight. International guidelines for elective cesarean delivery in suspected cases of macrosomia may not, therefore, apply to Chinese women. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

A hospital-based birth weight analysis using computerized perinatal data base for a Chinese population.

PubMed

Fu, Jing; Yu, Mei

2011-04-01

We aimed to construct birth weight-for-gestational age nomograms based on a computerized perinatal data base in a hospital-based Chinese population. Retrospectively collected 28,052 singleton deliveries at Women and Children's Medical Center, Guangzhou, China. Standard curves of birth weight from 27 to 43 week's gestation were computed. The nomograms included the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles and standard deviations. 79.9% pregnant women delivered between 38, 39, and 40 gestational week, and the mean birth weights are 3160, 3282, and 3388 g, respectively. Preterm birth is 5.7%. In general, male birth weights are greater than females at each gestational week. The hospital-based Chinese population birth weight is lower than that of North American and Scandinavian population. A different standard birth weight is needed for different population. A hospital-based birth weight curve by gestational week is established, which can be a useful tool to estimate intrauterine fetal growth to define SGA or LGA fetuses.

Residential proximity to major roads and placenta/birth weight ratio.

PubMed

Yorifuji, Takashi; Naruse, Hiroo; Kashima, Saori; Murakoshi, Takeshi; Tsuda, Toshihide; Doi, Hiroyuki; Kawachi, Ichiro

2012-01-01

Exposure to air pollution has been demonstrated to increase the risk of preterm birth and low birth weight. We examined whether proximity to major roads (as a marker of exposure to air pollution) is associated with increased placenta/birth weight ratio (as a biomarker of the placental transport function). Data on parental characteristics and birth outcomes were extracted from the database maintained by a major hospital in Shizuoka Prefecture, Japan. We restricted the analysis to mothers who delivered liveborn single births from 1997 to 2008 (n = 14,189). Using geocoded residential information, each birth was classified according to proximity to major roads. We examined the association between proximity to major roads and the placenta/birth weight ratio, using multiple linear regression. Proximity to major roads was associated with higher placenta/birth weight ratio. After adjusting for potential confounders, living within 200 m of a major road increased the ratio by 0.48% (95% CI = 0.15 to 0. 80). In addition, proximity to major roads was associated with lower placenta weight and birth weight. These observed associations were stronger among participants living closer to major roads. Exposure to traffic-related air pollution is associated with higher placenta/birth weight ratio. Impaired placental oxygen and nutrient transport function might be a mechanism for explaining the observed association between air pollution and low birth weight as well as preterm birth. Copyright © 2011 Elsevier B.V. All rights reserved.

Associations of Perfluoroalkyl Substances (PFAS) with Lower Birth Weight: An Evaluation of Potential Confounding by Glomerular Filtration Rate Using a Physiologically Based Pharmacokinetic Model (PBPK).

PubMed

Verner, Marc-André; Loccisano, Anne E; Morken, Nils-Halvdan; Yoon, Miyoung; Wu, Huali; McDougall, Robin; Maisonet, Mildred; Marcus, Michele; Kishi, Reiko; Miyashita, Chihiro; Chen, Mei-Huei; Hsieh, Wu-Shiun; Andersen, Melvin E; Clewell, Harvey J; Longnecker, Matthew P

2015-12-01

Prenatal exposure to perfluoroalkyl substances (PFAS) has been associated with lower birth weight in epidemiologic studies. This association could be attributable to glomerular filtration rate (GFR), which is related to PFAS concentration and birth weight. We used a physiologically based pharmacokinetic (PBPK) model of pregnancy to assess how much of the PFAS-birth weight association observed in epidemiologic studies might be attributable to GFR. We modified a PBPK model to reflect the association of GFR with birth weight (estimated from three studies of GFR and birth weight) and used it to simulate PFAS concentrations in maternal and cord plasma. The model was run 250,000 times, with variation in parameters, to simulate a population. Simulated data were analyzed to evaluate the association between PFAS levels and birth weight due to GFR. We compared simulated estimates with those from a meta-analysis of epidemiologic data. The reduction in birth weight for each 1-ng/mL increase in simulated cord plasma for perfluorooctane sulfonate (PFOS) was 2.72 g (95% CI: -3.40, -2.04), and for perfluorooctanoic acid (PFOA) was 7.13 g (95% CI: -8.46, -5.80); results based on maternal plasma at term were similar. Results were sensitive to variations in PFAS level distributions and the strength of the GFR-birth weight association. In comparison, our meta-analysis of epidemiologic studies suggested that each 1-ng/mL increase in prenatal PFOS and PFOA levels was associated with 5.00 g (95% CI: -21.66, -7.78) and 14.72 g (95% CI: -8.92, -1.09) reductions in birth weight, respectively. Results of our simulations suggest that a substantial proportion of the association between prenatal PFAS and birth weight may be attributable to confounding by GFR and that confounding by GFR may be more important in studies with sample collection later in pregnancy.

Investigation of Metronidazole Use during Pregnancy and Adverse Birth Outcomes

PubMed Central

Koss, Catherine A.; Baras, Dana C.; Lane, Sandra D.; Aubry, Richard; Marcus, Michele; Markowitz, Lauri E.

2012-01-01

To assess whether treatment with metronidazole during pregnancy is associated with preterm birth, low birth weight, or major congenital anomalies, we conducted chart reviews and an analysis of electronic data from a cohort of women delivering at an urban New York State hospital. Of 2,829 singleton/mother pairs, 922 (32.6%) mothers were treated with metronidazole for clinical indications, 348 (12.3%) during the first trimester of pregnancy and 553 (19.5%) in the second or third trimester. There were 333 (11.8%) preterm births, 262 (9.3%) infants of low birth weight, and 52 infants (1.8%) with congenital anomalies. In multivariable analysis, no association was found between metronidazole treatment and preterm birth (odds ratio [OR], 1.02 [95% confidence interval [CI], 0.80 to 1.32]), low birth weight (OR, 1.05 [95% CI, 0.77 to 1.43]), or treatment in the first trimester and congenital anomalies (OR, 0.86 [0.30 to 2.45]). We found no association between metronidazole treatment during the first or later trimesters of pregnancy and preterm birth, low birth weight, or congenital anomalies. PMID:22751543

Young adults with very low birth weight: leaving the parental home and sexual relationships--Helsinki Study of Very Low Birth Weight Adults.

PubMed

Kajantie, Eero; Hovi, Petteri; Räikkönen, Katri; Pesonen, Anu-Katriina; Heinonen, Kati; Järvenpää, Anna-Liisa; Eriksson, Johan G; Strang-Karlsson, Sonja; Andersson, Sture

2008-07-01

Although most children and adults who are born very preterm live healthy lives, they have, on average, lower cognitive scores, more internalizing behaviors, and deficits in social skills. This could well affect their transition to adulthood. We studied the tempo of first leaving the parental home and starting cohabitation with an intimate partner and sexual experience of young adults with very low birth weight (<1500 g). In conjunction with the Helsinki Study of Very Low Birth Weight Adults, 162 very low birth weight individuals and 188 individuals who were born at term (mean age: 22.3 years [range: 18.5-27.1]) and did not have any major disability filled out a questionnaire. For analysis of their ages at events which had not occurred in all subjects, we used survival analysis (Cox regression), adjusted for gender, current height, parents' ages at the birth, maternal smoking during pregnancy, parental educational attainment, number of siblings, and parental divorce/death. During their late teens and early adulthood, these very low birth weight adults were less likely to leave the parental home and to start cohabiting with an intimate partner. In gender-stratified analyses, these hazard ratios were similar between genders, but the latter was statistically significant for women only. These very low birth weight adults were also less likely to experience sexual intercourse. This relationship was statistically significant for women but not for men; however, very low birth weight women and men both reported a smaller lifetime number of sex partners than did control subjects. Healthy young adults with very low birth weight show a delay in leaving the parental home and starting sexual activity and partnerships.

Persistence of lower birth weight in second generation South Asian babies born in the United Kingdom

PubMed Central

Margetts, B; Mohd, Y; Al, D; Jackson, A

2002-01-01

Objective: To assess differences in birth weight between all first and second generation South Asian babies born in Southampton, and trends since 1957. Design: Retrospective, cohort study. Setting: Birth records for babies born in Southampton from 1957 to 1996 were searched to identify all babies born of South Asian origin (including from the Indian subcontinent, East Africa, and elsewhere). Main outcome measures: All information recorded in the birth record about the mother and baby was extracted. Results: 2395 full term (>37 weeks; mean birth weight 3110; 95%CI 3092 to 3129) singleton births were identified. Detailed analysis was restricted to mothers either born in the Indian subcontinent (India, Pakistan, or Bangladesh (1435)) or United Kingdom (283). Mean birth weight and % low birth weight (<2500 g) were 3133 g (95%CI 3108 to 3157) and 7.5%, for first generation babies and 3046 g (2992 to 3099) and 11.7% for second generation babies. There was no trend over time to increased average birth weight in either first or second generation babies. Adjusting for other factors that were statistically significantly related to birth weight (gender, gestational age, mother's age, maternal weight at 15 weeks, parity, and mother's ethnic group) did not alter the trends. Conclusions: For that group in the UK who derive from the Indian subcontinent, average birth weight is significantly less than the national average. There has not been any increase in the average birth weight over the past 40 years, and the birth weight of babies of women who were born in the UK are no greater. The persistence of lower than desirable birth weight may result long term in higher than average rates of diabetes and heart disease in these groups. PMID:12177085

Persistence of lower birth weight in second generation South Asian babies born in the United Kingdom.

PubMed

Margetts, B M; Mohd Yusof, S; Al Dallal, Z; Jackson, A A

2002-09-01

To assess differences in birth weight between all first and second generation South Asian babies born in Southampton, and trends since 1957. Retrospective, cohort study. Birth records for babies born in Southampton from 1957 to 1996 were searched to identify all babies born of South Asian origin (including from the Indian subcontinent, East Africa, and elsewhere). All information recorded in the birth record about the mother and baby was extracted. 2395 full term (>37 weeks; mean birth weight 3110; 95%CI 3092 to 3129) singleton births were identified. Detailed analysis was restricted to mothers either born in the Indian subcontinent (India, Pakistan, or Bangladesh (1435)) or United Kingdom (283). Mean birth weight and % low birth weight (<2500 g) were 3133 g (95%CI 3108 to 3157) and 7.5%, for first generation babies and 3046 g (2992 to 3099) and 11.7% for second generation babies. There was no trend over time to increased average birth weight in either first or second generation babies. Adjusting for other factors that were statistically significantly related to birth weight (gender, gestational age, mother's age, maternal weight at 15 weeks, parity, and mother's ethnic group) did not alter the trends. For that group in the UK who derive from the Indian subcontinent, average birth weight is significantly less than the national average. There has not been any increase in the average birth weight over the past 40 years, and the birth weight of babies of women who were born in the UK are no greater. The persistence of lower than desirable birth weight may result long term in higher than average rates of diabetes and heart disease in these groups.

Cooking fuel choices and garbage burning practices as determinants of birth weight: a cross-sectional study in Accra, Ghana

PubMed Central

2012-01-01

Background Effect of indoor air pollution (IAP) on birth weight remains largely unexplored but yet purported as the most important environmental exposure for pregnant women in developing countries due to the effects of second-hand smoke. We investigated the associations between the determinants of indoor air quality in households and birth weight. Methods A cross-sectional study of 592 mothers and their newborns using postnatal services at the Korle Bu Teaching Hospital located in Accra, Ghana was conducted in 2010 to collect information on characteristics of indoor environment and other potential determinants of fetal growth. Birth weight was recorded from hospital records. Results Household cooking fuel choices and garbage burning practices were determinants of birth weight. Multivariate linear regression analysis adjusting for age, social class, marital status and gravidity of mothers, and sex of neonate resulted in a 243g (95% CI: 496, 11) and 178g (95% CI: 421, 65) reduction in birth weight for use of charcoal, and garbage burning respectively compared with use of LPG only. The estimated reductions in birth weight was not statistically significant. Applying the ordinal scale exposure parameter nonetheless revealed a significant exposure-response relationship between maternal exposures from charcoal use and garbage burning, and birth weight. Generalized linear models adjusting for confounders resulted in a 41% (risk ratio [RR] = 1.41; 95% CI: 0.62, 3.23) and 195% (RR=2.95; 95% CI: 1.10, 7.92) increase in the risk of low birth weight (LBW) for use of charcoal, and garbage burning respectively compared with use of LPG only. A combination of charcoal use and household garbage burning during pregnancy on fetal growth resulted in a 429g (95% CI: 259, 599) reduction in birth weight and 316% (RR=4.16; 95% CI: 2.02, 8.59) excess risk of LBW. Sensitivity analysis performed by restricting the analysis to term births produced similar results. Conclusions Maternal use of charcoal as a cooking fuel during pregnancy and burning of garbage at home are strong determinants of average fetal growth and risk of LBW. Efforts to reduce maternal exposures to IAP are thus important to improve birth outcomes. PMID:23075225

Birth weight centiles by gestational age for twins born in south India.

PubMed

Premkumar, Prasanna; Antonisamy, Belavendra; Mathews, Jiji; Benjamin, Santhosh; Regi, Annie; Jose, Ruby; Kuruvilla, Anil; Mathai, Mathews

2016-03-24

Birth weight centile curves are commonly used as a screening tool and to assess the position of a newborn on a given reference distribution. Birth weight of twins are known to be less than those of comparable singletons and twin-specific birth weight centile curves are recommended for use. In this study, we aim to construct gestational age specific birth weight centile curves for twins born in south India. The study was conducted at the Christian Medical College, Vellore, south India. The birth records of all consecutive pregnancies resulting in twin births between 1991 and 2005 were reviewed. Only live twin births between 24 and 42 weeks of gestation were included. Birth weight centiles for gestational age were obtained using the methodology of generalized additive models for location, scale and shape (GAMLSS). Centiles curves were obtained separately for monochorionic and dichorionic twins. Of 1530 twin pregnancies delivered during the study period (1991-2005), 1304 were included in the analysis. The median gestational age at birth was 36 weeks (1st quartile 34, 3rd quartile 38 weeks). Smoothed percentile curves for birth weight by gestational age increased progressively till 38 weeks and levels off thereafter. Compared with dichorionic twins, monochorionic twins had lower birth weight for gestational age from after 27 weeks. We provide centile values of birth weight at 24 to 42 completed weeks of gestation for twins born in south India. These charts could be used both in routine clinical assessments and epidemiological studies.

The association of neighborhood social capital and ethnic (minority) density with pregnancy outcomes in the Netherlands.

PubMed

Schölmerich, Vera L N; Erdem, Özcan; Borsboom, Gerard; Ghorashi, Halleh; Groenewegen, Peter; Steegers, Eric A P; Kawachi, Ichiro; Denktaş, Semiha

2014-01-01

Perinatal morbidity rates are relatively high in the Netherlands, and significant inequalities in perinatal morbidity and mortality can be found across neighborhoods. In socioeconomically deprived areas, 'Western' women are particularly at risk for adverse birth outcomes. Almost all studies to date have explained the disparities in terms of individual determinants of birth outcomes. This study examines the influence of neighborhood contextual characteristics on birth weight (adjusted for gestational age) and preterm birth. We focused on the influence of neighborhood social capital--measured as informal socializing and social connections between neighbors--as well as ethnic (minority) density. Data on birth weight and prematurity were obtained from the Perinatal Registration Netherlands 2000-2008 dataset, containing 97% of all pregnancies. Neighborhood-level measurements were obtained from three different sources, comprising both survey and registration data. We included 3.422 neighborhoods and 1.527.565 pregnancies for the birth weight analysis and 1.549.285 pregnancies for the premature birth analysis. Linear and logistic multilevel regression was performed to assess the associations of individual and neighborhood level variables with birth weight and preterm birth. We found modest but significant neighborhood effects on birth weight and preterm births. The effect of ethnic (minority) density was stronger than that of neighborhood social capital. Moreover, ethnic (minority) density was associated with higher birth weight for infants of non-Western ethnic minority women compared to Western women (15 grams; 95% CI: 12,4/17,5) as well as reduced risk for prematurity (OR 0.97; CI 0,95/0,99). Our results indicate that neighborhood contexts are associated with birth weight and preterm birth in the Netherlands. Moreover, ethnic (minority) density seems to be a protective factor for non-Western ethnic minority women, but not for Western women. This helps explain the increased risk of Western women in deprived neighborhoods for adverse birth outcomes found in previous studies.

The Association of Neighborhood Social Capital and Ethnic (Minority) Density with Pregnancy Outcomes in the Netherlands

PubMed Central

Schölmerich, Vera L. N.; Erdem, Özcan; Borsboom, Gerard; Ghorashi, Halleh; Groenewegen, Peter; Steegers, Eric A. P.; Kawachi, Ichiro; Denktaş, Semiha

2014-01-01

Background Perinatal morbidity rates are relatively high in the Netherlands, and significant inequalities in perinatal morbidity and mortality can be found across neighborhoods. In socioeconomically deprived areas, ‘Western’ women are particularly at risk for adverse birth outcomes. Almost all studies to date have explained the disparities in terms of individual determinants of birth outcomes. This study examines the influence of neighborhood contextual characteristics on birth weight (adjusted for gestational age) and preterm birth. We focused on the influence of neighborhood social capital – measured as informal socializing and social connections between neighbors – as well as ethnic (minority) density. Methods Data on birth weight and prematurity were obtained from the Perinatal Registration Netherlands 2000–2008 dataset, containing 97% of all pregnancies. Neighborhood-level measurements were obtained from three different sources, comprising both survey and registration data. We included 3.422 neighborhoods and 1.527.565 pregnancies for the birth weight analysis and 1.549.285 pregnancies for the premature birth analysis. Linear and logistic multilevel regression was performed to assess the associations of individual and neighborhood level variables with birth weight and preterm birth. Results We found modest but significant neighborhood effects on birth weight and preterm births. The effect of ethnic (minority) density was stronger than that of neighborhood social capital. Moreover, ethnic (minority) density was associated with higher birth weight for infants of non-Western ethnic minority women compared to Western women (15 grams; 95% CI: 12,4/17,5) as well as reduced risk for prematurity (OR 0.97; CI 0,95/0,99). Conclusions Our results indicate that neighborhood contexts are associated with birth weight and preterm birth in the Netherlands. Moreover, ethnic (minority) density seems to be a protective factor for non-Western ethnic minority women, but not for Western women. This helps explain the increased risk of Western women in deprived neighborhoods for adverse birth outcomes found in previous studies. PMID:24806505

Are Birth Weight, Early Growth, and Motor Development Determinants of Physical Activity in Children and Youth? A Systematic Review and Meta-Analysis.

PubMed

Øglund, Guro Pauck; Hildebrand, Maria; Ekelund, Ulf

2015-11-01

The purpose of this systematic review was to explore whether birth weight, early growth and motor development act as determinants of physical activity in children and youth. We performed a systematic literature search on the possible early life determinants. A meta-analysis was performed on the association between birthweight and objectively measured physical activity. We identified 9 studies examining birth weight, in which none of the studies with objectively measured physical activity observed an association between birth weight and physical activity. The meta-analysis confirmed this result (b=-3.08, 95% CI -10.20, 4.04). The 3 studies examining early growth and physical activity in youth differ in methodology and the results are inconsistent. Two studies suggest an association between earlier motor development and physical activity and sport participation in youth. This was not confirmed in a third study. Our meta-analysis suggests that birth weight is not an important determinant of physical activity in youth. Available data does not allow firm conclusions whether early growth and motor development act as determinants of physical activity in youth.

Birth Weight by Gestational Age for 76,710 Twins Born in the United States as a Result of In Vitro Fertilization: 2006 to 2010.

PubMed

Dickey, Richard P; Pridjian, Gabriella; Xiong, Xu; Klempel, Monica C

2017-01-01

Objective  The objective of this study was to establish twin-specific birth weight percentiles by gestational age using U.S. twin births resulting from in vitro fertilization (IVF). Study Design  A retrospective analysis of birth weight by completed weeks of gestation for 76,710 twin IVF births reported to the Society for Assisted Reproductive Technologies from 2006 to 2010. Mean and median birth weights and 3rd, 5th, 10th, 25th, 50th, 75th, 90th, and 97th percentiles were calculated by completed week of gestation and infant sex. Results  IVF twin birth weight accelerates until term and then declines. The deceleration in twin birth weight occurs at 39 completed weeks of gestation for larger twins, those at or above the 50th percentile in weight. For smaller twins, the growth deceleration occurs earlier, at 38 weeks of gestation. IVF female and male twin birth weights for gestational age were similar to all IVF twins, showing similar decelerations near term. Conclusion  Using U.S. IVF twin-specific growth charts, with known date of conception, twins demonstrate a deceleration in birth weight near term. Larger twins demonstrate a deceleration in birth weight by 39 completed weeks of gestation; smaller twins show a deceleration at 38 weeks. These data may assist in the clinical management of twins near term. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis.

PubMed

Haider, Batool A; Olofin, Ibironke; Wang, Molin; Spiegelman, Donna; Ezzati, Majid; Fawzi, Wafaie W

2013-06-21

To summarise evidence on the associations of maternal anaemia and prenatal iron use with maternal haematological and adverse pregnancy outcomes; and to evaluate potential exposure-response relations of dose of iron, duration of use, and haemoglobin concentration in prenatal period with pregnancy outcomes. Systematic review and meta-analysis Searches of PubMed and Embase for studies published up to May 2012 and references of review articles. Randomised trials of prenatal iron use and prospective cohort studies of prenatal anaemia; cross sectional and case-control studies were excluded. 48 randomised trials (17 793 women) and 44 cohort studies (1 851 682 women) were included. Iron use increased maternal mean haemoglobin concentration by 4.59 (95% confidence interval 3.72 to 5.46) g/L compared with controls and significantly reduced the risk of anaemia (relative risk 0.50, 0.42 to 0.59), iron deficiency (0.59, 0.46 to 0.79), iron deficiency anaemia (0.40, 0.26 to 0.60), and low birth weight (0.81, 0.71 to 0.93). The effect of iron on preterm birth was not significant (relative risk 0.84, 0.68 to 1.03). Analysis of cohort studies showed a significantly higher risk of low birth weight (adjusted odds ratio 1.29, 1.09 to 1.53) and preterm birth (1.21, 1.13 to 1.30) with anaemia in the first or second trimester. Exposure-response analysis indicated that for every 10 mg increase in iron dose/day, up to 66 mg/day, the relative risk of maternal anaemia was 0.88 (0.84 to 0.92) (P for linear trend<0.001). Birth weight increased by 15.1 (6.0 to 24.2) g (P for linear trend=0.005) and risk of low birth weight decreased by 3% (relative risk 0.97, 0.95 to 0.98) for every 10 mg increase in dose/day (P for linear trend<0.001). Duration of use was not significantly associated with the outcomes after adjustment for dose. Furthermore, for each 1 g/L increase in mean haemoglobin, birth weight increased by 14.0 (6.8 to 21.8) g (P for linear trend=0.002); however, mean haemoglobin was not associated with the risk of low birth weight and preterm birth. No evidence of a significant effect on duration of gestation, small for gestational age births, and birth length was noted. Daily prenatal use of iron substantially improved birth weight in a linear dose-response fashion, probably leading to a reduction in risk of low birth weight. An improvement in prenatal mean haemoglobin concentration linearly increased birth weight.

Mid-gestational serum uric acid concentration effect on neonate birth weight and insulin resistance in pregnant women.

PubMed

Nasri, Khadijeh; Razavi, Maryamsadat; Rezvanfar, Mohammad Reza; Mashhadi, Esmat; Chehrei, Ali; Mohammadbeigi, Abolfazl

2015-01-01

To investigate the relationship between mid-gestational serum uric acid and birth weight in diabetic pregnant women with or without insulin resistance. In a prospective cohort study, fasting uric acid, blood glucose, and serum insulin were measured in 247 pregnant women between 20-22 weeks of gestational period. Insulin resistance was estimated using the homeostasis model assessment-insulin resistance (HOMA-IR). Stratification analysis and independent t-test was used to assess the association between uric acid and birth weights regarding to insulin resistance. The means of the mid-gestational serum uric acid concentrations were not significantly different in women with and without insulin resistance. But stratification analysis showed that there was a significant difference between uric acid concentration and macrosomic birth in diabetic women without insulin resistance. Higher mid - gestation serum uric acid concentration, even if it does not exceed the normal range, is accompanied by lower birth weight only in non-insulin resistance women. Insulin resistance could have a negative confounding effect on hyperuriemia and birth weight.

Coronary Artery Disease: A Study on the Joint Role of Birth Weight, Adenosine Deaminase, and Gender

PubMed Central

Gloria-Bottini, F.; Banci, M.; Saccucci, P.; Lucarini, N.; Ianniello, F.; Paradisi, G.; Magrini, A.; Bottini, E.

2009-01-01

An inverse relationship between birth weight and coronary artery diseases is well documented but it remains unclear which exposure in early life might underlie such association. Recently it has been reported an association between adenosine deaminase genetic polymorphism and coronary artery diseases. Gender differences in the degree of this association have been also observed. These observations prompted us to study the possible joint effects of BW, ADA, and gender on the susceptibility to coronary artery diseases. 222 subjects admitted to hospital for nonfatal coronary artery diseases, and 762 healthy consecutive newborns were studied. ADA genotypes were determined by DNA analysis. A highly significant complex relationship has emerged among ADA, birth weight, and gender concerning their role on susceptibility to coronary artery diseases in adult life. Odds ratio analysis suggests that low birth weight is more important in females than in males. ADA∗2 allele appears protective in males, while in females such effect is obscured by birth weight. PMID:20428226

Spatial distribution of low birthweight infants in Taubaté, São Paulo, Brazil

PubMed Central

Nascimento, Luiz Fernando C.; Costa, Thais Moreira; Zöllner, Maria Stella A. da C.

2013-01-01

OBJECTIVE: To identify the spatial pattern of low birth weight infants in the city of Taubaté, São Paulo, Southeast Brazil. METHODS: Ecological and exploratory study, developed with the data acquired from the Health Department of Taubaté, regarding the period from January 1st 2006 and December 31st 2010. Birth certificates were used to obtain the data from infants weighing less than 2500g. A digital basis of census tracts was applied and the Global Moran index (IM) was estimated. Thematic maps were built for the distribution of low birth weight, health centers and tracts, according to the priority care (Moran map). The adopted statistical significance was α=5% and TerraView software conducted the spatial analysis. RESULTS: There were 18,915 live births during the study period, with 1,817 low birth weight infants (9.6%). The low birth weight infants' prevalence during the period ranged from 9.3 to 9.8%. A total of 1,185 infants with known addresses, compatible with the digital base (65.2% of low birth weight infants), were included. The IM for low birth weight was 0.12, with p<0.01; regarding the health centers distribution, IM was -0.07, with p=0.01. The Moran map identified 11 census tracts with high priority for intervention by health managers, located in the outskirts of the city. CONCLUSIONS: The spatial analysis identified the low birth weight distribution by census tracts and the sectors with a high priority for intervention. PMID:24473951

Health behaviors as mediators for the effect of partner abuse on infant birth weight.

PubMed

Kearney, Margaret H; Munro, Barbara Hazard; Kelly, Ursula; Hawkins, Joellen W

2004-01-01

Intimate partner abuse of pregnant women has been linked to the delivery of low-birth-weight infants. Also, abused pregnant women have reported a greater prevalence of substance abuse, poor nutrition, and demographic risk factors for poor birth outcomes. These factors may play a role in the reported relation between intimate partner violence and birth weight. To explore the role of substance abuse (smoking, alcohol, and drug use) and weight gain of less than 15 pounds during pregnancy as potential mediators of the relation between recent partner abuse and infant birth weight, and to investigate the role of demographic risk factors as potential moderators for the impact of abuse on birth weight. Data were extracted on abuse screening results, demographics, birth outcomes, and a range of medical and obstetric risks and complications from the medical records of 1969 women who had been screened by clinicians for domestic abuse during pregnancy. Hypotheses were tested using multiple regression analysis. Recent physical or psychological abuse had a small but significant effect on birth weight in this sample. Smoking and low weight gain were weak but significant mediators of the relation between recent abuse and infant birth weight. Single marital status was the strongest demographic predictor of decreased birth weight. No moderator effects were found. Although prospective studies are warranted, nursing care to reduce smoking and promote adequate weight gain in all women along with support for women's efforts to seek safety from abuse may help to improve birth outcomes and promote maternal well-being.

Periodontal treatment during pregnancy and birth outcomes: a meta-analysis of randomised trials.

PubMed

George, Ajesh; Shamim, Simin; Johnson, Maree; Ajwani, Shilpi; Bhole, Sameer; Blinkhorn, Anthony; Ellis, Sharon; Andrews, Karen

2011-06-01

The objective of this review was to conduct a meta-analysis of all up-to-date randomised control trials to determine whether periodontal treatment during pregnancy has the potential of reducing preterm birth and low birth weight incidence. Bibliographic databases MEDLINE (1966-present), EMBASE (1980-present), CINAHL (1982-present) and the Cochrane library up to and including 2010 Issue 10 were searched. The reference list of included studies and reviews were also searched for additional literature. Eligible studies were, published and ongoing randomised control trials that compared pregnancy outcomes for pregnant women who received periodontal treatment during the prenatal period. Two of the investigators independently assessed the studies and then extracted and summarised data from eligible trials. Extracted data were entered into Review Manager software and analysed. A total of 5645 pregnant women participated in the 10 eligible trials. Meta-analysis found that periodontal treatment significantly lowered preterm birth (odd ratio 0.65; 95% confidence interval, 0.45-0.93; P = 0.02) and low birth weight (odd ratio 0.53; 95% confidence interval, 0.31-0.92; P = 0.02) rates while no significant difference was found for spontaneous abortion/stillbirth (odd ratio 0.71; 95% confidence interval, 0.43-1.16; P = 0.17). Moderate heterogeneity was observed among the studies for preterm birth and low birth weight. Subgroup analysis showed significant effect of periodontal treatment in pregnant women with low rate of previous preterm birth/low birth weight (odd ratio 0.35; 95% confidence interval, 017-0.70; P = 0.003) and less severe periodontal disease (odd ratio 0.49; confidence interval, 028-0.87; P = 0.01) as defined by probing depth. The cumulative evidence suggests that periodontal treatment during pregnancy may reduce preterm birth and low birth weight incidence. However, these findings need to be further validated through larger more targeted randomised control trials. © 2011 The Authors. International Journal of Evidence-Based Healthcare © 2011 The Joanna Briggs Institute.

The Impact of Maternal Obesity and Excessive Gestational Weight Gain on Maternal and Infant Outcomes in Maine: Analysis of Pregnancy Risk Assessment Monitoring System Results from 2000 to 2010.

PubMed

Baugh, Nancy; Harris, David E; Aboueissa, AbouEl-Makarim; Sarton, Cheryl; Lichter, Erika

2016-01-01

The objective of this study is to understand the relationships between prepregnancy obesity and excessive gestational weight gain (GWG) and adverse maternal and fetal outcomes. Pregnancy risk assessment monitoring system (PRAMS) data from Maine for 2000-2010 were used to determine associations between demographic, socioeconomic, and health behavioral variables and maternal and infant outcomes. Multivariate logistic regression analysis was performed on the independent variables of age, race, smoking, previous live births, marital status, education, BMI, income, rurality, alcohol use, and GWG. Dependent variables included maternal hypertension, premature birth, birth weight, infant admission to the intensive care unit (ICU), and length of hospital stay of the infant. Excessive prepregnancy BMI and excessive GWG independently predicted maternal hypertension. A high prepregnancy BMI increased the risk of the infant being born prematurely, having a longer hospital stay, and having an excessive birth weight. Excessive GWG predicted a longer infant hospital stay and excessive birth weight. A low pregnancy BMI and a lower than recommended GWG were also associated with poor outcomes: prematurity, low birth weight, and an increased risk of the infant admitted to ICU. These findings support the importance of preconception care that promotes achievement of a healthy weight to enhance optimal reproductive outcomes.

Replication of a Genome-Wide Association Study of Birth Weight in Preterm Neonates

PubMed Central

Ryckman, Kelli K; Feenstra, Bjarke; Shaffer, John R.; Bream, Elise NA; Geller, Frank; Feingold, Eleanor; Weeks, Daniel E; Gadow, Enrique; Cosentino, Viviana; Saleme, Cesar; Simhan, Hyagriv N; Merrill, David; Fong, Chin-To; Busch, Tamara; Berends, Susan K; Comas, Belen; Camelo, Jorge L; Boyd, Heather; Laurie, Cathy; Crosslin, David; Zhang, Qi; Doheny, Kim F; Pugh, Elizabeth; Melbye, Mads; Marazita, Mary L; Dagle, John M; Murray, Jeffrey C

2011-01-01

Objective To examine associations in a preterm population between rs9883204 in ADCY5 and rs900400 near LEKR1 and CCNL1 with birth weight. Both markers were associated with birth weight in a term population in a recent genome-wide association (GWA) study by Freathy et al. Study design A meta-analysis of mother and infant samples was performed for associations of rs900400 and rs9883204 with birth weight in 393 families from the U.S., 265 families from Argentina and 735 mother-infant pairs from Denmark. Z scores adjusted for infant sex and gestational age were generated for each population separately and regressed on allele counts. Association evidence was combined across sites by inverse-variance weighted meta-analysis. Results Each additional C allele of rs900400 (LEKR1/CCNL1) in infants was marginally associated with a 0.069 standard deviation (SD) lower birth weight (95% CI = −0.159 – 0.022, P = 0.068). This result was slightly more pronounced after adjusting for smoking (P = 0.036). There were no significant associations identified with rs9883204 or in maternal samples. Conclusions These results indicate the potential importance of this marker on birth weight irrespective of gestational age. PMID:21885063

Low Birth Weight as a Predictor of Cardiovascular Risk Factors in Childhood and Adolescence? The PEP Family Heart Study

PubMed Central

Haas, Gerda-Maria; Liepold, Evelyn; Schwandt, Peter

2015-01-01

Background: Low birth weight is considered a risk factor for cardiovascular disease (CVD) in later life. Because data in children and adolescents are sparse and controversial, we assessed the association of birth weight with CVD risk factors in German youths. Methods: We categorized 843 urban children and adolescents aged 3-18 years by quintiles of birth weight and measured nine traditional risk factors in terms of body mass index (BMI), waist circumference (WC), systolic (SBP) and diastolic (DBP) blood pressure, total cholesterol (TC), LDL-C, HDL-C, Non HDL-C and triglycerides (TG). SPSS 21 was used for statistical analysis. Results: Mean values and prevalence of nine anthropometric and lipid risk variables were equally distributed over the five birth weight groups. Though risk factors clustered between 3.0 kg and 4.0 kg of birth weight in both genders we found only one significant correlation of birth weight with TG for males and females and another one for HDL-C in males. The strongest clustering of significant regression coefficients occurred in the 2nd birth weight quintile for SBP (ß 0.018), TC (ß -0.050), LDL-C (ß -0.039), non LDL-C (ß -0.049) and log TG (ß -0.001) in males and females. Conclusions: Overall we did not find significant associations between birth weight and nine traditional cardiovascular risk factors in children and adolescents. However, the 2nd quintile of birth weight might suggest clustering of risk factors. PMID:26900435

Relation between birth weight and weight and height at the age of 2 in children born preterm.

PubMed

Olson, Gayle; Weiner, Steven J; Rouse, Dwight J; Reddy, Uma M; Mercer, Brian M; Varner, Michael W; Leveno, Kenneth J; Iams, Jay D; Wapner, Ronald J; Ramin, Susan M; Malone, Fergal D; Carpenter, Marshall W; O'Sullivan, Mary J; Dinsmoor, Mara J; Hankins, Gary D V; Caritis, Steve N

2015-05-01

The aim of the study was to evaluate associations between fetal growth and weight at 2 years in infants born preterm using a customized approach for birth weight. This is a secondary analysis of a multicenter trial that included a 2-year follow-up of children born prematurely. Customized birth weight percentiles were calculated using the Gardosi model for a U.S. population, and the relation between customized percentile and weight and height at 2 years (adjusted for gender using z-score) was determined using regression analysis and by comparing z-scores for children with birth weight <10th versus ≥10th percentile. Weight z-score at 2 years was significantly lower in the <10th than in the ≥10th percentile group (median [interquartile range, IQR]: -0.66 [-1.58, -0.01] vs. -0.23 [-1.05, 0.55]; p < 0.001), and remained after adjusting for maternal education (p < 0.001). A similar relationship was noted for height z-score between groups (median [IQR]: -0.56 [-1.29, 0.19] vs. -0.24 [-0.99, 0.37]; p < 0.001). Positive relationships between customized birth weight percentile and weight and height at 2 years were noted (p < 0.001 for both), but were not strong (R (2) = 0.04 and 0.02, respectively). Customized birth weight percentile is a minor determinant of weight at 2 years among children born preterm. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

[A dose-response analysis on the association of gestational weight gain rate and the normal term neonate birth weight].

PubMed

Mao, Yuanyuan; Hu, Wenbin; Liu, Qin; Liu, Li; Li, Yuanming; Shen, Yueping

2015-08-01

To examine the dose-response relationship between gestational weight gain rate and the neonate birth weight. A total of 18 868 women with singleton gestations who delivered between January 2006 and December 2013 were included in this study. Maternal and neonate details of these women were drawn from the Perinatal Monitoring System database. Gestational weight gain rate was defined as the total weight gain during the last and first prenatal care visits divided by the interval weeks. Both Multiple logistic regression analysis and restricted cubic spline methods were performed. Confounding factors included maternal age, education, pre-pregnancy body mass index (BMI), state of residence, parity, gestational weeks of prenatal care entry, and sex of the neonate. The adjusted odds ratio for macrosomia was associated with gestational weight gain rate in lower pre-pregnancy BMI (OR = 3.15, 95% CI: 1.40-7.07), normal (OR = 3.64, 95% CI: 2.84-4.66) or overweight (OR = 2.37, 95% CI: 1.71-3.27). The odds ratios of low birth weight appeared a decrease in those women with lower pre-pregnancy BMI (OR = 0.28, 95% CI: 0.13-0.61) while the normal weight (OR = 0.37, 95% CI: 0.22-0.64) group with gestational weight gain, the rate showed an increase. Association of gestational weight gain rate for macrosomia was found a S-curve in those term delivery women (non-linearity test P < 0.000 1). However, L-curve was observed for low birth weight and gestational weight gain rate in term births (non-linearity test P < 0.000 1). A S-curve was seen between gestational weight gain rate and term delivered macrosomia while L-curve was observed among term delivered low birth weight neonates.

High birth weight and perinatal mortality among siblings: A register based study in Norway, 1967-2011.

PubMed

Kristensen, Petter; Keyes, Katherine M; Susser, Ezra; Corbett, Karina; Mehlum, Ingrid Sivesind; Irgens, Lorentz M

2017-01-01

Perinatal mortality according to birth weight has an inverse J-pattern. Our aim was to estimate the influence of familial factors on this pattern, applying a cohort sibling design. We focused on excess mortality among macrosomic infants (>2 SD above the mean) and hypothesized that the birth weight-mortality association could be explained by confounding shared family factors. We also estimated how the participant's deviation from mean sibling birth weight influenced the association. We included 1 925 929 singletons, born term or post-term to mothers with more than one delivery 1967-2011 registered in the Medical Birth Registry of Norway. We examined z-score birth weight and perinatal mortality in random-effects and sibling fixed-effects logistic regression models including measured confounders (e.g. maternal diabetes) as well as unmeasured shared family confounders (through fixed effects models). Birth weight-specific mortality showed an inverse J-pattern, being lowest (2.0 per 1000) at reference weight (z-score +1 to +2) and increasing for higher weights. Mortality in the highest weight category was 15-fold higher than reference. This pattern changed little in multivariable models. Deviance from mean sibling birth weight modified the mortality pattern across the birth weight spectrum: small and medium-sized infants had increased mortality when being smaller than their siblings, and large-sized infants had an increased risk when outweighing their siblings. Maternal diabetes and birth weight acted in a synergistic fashion with mortality among macrosomic infants in diabetic pregnancies in excess of what would be expected for additive effects. The inverse J-pattern between birth weight and mortality is not explained by measured confounders or unmeasured shared family factors. Infants are at particularly high mortality risk when their birth weight deviates substantially from their siblings. Sensitivity analysis suggests that characteristics related to maternal diabetes could be important in explaining the increased mortality among macrosomic infants.

Birth weight, childhood socioeconomic environment, and cognitive development in the 1958 British birth cohort study

PubMed Central

Jefferis, Barbara J M H; Power, Chris; Hertzman, Clyde

2002-01-01

Objectives To examine the combined effect of social class and weight at birth on cognitive trajectories during school age and the associations between birth weight and educational outcomes through to 33 years. Design Longitudinal, population based, birth cohort study. Participants 10 845 males and females born during 3-9 March 1958 with information on birth weight, social class, and cognitive tests. Main outcome measures Reading, maths, draw a man, copying designs, verbal and non-verbal ability tests at ages 7, 11, and 16, highest qualifications achieved by 33, and trajectories of maths standardised scores at 7-16 years. Results The outcome of all childhood cognitive tests and educational achievements improved significantly with increasing birth weight. Analysis of maths scores at 7 and of highest qualifications achieved by 33 showed that the relations were robust to adjustment for potential confounding factors. For each kilogram increase in birth weight, maths z score increased by 0.17 (adjusted estimate 0.15, 95% confidence interval 0.10 to 0.21) for males and 0.21 (0.20, 0.14 to 0.25) for females. Trajectories of maths z scores between 7 and 16 years diverged for different social class groups: participants from classes I and II increased their relative position on the score with increasing age, whereas classes IV and V showed a relative decline with increasing age. Birth weight explained much less of the variation in cognition than did social class (range 0.5-1.5% v 2.9-12.5%). Conclusions The postnatal environment has an overwhelming influence on cognitive function through to early adulthood, but these strong effects do not explain the weaker but independent association with birth weight. What is already known on this topicWeight at birth is associated with later cognitive developmentThis is maintained across the range of normal birth weightsWhat this study addsSocial class at birth and birth weight have independent effects on maths scores in childhood, but social class at birth explains more of the variation in the scoresThe relation between maths scores and birth weight persists across birth weights after adjustment for gestational age, parental education, and other potential confounding factorsTrajectories of maths attainment diverge, with more affluent social groups increasing their relative advantage whereas the effect of birth weight remains constant over time PMID:12169505

Weight loss in exclusively breastfed infants delivered by cesarean birth.

PubMed

Preer, Genevieve L; Newby, P K; Philipp, Barbara L

2012-05-01

Rates of exclusive breastfeeding during the postpartum hospital stay are a key measure of quality maternity care. Often, however, concern for excessive in-hospital weight loss leads to formula supplementation of breastfed infants. The American Academy of Pediatrics defines 7% weight loss as acceptable for breastfed newborns regardless of mode of delivery. Typical weight loss in exclusively breastfed infants delivered by cesarean birth has not been studied nor have possible correlates of greater weight loss in this population. To determine average weight loss in a cohort of exclusively breastfed infants delivered by cesarean birth and to identify correlates of greater than expected weight loss. We performed a retrospective chart review of exclusively breastfed infants delivered via cesarean birth at a Baby-Friendly hospital between 2005 and 2007. Average weight loss was calculated, and multivariate regression analysis was performed. Average weight loss during the hospital stay in our cohort of 200 infants was 7.2% ± 2.1% of birth weight, slightly greater than the American Academy of Pediatrics guideline of 7%. Absence of labor prior to delivery was significantly associated with a greater percentage of weight loss (P = .0004), as were lower gestational age (P = .0004) and higher birth weight (P < .0001). Maternal age, gravity, parity, infant sex, Apgar scores, and prior cesarean birth were not significantly associated. We conclude that for exclusively breastfed infants delivered by cesarean birth in a Baby-Friendly hospital, absence of labor prior to cesarean birth may be a previously unreported risk factor for greater than expected weight loss.

Changes in Birth Weight between 2002 and 2012 in Guangzhou, China

PubMed Central

Xia, Xiao-Yan; Mo, Wei-Jian; Wang, Ping; Feng, Qiong; Larson, Charles P.; Xia, Hui-Min; Qiu, Xiu

2014-01-01

Background Recent surveillance data suggest that mean birth weight has begun to decline in several developed countries. The aim of this study is to examine the changes in birth weight among singleton live births from 2002 to 2012 in Guangzhou, one of the most rapidly developed cities in China. Methods We used data from the Guangzhou Perinatal Health Care and Delivery Surveillance System for 34108 and 54575 singleton live births with 28–41 weeks of gestation, who were born to local mothers, in 2002 and 2012, respectively. The trends in birth weight, small (SGA) and large (LGA) for gestational age and gestational length were explored in the overall population and gestational age subgroups. Results The mean birth weight decreased from 3162 g in 2002 to 3137 g in 2012 (crude mean difference, −25 g; 95% CI, −30 to −19). The adjusted change in mean birth weight appeared to be slight (−6 g from 2002 to 2012) after controlling for maternal age, gestational age, educational level, parity, newborn's gender and delivery mode. The percentages of SGA and LGA in 2012 were 0.6% and 1.5% lower than those in 2002, respectively. The mean gestational age dropped from 39.2 weeks in 2002 to 38.9 weeks in 2012. In the stratified analysis, we observed the changes in birth weight differed among gestational age groups. The mean birth weight decreased among very preterm births (28–31 weeks), while remained relatively stable among other gestational age subcategories. Conclusions Among local population in Guangzhou from 2002 to 2012, birth weight appeared to slightly decrease. The percentage of SGA and LGA also simultaneously dropped, indicating that newborns might gain a healthier weight for gestational age. PMID:25531295

Infant growth patterns in the slums of Dhaka in relation to birth weight, intrauterine growth retardation, and prematurity.

PubMed

Arifeen, S E; Black, R E; Caulfield, L E; Antelman, G; Baqui, A H; Nahar, Q; Alamgir, S; Mahmud, H

2000-10-01

Relations between size and maturity at birth and infant growth have been studied inadequately in Bangladesh, where the incidence of low birth weight is high and most infants are breast-fed. This study was conducted to describe infant growth patterns and their relations to birth weight, intrauterine growth retardation, and prematurity. A total of 1654 infants born in selected low-socioeconomic areas of Dhaka, Bangladesh, were enrolled at birth. Weight and length were measured at birth and at 1, 3, 6, 9, and 12 mo of age. The infants' mean birth weight was 2516 g, with 46.4% weighing <2500 g; 70% were small for gestational age (SGA) and 17% were premature. Among the SGA infants, 63% had adequate ponderal indexes. The mean weight of the study infants closely tracked the -2 SD curve of the World Health Organization pooled breast-fed sample. Weight differences by birth weight, SGA, or preterm categories were retained throughout infancy. Mean z scores based on the pooled breast-fed sample were -2.38, -1. 72, and -2.34 at birth, 3 mo, and 12 mo. Correlation analysis showed greater plasticity of growth in the first 3 mo of life than later in the first year. Infant growth rates were similar to those observed among breast-fed infants in developed countries. Most study infants experienced chronic intrauterine undernourishment. Catch-up growth was limited and weight at 12 mo was largely a function of weight at birth. Improvement of birth weight is likely to lead to significant gains in infant nutritional status in this population, although interventions in the first 3 mo are also likely to be beneficial.

[Perinatal health: low birth weight and social class].

PubMed

da Silva, A A; Barbieri, M A; Bettiol, H; Dal Bó, C M; Mucillo, G; Gomes, U A

1991-04-01

A survey was carried out in Ribeirão Preto, S. Paulo State, Brazil, between June 1978 and May 1979 with a view to studying the prevalence of low birth weight and its occurrence among different social classes. Data were collected from 8,878 singleton live births in eight maternity hospitals, accounting for 98% of all births in the area. Social classes were determinated by the use of a model proposed by Singer and modified for epidemiological purposes by Barros. Out of the 8,878 births, 660 (7.5%) were of low birth weight. The prevalence of deficient weight at birth (between 2,500 and 2,999 grams) was of 21.1%. Analysis indicated that 50.6% of children with low birth weight were at term and the majority of them suffered form intrauterine growth retardation. The prevalence of low birth weight according to social class was seen to be lower in the bourgeoisie classes (ranging from 2.8% to 3.9%) and higher in working classes (from 7% up to 9.5%). Low birth weight (defined as less than or equal to 2,500 grams) was used for purposes of comparison with other previous surveys. The percentage was lower in this study (8.3%) than that found in the Interamerican Investigation of Mortality in Childhood (8.7%), carried out in 1968-70. No statistically significant differences in the percentage of low birth weight were found in the case of Ribeirão Preto when these two surveys were compared.

Foot length, chest and head circumference measurements in detection of Low birth weight neonates in Mekelle, Ethiopia: a hospital based cross sectional study.

PubMed

Hadush, Marta Yemane; Berhe, Amanuel Hadgu; Medhanyie, Araya Abrha

2017-04-21

Low birth weight (Birth weight < 2500 g) is a leading cause of prenatal and neonatal deaths. The early identification of Low birth weight (LBW) neonates is essential for any comprehensive initiative to improve their chance of survival. However, a large proportion of births in developing countries take place at home and birth weight statistics are not available. Therefore, there is a need to develop simple, inexpensive and practical methods to identify low birth weight (LBW) neonates soon after birth. This is a hospital based cross sectional study. Four hundred twenty two (422) live born neonates were included and anthropometric measurements were carried out within 24 h of birth by three trained nurses. Birth weight was measured by digital scale. Head and chest circumference were measured by using non extendable measuring tape and foot length with hard transparent plastic ruler. Data was entered into SPSS version 20 for analysis. Characteristics of study participants were analyzed using descriptive statistics such as frequency and percentage for categorical data and mean and standard deviation for continuous data. Correlation with birth weight using Pearson's correlation coefficient and linear regression were used to identify the association between dependent and independent variables. Receiver operating characteristic (ROC) curve was used to evaluate accuracy of the anthropometric measurements to predict LBW. The prevalence of low birth weight was found to be 27%. All anthropometric measurements had a positive correlation with birth weight, chest circumference attaining the highest correlation with birth weight (r = 0.85) and foot length had the weakest correlation (r = 0.74). Head circumference had the highest predictive value for birth weight (AUC = 0.93) followed by Chest circumference (AUC = 0.91). A cut off point of chest circumference 30.15 cm had 84.2% sensitivity, 85.4% specificity and diagnostic accuracy (P < 0.001). A cut off point of head circumference 33.25 had the highest positive predictive value (77%). Chest circumference and head circumference were found to be better surrogate measurements to identify low birth weight neonates.

Birth weight and neonatal adiposity prediction using fractional limb volume obtained with 3D ultrasound.

PubMed

O'Connor, Clare; O'Higgins, Amy; Doolan, Anne; Segurado, Ricardo; Stuart, Bernard; Turner, Michael J; Kennelly, Máireád M

2014-01-01

The objective of this investigation was to study fetal thigh volume throughout gestation and explore its correlation with birth weight and neonatal body composition. This novel technique may improve birth weight prediction and lead to improved detection rates for fetal growth restriction. Fractional thigh volume (TVol) using 3D ultrasound, fetal biometry and soft tissue thickness were studied longitudinally in 42 mother-infant pairs. The percentages of neonatal body fat, fat mass and fat-free mass were determined using air displacement plethysmography. Correlation and linear regression analyses were performed. Linear regression analysis showed an association between TVol and birth weight. TVol at 33 weeks was also associated with neonatal fat-free mass. There was no correlation between TVol and neonatal fat mass. Abdominal circumference, estimated fetal weight (EFW) and EFW centile showed consistent correlations with birth weight. Thigh volume demonstrated an additional independent contribution to birth weight prediction when added to the EFW centile from the 38-week scan (p = 0.03). Fractional TVol performed at 33 weeks gestation is correlated with birth weight and neonatal lean body mass. This screening test may highlight those at risk of fetal growth restriction or macrosomia.

The effect of gestational period on the association between maternal prenatal salivary cortisol and birth weight: A systematic review and meta-analysis.

PubMed

Cherak, Stephana J; Giesbrecht, Gerald F; Metcalfe, Amy; Ronksley, Paul E; Malebranche, Mary E

2018-04-24

Studies exploring the relations between maternal stress and fetal development show an association between increased maternal stress and adverse birth outcomes. A frequently proposed mechanism linking maternal prenatal stress and adverse birth outcomes is heightened concentrations of maternal cortisol. To date, studies exploring this association have reported conflicting results because of the diverse approaches taken to measuring cortisol and the wide variety of possible birth outcomes explored. To add clarity to the growing body of literature, this systematic review and meta-analysis reports empirical findings on the association between maternal prenatal salivary cortisol and newborn birth weight. Searches for relevant papers published up until November 2017 were run in MEDLINE, EMBASE, PsycINFO, and CINAHL. Non-English language papers were included and experts were contacted when necessary. We included data from human observational studies that were designed or had an underlying intention to measure maternal prenatal salivary cortisol and newborn birth weight. We only included data from measurements of salivary cortisol to prevent rendering of the review unsuitable for meta-analysis. Two independent reviewers assessed study eligibility and quality. For every maternal-fetal dyad, an area under the curve with respect to ground (AUCg) of maternal cortisol was calculated to determine a Pearson's correlation coefficient with a continuous measure of newborn birth weight. Correlation coefficients were then pooled across all stages of gestation. To examine if there are critical gestational periods in which the fetus may be more susceptible to elevated concentration of maternal salivary cortisol, a meta-analysis was performed on separate correlations calculated from gestational trimesters. Nine studies with a total of 1606 maternal-fetal dyads demonstrated a negative correlation between pooled maternal salivary cortisol and birth weight (-0.24, 95% CI -0.28 to -0.20), but there was a high degree of heterogeneity between studies (I 2  = 88.9%). To investigate heterogeneity, subgroup analysis by trimester of the pooled correlation between salivary cortisol and birth weight was performed with the following correlations found: first trimester, -0.18 (95% CI -0.32 to -0.03, I 2  = 97.3%); second trimester, -0.20 (95% CI -0.28 to -0.12, I 2  = 98.3%); and third trimester, -0.30 (95% CI -0.33 to -0.26, I 2  = 85.4%). A consistently negative association was observed between maternal cortisol and infant birth weight. The review highlights specific gaps in the literature on the relationship between maternal prenatal salivary cortisol and newborn birth weight. Although a significant negative correlation was found, substantial heterogeneity of effects and the likelihood of publication bias exist. The third trimester was revealed as a possible critical gestational period for heightened maternal cortisol concentration to affect birth weight. Challenges faced in this body of research and recommendations for future research are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

Variations in costs for the care of low-birth-weight infants among academic hospitals.

PubMed

Herrod, Henry G; Chang, Cyril F; Steinberg, Stephanie S

2010-05-01

To determine the relative role that academic hospitals (AHs) play in providing neonatal care for low-birth-weight infants within a single state and to determine if there are variations in inpatient costs for neonatal services among AHs. Retrospective analysis of hospital costs for low-birth-weight infants. Cases were identified using 2003-2005 data from the Tennessee Hospital Discharge Data System. A specific focus was discharge data from the 5 AHs that support obstetrical residencies and have a neonatal intensive care unit. Cases included all discharged infants with a birth weight of <2500 grams. The 5 AHs discharged 18% of the total normal-birth-weight infants and 30% of the low-birth-weight infants for the entire state. AHs had higher costs associated with these infants than did other hospitals, with a single exception The difference in costs at this hospital was consistent with the finding of lower utilization rates of hospital services, a shorter average length of stay, and lower costs for infants insured by the state Medicaid program. Academic obstetrical hospitals discharged a disproportionately high percentage of low-birth-weight infants compared with other Tennessee hospitals. The lower costs observed in the Shelby County hospital indicates that other hospitals could potentially lower their costs for the care of low-birth-weight infants.

Effects of low birth weight on time to BCG vaccination in an urban poor settlement in Nairobi, Kenya: an observational cohort study.

PubMed

Mutua, Martin Kavao; Ochako, Rhoune; Ettarh, Remare; Ravn, Henrik; Echoka, Elizabeth; Mwaniki, Peter

2015-04-18

The World Health Organization recommends Bacillus Calmette-Guérin (BCG) vaccination against tuberculosis be given at birth. However, in many developing countries, pre-term and low birth weight infants get vaccinated only after they gain the desired weight. In Kenya, the ministry of health recommends pre-term and low birth weight infants to be immunized at the time of discharge from hospital irrespective of their weight. This paper seeks to understand the effects of birth weight on timing of BCG vaccine. The study was conducted in two Nairobi urban informal settlements, Korogocho and Viwandani which hosts the Nairobi Urban Health and Demographic Surveillance system. All infants born in the study area since September 2006 were included in the study. Data on immunization history and birth weight of the infant were recorded from child's clinic card. Follow up visits were done every four months to update immunization status of the child. A total of 3,602 infants were included in this analysis. Log normal accelerated failure time parametric model was used to assess the association between low birth weight infants and time to BCG immunization. In total, 229 (6.4%) infants were low birth weight. About 16.6% of the low birth weight infants weighed less than 2000 grams and 83.4% weighed between 2000 and 2490 grams. Results showed that, 60% of the low birth weight infants received BCG vaccine after more than five weeks of life. Private health facilities were less likely to administer a BCG vaccine on time compared to public health facilities. The effects of low birth weight on females was 0.60 and 0.97-times that of males for infants weighing 2000-2499 grams and for infants weighing <2000 grams respectively. The effect of low birth weight among infants born in public health facilities was 1.52 and 3.94-times that of infants delivered in private health facilities for infants weighing 2000-2499 grams and those weighing < 2000 grams respectively. Low birth weight infants received BCG immunization late compared to normal birth weight infants. Low birth weight infants delivered in public health facilities were more likely to be immunized much later compared to private health facilities.

The Gly972Arg polymorphism in insulin receptor substrate-1 is associated with decreased birth weight in a population-based sample of Brazilian newborns.

PubMed

Bezerra, Rosângela M N; de Castro, Vagner; Sales, Teresa; Passini, Renato; Marba, Sergio T M; Saad, Sara T O; Saad, Mario J A

2002-03-01

We studied the association between the Gly972Arg polymorphism in insulin receptor substrate-1 (IRS-1) and birth weight in a population-based sample of Brazilian newborns. We studied 194 newborn children with adequate gestational age to identify the association between the Gly972Arg polymorphism and birth weight using PCR-restriction fragment length polymorphism analysis. The data showed that the birth weight was lower in the newborns with the Gly972Arg polymorphism in IRS-1 compared with control subjects (3,141 +/- 31.8 vs. 3,373 +/- 80.3 g, P < 0.008). The results also showed that the frequency of this polymorphism was increased in newborns with a birth weight <3,000 g (P=0.041). These results suggest that the genotype Gly972Arg may influence birth weight, reinforcing the hypothesis that genetically determined insulin resistance and/or reduced insulin secretion can result in impaired insulin-mediated growth in the fetus.

Maternal Experiences with Everyday Discrimination and Infant Birth Weight: A Test of Mediators and Moderators among Young, Urban Women of Color

PubMed Central

Earnshaw, Valerie A.; Rosenthal, Lisa; Lewis, Jessica B.; Stasko, Emily C.; Tobin, Jonathan N.; Lewis, Tené T.; Reid, Allecia E.; Ickovics, Jeannette R.

2012-01-01

Background Racial/ethnic disparities in birth weight persist within the United States. Purpose Examine the association between maternal everyday discrimination and infant birth weight among young, urban women of color; as well as mediators (depressive symptoms, pregnancy distress, pregnancy symptoms) and moderators (age, race/ethnicity, attributions of discrimination) of this association. Methods 420 women participated (14–21 years old; 62% Latina, 38% Black), completing measures of everyday discrimination and moderators during their second trimester of pregnancy and mediators during their third trimester. Birth weight was primarily recorded from medical record review. Results Path analysis demonstrated that everyday discrimination was associated with lower birth weight. Depressive symptoms mediated this relationship, and no tested factors moderated this relationship. Conclusions Given the association between birth weight and health across the lifespan, it is critical to reduce discrimination directed at young, urban women of color so that all children can begin life with greater promise for health. PMID:22927016

Maternal experiences with everyday discrimination and infant birth weight: a test of mediators and moderators among young, urban women of color.

PubMed

Earnshaw, Valerie A; Rosenthal, Lisa; Lewis, Jessica B; Stasko, Emily C; Tobin, Jonathan N; Lewis, Tené T; Reid, Allecia E; Ickovics, Jeannette R

2013-02-01

Racial/ethnic disparities in birth weight persist within the USA. The purpose of this study is to examine the association between maternal everyday discrimination and infant birth weight among young, urban women of color as well as mediators (depressive symptoms, pregnancy distress, and pregnancy symptoms) and moderators (age, race/ethnicity, and attributions of discrimination) of this association. A total of 420 women participated (14-21 years old; 62 % Latina, 38 % Black), completing measures of everyday discrimination and moderators during their second trimester of pregnancy and mediators during their third trimester. Birth weight was primarily recorded from medical record review. Path analysis demonstrated that everyday discrimination was associated with lower birth weight. Depressive symptoms mediated this relationship, and no tested factors moderated this relationship. Given the association between birth weight and health across the lifespan, it is critical to reduce discrimination directed at young, urban women of color so that all children can begin life with greater promise for health.

The Impact of Maternal Obesity and Excessive Gestational Weight Gain on Maternal and Infant Outcomes in Maine: Analysis of Pregnancy Risk Assessment Monitoring System Results from 2000 to 2010

PubMed Central

Sarton, Cheryl; Lichter, Erika

2016-01-01

The objective of this study is to understand the relationships between prepregnancy obesity and excessive gestational weight gain (GWG) and adverse maternal and fetal outcomes. Pregnancy risk assessment monitoring system (PRAMS) data from Maine for 2000–2010 were used to determine associations between demographic, socioeconomic, and health behavioral variables and maternal and infant outcomes. Multivariate logistic regression analysis was performed on the independent variables of age, race, smoking, previous live births, marital status, education, BMI, income, rurality, alcohol use, and GWG. Dependent variables included maternal hypertension, premature birth, birth weight, infant admission to the intensive care unit (ICU), and length of hospital stay of the infant. Excessive prepregnancy BMI and excessive GWG independently predicted maternal hypertension. A high prepregnancy BMI increased the risk of the infant being born prematurely, having a longer hospital stay, and having an excessive birth weight. Excessive GWG predicted a longer infant hospital stay and excessive birth weight. A low pregnancy BMI and a lower than recommended GWG were also associated with poor outcomes: prematurity, low birth weight, and an increased risk of the infant admitted to ICU. These findings support the importance of preconception care that promotes achievement of a healthy weight to enhance optimal reproductive outcomes. PMID:27747104

Birth weight differences between those offered financial voucher incentives for verified smoking cessation and control participants enrolled in the Cessation in Pregnancy Incentives Trial (CPIT), employing an intuitive approach and a Complier Average Causal Effects (CACE) analysis.

PubMed

McConnachie, Alex; Haig, Caroline; Sinclair, Lesley; Bauld, Linda; Tappin, David M

2017-07-20

The Cessation in Pregnancy Incentives Trial (CPIT), which offered financial incentives for smoking cessation during pregnancy showed a clinically and statistically significant improvement in cessation. However, infant birth weight was not seen to be affected. This study re-examines birth weight using an intuitive and a complier average causal effects (CACE) method to uncover important information missed by intention-to-treat analysis. CPIT offered financial incentives up to £400 to pregnant smokers to quit. With incentives, 68 women (23.1%) were confirmed non-smokers at primary outcome, compared to 25 (8.7%) without incentives, a difference of 14.3% (Fisher test, p < 0.0001). For this analysis, randomised groups were split into three theoretical sub-groups: independent quitters - quit without incentives, hardened smokers - could not quit even with incentives and potential quitters - required the addition of financial incentives to quit. Viewed in this way, the overall birth weight gain with incentives is attributable only to potential quitters. We compared an intuitive approach to a CACE analysis. Mean birth weight of potential quitters in the incentives intervention group (who therefore quit) was 3338 g compared with potential quitters in the control group (who did not quit) 3193 g. The difference attributable to incentives, was 3338 - 3193 = 145 g (95% CI -617, +803). The mean difference in birth weight between the intervention and control groups was 21 g, and the difference in the proportion who managed to quit was 14.3%. Since the intervention consisted of the offer of incentives to quit smoking, the intervention was received by all women in the intervention group. However, "compliance" was successfully quitting with incentives, and the CACE analysis yielded an identical result, causal birth weight increase 21 g ÷ 0.143 = 145 g. Policy makers have great difficulty giving pregnant women money to stop smoking. This study indicates that a small clinically insignificant improvement in average birth weight is likely to hide an important clinically significant increase in infants born to pregnant smokers who want to stop but cannot achieve smoking cessation without the addition of financial voucher incentives. ISRCTN Registry, ISRCTN87508788 . Registered on 1 September 2011.

Pre-Eclampsia, Birth Weight, and Autism Spectrum Disorders

ERIC Educational Resources Information Center

Mann, Joshua R.; McDermott, Suzanne; Bao, Haikun; Hardin, James; Gregg, Anthony

2010-01-01

Autism spectrum disorders (ASD) are primarily inherited, but perinatal or other environmental factors may also be important. In an analysis of 87,677 births from 1996 through 2002, insured by the South Carolina Medicaid program, birth weight was significantly inversely associated with the odds of ASD (OR = 0.78, p = 0.001 for each additional…

Associations of Perfluoroalkyl Substances (PFAS) with Lower Birth Weight: An Evaluation of Potential Confounding by Glomerular Filtration Rate Using a Physiologically Based Pharmacokinetic Model (PBPK)

PubMed Central

Loccisano, Anne E.; Morken, Nils-Halvdan; Yoon, Miyoung; Wu, Huali; McDougall, Robin; Maisonet, Mildred; Marcus, Michele; Kishi, Reiko; Miyashita, Chihiro; Chen, Mei-Huei; Hsieh, Wu-Shiun; Andersen, Melvin E.; Clewell, Harvey J.; Longnecker, Matthew P.

2015-01-01

Background Prenatal exposure to perfluoroalkyl substances (PFAS) has been associated with lower birth weight in epidemiologic studies. This association could be attributable to glomerular filtration rate (GFR), which is related to PFAS concentration and birth weight. Objectives We used a physiologically based pharmacokinetic (PBPK) model of pregnancy to assess how much of the PFAS–birth weight association observed in epidemiologic studies might be attributable to GFR. Methods We modified a PBPK model to reflect the association of GFR with birth weight (estimated from three studies of GFR and birth weight) and used it to simulate PFAS concentrations in maternal and cord plasma. The model was run 250,000 times, with variation in parameters, to simulate a population. Simulated data were analyzed to evaluate the association between PFAS levels and birth weight due to GFR. We compared simulated estimates with those from a meta-analysis of epidemiologic data. Results The reduction in birth weight for each 1-ng/mL increase in simulated cord plasma for perfluorooctane sulfonate (PFOS) was 2.72 g (95% CI: –3.40, –2.04), and for perfluorooctanoic acid (PFOA) was 7.13 g (95% CI: –8.46, –5.80); results based on maternal plasma at term were similar. Results were sensitive to variations in PFAS level distributions and the strength of the GFR–birth weight association. In comparison, our meta-analysis of epidemiologic studies suggested that each 1-ng/mL increase in prenatal PFOS and PFOA levels was associated with 5.00 g (95% CI: –21.66, –7.78) and 14.72 g (95% CI: –8.92, –1.09) reductions in birth weight, respectively. Conclusion Results of our simulations suggest that a substantial proportion of the association between prenatal PFAS and birth weight may be attributable to confounding by GFR and that confounding by GFR may be more important in studies with sample collection later in pregnancy. Citation Verner MA, Loccisano AE, Morken NH, Yoon M, Wu H, McDougall R, Maisonet M, Marcus M, Kishi R, Miyashita C, Chen MH, Hsieh WS, Andersen ME, Clewell HJ III, Longnecker MP. 2015. Associations of perfluoroalkyl substances (PFAS) with lower birth weight: an evaluation of potential confounding by glomerular filtration rate using a physiologically based pharmacokinetic model (PBPK). Environ Health Perspect 123:1317–1324; http://dx.doi.org/10.1289/ehp.1408837 PMID:26008903

Race differences in infant mortality from endogenous causes: a population-based study in North Carolina.

PubMed

Michielutte, R; Moore, M L; Meis, P J; Ernest, J M; Wells, H B

1994-02-01

This study examines the associations between race, birth weight, and mortality from endogenous causes for all singleton births born in 1984-1987 in a 20-county region of North Carolina. A more detailed analysis of preterm low birth weight infants examines these associations according to the proximate medical causes (medical etiology) of the preterm birth. Overall, black infants were found to have approximately twice the mortality risk of white infants. Most of the excess black mortality risk is explained by the larger proportion of black infants born at lower birth weights. The pattern of race differences in infant mortality by birth weight generally replicates the results of earlier studies, but the relative risk ratios within specific birth weight categories are smaller than previously reported. Among preterm low birth weight infants, the association between race and endogenous mortality differs within categories of medical etiology. The mortality risk is the same for black and white infants born preterm due to premature rupture of the membranes (PROM), lower for black infants born preterm due to medical problems, and higher for black infants born preterm due to idiopathic premature labor (IPL).

The effect of maternal anthropometric characteristics and social factors on gestational age and birth weight in Sudanese newborn infants.

PubMed

Elshibly, Eltahir M; Schmalisch, Gerd

2008-07-18

In Africa low birth weight (LBW) (<2500 g), is the strongest determinant of infant morbidity and mortality. The aim of this study was to quantify the effect of maternal anthropometry, education and socio-economic status on gestational age and birth weight. In 1000 Sudanese mothers with singleton births, anthropometric measurements (weight, height, mid-arm circumference) and newborn birth weight were taken within 24 hours of delivery. Furthermore, maternal education and socio-economic status were recorded. The effect of these maternal variables on gestational age and birth weight was investigated by receiver operating characteristic (ROC) curves and by multivariate logistic regression analysis. Although maternal height was significantly correlated (p = 0.002) with gestational age, we did not find maternal characteristics of value in determining the risk for preterm birth. Birth order was the strongest determinant of birth weight compared to other maternal characteristics. The LBW rate of first born babies of 12.2% was nearly twice that of infants of multiparous mothers. Maternal age and all maternal anthropometric measurements were positively correlated (p < 0.001) with birth weight. A maternal height of <156 cm, a maternal weight of <66 kg, a maternal mid arm circumference of <27 cm and years of education of 12 years of education. Birth order and maternal height were found to be the most important maternal parameters which influences birth weight and the risk for LBW. The duration of maternal education and not social class was found to significantly affect the risk for LBW.

Population-based birth weight reference percentiles for Chinese twins.

PubMed

Dai, Li; Deng, Changfei; Li, Yanhua; Yi, Ling; Li, Xiaohong; Mu, Yi; Li, Qi; Yao, Qiang; Wang, Yanping

2017-09-01

Birth weight percentiles by gestational age are important for assessing prenatal growth and predicting postnatal outcomes of newborns. Several countries have developed nation-specific birth weight references for twins, but China still lacks such references. Birth weight data for twins born between October 2006 and September 2015 were abstracted from the China National Population-based Birth Defects Surveillance System. A total of 54,786 live twin births aged ≥28 weeks of gestation without birth defects were included in the analysis. The LMS method was adopted to generate gestational age-specific birth weight percentiles and curves for male and female twins separately. Significant differences were observed between the current reference and other references developed for Chinese or non-Chinese twins. The neonatal mortality rate in this cohort was 12.3‰, and much higher rates at very early gestation weeks were identified in small-for-gestational-age twins grouped by the newly developed reference cutoffs. The established birth weight centiles represent the first birth weight norm for contemporary Chinese twins and can be a useful tool to assess growth of twins in clinical and research settings. Key Messages There have been no population-based birth weight percentiles for Chinese twins prior to this study. The established birth weight centiles for female and male twins are markedly lower than those for Chinese singletons. Twin-specific curves should be used for determining inappropriate for gestational age in twins rather than using existing singleton reference. The birth weight percentiles for twins differed significantly from those for non-Chinese twins. In addition to ethnic influences, the observed differences could be ascribed to variations in prenatal care, fetal or maternal nutrition status or other environmental factors. Neonatal mortality rates varied considerably among twins grouped by the newly developed reference percentiles. Small-for-gestational-age twins had much higher mortality than did appropriate-for-gestational-age twins, highlighting the need to reduce postnatal mortality by improving perinatal health care for twins.

Outdoor Air Pollution, Preterm Birth, and Low Birth Weight: Analysis of the World Health Organization Global Survey on Maternal and Perinatal Health

PubMed Central

Merialdi, Mario; van Donkelaar, Aaron; Vadillo-Ortega, Felipe; Martin, Randall V.; Betran, Ana Pilar; Souza, João Paulo

2014-01-01

Background: Inhaling fine particles (particulate matter with diameter ≤ 2.5 μm; PM2.5) can induce oxidative stress and inflammation, and may contribute to onset of preterm labor and other adverse perinatal outcomes. Objectives: We examined whether outdoor PM2.5 was associated with adverse birth outcomes among 22 countries in the World Health Organization Global Survey on Maternal and Perinatal Health from 2004 through 2008. Methods: Long-term average (2001–2006) estimates of outdoor PM2.5 were assigned to 50-km–radius circular buffers around each health clinic where births occurred. We used generalized estimating equations to determine associations between clinic-level PM2.5 levels and preterm birth and low birth weight at the individual level, adjusting for seasonality and potential confounders at individual, clinic, and country levels. Country-specific associations were also investigated. Results: Across all countries, adjusting for seasonality, PM2.5 was not associated with preterm birth, but was associated with low birth weight [odds ratio (OR) = 1.22; 95% CI: 1.07, 1.39 for fourth quartile of PM2.5 (> 20.2 μg/m3) compared with the first quartile (< 6.3 μg/m3)]. In China, the country with the largest PM2.5 range, preterm birth and low birth weight both were associated with the highest quartile of PM2.5 only, which suggests a possible threshold effect (OR = 2.54; CI: 1.42, 4.55 and OR = 1.99; CI: 1.06, 3.72 for preterm birth and low birth weight, respectively, for PM2.5 ≥ 36.5 μg/m3 compared with PM2.5 < 12.5 μg/m3). Conclusions: Outdoor PM2.5 concentrations were associated with low birth weight but not preterm birth. In rapidly developing countries, such as China, the highest levels of air pollution may be of concern for both outcomes. Citation: Fleischer NL, Merialdi M, van Donkelaar A, Vadillo-Ortega F, Martin RV, Betran AP, Souza JP, O´Neill MS. 2014. Outdoor air pollution, preterm birth, and low birth weight: analysis of the World Health Organization Global Survey on Maternal and Perinatal Health. Environ Health Perspect 122:425–430; http://dx.doi.org/10.1289/ehp.1306837 PMID:24508912

Comparative Investigation of Indicators of Growth and Behavioral Disorders in Children with Normal, Low, and Very Low Birth Weight at Pre-school Age in Isfahan during 2015

PubMed Central

Yousefi, Marzieh; Abdeyazdan, Zahra; Ehsanpour, Soheila

2017-01-01

Introduction: Birth weight is one of the most important indicators of infant's health and could predict their health condition in future. This study was conducted to determine and compare indicators of growth [weight, height, and body mass index (BMI)] and behavioral disorders in children with normal, low, and very low birth weight at pre-school age. Materials and Methods: In this descriptive analytical study, 236 children (126 with normal weight, 100 with low birth weight, and 10 with very low birth weight) at pre-school age were investigated in three groups. Data collection tools were a two-part questionnaire including the Rutter Children Behavior Questionnaire for parents, and parents’ and children's demographic characteristics questionnaire, scale, and stadiometer. Data were analyzed using descriptive statistics, variance analysis, Chi square, and Kruskal–Wallis tests. Results: The mean of weight, height, and BMI at pre-school age in three groups had a significant difference (P = 0.009) and it was lower in the group with very low birth weight than the other two groups; however, the difference between the group with normal birth weight and the group with low birth weight was not significant (P = 0.10). The mean score of behavioral disorder had no significant difference between groups (P = 0.49). Conclusions: Results showed that children with very low birth weight grew less than the other two groups. Therefore, this group needs special attention and long-term follow-up for taking care of them to ensure better growth. It is recommended to conduct more extended studies to evaluate behavioral disorders in these children. PMID:28382052

Comparative Investigation of Indicators of Growth and Behavioral Disorders in Children with Normal, Low, and Very Low Birth Weight at Pre-school Age in Isfahan during 2015.

PubMed

Yousefi, Marzieh; Abdeyazdan, Zahra; Ehsanpour, Soheila

2017-01-01

Birth weight is one of the most important indicators of infant's health and could predict their health condition in future. This study was conducted to determine and compare indicators of growth [weight, height, and body mass index (BMI)] and behavioral disorders in children with normal, low, and very low birth weight at pre-school age. In this descriptive analytical study, 236 children (126 with normal weight, 100 with low birth weight, and 10 with very low birth weight) at pre-school age were investigated in three groups. Data collection tools were a two-part questionnaire including the Rutter Children Behavior Questionnaire for parents, and parents' and children's demographic characteristics questionnaire, scale, and stadiometer. Data were analyzed using descriptive statistics, variance analysis, Chi square, and Kruskal-Wallis tests. The mean of weight, height, and BMI at pre-school age in three groups had a significant difference ( P = 0.009) and it was lower in the group with very low birth weight than the other two groups; however, the difference between the group with normal birth weight and the group with low birth weight was not significant ( P = 0.10). The mean score of behavioral disorder had no significant difference between groups ( P = 0.49). Results showed that children with very low birth weight grew less than the other two groups. Therefore, this group needs special attention and long-term follow-up for taking care of them to ensure better growth. It is recommended to conduct more extended studies to evaluate behavioral disorders in these children.

Maternal Weight and Body Composition during Pregnancy Are Associated with Placental and Birth Weight in Rural Bangladesh12

PubMed Central

Gernand, Alison D.; Christian, Parul; Paul, Rina Rani; Shaikh, Saijuddin; Labrique, Alain B.; Schulze, Kerry J.; Shamim, Abu Ahmed; West, Keith P.

2012-01-01

Placental growth is a strong predictor of fetal growth, but little is known about maternal predictors of placental growth in malnourished populations. Our objective was to investigate in a prospective study the associations of maternal weight and body composition [total body water (TBW) estimated by bioelectrical impedance and fat and fat-free mass derived from upper arm fat and muscle areas (UAFA, UAMA)] and changes in these with placental and birth weights. Within a cluster-randomized trial of maternal micronutrient supplementation, a subsample of 350 women was measured 3 times across gestation. Longitudinal analysis was used to examine independent associations of ∼10-wk measurements and ∼10–20 wk and ∼20–32 wk changes with birth outcomes. Weight, TBW, and UAMA, but not UAFA, at ∼10 wk were each positively and independently associated with placental weight and birth weight (P < 0.05). Of the maternal ∼10–20 wk changes in measurements, only TBW change and placental weight, and maternal weight and birth weight were positively associated (P < 0.05). Gains in weight, TBW, and UAMA from 20 to 32 wk were positively and UAFA gain was negatively associated with placental weight (P ≤ 0.01). Gains in weight and UAMA from 20 to 32 wk were positively associated with birth weight (P ≤ 0.01). Overall, higher maternal weight and measures of fat-free mass at ∼10 wk gestation and gains from 20 to 32 wk are independently associated with higher placental and birth weight. PMID:22990469

Maternal weight and body composition during pregnancy are associated with placental and birth weight in rural Bangladesh.

PubMed

Gernand, Alison D; Christian, Parul; Paul, Rina Rani; Shaikh, Saijuddin; Labrique, Alain B; Schulze, Kerry J; Shamim, Abu Ahmed; West, Keith P

2012-11-01

Placental growth is a strong predictor of fetal growth, but little is known about maternal predictors of placental growth in malnourished populations. Our objective was to investigate in a prospective study the associations of maternal weight and body composition [total body water (TBW) estimated by bioelectrical impedance and fat and fat-free mass derived from upper arm fat and muscle areas (UAFA, UAMA)] and changes in these with placental and birth weights. Within a cluster-randomized trial of maternal micronutrient supplementation, a subsample of 350 women was measured 3 times across gestation. Longitudinal analysis was used to examine independent associations of ∼10-wk measurements and ∼10-20 wk and ∼20-32 wk changes with birth outcomes. Weight, TBW, and UAMA, but not UAFA, at ∼10 wk were each positively and independently associated with placental weight and birth weight (P < 0.05). Of the maternal ∼10-20 wk changes in measurements, only TBW change and placental weight, and maternal weight and birth weight were positively associated (P < 0.05). Gains in weight, TBW, and UAMA from 20 to 32 wk were positively and UAFA gain was negatively associated with placental weight (P ≤ 0.01). Gains in weight and UAMA from 20 to 32 wk were positively associated with birth weight (P ≤ 0.01). Overall, higher maternal weight and measures of fat-free mass at ∼10 wk gestation and gains from 20 to 32 wk are independently associated with higher placental and birth weight.

Prenatal Ambient Air Pollution, Placental Mitochondrial DNA Content, and Birth Weight in the INMA (Spain) and ENVIRONAGE (Belgium) Birth Cohorts.

PubMed

Clemente, Diana B P; Casas, Maribel; Vilahur, Nadia; Begiristain, Haizea; Bustamante, Mariona; Carsin, Anne-Elie; Fernández, Mariana F; Fierens, Frans; Gyselaers, Wilfried; Iñiguez, Carmen; Janssen, Bram G; Lefebvre, Wouter; Llop, Sabrina; Olea, Nicolás; Pedersen, Marie; Pieters, Nicky; Santa Marina, Loreto; Souto, Ana; Tardón, Adonina; Vanpoucke, Charlotte; Vrijheid, Martine; Sunyer, Jordi; Nawrot, Tim S

2016-05-01

Mitochondria are sensitive to environmental toxicants due to their lack of repair capacity. Changes in mitochondrial DNA (mtDNA) content may represent a biologically relevant intermediate outcome in mechanisms linking air pollution and fetal growth restriction. We investigated whether placental mtDNA content is a possible mediator of the association between prenatal nitrogen dioxide (NO2) exposure and birth weight. We used data from two independent European cohorts: INMA (n = 376; Spain) and ENVIRONAGE (n = 550; Belgium). Relative placental mtDNA content was determined as the ratio of two mitochondrial genes (MT-ND1 and MTF3212/R3319) to two control genes (RPLP0 and ACTB). Effect estimates for individual cohorts and the pooled data set were calculated using multiple linear regression and mixed models. We also performed a mediation analysis. Pooled estimates indicated that a 10-μg/m3 increment in average NO2 exposure during pregnancy was associated with a 4.9% decrease in placental mtDNA content (95% CI: -9.3, -0.3%) and a 48-g decrease (95% CI: -87, -9 g) in birth weight. However, the association with birth weight was significant for INMA (-66 g; 95% CI: -111, -23 g) but not for ENVIRONAGE (-20 g; 95% CI: -101, 62 g). Placental mtDNA content was associated with significantly higher mean birth weight (pooled analysis, interquartile range increase: 140 g; 95% CI: 43, 237 g). Mediation analysis estimates, which were derived for the INMA cohort only, suggested that 10% (95% CI: 6.6, 13.0 g) of the association between prenatal NO2 and birth weight was mediated by changes in placental mtDNA content. Our results suggest that mtDNA content can be one of the potential mediators of the association between prenatal air pollution exposure and birth weight. Clemente DB, Casas M, Vilahur N, Begiristain H, Bustamante M, Carsin AE, Fernández MF, Fierens F, Gyselaers W, Iñiguez C, Janssen BG, Lefebvre W, Llop S, Olea N, Pedersen M, Pieters N, Santa Marina L, Souto A, Tardón A, Vanpoucke C, Vrijheid M, Sunyer J, Nawrot TS. 2016. Prenatal ambient air pollution, placental mitochondrial DNA content, and birth weight in the INMA (Spain) and ENVIRONAGE (Belgium) birth cohorts. Environ Health Perspect 124:659-665; http://dx.doi.org/10.1289/ehp.1408981.

The Association Between Maternal Early Life Forced Sexual Intercourse and Offspring Birth Weight: The Role of Socioeconomic Status.

PubMed

Gavin, Amelia R; Morris, Julia

2017-05-01

This study utilizes a life-course framework to investigate whether maternal early life forced sexual intercourse operates in conjunction with health behaviors during adolescence, young adulthood, and the prenatal period to influence offspring birth weight. Using data from the 1994-2009 National Longitudinal Study of Adolescent Health (Add Health), we examined whether early life forced sexual intercourse predicted offspring birth weight through a mediated pathway, including depressive symptoms, substance use, and prenatal cigarette smoking. We stratify our analysis by socioeconomic status (SES) to determine whether the proposed pathways operate similarly, or differently, according to SES. Our findings suggest that the pathways through which forced sexual intercourse affects offspring birth weight differ by SES. Among middle-to-high SES women, we found a mediated pathway linking forced sexual intercourse to offspring birth weight with prenatal cigarette smoking predicting lower offspring birth weight. Among low SES women, however, we did not find a mediated pathway linking forced sexual intercourse to birth weight. Findings suggest that prenatal cigarette smoking was not a mechanism of influence in the pathway between maternal early life forced sexual intercourse and offspring birth weight for low SES women. Our findings suggest that forced sexual intercourse may influence infant birth weight in the next generation. Infants born with a low birth weight are at increased risk for a myriad of adverse outcomes across the life-course. Study results suggest the importance of interventions designed to reduce behavioral risks and to support health promoting behaviors among survivors in the short term, in an effort to prevent long-term consequences among later-born offspring.

Epilepsy, birth weight and academic school readiness in Canadian children: Data from the national longitudinal study of children and youth.

PubMed

Prasad, A N; Corbett, B

2017-02-01

Birth weight is an important indicator of prenatal/in-utero environment. Variations in birth weight have been reportedly associated with risks for cognitive problems. The National Longitudinal Survey of Children and Youth (NLSCY) dataset was explored to examine relationships between birth weight, academic school readiness and epilepsy. A population based sample of 32,900 children of the NLSCY were analyzed to examine associations between birth weight, and school readiness scores in 4-5-year-old children. Logistic and Linear regression was used to examine associations between having epilepsy and these outcomes. Gestation data was available on 19,867 children, full-term children represented 89.67% (gestation >259days), while 10.33% of children were premature (gestation <258days). There were 20 children with reported epilepsy in the sample. Effects of confounding variables (diabetes in pregnancy, smoking in pregnancy, high blood pressure during pregnancy, and gender of the infant) on birth weight and epilepsy were controlled using a separate structural equation model. Logistic regression analysis identified an association between epilepsy and lower birth weights, as well as an association between lower birth weight, having epilepsy and lower PPVT-R Scores. Model results show the relationship between low birth weight and epilepsy remains statistically significant even when controlling for the influence of afore mentioned confounding variables. Low birth weight appears to be associated with both epilepsy and academic school readiness. The data suggest that an abnormal prenatal environment can influence both childhood onset of epilepsy and cognition. Additional studies with larger sample sizes are needed to verify this relationship in detail. Copyright © 2017 Elsevier B.V. All rights reserved.

Maternal biomass smoke exposure and birth weight in Malawi: Analysis of data from the 2010 Malawi Demographic and Health Survey.

PubMed

Milanzi, Edith B; Namacha, Ndifanji M

2017-06-01

Use of biomass fuels has been shown to contribute to ill health and complications in pregnancy outcomes such as low birthweight, neonatal deaths and mortality in developing countries. However, there is insufficient evidence of this association in the Sub-Saharan Africa and the Malawian population. We, therefore, investigated effects of exposure to biomass fuels on reduced birth weight in the Malawian population. We conducted a cross-sectional analysis using secondary data from the 2010 Malawi Demographic Health Survey with a total of 9124 respondents. Information on exposure to biomass fuels, birthweight, and size of child at birth as well as other relevant information on risk factors was obtained through a questionnaire. We used linear regression models for continuous birth weight outcome and logistic regression for the binary outcome. Models were systematically adjusted for relevant confounding factors. Use of high pollution fuels resulted in a 92 g (95% CI: -320.4; 136.4) reduction in mean birth weight compared to low pollution fuel use after adjustment for child, maternal as well as household characteristics. Full adjusted OR (95% CI) for risk of having size below average at birth was 1.29 (0.34; 4.48). Gender and birth order of child were the significant confounders factors in our adjusted models. We observed reduced birth weight in children whose mothers used high pollution fuels suggesting a negative effect of maternal exposure to biomass fuels on birth weight of the child. However, this reduction was not statistically significant. More carefully designed studies need to be carried out to explore effects of biomass fuels on pregnancy outcomes and health outcomes in general.

Regional differences in low birth weight in Spain: biological, demographic and socioeconomic variables.

PubMed

Fuster, Vicente; Zuluaga, Pilar; Colantonio, S E; Román-Busto, J

2015-01-01

The geographic and demographic dimensions of Spain, in terms of surface and number of inhabitants, and its heterogeneous socioeconomic development offer an adequate opportunity to study the provincial differences in birth weight from 1996 to 2010, focusing on possible factors determining the relative frequency of low birth weight. The study analysed geographic differences with regard to biological, demographic and socioeconomic factors that interfere with the female reproductive pattern. The variables considered here were: birth order, proportion of premature deliveries, mother's age, multiparity, mother's country of origin and professional qualifications. Two periods (1996-2000 and 2006-2010) were compared by means of principal components analysis. An increase in the relative frequency of deliveries weighing less than 2500 g occurred in most of the 52 geographic units studied, differences being significant in 42. Only in five cases was there a non-significant reduction in the proportion of low weight births. The first component after principal component analysis indicated that low birth weight was positively related to maternal age and to multiple deliveries, and negatively to the mother's low professional qualification. The second component related positively to the incidence of premature deliveries and to non-Spanish status and negatively in the case of primiparous mothers. The progressive increase in low birth weight incidence observed in Spain from 1996 onwards has occurred with considerable variation in each province. In part, this diversity can be attributed to the unequal reproductive patterns of immigrant mothers.

Birth outcomes across ethnic groups of women in Nepal.

PubMed

Acharya, Pratima Poudel; Alpass, Fiona

2004-01-01

This study was conducted at the Western Regional Hospital (WRH), Pokhara, Nepal. We investigated the relationship between selected socioeconomic variables, pregnancy indices, birth weight, and maternal health in women of different ethnic origins. In our cross-sectional data set, 29.8% of infants were born with a low birth weight. Our data analysis showed Indo-Aryan and lower caste ethnic groups had significantly lower weight babies than Tibeto-Burman and Newar groups. Further analysis showed that the Tibeto-Burman group received better care during pregnancy. Similarly, the Newar groups had significantly better nutritional intake than the Indo-Aryan and lower caste groups. The outcome of food restriction and antenatal care during pregnancy in specific ethnic groups has important implications for the health care delivery system. Health policymakers should target those ethnic groups and develop culturally based policies to reduce the incidence of low birth weight in Nepal.

Re-evaluation of link between interpregnancy interval and adverse birth outcomes: retrospective cohort study matching two intervals per mother

PubMed Central

Pereira, Gavin; Jacoby, Peter; de Klerk, Nicholas; Stanley, Fiona J

2014-01-01

Objective To re-evaluate the causal effect of interpregnancy interval on adverse birth outcomes, on the basis that previous studies relying on between mother comparisons may have inadequately adjusted for confounding by maternal risk factors. Design Retrospective cohort study using conditional logistic regression (matching two intervals per mother so each mother acts as her own control) to model the incidence of adverse birth outcomes as a function of interpregnancy interval; additional unconditional logistic regression with adjustment for confounders enabled comparison with the unmatched design of previous studies. Setting Perth, Western Australia, 1980-2010. Participants 40 441 mothers who each delivered three liveborn singleton neonates. Main outcome measures Preterm birth (<37 weeks), small for gestational age birth (<10th centile of birth weight by sex and gestational age), and low birth weight (<2500 g). Results Within mother analysis of interpregnancy intervals indicated a much weaker effect of short intervals on the odds of preterm birth and low birth weight compared with estimates generated using a traditional between mother analysis. The traditional unmatched design estimated an adjusted odds ratio for an interpregnancy interval of 0-5 months (relative to the reference category of 18-23 months) of 1.41 (95% confidence interval 1.31 to 1.51) for preterm birth, 1.26 (1.15 to 1.37) for low birth weight, and 0.98 (0.92 to 1.06) for small for gestational age birth. In comparison, the matched design showed a much weaker effect of short interpregnancy interval on preterm birth (odds ratio 1.07, 0.86 to 1.34) and low birth weight (1.03, 0.79 to 1.34), and the effect for small for gestational age birth remained small (1.08, 0.87 to 1.34). Both the unmatched and matched models estimated a high odds of small for gestational age birth and low birth weight for long interpregnancy intervals (longer than 59 months), but the estimated effect of long interpregnancy intervals on the odds of preterm birth was much weaker in the matched model than in the unmatched model. Conclusion This study questions the causal effect of short interpregnancy intervals on adverse birth outcomes and points to the possibility of unmeasured or inadequately specified maternal factors in previous studies. PMID:25056260

Are gestational age, birth weight, and birth length indicators of favorable fetal growth conditions? A structural equation analysis of Filipino infants.

PubMed

Bollen, Kenneth A; Noble, Mark D; Adair, Linda S

2013-07-30

The fetal origins hypothesis emphasizes the life-long health impacts of prenatal conditions. Birth weight, birth length, and gestational age are indicators of the fetal environment. However, these variables often have missing data and are subject to random and systematic errors caused by delays in measurement, differences in measurement instruments, and human error. With data from the Cebu (Philippines) Longitudinal Health and Nutrition Survey, we use structural equation models, to explore random and systematic errors in these birth outcome measures, to analyze how maternal characteristics relate to birth outcomes, and to take account of missing data. We assess whether birth weight, birth length, and gestational age are influenced by a single latent variable that we call favorable fetal growth conditions (FFGC) and if so, which variable is most closely related to FFGC. We find that a model with FFGC as a latent variable fits as well as a less parsimonious model that has birth weight, birth length, and gestational age as distinct individual variables. We also demonstrate that birth weight is more reliably measured than is gestational age. FFGCs were significantly influenced by taller maternal stature, better nutritional stores indexed by maternal arm fat and muscle area during pregnancy, higher birth order, avoidance of smoking, and maternal age 20-35 years. Effects of maternal characteristics on newborn weight, length, and gestational age were largely indirect, operating through FFGC. Copyright © 2013 John Wiley & Sons, Ltd.

Determinants of birth weight in Portugal: 1988 to 2011.

PubMed

Fuster, Vicente; Santos, Carlota

2016-01-01

The objective of this paper is to analyse temporal birth weight variation, its relationship to the frequency of premature births in Portugal, and the influence of native and immigrant mothers' characteristics as well as to determine the possible existence of a pattern of temporal change in birth weight in the Iberian Peninsula as a whole. Individual mother-child data from the Portuguese National Institute of Statistics regarding live births (N = 2,661,542) permitted an analysis, for the first time, of weight at birth in Portugal from a bio-demographic perspective. The results obtained show that from 1988 to 2011 there was a gradual decline in the average weight at birth in Portugal that may be related to shifts in the duration of gestation. An initial rapid decline in the relative frequency of post-term births took place, followed by small variations from 1995 on. Logistic regressions indicated a pattern unaffected by maternal origin or the sex of the newborn. With regard to weeks of gestation, the odds values obtained were < 1 when the reference category was < 28 weeks. For this factor, no significant differences were found in relation to the mother's origin. Portuguese mothers over 35 years were associated with a higher incidence of low birth weight. Regardless of maternal origin, being a newborn of parity 1, and with the mother not in a couple, resulted in unfavourable outcomes with regard to low birth weight. On the other hand, long gestation periods and having secondary or university education constituted a protective factor.

Mediation analysis of gestational age, congenital heart defects, and infant birth-weight.

PubMed

Wogu, Adane F; Loffredo, Christopher A; Bebu, Ionut; Luta, George

2014-12-17

In this study we assessed the mediation role of the gestational age on the effect of the infant's congenital heart defects (CHD) on birth-weight. We used secondary data from the Baltimore-Washington Infant Study (1981-1989). Mediation analysis was employed to investigate whether gestational age acted as a mediator of the association between CHD and reduced birth-weight. We estimated the mediated effect, the mediation proportion, and their corresponding 95% confidence intervals (CI) using several methods. There were 3362 CHD cases and 3564 controls in the dataset with mean birth-weight of 3071 (SD = 729) and 3353 (SD = 603) grams, respectively; the mean gestational age was 38.9 (SD = 2.7) and 39.6 (SD = 2.2) weeks, respectively. After adjusting for covariates, the estimated mediated effect by gestational age was 113.5 grams (95% CI, 92.4-134.2) and the mediation proportion was 40.7% (95% CI, 34.7%-46.6%), using the bootstrap approach. Gestational age may account for about 41% of the overall effect of heart defects on reduced infant birth-weight. Improved prenatal care and other public health efforts that promote full term delivery, particularly targeting high-risk families and mothers known to be carrying a fetus with CHD, may therefore be expected to improve the birth-weight of these infants and their long term health.

Seasonal Variations in Birth Weight in Suzhou Industrial Park.

PubMed

Wu, Lei; Ding, Yi; Rui, Xing Li; Mao, Cai Ping

2016-10-01

Many environmental factors have been shown to adversely influence birth weight, and new insight has been gained into 'seasonal programming'. We studied a total of 23,064 infants. The mean birth weight varied across seasons. Logistic regression analysis was used to obtain the crude and adjusted odds ratios (ORs) for dichotomous outcomes (e.g., macrosomia, low birth weight). There were significant differences in the risks for macrosomia in infants born in different seasons. Compared with those for infants born in spring, the ORs for macrosomia were 0.85 [95% confidence interval (CI): 0.75-0.98] and 0.87 (95% CI: 0.77-0.99) for infants born in summer and autumn, respectively. These findings suggest that environmental factors may have public health implications and should be considered when primary prevention programs are developed for macrosomia or low birth weight. Copyright © 2016 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

The effect of the Family Case Management Program on 1996 birth outcomes in Illinois.

PubMed

Keeton, Kristie; Saunders, Stephen E; Koltun, David

2004-03-01

The purpose of this study was to determine if birth outcomes for Medicaid recipients were improved with participation in the Illinois Family Case Management Program. Health program data files were linked with the 1996 Illinois Vital Records linked birth-death certificate file. Logistic regression was used to characterize the variation in birth outcomes as a function of Family Case Management participation while statistically controlling for measurable factors found to be confounders. Results of the logistic regression analysis show that women who participated in the Family Care Management Program were significantly less likely to give birth to very low birth weight infants (odds ratio [OR] = 0.86, 95% confidence interval [CI] = 0.75, 0.99) and low birth weight infants (OR = 0.83, CI = 0.79, 0.89). For infant mortality, however, the adjusted OR (OR = 0.98, CI = 0.82, 1.17), although under 1, was not statistically significant. These results suggest that the Family Case Management Program may be effective in reducing very low birth weight and low birth weight rates among infants born to low-income women.

Birth weight among singletons born to foreign-born mothers in Taiwan: a population-based birth register study.

PubMed

Shen, Yu-Ming; See, Lai-Chu; Lin, Sheue-Rong

2009-01-01

We compared the birth weight of newborns born to foreign-born mothers (FBMs) and Taiwan-born mothers (TBMs), using data from the 2005-2006 Taiwan Birth Registry of singleton live births. The Wilcox-Russell method, data restriction, and multiple linear regression were used to analyze the data. The rates of low birth weight (<2500 g) with 95% confidence intervals were computed for TBMs, and for each of the nationalities of FBMs. The mean birth weight of newborns of FBMs was 3157 g, which was higher than that of newborns of TBMs (3109 g). On analysis using the Wilcox-Russell method, both the rate and residual proportion of low-birth-weight (LBW) births were lower among newborns of FBMs (4.1% and 1.1%, respectively) than among newborns of TBMs (5.9% and 1.7%, respectively). After adjusting for sex, mode of delivery, maternal age, smoking status, predisposing maternal risk factors, and condition during pregnancy, the newborns of FBMs weighed 72.9 g (95% CI, 68.8 g to 77.0 g) more than the newborns of TBMs. When data were restricted to mothers without any adverse conditions and adjusted for maternal age, the differences in birth weight between the 2 groups remained unchanged. The rates of LBW deliveries among FBMs in Taiwan were significantly lower than those in their respective countries of origin. In Taiwan, newborns of FBMs had a higher birth weight than those of TBMs, even after accounting for potential confounding factors, and had lower rates of LBW deliveries than did mothers in their respective countries of origin.

Race Disparities and Decreasing Birth Weight: Are All Babies Getting Smaller?

PubMed Central

Catov, Janet M.; Lee, MinJae; Roberts, James M.; Xu, Jia; Simhan, Hyagriv N.

2016-01-01

The mean infant birth weight in the United States increased for decades, but it might now be decreasing. Given race disparities in fetal growth, we explored race-specific trends in birth weight at Magee-Womens Hospital, Pittsburgh, Pennsylvania, from 1997 to 2011. Among singleton births delivered at 37–41 weeks (n = 70,607), we evaluated the proportions who were small for gestational age and large for gestational age and changes in mean birth weights over time. Results were stratified by maternal race/ethnicity. Since 1997, the number of infants born small for their gestational ages increased (8.7%–9.9%), whereas the number born large for their gestational ages decreased (8.9%–7.7%). After adjustment for gestational week at birth, maternal characteristics, and pregnancy conditions, birth weight decreased by 2.20 g per year (P < 0.0001). Decreases were greater for spontaneous births. Reductions were significantly greater in infants born to African-American women than in those born to white women (−3.78 vs. −1.88 per year; P for interaction = 0.010). Quantile regression models indicated that birth weight decreased across the entire distribution, but reductions among infants born to African-American women were limited to those in the upper quartile after accounting for maternal factors. Limiting the analysis to low-risk women eliminated birth weight reductions. Birth weight has decreased in recent years, and reductions were greater in infants born to African-American women. These trends might be explained by accumulation of risk factors such as hypertension and prepregnancy obesity that disproportionately affect African-American women. Our results raise the possibility of worsening race disparities in fetal growth. PMID:26667251

Factors Affecting the Mental Development of Very Low Birthweight Infants: An Evaluation Based Primarily on Covariance Structure Analysis.

ERIC Educational Resources Information Center

Honjo, Shuji; And Others

1998-01-01

Evaluated statistically the effect of intranatal and early postnatal period factors on mental development of very low-birth-weight infants. Covariance structure analysis revealed direct influence of birth weight and gestational age in weeks on mental development at age 1, and of opthalmological aberrations and respirator disorder on mental…

Improving women's diet quality preconceptionally and during gestation: effects on birth weight and prevalence of low birth weight—a randomized controlled efficacy trial in India (Mumbai Maternal Nutrition Project)12345

PubMed Central

Potdar, Ramesh D; Sahariah, Sirazul A; Gandhi, Meera; Kehoe, Sarah H; Brown, Nick; Sane, Harshad; Dayama, Monika; Jha, Swati; Lawande, Ashwin; Coakley, Patsy J; Marley-Zagar, Ella; Chopra, Harsha; Shivshankaran, Devi; Chheda-Gala, Purvi; Muley-Lotankar, Priyadarshini; Subbulakshmi, G; Wills, Andrew K; Cox, Vanessa A; Taskar, Vijaya; Barker, David JP; Jackson, Alan A; Margetts, Barrie M; Fall, Caroline HD

2014-01-01

Background: Low birth weight (LBW) is an important public health problem in undernourished populations. Objective: We tested whether improving women's dietary micronutrient quality before conception and throughout pregnancy increases birth weight in a high-risk Indian population. Design: The study was a nonblinded, individually randomized controlled trial. The intervention was a daily snack made from green leafy vegetables, fruit, and milk (treatment group) or low-micronutrient vegetables (potato and onion) (control group) from ≥90 d before pregnancy until delivery in addition to the usual diet. Treatment snacks contained 0.69 MJ of energy (controls: 0.37 MJ) and 10–23% of WHO Reference Nutrient Intakes of β-carotene, riboflavin, folate, vitamin B-12, calcium, and iron (controls: 0–7%). The primary outcome was birth weight. Results: Of 6513 women randomly assigned, 2291 women became pregnant, 1962 women delivered live singleton newborns, and 1360 newborns were measured. In an intention-to-treat analysis, there was no overall increase in birth weight in the treatment group (+26 g; 95% CI: −15, 68 g; P = 0.22). There was an interaction (P < 0.001) between the allocation group and maternal prepregnant body mass index (BMI; in kg/m2) [birth-weight effect: −23, +34, and +96 g in lowest (<18.6), middle (18.6–21.8), and highest (>21.8) thirds of BMI, respectively]. In 1094 newborns whose mothers started supplementation ≥90 d before pregnancy (per-protocol analysis), birth weight was higher in the treatment group (+48 g; 95% CI: 1, 96 g; P = 0.046). Again, the effect increased with maternal BMI (−8, +79, and +113 g; P-interaction = 0.001). There were similar results for LBW (intention-to-treat OR: 0.83; 95% CI: 0.66, 1.05; P = 0.10; per-protocol OR = 0.76; 95% CI: 0.59, 0.98; P = 0.03) but no effect on gestational age in either analysis. Conclusions: A daily snack providing additional green leafy vegetables, fruit, and milk before conception and throughout pregnancy had no overall effect on birth weight. Per-protocol and subgroup analyses indicated a possible increase in birth weight if the mother was supplemented ≥3 mo before conception and was not underweight. This trial was registered at www.controlled-trials.com/isrctn/ as ISRCTN62811278. PMID:25332324

Sex-specific associations of insulin-like peptides in cord blood with size at birth.

PubMed

van Poppel, Mireille Nm; Eder, Martina; Lang, Uwe; Desoye, Gernot

2018-05-11

Insulin-like peptides (insulin, IGF-1, IGF-2) are essential regulators of fetal growth. We assessed the role of these peptides for birth size in a sex-specific manner. Cross-sectional cohort analysis. In 369 neonates, cord blood insulin, C-peptide, IGF-1 and IGF-2 levels were measured. Outcomes were placenta weight, birth weight, length, and ponderal index. In linear regression models the association of insulin-like peptides with growth outcomes was assessed, adjusted for gestational age and delivery mode. Interaction between insulin-like peptides and neonatal sex was assessed. No sex differences in levels of insulin-like peptides were observed. Significant interactions were found of sex with IGF-1 for birth weight, and of sex with C-peptide for all outcomes, except ponderal index. The association of IGF-1 (ng/ml) with birth weight was stronger and only significant in males (beta coefficient 3.30 g; 95%CI 1.98 to 4.63 in males and 1.45 g; -0.09 to 2.99 in females). Associations of C-peptide (ng/ml) with growth outcomes were stronger and only significant in females (placenta weight females: 181.3 g; 109.3 to 253.3; p<0.001, males: 29.8 g; -51.5 to 111.1; p=0.47, birth weight females: 598.5 g; 358.3 to 838.7: p<0.001, males: 113.7 g; -154.0 to 381.4; p=0.40). Associations of IGF2 with birth weight were similar in males and females. No associations were found with ponderal index. C-peptide and IGF-1 in cord blood associate with birth weight, length and placenta weight in a sex-specific manner, with stronger associations of C-peptide levels with placenta weight, birth weight and length in females, and stronger associations of IGF-1 levels with birth weight in males. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Genetic trends for live weight traits reflect breeding strategies in registered Charolais Farms in Mexico.

PubMed

Parra-Bracamonte, G M; Lopez-Villalobos, N; Morris, S T; Sifuentes-Rincón, A M; Lopez-Bustamante, L A

2016-12-01

Genetic trends are commonly used to verify genetic improvement; however, there are few reports on beef cattle in Mexico. Data from 1998 to 2013 from four Charolais bull breeding farms were examined to verify the genetic responses to different breeding management and selection criteria. Analysis included the comparison of regression lines of breeding values for birth (BW), weaning (WW) and yearling weights (YW), and maternal weaning weight (MWW) on the year of birth of the animals. Results revealed differential genetic progress for BW and YW and indicated that the overall analysis may have diluted the perception of genetic progress from the farmer's point of view. The use of breeding values as a tool for selection is effective to achieve genetic progress, even in negatively correlated traits, such as birth weight and yearling weight.

Low birth weight in Kansas.

PubMed

Guillory, V James; Lai, Sue Min; Suminski, R; Crawford, G

2015-05-01

Low birth weight (LBW) is associated with infant morbidity and mortality. This is the first study of LBW in Kansas using vital statistics to determine maternal and health care system factors associated with LBW. Low birth weight. Determine if prenatal care, maternal socio-demographic or medical factors, or insurance status were associated with LBW. Birth certificate data were merged with Medicaid eligibility data and subjected to logistic regression analysis. Of the 37,081 single vaginal births, LBW rates were 5.5% overall, 10.8% for African Americans, and 5% for White Americans. Lacking private insurance was associated with 34% more LBW infants (AOR 1.34; 95% CI 1.13-1.58), increased comorbidity, and late or less prenatal care. Low birth weight was associated with maternal medical comorbidity and with previous adverse birth outcomes. Insurance status, prenatal care, and maternal health during pregnancy are associated with LBW. Private insurance was consistently associated with more prenatal care and better outcomes. This study has important implications regarding health care reform.

Placental weight and birth weight to placental weight ratio in monochorionic and dichorionic growth-restricted and non-growth-restricted twins

PubMed Central

Souza, Mariângela Alves; de Lourdes Brizot, Maria; Biancolin, Sckarlet Ernandes; Schultz, Regina; de Carvalho, Mário Henrique Burlacchini; Francisco, Rossana Pulcineli Vieira; Zugaib, Marcelo

2017-01-01

OBJECTIVE: The aim of the present study was to compare the placental weight and birth weight/placental weight ratio for intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins. METHODS: This was a retrospective analysis of placentas from twin pregnancies. Placental weight and the birth weight/placental weight ratio were compared in intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins. The association between cord insertion type and placental lesions in intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins was also investigated. RESULTS: A total of 105 monochorionic (intrauterine growth restriction=40; non-intrauterine growth restriction=65) and 219 dichorionic (intrauterine growth restriction=57; non-intrauterine growth restriction=162) placentas were analyzed. A significantly lower placental weight was observed in intrauterine growth-restricted monochorionic (p=0.022) and dichorionic (p<0.001) twins compared to non-intrauterine growth-restricted twins. There was no difference in the birth weight/placental weight ratio between the intrauterine growth restriction and non-intrauterine growth restriction groups for either monochorionic (p=0.36) or dichorionic (p=0.68) twins. Placental weight and the birth weight/placental weight ratio were not associated with cord insertion type or with placental lesions. CONCLUSION: Low placental weight, and consequently reduced functional mass, appears to be involved in fetal growth restriction in monochorionic and dichorionic twins. The mechanism by which low placental weight influences the birth weight/placental weight ratio in intrauterine growth-restricted monochorionic and dichorionic twins needs to be determined in larger prospective studies. PMID:28591337

The Effect of Neonatal Intensive Care Unit Noise on the Habituation of Neonatal Chicks

DTIC Science & Technology

1991-05-01

loss is 0.1% in healthy term newborns (Simmons, 1980), 9% to 12.4% of all low birth weight infants develop a hearing deficit (Abramovich et al., 1979...chi-square analysis, mean birth weight , mean gestational age, mean length of incubator care, and use of ototoxic drugs were not significantly...As with the previous study, 9% of the subjects had a hearing deficit. Also, mean birth weight , mean gestational age, mean length of incubator care

Relationship between birth weight, maternal smoking during pregnancy and childhood and adolescent lung function: A path analysis.

PubMed

Balte, Pallavi; Karmaus, Wilfried; Roberts, Graham; Kurukulaaratchy, Ramesh; Mitchell, Frances; Arshad, Hasan

2016-12-01

Low birth weight and gestational maternal smoking have been linked with reduced lung function in children in many cross sectional studies. However, these associations have not yet been assessed with repeated measurements of lung function. Our aim was to investigate the effects of birth weight, gestational age, and gestational maternal smoking on lung function in children at age 10 and 18 years. In the Isle of Wight birth cohort spirometry was performed at age 10 and 18 years. Information on birth weight and gestational age were obtained from hospital records. Mothers were asked about smoking during pregnancy. We employed linear mixed models to estimate the effect of these risk factors on repeated measurements of lung function. We considered maternal asthma, sex, neonatal intensive care unit admission, height, socio-economic status, personal smoking in participants at age 18, body mass index and environmental tobacco smoke exposure as potential confounders. Finally, we used path analysis to determine links between birth weight, gestational age and gestational maternal smoking on lung function at age 10 and 18 years. Linear mixed models showed that with every 1 kg increase in birth weight, Forced expiratory volume in one second (FEV 1 ) increased by 42.6 ± 17.2 mL and Forced expiratory flow between 25% and 75% (FEF 25-75 ) of Forced vital capacity (FVC) increased by 95.5 ± 41.2 mL at age 18 years after adjusting for potential confounders. Path analysis suggested that birth weight had positive direct effects on FEV 1 and FEF 25-75 and positive indirect effect on FVC at 10 years which were carried forward to 18 years. Additionally, results also suggested a positive association between gestational age and FEV 1 , FVC and FEF 25-75  at ages 10 and 18 years and an inverse association between gestational smoke exposure and FEV 1 /FVC ratio and FEF 25-75  at age 18 years. Higher birth weight and gestational age were associated with higher FEV 1 , FVC and FEF 25-75 and maternal smoking during pregnancy was associated with reduced FEV 1 /FVC ratio and FEF 25-75 . The use of path analysis can improve our understanding of underlying "causal" pathways among different prenatal and childhood factors that affect lung function in both pre-adolescent and adolescent periods. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

A common haplotype of the glucokinase gene alters fasting glucose and birth weight: association in six studies and population-genetics analyses.

PubMed

Weedon, Michael N; Clark, Vanessa J; Qian, Yudong; Ben-Shlomo, Yoav; Timpson, Nicholas; Ebrahim, Shah; Lawlor, Debbie A; Pembrey, Marcus E; Ring, Susan; Wilkin, Terry J; Voss, Linda D; Jeffery, Alison N; Metcalf, Brad; Ferrucci, Luigi; Corsi, Anna Maria; Murray, Anna; Melzer, David; Knight, Bridget; Shields, Bev; Smith, George Davey; Hattersley, Andrew T; Di Rienzo, Anna; Frayling, Tim M

2006-12-01

Fasting glucose is associated with future risk of type 2 diabetes and ischemic heart disease and is tightly regulated despite considerable variation in quantity, type, and timing of food intake. In pregnancy, maternal fasting glucose concentration is an important determinant of offspring birth weight. The key determinant of fasting glucose is the enzyme glucokinase (GCK). Rare mutations of GCK cause fasting hyperglycemia and alter birth weight. The extent to which common variation of GCK explains normal variation of fasting glucose and birth weight is not known. We aimed to comprehensively define the role of variation of GCK in determination of fasting glucose and birth weight, using a tagging SNP (tSNP) approach and studying 19,806 subjects from six population-based studies. Using 22 tSNPs, we showed that the variant rs1799884 is associated with fasting glucose at all ages in the normal population and exceeded genomewide levels of significance (P=10-9). rs3757840 was also highly significantly associated with fasting glucose (P=8x10-7), but haplotype analysis revealed that this is explained by linkage disequilibrium (r2=0.2) with rs1799884. A maternal A allele at rs1799884 was associated with a 32-g (95% confidence interval 11-53 g) increase in offspring birth weight (P=.002). Genetic variation influencing birth weight may have conferred a selective advantage in human populations. We performed extensive population-genetics analyses to look for evidence of recent positive natural selection on patterns of GCK variation. However, we found no strong signature of positive selection. In conclusion, a comprehensive analysis of common variation of the glucokinase gene shows that this is the first gene to be reproducibly associated with fasting glucose and fetal growth.

The association between domestic violence during pregnancy and low birth weight or prematurity.

PubMed

Audi, Celene Aparecida Ferrari; Corrêa, Ana M Segall; Latorre, Maria do Rosário Dias de Oliveira; Santiago, Silvia M

2008-01-01

To investigate whether domestic violence during pregnancy is associated with unfavorable infant health outcomes, measured by low birth weight or prematurity. This was a prospective cohort study enrolling pregnant women whose prenatal care was provided by 10 basic health units in the city of Campinas, SP, Brazil, between 2004 and 2006. A structured questionnaire was employed that had previously been validated for use in Brazil. Each mother attended a minimum of two and a maximum of three interviews during the prenatal and postnatal periods. Data were analyzed using descriptive statistics. Student's t test was used to compare means for birth weight and gestational age between mothers who had suffered domestic violence during the current pregnancy and those who had not. Logistic regression analysis was employed to identify factors associated with low birth weight or prematurity. During the prenatal and postnatal periods, 89.1% (n = 1,229) of the pregnant women were followed up, 10.9% being lost to follow-up, basically due to changes of address. Mean birth weight was 3,233 g; mean gestational age was 38.56 weeks. A total of 13.8% of the infants had low birth weight or were premature. Conditions associated with risk of low birth weight or prematurity were: mothers who had previously given birth prematurely (p < 0.005), who smoked (p < 0.001), who delivered by caesarian (p < 0.001) and whose partners had a low educational level (p < 0.008). In this study, no statistically significant association was observed between domestic violence perpetrated by partners and low birth weight or prematurity.

Birth weight by gestational age in twin pregnancies: analysis of 661 pairs.

PubMed

Hsieh, T T; Chen, C J; Hsu, J J

1992-02-01

The mortality of twin infants is four to five times higher than that of singletons, and one-half to two-thirds of all twins weigh < 2,500 g at birth. The appropriate interpretation of fetal growth throughout pregnancy is dependent upon the availability of adequate standards. We reviewed 661 pairs of live twin infants born at Chang Gung Memorial Hospital from 1979 to 1990. The frequency of twin births was 1.17% (1:86), and the ratio of males to females was 1.03. The frequency of preterm births (< 37 weeks) was 36.9%, the frequency of low birth weight (< 2,500 g) was 47.9% and very low birth weight (< 1,500 g) was 6.7%. A fetus grows most rapidly from the 32nd to the 35th week of gestation (200 g per week). The growth was 145 g per week from the 28th to the 32nd week and from the 35th to the 38th week of gestation. After the 38th week, the mean birth weight increased by only 35 g per week. Compared with a singleton birth, the mean birth weight of twins was about 100 g lighter during the 28th to the 32nd week, then the difference increased gradually to about 500 g at term.

Assessing the Causal Relationship of Maternal Height on Birth Size and Gestational Age at Birth: A Mendelian Randomization Analysis.

PubMed

Zhang, Ge; Bacelis, Jonas; Lengyel, Candice; Teramo, Kari; Hallman, Mikko; Helgeland, Øyvind; Johansson, Stefan; Myhre, Ronny; Sengpiel, Verena; Njølstad, Pål Rasmus; Jacobsson, Bo; Muglia, Louis

2015-08-01

Observational epidemiological studies indicate that maternal height is associated with gestational age at birth and fetal growth measures (i.e., shorter mothers deliver infants at earlier gestational ages with lower birth weight and birth length). Different mechanisms have been postulated to explain these associations. This study aimed to investigate the casual relationships behind the strong association of maternal height with fetal growth measures (i.e., birth length and birth weight) and gestational age by a Mendelian randomization approach. We conducted a Mendelian randomization analysis using phenotype and genome-wide single nucleotide polymorphism (SNP) data of 3,485 mother/infant pairs from birth cohorts collected from three Nordic countries (Finland, Denmark, and Norway). We constructed a genetic score based on 697 SNPs known to be associated with adult height to index maternal height. To avoid confounding due to genetic sharing between mother and infant, we inferred parental transmission of the height-associated SNPs and utilized the haplotype genetic score derived from nontransmitted alleles as a valid genetic instrument for maternal height. In observational analysis, maternal height was significantly associated with birth length (p = 6.31 × 10-9), birth weight (p = 2.19 × 10-15), and gestational age (p = 1.51 × 10-7). Our parental-specific haplotype score association analysis revealed that birth length and birth weight were significantly associated with the maternal transmitted haplotype score as well as the paternal transmitted haplotype score. Their association with the maternal nontransmitted haplotype score was far less significant, indicating a major fetal genetic influence on these fetal growth measures. In contrast, gestational age was significantly associated with the nontransmitted haplotype score (p = 0.0424) and demonstrated a significant (p = 0.0234) causal effect of every 1 cm increase in maternal height resulting in ~0.4 more gestational d. Limitations of this study include potential influences in causal inference by biological pleiotropy, assortative mating, and the nonrandom sampling of study subjects. Our results demonstrate that the observed association between maternal height and fetal growth measures (i.e., birth length and birth weight) is mainly defined by fetal genetics. In contrast, the association between maternal height and gestational age is more likely to be causal. In addition, our approach that utilizes the genetic score derived from the nontransmitted maternal haplotype as a genetic instrument is a novel extension to the Mendelian randomization methodology in casual inference between parental phenotype (or exposure) and outcomes in offspring.

Assessing the Causal Relationship of Maternal Height on Birth Size and Gestational Age at Birth: A Mendelian Randomization Analysis

PubMed Central

Zhang, Ge; Bacelis, Jonas; Lengyel, Candice; Teramo, Kari; Hallman, Mikko; Helgeland, Øyvind; Johansson, Stefan; Myhre, Ronny; Sengpiel, Verena; Njølstad, Pål Rasmus; Jacobsson, Bo; Muglia, Louis

2015-01-01

Background Observational epidemiological studies indicate that maternal height is associated with gestational age at birth and fetal growth measures (i.e., shorter mothers deliver infants at earlier gestational ages with lower birth weight and birth length). Different mechanisms have been postulated to explain these associations. This study aimed to investigate the casual relationships behind the strong association of maternal height with fetal growth measures (i.e., birth length and birth weight) and gestational age by a Mendelian randomization approach. Methods and Findings We conducted a Mendelian randomization analysis using phenotype and genome-wide single nucleotide polymorphism (SNP) data of 3,485 mother/infant pairs from birth cohorts collected from three Nordic countries (Finland, Denmark, and Norway). We constructed a genetic score based on 697 SNPs known to be associated with adult height to index maternal height. To avoid confounding due to genetic sharing between mother and infant, we inferred parental transmission of the height-associated SNPs and utilized the haplotype genetic score derived from nontransmitted alleles as a valid genetic instrument for maternal height. In observational analysis, maternal height was significantly associated with birth length (p = 6.31 × 10−9), birth weight (p = 2.19 × 10−15), and gestational age (p = 1.51 × 10−7). Our parental-specific haplotype score association analysis revealed that birth length and birth weight were significantly associated with the maternal transmitted haplotype score as well as the paternal transmitted haplotype score. Their association with the maternal nontransmitted haplotype score was far less significant, indicating a major fetal genetic influence on these fetal growth measures. In contrast, gestational age was significantly associated with the nontransmitted haplotype score (p = 0.0424) and demonstrated a significant (p = 0.0234) causal effect of every 1 cm increase in maternal height resulting in ~0.4 more gestational d. Limitations of this study include potential influences in causal inference by biological pleiotropy, assortative mating, and the nonrandom sampling of study subjects. Conclusions Our results demonstrate that the observed association between maternal height and fetal growth measures (i.e., birth length and birth weight) is mainly defined by fetal genetics. In contrast, the association between maternal height and gestational age is more likely to be causal. In addition, our approach that utilizes the genetic score derived from the nontransmitted maternal haplotype as a genetic instrument is a novel extension to the Mendelian randomization methodology in casual inference between parental phenotype (or exposure) and outcomes in offspring. PMID:26284790

The Effect of Activity Restriction on Infant's Birth Weight and Gestational Age at Birth: PRAMS Data Analysis.

PubMed

Omar, Abeer

2018-01-01

Activity restriction is extensively prescribed for pregnant women with major comorbidities despite the lack of evidence to support its effectiveness in preventing preterm birth or low birth weight. To determine the moderation effect of home activity restriction for more than a week on infant's birth weight and gestational age at birth for high-risk women with obstetrical and medical comorbidities. A secondary analysis of 2004-2008 New York Pregnancy Risk Assessment Monitoring System was conducted with 1426 high-risk women. High-risk group included 41% of women treated with activity restriction and 59% of those not treated with activity restriction. Women with preterm premature rupture of membrane (PPROM) who were treated with activity restriction had a lower infant birth weight ( b = -202.85, p = ≤.001) and gestational age at birth ( b = -.91, p = ≤.001) than those without activity restriction. However, women with preterm labor and hypertensive disorders of pregnancy who were not treated with activity restriction had lower infant gestational age at birth ( b = -96, p = ≤.01) and ( b = -92, p = ≤.001), respectively, compared to those who were treated with activity restriction. Findings suggest a contrary effect of activity restriction on infants born to women with PPROM, which is a major reason for prescribing activity restriction. The current study results may trigger the need to conduct randomized control trials to determine the effect of severity of activity restriction on maternal and infant outcomes.

Birth weight, childhood socioeconomic environment, and cognitive development in the 1958 British birth cohort study.

PubMed

Jefferis, Barbara J M H; Power, Chris; Hertzman, Clyde

2002-08-10

To examine the combined effect of social class and weight at birth on cognitive trajectories during school age and the associations between birth weight and educational outcomes through to 33 years. Longitudinal, population based, birth cohort study. 10 845 males and females born during 3-9 March 1958 with information on birth weight, social class, and cognitive tests. Reading, maths, draw a man, copying designs, verbal and non-verbal ability tests at ages 7, 11, and 16, highest qualifications achieved by 33, and trajectories of maths standardised scores at 7-16 years. The outcome of all childhood cognitive tests and educational achievements improved significantly with increasing birth weight. Analysis of maths scores at 7 and of highest qualifications achieved by 33 showed that the relations were robust to adjustment for potential confounding factors. For each kilogram increase in birth weight, maths z score increased by 0.17 (adjusted estimate 0.15, 95% confidence interval 0.10 to 0.21) for males and 0.21 (0.20, 0.14 to 0.25) for females. Trajectories of maths z scores between 7 and 16 years diverged for different social class groups: participants from classes I and II increased their relative position on the score with increasing age, whereas classes IV and V showed a relative decline with increasing age. Birth weight explained much less of the variation in cognition than did social class (range 0.5-1.5% v 2.9-12.5%). The postnatal environment has an overwhelming influence on cognitive function through to early adulthood, but these strong effects do not explain the weaker but independent association with birth weight.

Refractive errors and refractive development in premature infants.

PubMed

Ozdemir, O; Tunay, Z Ozen; Acar, D Erginturk; Acar, U

2015-12-01

To examine refractive errors and refractive development in premature infants. Premature infants in the retinopathy of prematurity (ROP) screening program were recruited and examined longitudinally between 28 and 58 weeks postmenstrual age. For performing cycloplegic retinoscopy, 1% tropicamide was administered, two drops with a 10-minute interval, in order to paralyze accommodation and to achieve cycloplegia. Birth weight, gestational age, gender and acute ROP disease were recorded. The relationship between spherical equivalent, astigmatism and postmenstrual age was evaluated. A total of 798 readings were obtained from 258 infants (131 females, 127 males) between 28 and 58 weeks postmenstrual age. The median number of examinations was 3 (minimum 1, maximum 7). In the comparisons of birth weight, gestational age, spherical equivalent and astigmatism between genders, there were no statistically significant differences (P>0.05). Gestational age (regression analysis, r(2)=0.30, P<0.01) and birth weight (regression analysis, r(2)=0.22, P<0.01) had a significant effect on refractive error development. Preterm babies with lower birth weight and those born more prematurely had lower spherical equivalent. The spherical equivalent of the eyes correlated significantly with the postmenstrual age of the infants (r=0.512, P<0.01). Infants with low gestational age and low birth weight also had low spherical equivalent. Moreover, spherical equivalent correlated with increasing postmenstrual age. However, astigmatism did not correlate with postmenstrual age and did not associate with gestational age or birth weight. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

[Study on relationship between mother's animal sourced food intake during pregnancy and neonate birth weight].

PubMed

Yan, H; Dang, S N; Mi, B B; Qu, P F; Zhang, L; Wang, H L; Bi, Y X; Zeng, L X; Li, Q; Yan, H

2017-05-10

Objective: To explore the effect of maternal animal sourced food intake during pregnancy on neonate birth weight and provide scientific basis for guiding the reasonable diet intake in pregnant women and increasing neonate birth weight. Methods: Data were derived from a cross-sectional project of"the prevalence and risk factors of birth defects in Shaanxi province" , which were conducted in 30 counties in Shaanxi province from July to November in 2013. A stratified multistage random sampling method was used to select women who were pregnant between January 2010 and December 2013 for a random semi-quantitative food frequency questionnaire survey to collect the data on the frequency and amount of food consumption on animal protein sources and the data of newborns. Children aged 0-1 years and their mothers were selected as the study subjects. The generalized linear model was used to analyze the relationship between the neonate birth weight and maternal animal sourced food intake during pregnancy, and by using neonate birth weight as dependent variable, food intake frequency as independent variable, three adjustment models were established for stratified analysis. Results: Totally 11 459 participants were involved in this study. The average birth weight of newborn was (3 279.9±454.6) g, the average weekly intake of animal sourced foods was4.00 times for egg, 1.50 times for meat, 3.00 times for dairy foods, 0.50 times for fish and 5.00 times for overall animal sourced foods in pregnant women. Without stratification, three models shown that meat and overall animal sourced food intake had effects on neonate birth weight. After adjustment for gestational weeks, maternal age, social and demographic factors and others, meat intake increased by 1 time a week, the increase of neonate birth weight was about 5.26 (95 %CI : 1.32-9.20) g, and the overall animal food increased by 1 times a week, the average neonate birth weight increased by 3.24 (95 %CI : 1.09-5.39) g. Stratified analysis showed that meat and overall animal sourced food always had more influences on baby girls and those living in rural area. In the region classification, the overall animal sourced food intake had more influences on women living in northern area and Guanzhong area of Shaanxi, and meat intake had greater influence on women living in southern Shaanxi. And the influences were positive, the more animal sourced foods were taken, the greater the birth weight increased. Conclusion: Animal sourced food intake during pregnancy would benefit the increase of neonate birth weight. It suggests that pregnant women should pay more attention to the intake of animal sourced food.

Sociodemographic risk factors associated with low birthweight in United Arab Emirates.

PubMed

Bener, A; Abdulrazzaq, Y M; Dawodu, A

1996-07-01

This case-control study was undertaken to determine sociodemographic risk factors for low birth weight in Al-Ain (United Arab Emirates) over a 12-month period in 1992-93. A total of 3485 live births occurred of which 293 (8.4%) were low birth weight. The risk factors considered were mother's occupation, house conditions, place of residence (urban or rural), maternal smoking habits, antenatal care, availability of help in the home, maternal BMI and educational status. Multiple logistic regression analysis showed that mother's occupation, maternal smoking, antenatal care, and lack of help in the home were associated with increased risk of low birth weight.

Correlation between pesticide use in agriculture and adverse birth outcomes in Brazil: an ecological study.

PubMed

de Siqueira, Marília Teixeira; Braga, Cynthia; Cabral-Filho, José Eulálio; Augusto, Lia Giraldo da Silva; Figueiroa, José Natal; Souza, Ariani Impieri

2010-06-01

This ecological study analyzed the association between pesticide use and prematurity, low weight and congenital abnormality at birth, infant death by congenital abnormality, and fetal death in Brazil in 2001. Simple linear regression analysis has determined a positive association between pesticide use and prematurity, low birth weight, and congenital abnormality. The association between pesticide use and low birth weight (p = 0.045) and, congenital abnormality (p = 0.004) and infant death rate by congenital abnormality (p = 0.039) remained after the adjustment made by the proportion of pregnant women with a low number of prenatal care visits.

Birth Weight and Acute Childhood Leukemia: A Meta-analysis of Observational Studies

DTIC Science & Technology

2005-03-22

22 MAR 2005 2. REPORT TYPE 3. DATES COVERED - 4. TITLE AND SUBTITLE Birth Weight and Acute Childhood Leukemia: A Meta - analysis of Observational...and to quantify the strength of the relationships. We conducted a meta - analysis of nine case-control studies (published between 1991 and 2004...Based on a meta - analysis of only three case-control studies (published between 1997 and 2004) involving over 700 children with AML and over 1,900

Population-based assessments of ophthalmologic and audiologic follow-up in children with very low birth weight enrolled in Medicaid: a quality-of-care study.

PubMed

Wang, C Jason; Elliott, Marc N; McGlynn, Elizabeth A; Brook, Robert H; Schuster, Mark A

2008-02-01

The purpose of our work was to determine whether children with very low birth weight (< 1500 g) who are at high risk for vision and hearing problems and enrolled in Medicaid receive recommended follow-up vision and hearing services and to examine predictors of services. We conducted a retrospective analysis of 2182 children born in South Carolina from 1996 to 1998 with birth weights of 401 to 1499 g, gestations of > or = 24 weeks, and survival of > or = 90 days of life. Receipt of services for Medicaid-enrolled children was assessed by using a linked data set that included files from vital records, death certificates, Medicaid, Chronic Rehabilitative Services, and the Early Intervention Program. We assessed the receipt of hearing rehabilitation by 6 months of age for children with nonconductive hearing loss and routine ophthalmologic examination between ages of 1 and 2 years for all children with very low birth weight. Multivariate logistic regression was restricted to ophthalmologic examinations because of sample size. Among children with very low birth weight with nonconductive hearing loss, 20% received hearing rehabilitation by 6 months of age. Twenty-three percent of children with very low birth weight received an ophthalmologic examination between the ages of 1 and 2 years. Limiting our analysis to children < 1000 g or extending the measurement period to 7 months (hearing) and age 3 years (vision) did not substantially increase the percentage of children receiving the services. The receipt of an ophthalmologic examination was associated positively with Medicaid enrollment by the time of hospital discharge and birth in a level-3 hospital and negatively associated with higher birth weight, an Apgar score of > or = 7, and black maternal race. Among children born at < 1000 g, all of whom were eligible for the Early Intervention Program, the receipt of an ophthalmologic examination was positively associated with program enrollment. There is a shortfall in the provision of critical services for children with very low birth weight. These findings reinforce the Institute of Medicine's concerns regarding inadequate outcome data and health care services for preterm infants and support the importance of enrollment in the Early Intervention Program for children with very low birth weight.

Prenatal Ambient Air Pollution, Placental Mitochondrial DNA Content, and Birth Weight in the INMA (Spain) and ENVIRONAGE (Belgium) Birth Cohorts

PubMed Central

Clemente, Diana B.P.; Casas, Maribel; Vilahur, Nadia; Begiristain, Haizea; Bustamante, Mariona; Carsin, Anne-Elie; Fernández, Mariana F.; Fierens, Frans; Gyselaers, Wilfried; Iñiguez, Carmen; Janssen, Bram G.; Lefebvre, Wouter; Llop, Sabrina; Olea, Nicolás; Pedersen, Marie; Pieters, Nicky; Santa Marina, Loreto; Souto, Ana; Tardón, Adonina; Vanpoucke, Charlotte; Vrijheid, Martine; Sunyer, Jordi; Nawrot, Tim S.

2015-01-01

Background: Mitochondria are sensitive to environmental toxicants due to their lack of repair capacity. Changes in mitochondrial DNA (mtDNA) content may represent a biologically relevant intermediate outcome in mechanisms linking air pollution and fetal growth restriction. Objective: We investigated whether placental mtDNA content is a possible mediator of the association between prenatal nitrogen dioxide (NO2) exposure and birth weight. Methods: We used data from two independent European cohorts: INMA (n = 376; Spain) and ENVIRONAGE (n = 550; Belgium). Relative placental mtDNA content was determined as the ratio of two mitochondrial genes (MT-ND1 and MTF3212/R3319) to two control genes (RPLP0 and ACTB). Effect estimates for individual cohorts and the pooled data set were calculated using multiple linear regression and mixed models. We also performed a mediation analysis. Results: Pooled estimates indicated that a 10-μg/m3 increment in average NO2 exposure during pregnancy was associated with a 4.9% decrease in placental mtDNA content (95% CI: –9.3, –0.3%) and a 48-g decrease (95% CI: –87, –9 g) in birth weight. However, the association with birth weight was significant for INMA (–66 g; 95% CI: –111, –23 g) but not for ENVIRONAGE (–20 g; 95% CI: –101, 62 g). Placental mtDNA content was associated with significantly higher mean birth weight (pooled analysis, interquartile range increase: 140 g; 95% CI: 43, 237 g). Mediation analysis estimates, which were derived for the INMA cohort only, suggested that 10% (95% CI: 6.6, 13.0 g) of the association between prenatal NO2 and birth weight was mediated by changes in placental mtDNA content. Conclusion: Our results suggest that mtDNA content can be one of the potential mediators of the association between prenatal air pollution exposure and birth weight. Citation: Clemente DB, Casas M, Vilahur N, Begiristain H, Bustamante M, Carsin AE, Fernández MF, Fierens F, Gyselaers W, Iñiguez C, Janssen BG, Lefebvre W, Llop S, Olea N, Pedersen M, Pieters N, Santa Marina L, Souto A, Tardón A, Vanpoucke C, Vrijheid M, Sunyer J, Nawrot TS. 2016. Prenatal ambient air pollution, placental mitochondrial DNA content, and birth weight in the INMA (Spain) and ENVIRONAGE (Belgium) birth cohorts. Environ Health Perspect 124:659–665; http://dx.doi.org/10.1289/ehp.1408981 PMID:26317635

Nutritional status and weight gain in pregnant women.

PubMed

Sato, Ana Paula Sayuri; Fujimori, Elizabeth

2012-01-01

This study described the nutritional status of 228 pregnant women and the influence of this on birth weight. This is a retrospective study, developed in a health center in the municipality of São Paulo, with data obtained from medical records. Linear regression analysis was carried out. An association was verified between the initial and final nutritional status (p<0.001). The mean of total weight gain in the pregnant women who began the pregnancy underweight was higher compared those who started overweight/obese (p=0.005). Weight gain was insufficient for 43.4% of the pregnant women with adequate initial weight and for 36.4% of all the pregnant women studied. However, 37.1% of those who began the pregnancy overweight/obese finished with excessive weight gain, a condition that ultimately affected almost a quarter of the pregnant women. Anemia and low birth weight were uncommon, however, in the linear regression analysis, birth weight was associated with weight gain (p<0.05). The study highlights the importance of nutritional care before and during pregnancy to promote maternal-infant health.

Birth characteristics and female sex hormone concentrations during adolescence: results from the Dietary Intervention Study in Children.

PubMed

Ruder, Elizabeth H; Hartman, Terryl J; Rovine, Michael J; Dorgan, Joanne F

2011-04-01

Birth characteristics and adult hormone concentrations influence breast cancer risk, but little is known about the influence of birth characteristics on hormone concentrations, particularly during adolescence. We evaluated the association of birth characteristics (birth weight, birth length, and gestational age) with serum sex hormone concentrations during late childhood and adolescence in 278 female participants of the Dietary Intervention Study in Children. Repeated measures analysis of variance models were used to assess the relationships of birth characteristics and serum estrogens and androgens at five different time points over a mean period of 7 years. In analyses that did not take into account time from blood draw until menarche, birth weight was inversely associated with pre-menarche concentrations of estradiol, estrone sulfate, androstenedione, testosterone, and dehydroepiandrosterone sulfate (DHEAS). In the post-menarche analyses, birth weight was not significantly associated with concentration of any of the hormones under investigation. Birth length and gestational age were not associated with hormone concentrations before or after menarche. Birth weight is inversely associated with sex hormone concentrations before menarche in the model unadjusted for time from blood draw until menarche. The in utero environment has long-term influences on the hormonal milieu, which could potentially contribute to breast cancer risk.

Assessing survey measures of infant birth weight and birth size in Ecuador.

PubMed

Eggleston, E; Tsui, A O; Fortney, J

2000-07-01

The purpose of this study was to assess the utility of using maternal assessments of infant birth size as proxy measures for birth weight in Ecuador, a country in which a sizeable proportion of births take place at home, where birth weight is typically not recorded. Four thousand and seventy-eight women who experienced a live singleton birth between January 1992 and August 1994 were interviewed in the Ecuador Demographic and Maternal-Child Health Survey. All women were asked if their child was weighed at birth, his/her weight, and what they considered to be his/her birth size relative to other newborns. The consistency between birth size and birth weight measures was assessed, and the differences between infants with and without reported birth weights were explored. The authors conclude that maternal assessments of birth size are poor proxy indicators of birth weight. Estimates of low birth weight based on maternal assessments of birth size as very small should be recognized as underestimates of the actual prevalence of low birth weight. Moreover, infants for whom birth weights are missing should not be considered similar to those for whom weight was reported. Those without reported birth weights are more likely to be low birth weight. Thus, relying solely on reports of numeric birth weight will underestimate the prevalence of low birth weight.

The association of birth weight and infant growth with childhood autonomic nervous system activity and its mediating effects on energy-balance-related behaviours-the ABCD study.

PubMed

van Deutekom, Arend W; Chinapaw, Mai Jm; Gademan, Maaike Gj; Twisk, Jos Wr; Gemke, Reinoud Jbj; Vrijkotte, Tanja Gm

2016-08-01

The purpose of this study was to examine the association of birth weight and infant growth with childhood autonomic nervous system (ANS) activity and to assess whether ANS activity mediates the associations of birth weight and infant growth with energy-balance-related behaviours, including energy intake, satiety response, physical activity and screen time. In 2089 children, we prospectively collected birth weight, infant growth defined as conditional weight and height gain between birth and 12 months and-at 5 years-indices of cardiac ANS activity and parent-reported energy-balance-related behaviours. A mediation analysis was conducted, based on MacKinnon's multivariate extension of the product-of-coefficients strategy. Birth weight and infant height gain were inversely associated with sympathetic, but not parasympathetic, activity at age 5. Infant weight gain was not associated with childhood ANS activity. Infant weight gain was predictive of increased childhood screen time and infant height gain of diminished childhood energy intake, but sympathetic activity did not mediate these associations. Low-birth-weight children have higher sympathetic activity, which is considered a risk factor for cardiovascular disease. Height gain in infancy seems to be beneficial for childhood sympathetic activity. However, sympathetic activity was no mediator of the associations of infant growth with childhood energy-balance-related behaviours. As individual differences in ANS activity predict increased risk of cardiovascular disease, these differences may offer insight into the early-life origins of chronic diseases and provide further basis for public health strategies to optimize birth weight and infant growth. © The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Increasing low birth weight rates: deliveries in a tertiary hospital in istanbul.

PubMed

Akin, Yasemin; Cömert, Serdar; Turan, Cem; Unal, Orhan; Piçak, Abdülkadir; Ger, Lale; Telatar, Berrin

2010-09-01

Prevalence of low birth weight deliveries may vary across different environments. The necessity of determination of regional data prompted this study. Information of all deliveries from January 2004 to December 2008 was obtained from delivery registry records retrospectively. Initial data including birth weight, vital status, sex, maternal age and mode of delivery were recorded using medical files. The frequency of low birth weight, very low birth weight, extremely low birth weight and stillbirth deliveries were determined. Among 19,533 total births, there were 450 (23.04 per 1000) stillbirths. Low birth weight rate was 10.61%. A significant increase in yearly distribution of low birth weight deliveries was observed (P<0.001). Very low birth weight and extremely low birth weight delivery rates were 3.14% and 1.58% respectively. Among 2073 low birth weight infants, 333 (16.06%) were stillbirths. The stillbirth delivery rate and the birth of a female infant among low birth weight deliveries were significantly higher than infants with birth weight ≥2500g (P<0.001, OR=28.37), (P<0.001) retrospectively. There was no statistical difference between low birth weight and maternal age. The rate of cesarean section among low birth weight infants was 49.4%. High low birth weight and stillbirth rates, as well as the increase in low birth weight deliveries over the past five years in this study are striking. For reduction of increased low birth weight rates, appropriate intervention methods should be initiated.

Determining an anthropometric surrogate measure for identifying low birth weight babies in Uganda: a hospital-based cross sectional study.

PubMed

Elizabeth, Nabiwemba L; Christopher, Orach Garimoi; Patrick, Kolsteren

2013-04-12

Achieving Millennium Development Goal 4 is dependent on significantly reducing neonatal mortality. Low birth weight is an underlying factor in most neonatal deaths. In developing countries the missed opportunity for providing life saving care is mainly a result of failure to identify low birth weight newborns. This study aimed at identifying a reliable anthropometric measurement for screening low birth weight and determining an operational cut-off point in the Uganda setting. This simple measurement is required because of lack of weighing scales in the community, and sometimes in the health facilities. This was a hospital-based cross-sectional study. Two midwives weighed 706 newborns and measured their foot length, head, chest, thigh and mid-upper arm circumferences within 24 hours after birth.Data was analysed using STATA version 10.0. Correlation with birth weight using Pearson's correlation coefficient and Receiver Operating Characteristics curve analysis were done to determine the measure that best predicts birth weight. Sensitivity and specificity were calculated for a range of measures to obtain operational cut-off points; and Likelihood Ratios and Diagnostic Odds Ratio were determined for each cut-off point. Birth weights ranged from 1370-5350 grams with a mean of 3050 grams (SD 0.53) and 85 (12%) babies weighed less than 2500 grams. All anthropometric measurements had a positive correlation with birth weight, with foot length showing the strongest (r = 0.76) and thigh circumference the weakest (r = 0.62) correlations. Foot length had the highest predictive value for low birth weight (AUC = 0.97) followed by mid-upper arm circumference (AUC = 0.94). Foot length and chest circumference had the highest sensitivity (94%) and specificity (90%) respectively for screening low birth weight babies at the selected cut-off points. Chest circumference had a significantly higher positive likelihood ratio (8.7) than any other measure, and foot length had the lowest negative likelihood ratio. Chest circumference and foot length had diagnostic odds ratios of 97% and 77% respectively. Foot length was easier to measure and it involved minimal exposure of the baby to cold. A cut-off of foot length 7.9 cm had sensitivity of 94% and specificity of 83% for predicting low birth weight. This study suggests foot length as the most appropriate predictor for low birth weight in comparison to chest, head, mid-upper arm and thigh circumference in the Uganda setting. Use of low cost and easy to use tools to identify low birth weight babies by village health teams could support community efforts to save newborns.

New loci associated with birth weight identify genetic links between intrauterine growth and adult height and metabolism.

PubMed

Horikoshi, Momoko; Yaghootkar, Hanieh; Mook-Kanamori, Dennis O; Sovio, Ulla; Taal, H Rob; Hennig, Branwen J; Bradfield, Jonathan P; St Pourcain, Beate; Evans, David M; Charoen, Pimphen; Kaakinen, Marika; Cousminer, Diana L; Lehtimäki, Terho; Kreiner-Møller, Eskil; Warrington, Nicole M; Bustamante, Mariona; Feenstra, Bjarke; Berry, Diane J; Thiering, Elisabeth; Pfab, Thiemo; Barton, Sheila J; Shields, Beverley M; Kerkhof, Marjan; van Leeuwen, Elisabeth M; Fulford, Anthony J; Kutalik, Zoltán; Zhao, Jing Hua; den Hoed, Marcel; Mahajan, Anubha; Lindi, Virpi; Goh, Liang-Kee; Hottenga, Jouke-Jan; Wu, Ying; Raitakari, Olli T; Harder, Marie N; Meirhaeghe, Aline; Ntalla, Ioanna; Salem, Rany M; Jameson, Karen A; Zhou, Kaixin; Monies, Dorota M; Lagou, Vasiliki; Kirin, Mirna; Heikkinen, Jani; Adair, Linda S; Alkuraya, Fowzan S; Al-Odaib, Ali; Amouyel, Philippe; Andersson, Ehm Astrid; Bennett, Amanda J; Blakemore, Alexandra I F; Buxton, Jessica L; Dallongeville, Jean; Das, Shikta; de Geus, Eco J C; Estivill, Xavier; Flexeder, Claudia; Froguel, Philippe; Geller, Frank; Godfrey, Keith M; Gottrand, Frédéric; Groves, Christopher J; Hansen, Torben; Hirschhorn, Joel N; Hofman, Albert; Hollegaard, Mads V; Hougaard, David M; Hyppönen, Elina; Inskip, Hazel M; Isaacs, Aaron; Jørgensen, Torben; Kanaka-Gantenbein, Christina; Kemp, John P; Kiess, Wieland; Kilpeläinen, Tuomas O; Klopp, Norman; Knight, Bridget A; Kuzawa, Christopher W; McMahon, George; Newnham, John P; Niinikoski, Harri; Oostra, Ben A; Pedersen, Louise; Postma, Dirkje S; Ring, Susan M; Rivadeneira, Fernando; Robertson, Neil R; Sebert, Sylvain; Simell, Olli; Slowinski, Torsten; Tiesler, Carla M T; Tönjes, Anke; Vaag, Allan; Viikari, Jorma S; Vink, Jacqueline M; Vissing, Nadja Hawwa; Wareham, Nicholas J; Willemsen, Gonneke; Witte, Daniel R; Zhang, Haitao; Zhao, Jianhua; Wilson, James F; Stumvoll, Michael; Prentice, Andrew M; Meyer, Brian F; Pearson, Ewan R; Boreham, Colin A G; Cooper, Cyrus; Gillman, Matthew W; Dedoussis, George V; Moreno, Luis A; Pedersen, Oluf; Saarinen, Maiju; Mohlke, Karen L; Boomsma, Dorret I; Saw, Seang-Mei; Lakka, Timo A; Körner, Antje; Loos, Ruth J F; Ong, Ken K; Vollenweider, Peter; van Duijn, Cornelia M; Koppelman, Gerard H; Hattersley, Andrew T; Holloway, John W; Hocher, Berthold; Heinrich, Joachim; Power, Chris; Melbye, Mads; Guxens, Mònica; Pennell, Craig E; Bønnelykke, Klaus; Bisgaard, Hans; Eriksson, Johan G; Widén, Elisabeth; Hakonarson, Hakon; Uitterlinden, André G; Pouta, Anneli; Lawlor, Debbie A; Smith, George Davey; Frayling, Timothy M; McCarthy, Mark I; Grant, Struan F A; Jaddoe, Vincent W V; Jarvelin, Marjo-Riitta; Timpson, Nicholas J; Prokopenko, Inga; Freathy, Rachel M

2013-01-01

Birth weight within the normal range is associated with a variety of adult-onset diseases, but the mechanisms behind these associations are poorly understood. Previous genome-wide association studies of birth weight identified a variant in the ADCY5 gene associated both with birth weight and type 2 diabetes and a second variant, near CCNL1, with no obvious link to adult traits. In an expanded genome-wide association meta-analysis and follow-up study of birth weight (of up to 69,308 individuals of European descent from 43 studies), we have now extended the number of loci associated at genome-wide significance to 7, accounting for a similar proportion of variance as maternal smoking. Five of the loci are known to be associated with other phenotypes: ADCY5 and CDKAL1 with type 2 diabetes, ADRB1 with adult blood pressure and HMGA2 and LCORL with adult height. Our findings highlight genetic links between fetal growth and postnatal growth and metabolism.

Advanced Maternal Age and the Risk of Low Birth Weight and Preterm Delivery: a Within-Family Analysis Using Finnish Population Registers

PubMed Central

Goisis, Alice; Remes, Hanna; Barclay, Kieron; Martikainen, Pekka; Myrskylä, Mikko

2017-01-01

Abstract Advanced maternal age at birth is considered a major risk factor for birth outcomes. It is unclear to what extent this association is confounded by maternal characteristics. To test whether advanced maternal age at birth independently increases the risk of low birth weight (<2,500 g) and preterm birth (<37 weeks’ gestation), we compared between-family models (children born to different mothers at different ages) with within-family models (children born to the same mother at different ages). The latter procedure reduces confounding by unobserved parental characteristics that are shared by siblings. We used Finnish population registers, including 124,098 children born during 1987–2000. When compared with maternal ages 25–29 years in between-family models, maternal ages of 35–39 years and ≥40 years were associated with percentage increases of 1.1 points (95% confidence intervals: 0.8, 1.4) and 2.2 points (95% confidence intervals: 1.4, 2.9), respectively, in the probability of low birth weight. The associations are similar for the risk of preterm delivery. In within-family models, the relationship between advanced maternal age and low birth weight or preterm birth is statistically and substantively negligible. In Finland, advanced maternal age is not independently associated with the risk of low birth weight or preterm delivery among mothers who have had at least 2 live births. PMID:29206985

The Impact of Gender on Anthropometric Measures of Twins.

PubMed

Jahanfar, Shayesteh; Lim, Kenneth

2016-12-01

Literature suggests that male hormones influence fetal growth in singleton pregnancies. We hypothesized that the same phenomenon is seen in twin gestations. (1) to identify the impact of gender associated with fetal birth weight, head circumference, and birth length for twins; (2) to examine the effect of gender on standardized fetal growth at birth, according to gestational age and birth order; (3) to examine the effect of gender on placenta weight and dimensions. This was a population-based retrospective cohort study of twins (4,368 twins, 2,184 pairs) born in British Columbia, Canada from 2000-2010. We excluded twins with stillbirth, congenital anomalies, and those delivered with cesarean section. We also controlled for confounding factors, including birth order, gestational age, maternal anthropometric measures, maternal smoking habits, and obstetric history. A subsample of this population was analyzed from Children and Women Hospital to obtain chorionicity information. Male-male twins were heavier than male-females and female-female twin pairs (p=.01). Within sex-discordant twin pairs, males were also heavier than females (p=.01). Regression analysis suggested that gender affects birth weight independent of birth order and gestational age. Other newborn anthropometric measures were not found to be dependent on gender. In analyzing a subsample with chorionicity data, birth weight was the only anthropometric measure that was both statistically and clinically affected by sex, even after adjustment for gestational age, chorionicity, birth order, and maternal age. Birth weight was affected by gender while head circumference and birth length were not.

Does Neighborhood Risk Explain Racial Disparities in Low Birth Weight among Infants Born to Adolescent Mothers?

PubMed Central

Nichols, Tracy R.; Rulison, Kelly L.; Aronson, Robert E.; Brown-Jeffy, Shelly L.; Morrison, Sharon D.

2015-01-01

Study objective To test associations and interactions between racial identification, neighborhood risk, and low birth weight disparities between infants born to African-American and White adolescent mothers. Design Retrospective cross-sectional study. Birth cases were geocoded and linked to census-tract information from the 2010 United States Census and the 2007-2011 American Community Survey. A “neighborhood risk” index was created through principal component analysis, and mothers were grouped into three neighborhood risk levels (low, medium, high). Multilevel models with cross-level interactions were used to identify variation in racial differences in low birth weight outcomes across neighborhood risk levels when controlling for maternal demographics and pregnancy behaviors (smoking, prenatal care use). Setting North Carolina, United States. Participants 7,923 cases of singleton infants born to non-Hispanic African-American and White adolescent mothers from the North Carolina State Center of Health Statistics for 2011. Main outcome measures Low birth weight. Results African-American mothers were significantly more likely to have infants of low birth weight than White mothers in this sample [OR 1.89, CI (1.53, 2.34)]. Mothers that resided in areas of high neighborhood risk were significantly more likely to have infants of low birth weight than mothers residing in areas of low neighborhood risk [OR 1.55, 95% CI (1.25, 1.93)]. Even when controlling for confounding factors, racial disparities in low birth weight odds did not significantly vary by neighborhood risk level. Conclusions Racial disparities can remain in low birth weight odds among infants born to adolescent mothers when controlling for maternal characteristics, pregnancy behaviors, and neighborhood risk. PMID:26307240

Low birth weight is associated with increased fat intake in school-aged boys.

PubMed

Bischoff, Adrianne R; Portella, André K; Paquet, Catherine; Dalle Molle, Roberta; Faber, Aida; Arora, Narendra; Levitan, Robert D; Silveira, Patrícia P; Dube, Laurette

2018-06-01

Evidence suggests that both high and low birth weight children have increased the risk for obesity and the metabolic syndrome in adulthood. Previously we have found altered feeding behaviour and food preferences in pre-school children and adults born with low birth weight. In this study, we investigated if birth weight was associated with different intake of fat, carbohydrate and/or protein at 6-12 years of age. This is a cross-sectional study where 255 guardians answered online and telephone questions including anthropometrics and demographic data, parental family food rules (food control, encouragement and restriction) and a complete web-based FFQ for their children (130 boys and 125 girls). Baseline demographic and parental food rules characteristics did not differ accordingly to sex. Linear regression models were conducted separately for each sex, adjusted for income, age and maternal age. There were no differences in total energy intake, but energy density (ED, energy content/g) was negatively associated with birth weight in boys. Macronutrient analysis showed that ED intake was from a greater intake of fat. Birth weight was not a significant predictor of protein and carbohydrate intake in boys. In girls, we saw a positive correlation between fat intake and cholesterol intake v. birth weight, but no association with ED intake (results did not remain after adjustment). The study shows that low birth weight is associated with altered fat intake in childhood in a sex-specific manner. It is likely that biological factors such as fetal programming of homoeostatic and/or hedonic pathways influencing food preferences are involved in this process.

Academic achievement of twins and singletons in early adulthood: Taiwanese cohort study.

PubMed

Tsou, Meng-Ting; Tsou, Meng-Wen; Wu, Ming-Ping; Liu, Jin-Tan

2008-07-21

To examine the long term effects of low birth weight on academic achievements in twins and singletons and to determine whether the academic achievement of twins in early adulthood is inferior to that of singletons. Cohort study. Taiwanese nationwide register of academic outcome. A cohort of 218 972 singletons and 1687 twins born in Taiwan, 1983-5. College attendance and test scores in the college joint entrance examinations. After adjustment for birth weight, gestational age, birth order, and sex and the sociodemographic characteristics of the parents, twins were found to have significantly lower mean test scores than singletons in Chinese, mathematics, and natural science, as well as a 2.2% lower probability of attending college. Low birthweight twins had an 8.5% lower probability of college attendance than normal weight twins, while low birthweight singletons had only a 3.2% lower probability. The negative effects of low birth weight on the test scores in English and mathematics were substantially greater for twins than for singletons. The twin pair analysis showed that the association between birth weight and academic achievement scores, which existed for opposite sex twin pairs, was not discernible for same sex twin pairs, indicating that birth weight might partly reflect other underlying genetic variations. These data support the proposition that twins perform less well academically than singletons. Low birth weight has a negative association with subsequent academic achievement in early adulthood, with the effect being stronger for twins than for singletons. The association between birth weight and academic performance might be partly attributable to genetic factors.

Estimation of Genetic Parameters from Longitudinal Records of Body Weight of Berkshire Pigs

PubMed Central

Lee, Dong-Hee; Do, Chang-Hee

2012-01-01

Direct and maternal genetic heritabilities and their correlations with body weight at 5 stages in the life span of purebred Berkshire pigs, from birth to harvest, were estimated to scrutinize body weight development with the records for 5,088 purebred Berkshire pigs in a Korean farm, using the REML based on an animal model. Body weights were measured at birth (Birth), at weaning (Weaning: mean 22.9 d), at the beginning of a performance test (On: mean 72.7 d), at the end of a performance test (Off: mean 152.4 d), and at harvest (Finish: mean 174.3 d). Ordinary polynomials and Legendre with order 1, 2, and 3 were adopted to adjust body weight with age in the multivariate animal models. Legendre with order 3 fitted best concerning prediction error deviation (PED) and yielded the lowest AIC for multivariate analysis of longitudinal body weights. Direct genetic correlations between body weight at Birth and body weight at Weaning, On, Off, and Finish were 0.48, 0.36, 0.10, and 0.10, respectively. The estimated maternal genetic correlations of body weight at Finish with body weight at Birth, Weaning, On, and Off were 0.39, 0.49, 0.65, and 0.90, respectively. Direct genetic heritabilities progressively increased from birth to harvest and were 0.09, 0.11, 0.20, 0.31, and 0.43 for body weight at Birth, Weaning, On, Off, and Finish, respectively. Maternal genetic heritabilities generally decreased and were 0.26, 0.34, 0.15, 0.10, and 0.10 for body weight at Birth, Weaning, On, Off, and Finish, respectively. As pigs age, maternal genetic effects on growth are reduced and pigs begin to rely more on the expression of their own genes. Although maternal genetic effects on body weight may not be large, they are sustained through life. PMID:25049624

A Systematic Review and Meta-Analysis of Influenza A Virus Infection During Pregnancy Associated with an Increased Risk for Stillbirth and Low Birth Weight.

PubMed

He, Jing; Liu, Zhi-Wei; Lu, Yong-Ping; Li, Tao-Yuan; Liang, Xu-Jing; Arck, Petra C; Huang, Si-Min; Hocher, Berthold; Chen, You-Peng

2017-01-01

Impaired pregnancy outcomes, such as low birth weight are associated with increased disease risk in later life, however little is known about the impact of common infectious diseases during pregnancy on birth weight. The study had two aims: a) to investigate risk factors of influenza virus infection during pregnancy, and b) to analyze the impact of influenza virus infection on pregnancy outcome, especially birth weight. Prospective and retrospective observational studies found in PubMed, MEDLINE, Embase, Google Scholar, and WangFang database were included in this meta analysis. Data of included studies was extracted and analyzed by the RevMan software. Pregnant women with anemia (P=0.004, RR=1.46, 95% CI: 1.13-1.88), obesity (P<0.00001, RR=1.35, 95% CI: 1.25-1.46) and asthma (P<0.00001, RR=1.99, 95% CI: 1.67-2.37) had higher rates of influenza virus infection. Regarding birth outcomes, influenza A virus infection did not affect the likelihood for cesarean section. Mothers with influenza had a higher rate of stillbirth (P=0.04, RR=2.36, 95% CI: 1.05-5.31), and their offspring had low 5-minute APGR Scores (P=0.009, RR=1.39, 95% CI: 1.08-1.79). Furthermore, the rate for birth weight < 2500g (P=0.04, RR=1.71, 95% CI: 1.03-2.84) was increased. Results of this study showed that anemia, asthma and obesity during pregnancy are risk factors influenza A virus infection during pregnancy. Moreover, gestational influenza A infection impairs pregnancy outcomes and increases the risk for low birth weight, a known risk factor for later life disease susceptibility. © 2017 The Author(s). Published by S. Karger AG, Basel.

Ambient air pollution and birth weight in full-term infants in Atlanta, 1994-2004.

PubMed

Darrow, Lyndsey A; Klein, Mitchel; Strickland, Matthew J; Mulholland, James A; Tolbert, Paige E

2011-05-01

An emerging body of evidence suggests that ambient levels of air pollution during pregnancy are associated with fetal growth. We examined relationships between birth weight and temporal variation in ambient levels of carbon monoxide, nitrogen dioxide (NO₂), sulfur dioxide (SO₂), ozone, particulate matter ≤ 10 μm in diameter (PM₁₀), ≤ 2.5 μm (PM(2.5)), 2.5 to 10 µm (PM(2.5-10)), and PM(2.5) chemical component measurements for 406,627 full-term births occurring between 1994 and 2004 in five central counties of metropolitan Atlanta. We assessed relationships between birth weight and pollutant concentrations during each infant's first month of gestation and third trimester, as well as in each month of pregnancy using distributed lag models. We also conducted capture-area analyses limited to mothers residing within 4 miles (6.4 km) of each air quality monitoring station. In the five-county analysis, ambient levels of NO₂, SO₂, PM(2.5) elemental carbon, and PM(2.5) water-soluble metals during the third trimester were significantly associated with small reductions in birth weight (-4 to -16 g per interquartile range increase in pollutant concentrations). Third-trimester estimates were generally higher in Hispanic and non-Hispanic black infants relative to non-Hispanic white infants. Distributed lag models were also suggestive of associations between air pollutant concentrations in late pregnancy and reduced birth weight. The capture-area analyses provided little support for the associations observed in the five-county analysis. Results provide some support for an effect of ambient air pollution in late pregnancy on birth weight in full-term infants.

Interpretation of ambiguities by schoolchildren with low birth weight from Embu das Artes, São Paulo state, Brazil.

PubMed

Pessoa, Rebeca Rodrigues; Araújo, Sarah Cueva Cândido Soares de; Isotani, Selma Mie; Puccini, Rosana Fiorini; Perissinoto, Jacy

To assess the development of language regarding the ability to recognize and interpret lexical ambiguity in low-birth-weight schoolchildren enrolled at the school system in the municipality of Embu das Artes, Sao Paulo state, compared with that of schoolchildren with normal birth weight. A case-control, retrospective, cross-sectional study conducted with 378 schoolchildren, both genders, aged 5 to 9.9 years, from the municipal schools of Embu das Artes. Study Group (SG) comprising 210 schoolchildren with birth weight < 2500 g. Control Group (CG) composed of 168 school children with birth weight ≥ 2500 g. Participants of both groups were compared with respect to the skills of recognition and verbal interpretation of sentences containing lexical ambiguity using the Test of Language Competence. Variables of interest: Age and gender of children; age and schooling of mothers. Statistical analysis: Descriptive analysis to characterize the sample and score per group; Student's t test for comparison between the total scores of each skill/subtest; Chi-square test to compare items within each subtest; multiple regression analysis for the intervening variables. Participants of the SG presented lower scores for ambiguous sentences compared with those of participants of the CG. Multiple regression analysis showed that child's current age was a predictor for all metalinguistic skills regarding interpretation of ambiguities in both groups. Participants of the SG presented lower specific and total scores than those of participants of the CG for ambiguity skills. The child's current age factor positively influenced the ambiguity skills in both groups.

Birth Weight Ratio as an Alternative to Birth Weight Percentile to Express Infant Weight in Research and Clinical Practice: A Nationwide Cohort Study

PubMed Central

Kazemier, Brenda M.; Schuit, Ewoud; Mol, Ben Willem J.; Pajkrt, Eva; Ganzevoort, Wessel

2014-01-01

Objective. To compare birth weight ratio and birth weight percentile to express infant weight when assessing pregnancy outcome. Study Design. We performed a national cohort study. Birth weight ratio was calculated as the observed birth weight divided by the median birth weight for gestational age. The discriminative ability of birth weight ratio and birth weight percentile to identify infants at risk of perinatal death (fetal death and neonatal death) or adverse pregnancy outcome (perinatal death + severe neonatal morbidity) was compared using the area under the curve. Outcomes were expressed stratified by gestational age at delivery separate for birth weight ratio and birth weight percentile. Results. We studied 1,299,244 pregnant women, with an overall perinatal death rate of 0.62%. Birth weight ratio and birth weight percentile have equivalent overall discriminative performance for perinatal death and adverse perinatal outcome. In late preterm infants (33+0–36+6 weeks), birth weight ratio has better discriminative ability than birth weight percentile for perinatal death (0.68 versus 0.63, P  0.01) or adverse pregnancy outcome (0.67 versus 0.60, P < 0.001). Conclusion. Birth weight ratio is a potentially valuable instrument to identify infants at risk of perinatal death and adverse pregnancy outcome and provides several advantages for use in research and clinical practice. Moreover, it allows comparison of groups with different average birth weights. PMID:25197283

Using new satellite based exposure methods to study the association between pregnancy pm2.5 exposure, premature birth and birth weight in Massachusetts

PubMed Central

2012-01-01

Background Adverse birth outcomes such as low birth weight and premature birth have been previously linked with exposure to ambient air pollution. Most studies relied on a limited number of monitors in the region of interest, which can introduce exposure error or restrict the analysis to persons living near a monitor, which reduces sample size and generalizability and may create selection bias. Methods We evaluated the relationship between premature birth and birth weight with exposure to ambient particulate matter (PM2.5) levels during pregnancy in Massachusetts for a 9-year period (2000–2008). Building on a novel method we developed for predicting daily PM2.5 at the spatial resolution of a 10x10km grid across New-England, we estimated the average exposure during 30 and 90 days prior to birth as well as the full pregnancy period for each mother. We used linear and logistic mixed models to estimate the association between PM2.5 exposure and birth weight (among full term births) and PM2.5 exposure and preterm birth adjusting for infant sex, maternal age, maternal race, mean income, maternal education level, prenatal care, gestational age, maternal smoking, percent of open space near mothers residence, average traffic density and mothers health. Results Birth weight was negatively associated with PM2.5 across all tested periods. For example, a 10 μg/m3 increase of PM2.5 exposure during the entire pregnancy was significantly associated with a decrease of 13.80 g [95% confidence interval (CI) = −21.10, -6.05] in birth weight after controlling for other factors, including traffic exposure. The odds ratio for a premature birth was 1.06 (95% confidence interval (CI) = 1.01–1.13) for each 10 μg/m3 increase of PM2.5 exposure during the entire pregnancy period. Conclusions The presented study suggests that exposure to PM2.5 during the last month of pregnancy contributes to risks for lower birth weight and preterm birth in infants. PMID:22709681

Using new satellite based exposure methods to study the association between pregnancy PM₂.₅ exposure, premature birth and birth weight in Massachusetts.

PubMed

Kloog, Itai; Melly, Steven J; Ridgway, William L; Coull, Brent A; Schwartz, Joel

2012-06-18

Adverse birth outcomes such as low birth weight and premature birth have been previously linked with exposure to ambient air pollution. Most studies relied on a limited number of monitors in the region of interest, which can introduce exposure error or restrict the analysis to persons living near a monitor, which reduces sample size and generalizability and may create selection bias. We evaluated the relationship between premature birth and birth weight with exposure to ambient particulate matter (PM₂.₅) levels during pregnancy in Massachusetts for a 9-year period (2000-2008). Building on a novel method we developed for predicting daily PM₂.₅ at the spatial resolution of a 10x10 km grid across New-England, we estimated the average exposure during 30 and 90 days prior to birth as well as the full pregnancy period for each mother. We used linear and logistic mixed models to estimate the association between PM₂.₅ exposure and birth weight (among full term births) and PM₂.₅ exposure and preterm birth adjusting for infant sex, maternal age, maternal race, mean income, maternal education level, prenatal care, gestational age, maternal smoking, percent of open space near mothers residence, average traffic density and mothers health. Birth weight was negatively associated with PM₂.₅ across all tested periods. For example, a 10 μg/m³ increase of PM₂.₅ exposure during the entire pregnancy was significantly associated with a decrease of 13.80 g [95% confidence interval (CI) = -21.10, -6.05] in birth weight after controlling for other factors, including traffic exposure. The odds ratio for a premature birth was 1.06 (95% confidence interval (CI) = 1.01-1.13) for each 10 μg/m3 increase of PM₂.₅ exposure during the entire pregnancy period. The presented study suggests that exposure to PM₂.₅ during the last month of pregnancy contributes to risks for lower birth weight and preterm birth in infants.

Patterns of postnatal weight changes in infants with very low and extremely low birth weights.

PubMed

Smith, S L; Kirchhoff, K T; Chan, G M; Squire, S J

1994-01-01

To describe (1) short-term postnatal weight loss and gain patterns in infants with very low and extremely low birth weights and (2) the variables that may affect these weight change patterns. Descriptive, retrospective review. University hospital in the intermountain western United States. Sixty-two charts of infants admitted to a university neonatal intensive care unit from July 1990 through November 1992 were reviewed. Infants who weighed 1000 grams or less were categorized as extremely low birth weight (ELBW) and infants weighing 1001 to 1500 grams were categorized as very low birth weight (VLBW). Each group was comprised of 31 infants. Fifty percent of the sample were male, and 50% were female. Eighty-five percent of the sample were Anglo-American, and 15% were non-Anglo-American. Data were collected on a three-part data collection tool and included demographic and treatment variables. A significant difference was found in the maximum percent weight lost between the two groups, with the ELBW group losing a mean of 14.77% of birth weight and the VLBW group losing a mean of 11.35% of birth weight (t = 2.45, p < 0.05). The day the infants reached their nadir weight was significantly different between the two groups. The ELBW group reached their nadir on day of life 7, and the VLBW group reached their nadir on day of life 6 (t = 2.00, p < 0.05). No significant difference was noted in the time to return to birth weight between the two groups, with a mean of 15 days to return to birth weight. Factors associated with postnatal weight changes were intraventricular hemorrhage, use of diuretics and steroids, day of life when nadir weight occurred, and maximum percent of weight lost. Many of the independent variables were significantly interrelated to each other (r = -0.90 to r = 0.91, p < 0.01 to p < 0.001). However, only the variables that correlated with time to return to birth weight were entered into the regression analysis. These variables included number of days diuretics were given before return to birth weight, maximum percent of weight lost, and day of life the infants reached their nadir weight. Number of days diuretics were given before return to birth weight correlated significantly with time to return to birth weight (r = 0.77, F = 26.66, p < 0.0001) although maximum percent of weight lost and day of life the infants reached their nadir weight had a minimal effect. Further research into the effects of diuretic therapy on weight changes in this population of infants may lead to interventions to minimize the negative effects of diuretics on return to birth weight. In addition, the older growth charts may not be applicable to this population of infants. Generation of new growth charts that provide growth curves based on these data could be useful in developing nutritional therapies that would promote growth and possibly decrease the length of hospital stay for these infants.

Does intrauterine crowding affect locomotor development? A comparative study of motor performance, neuromotor maturation and gait variability among piglets that differ in birth weight and vitality

PubMed Central

Aerts, Peter; Prims, Sara; Ayuso, Miriam; Van Cruchten, Steven; Van Ginneken, Chris

2018-01-01

In polytocous species, such as pigs, the growth of an individual fetus is affected by competition from its littermates and the sow. This intrauterine competition greatly influences postnatal traits such as birth weight and vitality (physical strength). A lowered vitality is most often observed among low birth weight piglets. Since it has been argued that locomotion might be key to unraveling vitality-related differences, we compared gait development in piglets with a low birth weight and low vitality (L piglets) with piglets with a normal birth weight and normal vitality (N piglets) by means of spatio-temporal gait analysis during locomotion at self-selected speed. Video recordings of L and N piglets walking along a corridor at ten time points (between birth and 96 h after birth) were made and the footfalls were digitized. Hence, self-selected speed, spatio-temporal characteristics and gait symmetry were analyzed to compare motor performance, neuromotor maturation (motor task, interlimb and intralimb coordination) and gait variability for L and N piglets. The analysis included both absolute and normalized data (according to the dynamic similarity concept), to distinguish neuromotor maturation from effects caused by growth. Results indicate that intrauterine crowding affects locomotion, mainly by impairing growth in utero, with a lowered motor performance during the first 96 h of age as a consequence. A difference in neuromotor skills was also visible, though only for swing and stance duration, implying a difference in neuromotor development in utero. However, further maturation during the first days after birth does not seem to be affected by intrauterine crowding. We can therefore conclude that L piglets might be considered a smaller and fictitious younger version of N piglets. PMID:29689084

Maternal autonomy and low birth weight in India.

PubMed

Chakraborty, Priyanka; Anderson, Alex K

2011-09-01

The prevalence of low birth weight (LBW) is a major public health issue in India (30.0%) and is the highest among South-Asian countries. Maternal autonomy or the mother's status in the household indicates her decision-making power with respect to movement, finance, healthcare use, and other household activities. Evidence suggests that autonomy of the mother is significantly associated with the child's nutritional status. Although previous studies in India reported the determinants of LBW, literature on the association between mother's autonomy and birth weight are lacking. This study, therefore, aims to examine the influence of maternal autonomy on birth weight of the newborn. The study, a secondary data analysis, examined data from the 2005-2006 National Health and Family Survey (NFHS 3) of India. A maternal autonomy score was created through proximal component factor analysis and categorized as high, medium, and low autonomy levels. The main outcome variable included birth weight of the index child obtained from health cards and mother's recall. Descriptive and logistic regression analyses were performed. Results from the study indicate that 20.0% of the index children included in the analysis were born at LBW. Low maternal autonomy was an independent predictor of LBW (odds ratio [OR] 1.28, 95% confidence interval [CI] 1.07-1.53, p=0.007) after adjusting for other factors, and medium autonomy level was not significant. These findings clearly indicate the importance of empowering women in India to combat the high incidence of LBW.

Sonography in Fetal Birth Weight Estimation

ERIC Educational Resources Information Center

Akinola, R. A.; Akinola, O. I.; Oyekan, O. O.

2009-01-01

The estimation of fetal birth weight is an important factor in the management of high risk pregnancies. The information and knowledge gained through this study, comparing a combination of various fetal parameters using computer assisted analysis, will help the obstetrician to screen the high risk pregnancies, monitor the growth and development,…

Birth weight and optic nerve head parameters.

PubMed

Samarawickrama, Chameen; Huynh, Son C; Liew, Gerald; Burlutsky, George; Mitchell, Paul

2009-06-01

To assess the relationship of birth weight, birth length, and head circumference as proxy markers of intrauterine growth, cup/disc ratio, and other optic disc parameters measured using optical coherence tomography (OCT). Population-based cross sectional analysis. The Sydney Childhood Eye Study examined 2353 primarily 12-year-old children from 21 randomly selected secondary schools during 2003 to 2005. Of 2353 children examined, 2134 (90.7%) had OCT scans (Zeiss Stratus OCT, Carl Zeiss Meditec, Dublin, CA) and are included in this study. The "fast" optic disc scan protocol was used. Birth weight, birth length, and head circumference were ascertained from health records. Height and weight were measured using standardized protocols, body mass index (BMI) was defined as weight (kilograms)/ height squared (meters), and sociodemographic information was collected in a questionnaire completed by parents. Low birth weight was defined as birth weight

Outdoor air pollution, preterm birth, and low birth weight: analysis of the world health organization global survey on maternal and perinatal health.

PubMed

Fleischer, Nancy L; Merialdi, Mario; van Donkelaar, Aaron; Vadillo-Ortega, Felipe; Martin, Randall V; Betran, Ana Pilar; Souza, João Paulo

2014-04-01

Inhaling fine particles (particulate matter with diameter ≤ 2.5 μm; PM2.5) can induce oxidative stress and inflammation, and may contribute to onset of preterm labor and other adverse perinatal outcomes. We examined whether outdoor PM2.5 was associated with adverse birth outcomes among 22 countries in the World Health Organization Global Survey on Maternal and Perinatal Health from 2004 through 2008. Long-term average (2001-2006) estimates of outdoor PM2.5 were assigned to 50-km-radius circular buffers around each health clinic where births occurred. We used generalized estimating equations to determine associations between clinic-level PM2.5 levels and preterm birth and low birth weight at the individual level, adjusting for seasonality and potential confounders at individual, clinic, and country levels. Country-specific associations were also investigated. Across all countries, adjusting for seasonality, PM2.5 was not associated with preterm birth, but was associated with low birth weight [odds ratio (OR) = 1.22; 95% CI: 1.07, 1.39 for fourth quartile of PM2.5 (> 20.2 μg/m3) compared with the first quartile (< 6.3 μg/m3)]. In China, the country with the largest PM2.5 range, preterm birth and low birth weight both were associated with the highest quartile of PM2.5 only, which suggests a possible threshold effect (OR = 2.54; CI: 1.42, 4.55 and OR = 1.99; CI: 1.06, 3.72 for preterm birth and low birth weight, respectively, for PM2.5 ≥ 36.5 μg/m3 compared with PM2.5 < 12.5 μg/m3). Outdoor PM2.5 concentrations were associated with low birth weight but not preterm birth. In rapidly developing countries, such as China, the highest levels of air pollution may be of concern for both outcomes.

Maternal Active Smoking During Pregnancy and Low Birth Weight in the Americas: A Systematic Review and Meta-analysis.

PubMed

Pereira, Priscilla Perez da Silva; Da Mata, Fabiana A F; Figueiredo, Ana Claudia Godoy; de Andrade, Keitty Regina Cordeiro; Pereira, Maurício Gomes

2017-05-01

Smoking during pregnancy may negatively impact newborn birth weight. This study investigates the relationship between maternal active smoking during pregnancy and low birth weight in the Americas through systematic review and meta-analysis. A literature search was conducted through indexed databases and the grey literature. Case-control and cohort studies published between 1984 and 2016 conducted within the Americas were included without restriction regarding publication language. The article selection process and data extraction were performed by two independent investigators. A meta-analysis of random effects was conducted, and possible causes of between-study heterogeneity were evaluated by meta-regressions and subgroup analyses. Publication bias was assessed by visual inspection of Begg's funnel plot and by Egger's regression test. The literature search yielded 848 articles from which 34 studies were selected for systematic review and 30 for meta-analysis. Active maternal smoking was associated with low birth weight, OR = 2.00 (95% CI: 1.77-2.26; I2 = 66.3%). The funnel plot and Egger's test (p = .14) indicated no publication bias. Meta-regression revealed that sample size, study quality, and the number of confounders in the original studies did not account for the between-study heterogeneity. Subgroup analysis indicated no significant differences when studies were compared by design, sample size, and regions of the Americas. Low birth weight is associated with maternal active smoking during pregnancy regardless of the region in the Americas or the studies' methodological aspects. A previous search of the major electronic databases revealed that no studies appear to have been conducted to summarize the association between maternal active smoking during pregnancy and low birth weight within the Americas. Therefore, this systematic review may help to fill the information gap. The region of the Americas contains some of the most populous countries in the world; therefore, this study may provide useful data from this massive segment of the world's population. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Maternal Exposure to Polybrominated and Polychlorinated Biphenyls: Infant Birth Weight and Gestational Age

PubMed Central

Givens, Marjory L.; Small, Chanley M.; Terrell, Metrecia L.; Cameron, Lorraine L.; Blanck, Heidi Michels; Tolbert, Paige E.; Rubin, Carol; Henderson, Alden K.; Marcus, Michele

2007-01-01

Understanding the influence of maternal exposures on gestational age and birth weight is essential given that pre-term and/or low birth weight infants are at risk for increased mortality and morbidity. We performed a retrospective analysis of a cohort exposed to polybrominated biphenyls (PBB) through accidental contamination of cattle feed and polychlorinated biphenyls (PCB) through residual contamination in the geographic region. Our study population consisted of 444 mothers and their 899 infants born between 1975 and 1997. Using restricted maximum likelihood estimation, no significant association was found between estimated maternal serum PBB at conception or enrollment PCB levels and gestational age or infant birth weight in unadjusted models or in models that adjusted for maternal age, smoking, parity, infant gender, and decade of birth. For enrollment maternal serum PBB, no association was observed for gestational age. However, a negative association with high levels of enrollment maternal serum PBB and birth weight was suggested. We also examined the birth weight and gestational age among offspring of women with the highest (10%) PBB or PCB exposure, and observed no significant association. Because brominated compounds are currently used in consumer products and therefore, are increasingly prevalent in the environment, additional research is needed to better understand the potential relationship between in utero exposure to brominated compounds and adverse health outcomes. PMID:17617441

Determining an anthropometric surrogate measure for identifying low birth weight babies in Uganda: a hospital-based cross sectional study

PubMed Central

2013-01-01

Background Achieving Millennium Development Goal 4 is dependent on significantly reducing neonatal mortality. Low birth weight is an underlying factor in most neonatal deaths. In developing countries the missed opportunity for providing life saving care is mainly a result of failure to identify low birth weight newborns. This study aimed at identifying a reliable anthropometric measurement for screening low birth weight and determining an operational cut-off point in the Uganda setting. This simple measurement is required because of lack of weighing scales in the community, and sometimes in the health facilities. Methods This was a hospital-based cross-sectional study. Two midwives weighed 706 newborns and measured their foot length, head, chest, thigh and mid-upper arm circumferences within 24 hours after birth. Data was analysed using STATA version 10.0. Correlation with birth weight using Pearson’s correlation coefficient and Receiver Operating Characteristics curve analysis were done to determine the measure that best predicts birth weight. Sensitivity and specificity were calculated for a range of measures to obtain operational cut-off points; and Likelihood Ratios and Diagnostic Odds Ratio were determined for each cut-off point. Results Birth weights ranged from 1370–5350 grams with a mean of 3050 grams (SD 0.53) and 85 (12%) babies weighed less than 2500 grams. All anthropometric measurements had a positive correlation with birth weight, with foot length showing the strongest (r = 0.76) and thigh circumference the weakest (r = 0.62) correlations. Foot length had the highest predictive value for low birth weight (AUC = 0.97) followed by mid-upper arm circumference (AUC = 0.94). Foot length and chest circumference had the highest sensitivity (94%) and specificity (90%) respectively for screening low birth weight babies at the selected cut-off points. Chest circumference had a significantly higher positive likelihood ratio (8.7) than any other measure, and foot length had the lowest negative likelihood ratio. Chest circumference and foot length had diagnostic odds ratios of 97% and 77% respectively. Foot length was easier to measure and it involved minimal exposure of the baby to cold. A cut-off of foot length 7.9 cm had sensitivity of 94% and specificity of 83% for predicting low birth weight. Conclusions This study suggests foot length as the most appropriate predictor for low birth weight in comparison to chest, head, mid-upper arm and thigh circumference in the Uganda setting. Use of low cost and easy to use tools to identify low birth weight babies by village health teams could support community efforts to save newborns. PMID:23587297

Elevated progesterone and its impact on birth weight after fresh embryo transfers.

PubMed

Ibrahim, Yetunde; Haviland, Miriam J; Hacker, Michele R; Penzias, Alan S; Thornton, Kim L; Sakkas, Denny

2017-06-01

The purpose of the study was to examine the association between serum progesterone levels on the day of hCG administration and birth weight among singleton live births after fresh embryo transfer. This study was conducted as a retrospective cohort database analysis on patients who underwent IVF treatment cycles from January 2004 to April 2012. The study was performed at a University affiliated private infertility practice. All cycles that had achieved a singleton live birth after fresh embryo transfer and for which progesterone was measured on the day of hCG administration were examined. Generalized linear models were used to calculate mean birth weight and z-scores. We analyzed 817 fresh IVF embryo transfers in which birth weight, gestational age, and progesterone (ng/mL) level on day of hCG administration were documented. While there was a decrease in birth weight as progesterone quartile [≤0.54; >0.54 to ≤0.81; >0.81 to ≤1.17; >1.17 ng/mL] increased, the difference in mean birth weights among the four quartiles was not statistically significant (p = 0.11) after adjusting for maternal age and peak estradiol levels. When dichotomizing based on a serum progesterone considered clinically elevated, cycles with progesterone >2.0 ng/mL had a significantly lower mean singleton birth weight (2860 g (95% CI 2642 g, 3079 g)) compared to cycles with progesterone ≤2.0 ng/mL (3167 g (95% CI 3122 g, 3211 g) p = 0.007)) after adjusting for maternal age and estradiol. We demonstrated that caution should be exercised when performing fresh embryo transfers with elevated progesterone levels and in particular with levels (>2.0 ng/mL) as this may lead to lower birth weight.

Advanced Maternal Age and the Risk of Low Birth Weight and Preterm Delivery: a Within-Family Analysis Using Finnish Population Registers.

PubMed

Goisis, Alice; Remes, Hanna; Barclay, Kieron; Martikainen, Pekka; Myrskylä, Mikko

2017-12-01

Advanced maternal age at birth is considered a major risk factor for birth outcomes. It is unclear to what extent this association is confounded by maternal characteristics. To test whether advanced maternal age at birth independently increases the risk of low birth weight (<2,500 g) and preterm birth (<37 weeks' gestation), we compared between-family models (children born to different mothers at different ages) with within-family models (children born to the same mother at different ages). The latter procedure reduces confounding by unobserved parental characteristics that are shared by siblings. We used Finnish population registers, including 124,098 children born during 1987-2000. When compared with maternal ages 25-29 years in between-family models, maternal ages of 35-39 years and ≥40 years were associated with percentage increases of 1.1 points (95% confidence intervals: 0.8, 1.4) and 2.2 points (95% confidence intervals: 1.4, 2.9), respectively, in the probability of low birth weight. The associations are similar for the risk of preterm delivery. In within-family models, the relationship between advanced maternal age and low birth weight or preterm birth is statistically and substantively negligible. In Finland, advanced maternal age is not independently associated with the risk of low birth weight or preterm delivery among mothers who have had at least 2 live births. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Maternal maya ancestry and birth weight in Yucatan, Mexico.

PubMed

Azcorra, Hugo; Vázquez-Vázquez, Adriana; Mendez, Nina; Carlos Salazar, Juan; Datta-Banik, Sudip

2016-05-01

The purpose of this study was to analyze the association between maternal Maya ancestry and the birth weight of infants born in Yucatan, Mexico, during 2013. A total of 30,435 singletons born at term (≥37 weeks) in Yucatan during 2013 were analyzed. Birth weights, gestational ages, and maternal socioeconomic data were provided by the Ministry of Health of Yucatan. Maternal Maya ancestry was defined by the presence of Maya surnames in: (1) non-Maya surnames (NM-NM), (2) one Maya surname (NM-M), and (3) two Maya surnames (M-M). Biological and socioeconomic parameters were compared between the categories of ancestry through one-way analysis of variance (ANOVA) and a multiple regression model was used to analyze the association between ancestry and infants' birth weight controlling for influence of covariates. Mean birth weight was 3,114 g (SD = 406) (NM-NM: 3,150 g [SD = 404], NM-M: 3,106 g [SD = 402], M-M: 3,088 g [SD = 408]). With the biological and socioeconomic variables statistically adjusted for, the presence of one and two maternal Maya surnames was associated with decreases in birth weight of 42 g and 63 g, respectively. None of the interactions between ancestry and other predictors was statistically significant. The lower mean birth weights of Maya infants are consistent with studies reporting poor growth and nutritional status of Maya children from Yucatan. Historically adverse socioeconomic conditions experienced by the Maya population are probably linked to the relatively lower birth weights of their infants. Am. J. Hum. Biol. 28:436-439, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Psychiatric Disorders and General Functioning in Low Birth Weight Adults: A Longitudinal Study.

PubMed

Lærum, Astrid M W; Reitan, Solveig Klæbo; Evensen, Kari Anne I; Lydersen, Stian; Brubakk, Ann-Mari; Skranes, Jon; Indredavik, Marit S

2017-02-01

To examine psychiatric morbidity and overall functioning in adults born with low birth weight compared with normal birth weight controls at age 26 years and to study longitudinal trajectories of psychiatric morbidity from early adolescence to adulthood. Prospective cohort study wherein 44 preterm very low birth weight (≤1500 g), 64 term small for gestational age (SGA; <10th percentile), and 81 control adults were examined using the MINI-International Neuropsychiatric Interview: M.I.N.I. Plus, Norwegian version, the Global Assessment of Functioning, and questions on daily occupation and level of education. Prevalence of psychiatric disorders from previous follow-ups at age 14 and 19 years were included for longitudinal analysis. From adolescence to adulthood, the term SGA group had a marked increase in the estimated probability of psychiatric disorders from 9% (95% confidence interval, 4-19) to 39% (95% confidence interval, 28-51). At 26 years, psychiatric diagnoses were significantly more prevalent in the preterm very low birth weight group (n = 16, 36%; P = .003) and the term SGA group (n = 24, 38%; P = .019) compared with the control group (n = 11, 14%). Both low birth weight groups had lower educational level and functioning scores than controls and a higher frequency of unemployment and disability benefit. Low birth weight was a substantial risk factor for adult psychiatric morbidity and lowered overall functioning. The results underscore the need for long-term follow-up of low birth weight survivors through adolescence and adulthood, focusing on mental health. The longitudinal increase in psychiatric morbidity in the term SGA group calls for additional investigation. Copyright © 2017 by the American Academy of Pediatrics.

Influence of low birth weight on C-reactive protein in asymptomatic younger adults: the bogalusa heart study.

PubMed

Bhuiyan, Azad R; Srinivasan, Sathanur R; Chen, Wei; Azevedo, Mario J; Berenson, Gerald S

2011-03-21

Both low birth weight, an indicator of intrauterine growth restriction, and low grade systemic inflammation depicted by high sensitivity C-reactive protein (hs-CRP) have emerged as independent predictors of cardiovascular (CV) disease and type 2 diabetes. However, information linking low birth weight and hs-CRP in a biracial (black/white) population is scant. We assessed a cohort of 776 black and white subjects (28% black, 43% male) aged 24-43 years (mean 36.1 years) enrolled in the Bogalusa Heart Study with regard to birth weight and gestational age data were retrieved from Louisiana State Public Health Office. Black subjects had significantly lower birth weight than white subjects (3.145 kg vs 3.441 kg, p < 0.0001) and higher hs-CRP level (3.29 mg/L vs 2.57 mg/L, p = 0.011). After adjusting for sex, age, body mass index (BMI), smoking status and race (for total sample), the hs-CRP level decreased across quartiles of increasing birth weight in white subjects (p = 0.001) and the combined sample (p = 0.002). Adjusting for sex, age, BMI, smoking status and race for the total sample in a multivariate regression model, low birth weight was retained as an independent predictor variable for higher hs-CRP levels in white subjects (p = 0.004) and the total sample (p = 0.007). Conversely, the area under the receiver operative curve (c statistic) analysis adjusted for race, sex, age, smoking status and BMI yielded a value of 0.777 with regard to the discriminating value of hs-CRP for predicting low birth weight. The deleterious effect of low birth weight on systemic inflammation depicted by the hs-CRP levels in asymptomatic younger adults may potentially link fetal growth retardation, CV disease and diabetes, with important health implications.

[Changes in the outcome for infants, with birth weight under 500 grams, at our department (First Department of Obstetrics and Gynecology, Semmelweis University, Budapest)].

PubMed

Varga, Péter; Jeager, Judit; Harmath, Ágnes; Berecz, Botond; Kollár, Tímea; Pete, Barbara; Magyar, Zsófia; Rigó, János; Romicsné Görbe, Éva

2015-03-08

The mortality and morbidity of extremely low birth weight infants (birth weight below 1000 grams) are different from low birth weight and term infants. The Centers for Disease Control statistics from the year 2009 shows that the mortality of preterm infants with a birth weight less than 500 grams is 83.4% in the United States. In many cases, serious complications can be expected in survivals. The aim of this retrospective study was to find prognostic factors which may improve the survival of the group of extremely low birth weight infants (<500 grams). Data of extremely low birth weight infants with less than 500 grams born at the 1st Department of Obstetrics and Gynecology, Semmelweis University between January 1, 2006 and June 1, 2012 were analysed, and mortality and morbidity of infants between January 1, 2006 and December 31, 2008 (period I) were compared those found between January 1, 2009 and June 1, 2012 (period II). Statistical analysis was performed with probe-t, -F and -Chi-square. Survival rate of extremely low birth weight infants less than 500 grams in period 1 and II was 26.31% and 55.17%, respectively (p = 0.048), whereas the prevalence of complications were not significantly different between the period examined. The mean gestational age of survived infants (25.57 weeks) was higher than the gestational age of infants who did not survive (24.18 weeks) and the difference was statistically significant (p = 0.0045). Education of the team of the Neonatal Intensive Care Unit, professional routine and technical conditions may improve the survival chance of preterm infants. The use of treatment protocols, conditions of the Neonatal Intensive Care Unit and steroid prophylaxis may improve the survival rate of extremely low birth weight infants.

Correlation between preconception maternal non-occupational exposure to interior decoration or oil paint odour and average birth weight of neonates: findings from a nationwide cohort study in China’s rural areas

PubMed Central

Liu, Huiting; Chen, Shi; Zhu, Huijuan; Yang, Hongbo; Gong, Fengying; Wang, Linjie; Jiang, Yu; Lian, Bill Q; Yan, Chengsheng; Li, Jianqang; Wang, Qing; Zhang, Shikun; Pan, Hui

2017-01-01

Background Birth weight is a critical indicator of neonatal health and foretells people’s health in adolescence and even adulthood. Some researchers have warned against the adverse effects on babies’ birth weight of exposure to pollutants in interior decoration or oil paint by odour intake. This study evaluated the effects of maternal exposure to such factors before conception on the birth weights of neonates. Methods Data on 213 461 cases in this study were from the database of the free National Pre-pregnancy Checkups Project. Defined as ‘exposed’ were those women exposed to oil paint odour or interior decoration at home or in the workplace within 6 months before their pregnancy. The study focused on revealing the correlation between such exposure and the birth weight of the neonates of these women, especially the incidence of macrosomia and low birth weight (LBW). Statistical analysis was conducted using the Kruskal–Wallis H test, the Mann–Whitney U test and logistic regression. Results The birth weight of babies from mothers non-occupationally exposed to such settings averaged 3465 g (range 3150–3650 g), whereas the birth weight of those from mothers free of such exposure averaged 3300 g (range 3000–3600g). Maternal exposure preconception to interior decoration or oil paint odour reduced the incidence of LBW in their babies (p=0.003, OR 0.749, 95% CI 0.617 to 0.909). Such exposure may also augment the probability of macrosomia (p<0.001, OR 1.297, 95% CI 1.133 to 1.484). Conclusion Maternal exposure to interior decoration or oil paint odour preconception may increase the average birth weight of neonates, as well as the incidence of macrosomia. PMID:28827230

Risk Factors for the Development of Refeeding Syndrome-Like Hypophosphatemia in Very Low Birth Weight Infants

PubMed Central

Okuno, Takashi; Ohta, Genrei; Tokuriki, Shuko

2017-01-01

Background Refeeding syndrome is characterized by metabolic disturbance including hypophosphatemia and hypokalemia upon reinstitution of nutrition in severely malnourished patients. Objective The present study sought to identify the risk factors for the development of refeeding syndrome-like metabolic disturbance in very low birth weight infants. Methods The correlations of severe hypophosphatemia with the serum levels of potassium and ionized calcium, daily calorie and phosphate intake, and umbilical cord blood flow on ultrasonography were analyzed in 49 very low birth weight infants. Results Fifteen infants (36%) presented with hypophosphatemia during the first postnatal week. Hypophosphatemia was significantly associated with birth weight z score (odds ratio, 1.60; 95% confidence interval, 1.04–2.47; p = 0.034) and umbilical artery resistance index (odds ratio, 7.72E−04; 95% confidence interval, 1.14E−06–0.523; p = 0.031). Multiple regression analysis revealed that umbilical artery resistance index was independently associated with hypophosphatemia. Conclusions Umbilical artery resistance index may serve as a useful marker for future development of refeeding syndrome-like hypophosphatemia in very low birth weight infants. Close monitoring of serum phosphorus and potassium levels and early intervention are important for the management of very low birth weight infants with intrauterine growth restriction due to placental dysfunction. PMID:29104345

Risk Factors for the Development of Refeeding Syndrome-Like Hypophosphatemia in Very Low Birth Weight Infants.

PubMed

Igarashi, Aiko; Okuno, Takashi; Ohta, Genrei; Tokuriki, Shuko; Ohshima, Yusei

2017-01-01

Refeeding syndrome is characterized by metabolic disturbance including hypophosphatemia and hypokalemia upon reinstitution of nutrition in severely malnourished patients. The present study sought to identify the risk factors for the development of refeeding syndrome-like metabolic disturbance in very low birth weight infants. The correlations of severe hypophosphatemia with the serum levels of potassium and ionized calcium, daily calorie and phosphate intake, and umbilical cord blood flow on ultrasonography were analyzed in 49 very low birth weight infants. Fifteen infants (36%) presented with hypophosphatemia during the first postnatal week. Hypophosphatemia was significantly associated with birth weight z score (odds ratio, 1.60; 95% confidence interval, 1.04-2.47; p = 0.034) and umbilical artery resistance index (odds ratio, 7.72 E -04; 95% confidence interval, 1.14 E -06-0.523; p = 0.031). Multiple regression analysis revealed that umbilical artery resistance index was independently associated with hypophosphatemia. Umbilical artery resistance index may serve as a useful marker for future development of refeeding syndrome-like hypophosphatemia in very low birth weight infants. Close monitoring of serum phosphorus and potassium levels and early intervention are important for the management of very low birth weight infants with intrauterine growth restriction due to placental dysfunction.

Combined Effects of Prenatal Exposures to Environmental Chemicals on Birth Weight.

PubMed

Govarts, Eva; Remy, Sylvie; Bruckers, Liesbeth; Den Hond, Elly; Sioen, Isabelle; Nelen, Vera; Baeyens, Willy; Nawrot, Tim S; Loots, Ilse; Van Larebeke, Nick; Schoeters, Greet

2016-05-12

Prenatal chemical exposure has been frequently associated with reduced fetal growth by single pollutant regression models although inconsistent results have been obtained. Our study estimated the effects of exposure to single pollutants and mixtures on birth weight in 248 mother-child pairs. Arsenic, copper, lead, manganese and thallium were measured in cord blood, cadmium in maternal blood, methylmercury in maternal hair, and five organochlorines, two perfluorinated compounds and diethylhexyl phthalate metabolites in cord plasma. Daily exposure to particulate matter was modeled and averaged over the duration of gestation. In single pollutant models, arsenic was significantly associated with reduced birth weight. The effect estimate increased when including cadmium, and mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP) co-exposure. Combining exposures by principal component analysis generated an exposure factor loaded by cadmium and arsenic that was associated with reduced birth weight. MECPP induced gender specific effects. In girls, the effect estimate was doubled with co-exposure of thallium, PFOS, lead, cadmium, manganese, and mercury, while in boys, the mixture of MECPP with cadmium showed the strongest association with birth weight. In conclusion, birth weight was consistently inversely associated with exposure to pollutant mixtures. Chemicals not showing significant associations at single pollutant level contributed to stronger effects when analyzed as mixtures.

Birth characteristics, maternal reproductive history, and the risk of infant leukemia: a report from the Children's Oncology Group.

PubMed

Spector, Logan G; Davies, Stella M; Robison, Leslie L; Hilden, Joanne M; Roesler, Michelle; Ross, Julie A

2007-01-01

Leukemias with MLL gene rearrangements predominate in infants (<1 year of age), but not in older children, and may have a distinct etiology. High birth weight, higher birth order, and prior fetal loss have, with varying consistency, been associated with infant leukemia, but no studies have reported results with respect to MLL status. Here, we report for the first time such an analysis. During 1999 to 2003, mothers of 240 incident cases (113 MLL(+), 80 MLL(-), and 47 indeterminate) and 255 random digit dialed controls completed a telephone interview. Odds ratios and 95% confidence intervals for quartile of birth weight, birth order, gestational age, maternal age at delivery, prior fetal loss, pre-pregnancy body mass index, and weight gain during pregnancy were obtained using unconditional logistic regression; P for linear trend was obtained by modeling continuous variables. There was a borderline significant linear trend of increasing birth weight with MLL(+) (P = 0.06), but not MLL(-) (P = 0.93), infant leukemia. Increasing birth order showed a significant inverse linear trend, independent of birth weight, with MLL(+) (P = 0.01), but not MLL(-) (P = 0.18), infant leukemia. Other variables of interest were not notably associated with infant leukemia regardless of MLL status. This investigation further supports the contention that molecularly defined subtypes of infant leukemia have separate etiologies.

Correlation between tobacco control policies and preterm births and low birth weight in Europe.

PubMed

Díez-Izquierdo, Ana; Balaguer, Albert; Lidón-Moyano, Cristina; Martín-Sánchez, Juan Carlos; Galán, Iñaki; Fernández, Esteve; Martínez-Sánchez, Jose M

2018-01-01

To assess the correlation between tobacco control policies- particularly smoking bans in work and public places-and the prevalence of preterm births and low birth weight in the European countries. This is an ecological study and the unit of analysis set at the country level. Tobacco control data in Europe were obtained for the years 2010 and 2013 as measured by the Tobacco Control Scale (TCS), which reflects the level of implementation of tobacco control policies. Prevalence data for preterm births and low birth weight were obtained from two sources: the European Perinatal Health Report (EPHR), which provides data for 2010, and the Eurostat data, which includes the years 2013 and 2014. We analyzed the correlation between the TCS score and the prevalence of preterm birth and low birth weight in the European countries by means of Spearman (rsp) rank-correlation coefficients and their 95% confidence intervals (95%CI). The 2010 TCS was negatively correlated with the prevalence of preterm births before week 37 (rsp = -0.51; 95% CI: -0.77, -0.15; p = 0.006) and week 32 (rsp = -0.42; 95%CI: -0.73, -0.01; p = 0.030) and with the prevalence of the low birth weight (< 2500g, (rsp = -0.42; 95% CI: -0.66, -0.09; p = 0.028) in European countries in 2010. We found a statistically significant inverse correlation between the level of restrictions on smoking in public places and the prevalence of low birth weight (< 2500g rsp: -0.54; 95%CI: -0.72, -0.10; p = 0.017). The level of smoke-free legislation in European countries correlates with lower preterm birth prevalence rates at the ecological level. Given the important negative effects of premature births for the public health system, these data support greater implementation of smoke-free policies and tend to support the implementation of tobacco control policies, but more research is needed. Copyright © 2017 Elsevier Inc. All rights reserved.

Birth weight and childhood growth in daughters of women with irregular menstrual cycles.

PubMed

Wang, Erica T; Cirillo, Piera M; Kao, Chia-Ning; Cohn, Barbara A; Cedars, Marcelle I

2013-06-01

Menstrual irregularity has been associated with insulin resistance, type 2 diabetes mellitus and markers of metabolic dysfunction. This study aimed to determine whether irregular menstrual cycles (MCs) in reproductive-age women are associated with the weight of their daughters at birth and growth up to age five. We studied 4863 pregnant women with menstrual history data in a prospective cohort, recruited from the Kaiser Health Plan (1959-1966). Serial measures of their daughters' weight and height were abstracted from medical records. We used analysis of covariance, stratified by maternal body mass index, to explore the association between maternal MC and infant birth weight (BW). We included 4774 daughters in a repeated measures analysis to compare the effect of maternal MC on childhood weight through age five. Daughters of non-obese women with irregular MC had a statistically significant lower BW compared to daughters of women with regular MC; this difference was notably amplified among obese women. The daughters' weights were not statistically different when growth was assessed from birth to five years. We conclude that daughters of obese women with irregular MC, in particular, had significantly lower BW compared to daughters of women with regular MC, which did not persist over five years of follow-up.

Metabolomic analysis of longissimus from underperforming piglets relative to piglets with normal preweaning growth

USDA-ARS?s Scientific Manuscript database

Background: The increase in intra-litter variability in weaning weight during the past twenty years has increased production costs in all in/all out swine production. One contributor to this variability is the normal birth weight pig that grows at a slower rate than littermates of similar birth weig...

Developmental pathways to adiposity begin before birth and are influenced by genotype, prenatal environment and epigenome.

PubMed

Lin, Xinyi; Lim, Ives Yubin; Wu, Yonghui; Teh, Ai Ling; Chen, Li; Aris, Izzuddin M; Soh, Shu E; Tint, Mya Thway; MacIsaac, Julia L; Morin, Alexander M; Yap, Fabian; Tan, Kok Hian; Saw, Seang Mei; Kobor, Michael S; Meaney, Michael J; Godfrey, Keith M; Chong, Yap Seng; Holbrook, Joanna D; Lee, Yung Seng; Gluckman, Peter D; Karnani, Neerja

2017-03-07

Obesity is an escalating health problem worldwide, and hence the causes underlying its development are of primary importance to public health. There is growing evidence that suboptimal intrauterine environment can perturb the metabolic programing of the growing fetus, thereby increasing the risk of developing obesity in later life. However, the link between early exposures in the womb, genetic susceptibility, and perturbed epigenome on metabolic health is not well understood. In this study, we shed more light on this aspect by performing a comprehensive analysis on the effects of variation in prenatal environment, neonatal methylome, and genotype on birth weight and adiposity in early childhood. In a prospective mother-offspring cohort (N = 987), we interrogated the effects of 30 variables that influence the prenatal environment, umbilical cord DNA methylation, and genotype on offspring weight and adiposity, over the period from birth to 48 months. This is an interim analysis on an ongoing cohort study. Eleven of 30 prenatal environments, including maternal adiposity, smoking, blood glucose and plasma unsaturated fatty acid levels, were associated with birth weight. Polygenic risk scores derived from genetic association studies on adult adiposity were also associated with birth weight and child adiposity, indicating an overlap between the genetic pathways influencing metabolic health in early and later life. Neonatal methylation markers from seven gene loci (ANK3, CDKN2B, CACNA1G, IGDCC4, P4HA3, ZNF423 and MIRLET7BHG) were significantly associated with birth weight, with a subset of these in genes previously implicated in metabolic pathways in humans and in animal models. Methylation levels at three of seven birth weight-linked loci showed significant association with prenatal environment, but none were affected by polygenic risk score. Six of these birth weight-linked loci continued to show a longitudinal association with offspring size and/or adiposity in early childhood. This study provides further evidence that developmental pathways to adiposity begin before birth and are influenced by environmental, genetic and epigenetic factors. These pathways can have a lasting effect on offspring size, adiposity and future metabolic outcomes, and offer new opportunities for risk stratification and prevention of obesity. This birth cohort is a prospective observational study, designed to study the developmental origins of health and disease, and was retrospectively registered on 1 July 2010 under the identifier NCT01174875 .

[Overweight and obesity in prepubertal schoolchildren: the association with low birth weight and family antecedents of cardiovascular disease. Embu - metropolitan region of São Paulo, 2006].

PubMed

Strufaldi, Maria Wany Louzada; Silva, Edina Mariko Koga da; Puccini, Rosana Fiorini

2011-11-01

The aim was to determine the prevalence of overweight and obesity in schoolchildren and the association with birth weight and family antecedents of cardiovascular disease. This cross-sectional study used a probabilistic sample of 929 schoolchildren aged 6 to 10 years. The variables were: body mass index (BMI), birth weight and family antecedents of cardiovascular disease. The statistical analysis consisted of the chi-square test (Pearson) and odds ratio, as association measurements. Of the schoolchildren (54.6% of which were female), 14.4% and 13.3% were overweight and obese, respectively. Low birth weight was reported among 9.4% and family antecedents of cardiovascular disease among 35.2%. Overweight or obesity (BMI e" P85) was associated with the presence of family antecedents of cardiovascular disease (OR = 1.66; 95% CI 1.23-2.23) and male sex (OR = 1.37; 95%CI 1.02-1.83); there was no association with birth weight. The results indicate the need for preventive actions for children with family antecedents of cardiovascular disease.

Incense Burning during Pregnancy and Birth Weight and Head Circumference among Term Births: The Taiwan Birth Cohort Study.

PubMed

Chen, Le-Yu; Ho, Christine

2016-09-01

Incense burning for rituals or religious purposes is an important tradition in many countries. However, incense smoke contains particulate matter and gas products such as carbon monoxide, sulfur, and nitrogen dioxide, which are potentially harmful to health. We analyzed the relationship between prenatal incense burning and birth weight and head circumference at birth using the Taiwan Birth Cohort Study. We also analyzed whether the associations varied by sex and along the distribution of birth outcomes. We performed ordinary least squares (OLS) and quantile regressions analysis on a sample of 15,773 term births (> 37 gestational weeks; 8,216 boys and 7,557 girls) in Taiwan in 2005. The associations were estimated separately for boys and girls as well as for the population as a whole. We controlled extensively for factors that may be correlated with incense burning and birth weight and head circumference, such as parental religion, demographics, and health characteristics, as well as pregnancy-related variables. Findings from fully adjusted OLS regressions indicated that exposure to incense was associated with lower birth weight in boys (-18 g; 95% CI: -36, -0.94) but not girls (1 g; 95% CI: -17, 19; interaction p-value = 0.31). Associations with head circumference were negative for boys (-0.95 mm; 95% CI: -1.8, -0.16) and girls (-0.71 mm; 95% CI: -1.5, 0.11; interaction p-values = 0.73). Quantile regression results suggested that the negative associations were larger among the lower quantiles of birth outcomes. OLS regressions showed that prenatal incense burning was associated with lower birth weight for boys and smaller head circumference for boys and girls. The associations were more pronounced among the lower quantiles of birth outcomes. Further research is necessary to confirm whether incense burning has differential effects by sex. Chen LY, Ho C. 2016. Incense burning during pregnancy and birth weight and head circumference among term births: The Taiwan Birth Cohort Study. Environ Health Perspect 124:1487-1492; http://dx.doi.org/10.1289/ehp.1509922.

Incense Burning during Pregnancy and Birth Weight and Head Circumference among Term Births: The Taiwan Birth Cohort Study

PubMed Central

Chen, Le-Yu; Ho, Christine

2016-01-01

Background: Incense burning for rituals or religious purposes is an important tradition in many countries. However, incense smoke contains particulate matter and gas products such as carbon monoxide, sulfur, and nitrogen dioxide, which are potentially harmful to health. Objectives: We analyzed the relationship between prenatal incense burning and birth weight and head circumference at birth using the Taiwan Birth Cohort Study. We also analyzed whether the associations varied by sex and along the distribution of birth outcomes. Methods: We performed ordinary least squares (OLS) and quantile regressions analysis on a sample of 15,773 term births (> 37 gestational weeks; 8,216 boys and 7,557 girls) in Taiwan in 2005. The associations were estimated separately for boys and girls as well as for the population as a whole. We controlled extensively for factors that may be correlated with incense burning and birth weight and head circumference, such as parental religion, demographics, and health characteristics, as well as pregnancy-related variables. Results: Findings from fully adjusted OLS regressions indicated that exposure to incense was associated with lower birth weight in boys (–18 g; 95% CI: –36, –0.94) but not girls (1 g; 95% CI: –17, 19; interaction p-value = 0.31). Associations with head circumference were negative for boys (–0.95 mm; 95% CI: –1.8, –0.16) and girls (–0.71 mm; 95% CI: –1.5, 0.11; interaction p-values = 0.73). Quantile regression results suggested that the negative associations were larger among the lower quantiles of birth outcomes. Conclusions: OLS regressions showed that prenatal incense burning was associated with lower birth weight for boys and smaller head circumference for boys and girls. The associations were more pronounced among the lower quantiles of birth outcomes. Further research is necessary to confirm whether incense burning has differential effects by sex. Citation: Chen LY, Ho C. 2016. Incense burning during pregnancy and birth weight and head circumference among term births: The Taiwan Birth Cohort Study. Environ Health Perspect 124:1487–1492; http://dx.doi.org/10.1289/ehp.1509922 PMID:26967367

HEALTH STATUS OF EXTREMELY LOW BIRTH WEIGHT CHILDREN AT AGE 8 YEARS: CHILD AND PARENT PERSPECTIVE

PubMed Central

Hack, Maureen; Forrest, Christopher B; Schluchter, Mark; Taylor, H. Gerry; Drotar, Dennis; Holmbeck, Grayson; Andreias, Laura

2013-01-01

Context Parental proxy reports have indicated poorer health for preterm children as compared to normal birth weight controls. The perspective of their children may however differ. Objective To compare the self reported health of preterm children to normal birth weight controls and the children’s perspective to that of their parents. Design Study of extremely low birth weight (<1kg) and normal birth weight children and their parents conducted 2006–2009. Setting Children’s hospital. Participants Eight year old extremely low birth weight (n=202) and normal birth weight (n=176) children of similar sociodemographic status. Main Outcome Measures The Child Health and Illness Profile child and parent reports. Results There was poor agreement between the parent and child ratings of health for both the extremely low birth weight and normal birth weight cohorts. Extremely low birth weight children rated their health similar to normal birth weight children. In contrast parents of extremely low birth weight children reported significantly poorer health for their children than parents of normal birth weight controls including poorer Satisfaction with health, Comfort and Achievement and less Risk avoidance. Conclusion There is poor agreement between child and parent reports of health. Eight year old extremely low birth weight children rate their health similar to that of normal birth weight controls. Their parents however report significantly poorer health. Both child and parent perspective needs to be considered when making health care decisions. PMID:21969395

Trends in birth weight-specific and -adjusted infant mortality rates in Taiwan between 2004 and 2011.

PubMed

Liang, Fu-Wen; Chou, Hung-Chieh; Chiou, Shu-Ti; Chen, Li-Hua; Wu, Mei-Hwan; Lue, Hung-Chi; Chiang, Tung-Liang; Lu, Tsung-Hsueh

2018-06-01

A yearly increase in the proportion of very low birth weight (VLBW) live births has resulted in the slowdown of decreasing trends in crude infant mortality rates (IMRs). In this study, we examined the trends in birth weight-specific as well as birth weight-adjusted IMRs in Taiwan. We linked three nationwide datasets, namely the National Birth Reporting Database, National Birth Certification Registry, and National Death Certification Registry databases, to calculate the IMRs according to the birth weight category. Trend tests and mortality rate ratios in the periods 2010-2011 and 2004-2005 were used to examine the extent of reduction in birth weight-specific and birth weight-adjusted IMRs. The proportion of VLBW (<1500 g) infants among live births increased from 0.78% in 2004-2005 to 0.89% in 2010-2011, thus exhibiting a 15% increase. The extents of the decreases in birth weight-specific IMRs in the 500-999, 1000-1499, 1500-1999, 2000-2499, and 2500-2999 g birth weight categories were 15%, 33%, 43%, 30%, and 28%, respectively, from 2004-2005 to 2010-2011. The reduction in IMR in each birth weight category was larger than the reduction in the crude IMR (13%). By contrast, the IMR in the <500 g birth weight category exhibited a 56% increase during the study period. The IMRs were calculated by excluding all live births with a birth weight of <500 g. The birth weight-adjusted IMRs, which were calculated using a standard birth weight distribution structure for adjustment, exhibited similar extent reductions. In countries with an increasing proportion of VLBW live births, birth weight-specific or -adjusted IMRs are more appropriate than other indices for accurately assessing the real extent of reduction in IMRs. Copyright © 2017. Published by Elsevier B.V.

Mothers' birth weight and survival of their offspring: population based study.

PubMed

Skjaerven, R; Wilcox, A J; Oyen, N; Magnus, P

1997-05-10

To test the hypothesis that a baby's survival is related to the mother's birth weight. Population based dataset for two generations. Population registry in Norway. All birth records for women born in Norway since 1967 were linked to births during 1981-94, thereby forming 105104 mother-offspring units. Perinatal mortality specific for weight for offspring in groups of maternal birth weight (with 500 g categories in both). A mother's birth weight was strongly associated with the weight of her baby. Maternal birth weight was associated with perinatal survival of her baby only for mothers with birth weights under 2000 g. These mothers were more likely to lose a baby in the perinatal period (odds ratio 2.3, 95% confidence interval 1.4 to 3.7). Among mothers with a birth weight over 2000 g there was no overall association between mother's weight and infant survival. There was, however, a strong interaction between mother's birth weight, infant birth weight, and infant survival. Mortality among small babies was much higher for those whose mothers had been large at birth. For example, babies weighing 2500-2999 g had a threefold higher mortality if their mother's birth weight had been high (> or = 4000 g) than if the mother had been small (2500-2999 g). Mothers who weighed less than 2000 g at birth have a higher risk of losing their own babies. For mothers who weighed > or = 2000 g their birth weight provides a benchmark for judging the growth of their offspring. Babies who are small relative to their mother's birth weight are at increased risk of mortality.

Differences in the pregnancy gestation period and mean birth weights in infants born to Indian, Pakistani, Bangladeshi and white British mothers in Luton, UK: a retrospective analysis of routinely collected data.

PubMed

Garcia, Rebecca; Ali, Nasreen; Guppy, Andy; Griffiths, Malcolm; Randhawa, Gurch

2017-08-11

To compare mean birth weights and gestational age at delivery of infants born to Indian, Pakistani, Bangladeshi and white British mothers in Luton, UK. Retrospective analysis using routinely recorded secondary data in Ciconia Maternity information System, between 2008 and 2013. Luton, UK. Mothers whose ethnicity was recorded as white British, Bangladeshi, Pakistani or Indian and living in Luton, aged over 16, who had a live singleton birth over 24 weeks of gestation were included in the analysis (n=14 871). Primary outcome measures were mean birth weight and gestational age at delivery. After controlling for maternal age, smoking, diabetes, gestation age, parity and maternal height and body mass index at booking, a significant difference in infants' mean birth weight was found between white British and Indian, Pakistani and Bangladeshi infants, F(3, 12 287)=300.32, p<0.0001. The partial Eta-squared for maternal ethnicity was η 2 =0.067. The adjusted mean birth weight for white British infants was found to be 3377.89 g (95% CI 3365.34 to 3390.44); Indian infants, 3033.09 g (95% CI 3038.63 to 3103.55); Pakistani infants, 3129.49 g (95% CI 3114.5 to 3144.48); and Bangladeshi infants, 3064.21 g (95% CI 3041.36 to 3087.06). There was a significant association in preterm delivery found in primipara Indian mothers, compared with Indian mothers (Wald=8.192, df 1, p<0.005). Results show important differences in adjusted mean birth weight between Indian, Pakistani, Bangladeshi and white British women. Moreover, an association was found between primipara Indian mothers and preterm delivery, when compared with Pakistani, Bangladeshi and white British women. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Birth weight and special educational needs: results of a population-based study in Berlin.

PubMed

Bettge, Susanne; Oberwöhrmann, Sylke; Brockstedt, Matthias; Bührer, Christoph

2014-05-09

Preterm infants are at higher risk for developmental problems. The aim of this study is to quantify the relation between birth weight and special educational needs. We analyzed data from the pre-school examinations of 134 313 children in Berlin aged 5 to 6 who were examined between 2007 and 2011. Special educational needs were diagnosed in 8058 children (6.0%), 4943 (61%) of whom had weighed 3000 g or more at birth. The percentage of children with special educational needs rose steadily with decreasing birth weight (2250-2499 g, 9.2%; 1250-1499 g, 21.1%; less than 750 g, 35.6%). Logistic regression analysis yielded odds ratios and 99% confidence intervals for special educational needs that ranged from 1.32 [1.17-1.47] for birth weight 2750-2999 g to 12.83 [7.48-22.03] for birth weight less than 750 g. Further risk factors were male sex (1.88 [1.75-2.03]), low social status (5.96 [5.21-6.82]), an immigrant background associated with poor German language skills in the family (1.63 [1.43-1.86]), and being raised by a single parent (1.21 [1.12-1.31]). On the other hand, nursery school and/or kindergarten enrollment for at least two years before entering school (0.82 [0.73-0.91]) and an immigrant background with good German skills in the family (0.39 [0.34-0.45]) were associated with lower rates of special educational needs. The risk of special educational needs increases already with moderately decreased birth weight. The most important factor other than birth weight is the family's social status. Although children of very low birth weight have a much higher rate of special educational needs than other children, they still make up only a small percentage of all children with special educational needs.

Assessment of Fetal Kidney Growth and Birth Weight in an Indigenous Australian Cohort.

PubMed

Diehm, Christopher J; Lumbers, Eugenie R; Weatherall, Loretta; Keogh, Lyniece; Eades, Sandra; Brown, Alex; Smith, Roger; Johnson, Vanessa; Pringle, Kirsty G; Rae, Kym M

2017-01-01

Introduction: Indigenous Australians experience higher rates of renal disease and hypertension than non-Indigenous Australians. Low birth weight is recognized as a contributing factor in chronic disease and has been shown to increase the risk of renal failure in adulthood. A smaller kidney volume with fewer nephrons places an individual at risk of hypertension and renal failure. Indigenous Australians have fewer nephrons than non-Indigenous Australians. In this study, intrauterine fetal and kidney growth were evaluated in 174 Indigenous Australian babies throughout gestation in order to record and evaluate fetal growth and kidney size, within a population that is at high risk for chronic illness. Methods: Pregnant women that identified as Indigenous, or non-Indigenous women that were pregnant with a partner who identified as an Indigenous Australian were eligible to participate. Maternal history, smoking status, blood and urine samples and fetal ultrasounds were collected throughout pregnancy. Fetal kidney measurements were collected using ultrasound. Statistical analysis was performed using the Stata 14.1 software package. Results: 15.2% of babies were born prematurely. 44% of the mothers reported smoking in pregnancy. The median birth weight of this cohort was 3,240 g. Male fetuses had higher kidney to body weight ratios than female fetuses ( P = 0.02). The birth weights of term neonates whose mothers smoked during pregnancy were lower (327 g, P < 0.001) than the birth weights of term babies from non-smoking mothers. The kidney volumes of babies whose mothers smoked were also smaller ( P = 0.02), but were in proportion to body weight. Conclusion: In this cohort of Indigenous women smoking was associated with both increased number of preterm births and with a reduction in birth weights, even of term infants. Since kidney volume is a surrogate measure of nephron number and nephrogenesis is complete at birth, babies whose mothers smoked during pregnancy must have fewer nephrons than those from non-smoking mothers. Previous studies have shown that glomerular filtration rate is not related to birth weight, thus infants with smaller kidney volumes are hyperfiltering from birth and therefore are likely to be more susceptible to early onset renal disease in later life.

A Comparative Analysis of Selected Demographic Parameters for Evaluating Parity of Women in Poland, Spain, England and Wales for the Period 1996-2011.

PubMed

Strama, Agnieszka; Heimrath, Jerzy; Dudek, Krzysztof

2016-01-01

The Central Statistical Offices in Europe indicate an increase of women's parity age and extramarital births. The aim of this study was to analyze the chosen demographics of parity in European countries of Poland, Spain, England and Wales in 1996-2011. Statistical packet: women's average age at the time of their first and subsequent births, newborns' average body weight in relation to the age of mother; live marital and extramarital births. The age of mothers giving birth to their first and subsequent children in 1998-2011 in all of the researched countries is presented, and next compared in 1999, 2005 and 2011. An analysis of the births of children in marital and extramarital relationships as well as the body weight of live newborns is presented in detail in 1996-2006, and next in 6 year periods: 1999, 2005 and 2011. The average age of the mother giving birth to her first baby in 1996-2011 oscillates around: 26-27 years in England and Wales, 28-30 years in Spain and 23-26 years in Poland. In Poland, the highest average children's body weight, 3394 g, was achieved by children born by mothers at the age of 25-29. In Spain, however, at the mothers' age of 20-24, it was 3317 g. In England and Wales, at 30-34 years, it was 3262 g. The number of extramarital births in comparison to marital births is increasing. England and Wales has the lowest percentage of marital births, whereas Poland, the highest. In Spain, England and Wales we can observe an increase of extramarital births, while in Poland this number is stable at around 21.3%. The age of women having their first baby, the parity of later children, and extramarital births are increasing. In Poland, infant body weight is significantly bigger than in Spain, England and Wales.

Air pollution, neighbourhood and maternal-level factors modify the effect of smoking on birth weight: a multilevel analysis in British Columbia, Canada.

PubMed

Erickson, Anders C; Ostry, Aleck; Chan, Hing Man; Arbour, Laura

2016-07-16

Maternal smoking during pregnancy negatively impacts fetal growth, but the effect is not homogenous across the population. We sought to determine how the relationship between cigarette use and fetal growth is modified by the social and physical environment. Birth records with covariates were obtained from the BC Perinatal Database Registry (N = 232,291). Maternal smoking status was self-reported as the number of cigarettes smoked per day usually at the first prenatal care visit. Census dissemination areas (DAs) were used as neighbourhood-level units and linked to individual births using residential postal codes to assign exposure to particulate air pollution (PM 2.5 ) and neighbourhood-level attributes such as socioeconomic status (SES), proportion of post-secondary education, immigrant density and living in a rural place. Random coefficient models were used with cigarettes/day modeled with a random slope to estimate its between-DA variability and test cross-level interactions with the neighbourhood-level variables on continuous birth weight. A significant negative and non-linear association was found between maternal smoking and birth weight. There was significant between-DA intercept variability in birth weight as well as between-DA slope variability of maternal smoking on birth weight of which 68 and 30 % respectively was explained with the inclusion of DA-level variables and their cross-level interactions. High DA-level SES had a strong positive association with birth weight but the effect was moderated with increased cigarettes/day. Conversely, heavy smokers showed the largest increases in birth weight with rising neighbourhood education levels. Increased levels of PM 2.5 and immigrant density were negatively associated with birth weight, but showed positive interactions with increased levels of smoking. Older maternal age and suspected drug or alcohol use both had negative interactions with increased levels of maternal smoking. Maternal smoking had a negative and non-linear dose-response association with birth weight which was highly variable between neighbourhoods and evidence of effect modification with neighbourhood-level factors. These results suggest that focusing exclusively on individual behaviours may have limited success in improving outcomes without addressing the contextual influences at the neighbourhood-level. Further studies are needed to corroborate our findings and to understand how neighbourhood-level attributes interact with smoking to affect birth outcomes.

Assessing the impact of adolescent pregnancy and the premarital conception stress complex on birth weight among young mothers in Gibraltar's civilian community.

PubMed

Sawchuk, L A; Burke, S D; Benady, S

1997-10-01

The objective of this study was to assess the impact of young maternal age and the timing of conception on birth weight among primiparous women living in Gibraltar. The data for this study were derived from a population of 295 primiparous women who gave birth under 25 years of age. Only married women who had no previous maternal history and delivered live singleton newborns between 1980 and 1984 were included. The confounding effects of gestation length, sex, and socio-economic status on birth weight were taken into account using the multivariate technique of multiple classification analysis. A conception timing variable was constructed and partitioned into four groups which represented the separate and joint effects of maternal age and prenuptial stress on birth weight. The overall mean birth weight was 3344.15 g. After controlling for the specified factors and covariate, the infants of older mother (> 19) who conceived after marriage weighed 57.78 g above the referent group mean. Older mothers who conceived a child before marriage delivered infants weighing 75.67 below the grand mean. Young mother (< 20) who conceived within marriage had infants who weighed 37.32 g less than the grand mean. Infants delivered by young mothers who conceived before marriage weighed 133.66 g less than the overall mean birth weight. The only significant group difference detected within the conception timing variable was between young mothers who conceived before marriage versus older mothers who conceived after marriage. Premarital conception is identified as a risk factor for lower infant birth weights among mothers under 20 years of age. This study emphasizes the need to take into account the effects of culturally mediated behavior on the pregnancy experience of young women.

Comparison of umbilical cord ghrelin concentrations in full-term pregnant women with or without gestational diabetes.

PubMed

Karakulak, Murat; Saygili, Uğur; Temur, Muzaffer; Yilmaz, Özgür; Özün Özbay, Pelin; Calan, Mehmet; Coşar, Hese

2017-05-01

Ghrelin is a potent orexigenic peptide hormone secreted from the gastrointestinal tract that plays a crucial role in the regulation of lipids and glucose metabolism. Ghrelin also has links with fetal development and growth. Gestational diabetes mellitus (GDM) causes fetal macrosomia, but there is no available evidence of a relationship between ghrelin levels and birth weight in women with GDM. The purpose of this study is to investigate whether umbilical cord ghrelin concentrations are altered in full-term pregnant women with GDM compared to women without GDM and whether birth weight is correlated with ghrelin levels. Sixty pregnant women with GDM and 64 healthy pregnant women without GDM were included in this cross-sectional study. Blood samples were drawn from the umbilical vein following birth. Ghrelin concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Umbilical vein ghrelin levels were decreased in women with GDM (879.6 ± 256.1 vs. 972.2 ± 233.6 pg/ml in women without GDM, p=0.033), whereas birth weights were higher for babies in the GDM than in the non-GDM group (3448 ± 410 vs. 3308 ± 365 gr, respectively, p=0.046). Umbilical ghrelin levels were inversely correlated with birth weight (r=-0.765, p<0.001). Multiple regression analysis revealed that birth weight was independently and negatively associated with umbilical ghrelin levels (β= -2.077, 95% CI=-2.652 to -1.492, p=0.002). Umbilical ghrelin levels were lower in GDM women. Birth weight was inversely associated with umbilical ghrelin levels. This association may be explained by a negative feedback mechanism between ghrelin and birth weight.

Black/white differences in very low birth weight neonatal mortality rates among New York City hospitals.

PubMed

Howell, Elizabeth A; Hebert, Paul; Chatterjee, Samprit; Kleinman, Lawrence C; Chassin, Mark R

2008-03-01

We sought to determine whether differences in the hospitals at which black and white infants are born contribute to black/white disparities in very low birth weight neonatal mortality rates in New York City. We performed a population-based cohort study using New York City vital statistics records on all live births and deaths of infants weighing 500 to 1499 g who were born in 45 hospitals between January 1, 1996, and December 31, 2001 (N = 11 781). We measured very low birth weight risk-adjusted neonatal mortality rates for each New York City hospital and assessed differences in the distributions of non-Hispanic black and non-Hispanic white very low birth weight births among these hospitals. Risk-adjusted neonatal mortality rates for very low birth weight infants in New York City hospitals ranged from 9.6 to 27.2 deaths per 1000 births. White very low birth weight infants were more likely to be born in the lowest mortality tertile of hospitals (49%), compared with black very low birth weight infants (29%). We estimated that, if black women delivered in the same hospitals as white women, then black very low birth weight mortality rates would be reduced by 6.7 deaths per 1000 very low birth weight births, removing 34.5% of the black/white disparity in very low birth weight neonatal mortality rates in New York City. Volume of very low birth weight deliveries was modestly associated with very low birth weight mortality rates but explained little of the racial disparity. Black very low birth weight infants more likely to be born in New York City hospitals with higher risk-adjusted neonatal mortality rates than were very low birth weight infants, contributing substantially to black-white disparities.

The maternal and neonatal outcomes for an urban Indigenous population compared with their non-Indigenous counterparts and a trend analysis over four triennia.

PubMed

Kildea, Sue; Stapleton, Helen; Murphy, Rebecca; Kosiak, Machellee; Gibbons, Kristen

2013-08-30

Indigenous Australians experience significantly disproportionate poorer health outcomes compared to their non-Indigenous counterparts. Despite the recognised importance of maternal infant health (MIH), there is surprisingly little empirical research to guide service redesign that successfully addresses the disparities. This paper reports on a service evaluation that also compared key MIH indicators for Indigenous and non-Indigenous mothers and babies over a 12-year period 1998-2009. Trend analysis with logistic regression, using the independent variables of ethnicity and triennia, explored changes over time (1998-2009) between two cohorts: 1,523 births to Indigenous mothers and 43,693 births to non-Indigenous mothers. We included bivariate and multivariate analysis on key indicators (e.g. teenage births, preterm birth, low birth weight, smoking) and report odds ratios (ORs), 95% CIs and logistic regression adjusting for important confounders. We excluded transfers in from other areas which are identified within the database. Bivariate analysis revealed Indigenous women were statistically more likely to have spontaneous onset of labour and a non-instrumental vaginal birth. They were less likely to take epidurals for pain relief in labour, have assisted births, caesarean sections or perineal trauma. Despite better labour outcomes, Indigenous babies were more likely to be born preterm (< 37 weeks) and be low birth weight (< 2500 g); these differences remained significant in multivariate analysis. The trend analysis revealed relatively stable rates for teenage pregnancy, small for gestational age, low birth weight babies, and perinatal mortality for both cohorts, with the gap between cohorts consistent over time. A statistical widening of the gap in preterm birth and smoking rates was found with preterm birth demonstrating a relative increase of 51% over this period. The comprehensive database from a large urban hospital allowed a thorough examination of outcomes and contributing factors. The gap between both cohorts remains static in several areas but in some cases worsened. Alternative models for delivering care to Indigenous women and their babies have shown improved outcomes, including preterm birth, though not all have been sustained over time and none are available Australia-wide. New models of care, which recognise the heterogeneity of Indigenous communities, incorporate a multiagency approach, and are set within a research framework, are urgently needed.

The impact of first time mother’s body mass index or excessive weight gain in pregnancy on genital tract trauma at birth

PubMed Central

Gallagher, Kelly; Migliaccio, Laura; Rogers, Rebecca G; Leeman, Lawrence; Hervey, Elizabeth; Qualls, Clifford

2013-01-01

Objective To explore the impact of body mass index BMI or pregnancy weight gain on the presence, site and severity of genital tract trauma at childbirth in nulliparous women. Methods The present study is a sub-analysis of a prospective cohort of healthy nulliparous women recruited during pregnancy and followed through birth. Weight gain during pregnancy and pre-pregnancy BMI were recorded. At birth, women underwent detailed mapping of genital tract trauma. For analyses, women were dichotomized into obese(BMI ≥30) versus non obese(BMI <30) at baseline as well as into those who gained weight as recommended by the Institute of Medicine (IOM) and those who gained more than the recommended amount to determine the impact of obesity or excessive weight gain on rates of genital tract trauma. Results Data from 445 women were available for analysis. Presence and severity of genital tract trauma did not vary between obese and non-obese women (P = NS). Likewise women who gained more than the IOM recommended weight did not have a higher incidence of perineal lacerations (53% vs 51% with perineal lacerations, P= .61). Obese women were more likely to gain in excess of the IOM guidelines during pregnancy (75% vs 50% excessive weight gain, obese vs non-obese women, P<0.001). Conclusion A woman’s BMI or excessive weight gain in pregnancy did not influence her risk of genital tract trauma at birth. PMID:24588877

Prospective cohort study of factors influencing the relative weights of the placenta and the newborn infant.

PubMed

Williams, L A; Evans, S F; Newnham, J P

1997-06-28

To determine the demographic, environmental, and medical factors that influence the relative weights of the newborn infant and the placenta and compare this ratio with other factors known to predispose to adult ill health. Prospective cohort study. The tertiary referral centre for perinatal care in Perth, Western Australia. 2507 pregnant women who delivered a single live infant at term. Placental weight, birth weight, and the ratio of placental weight to birth weight. By multiple regression analysis the placental weight to birthweight ratio was significantly and positively associated with gestational age, female sex, Asian parentage, increasing maternal body mass index, increased maternal weight at booking, lower socioeconomic status, maternal anaemia, and increasing number of cigarettes smoked daily. There were no consistent relations between the placental weight to birthweight ratio and measures of newborn size. The ratio of placental weight to birth weight is not an accurate marker of fetal growth. In its role as a predictor of adult disease the ratio may be acting as a surrogate for other factors which are already known to influence health and may act before or after birth. Determining the role that relative growth rates of the fetus and placenta have in predisposing to adult disease requires prospective study to account for the many confounding variables which complicate this hypothesis.

Racial and Residential Differences in U.S. Infant Death Rates: A Temporal Analysis.

ERIC Educational Resources Information Center

Johnson, Nan E.; Zaki, Khalida P.

1988-01-01

Compares annual rates of neonatal, postneonatal mortality to annual rates of low birth weight, 1963-1982. Shows that same level of decline in incidence of low birth weight is associated with greater decline in mortality rates of non-White than White infants and for nonmetro than metro infants. Contains 15 references. (Author/DHP)

Anthropometrics at birth and risk of a primary central nervous system tumour: A systematic review and meta-analysis.

PubMed

Georgakis, Marios K; Kalogirou, Eleni I; Liaskas, Athanasios; Karalexi, Maria A; Papathoma, Paraskevi; Ladopoulou, Kyriaki; Kantzanou, Maria; Tsivgoulis, Georgios; Petridou, Eleni Th

2017-04-01

The aetiology of primary central nervous system (CNS) tumours remains largely unknown, but their childhood peak points to perinatal parameters as tentative risk factors. In this meta-analysis, we opted to quantitatively synthesise published evidence on the association between birth anthropometrics and risk of primary CNS tumour. Eligible studies were identified via systematic literature review; random-effects meta-analyses were conducted for the effect of birth weight and size-for-gestational-age on childhood and adult primary CNS tumours; subgroup, sensitivity, meta-regression and dose-response by birth weight category analyses were also performed. Forty-one articles, encompassing 53,167 CNS tumour cases, were eligible. Birth weight >4000 g was associated with increased risk of childhood CNS tumour (OR: 1.14, [1.08-1.20]; 22,330 cases). The risk was higher for astrocytoma (OR: 1.22, [1.13-1.31]; 7456 cases) and embryonal tumour (OR: 1.16, [1.04-1.29]; 3574 cases) and non-significant for ependymoma (OR: 1.12, [0.94-1.34]; 1374 cases). Increased odds for a CNS tumour were also noted among large-for-gestational-age children (OR: 1.12, [1.03-1.22]; 10,339 cases), whereas insufficient data for synthesis were identified for other birth anthropometrics. The findings remained robust across subgroup and sensitivity analyses controlling for several sources of bias, whereas no significant heterogeneity or publication bias were documented. The limited available evidence on adults (4 studies) did not reveal significant associations between increasing birth weight (500-g increment) and overall risk CNS tumour (OR: 0.99, [0.98-1.00]; 1091 cases) or glioma (OR: 1.03, [0.98-1.07]; 2052 cases). This meta-analysis confirms a sizeable association of high birth weight, with childhood CNS tumour risk, particularly astrocytoma and embryonal tumour, which seems to be independent of gestational age. Further research is needed to explore underlying mechanisms, especially modifiable determinants of infant macrosomia, such as gestational diabetes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Trends in Canadian Birth Weights, 1971 to 1989

PubMed Central

Wadhera, S.; Millar, W. J.; Nimrod, Carl

1992-01-01

This paper outlines levels and trends in birth weights of singleton birth weights of singleton births in Canada between 1971 and 1989. It relates these birth weights to maternal age, marital status, and parity and to gestational age. From 1971 to 1989, the median birth weight of all singletons increased by 104g, or 3.1%. The proportion of low birth weight babies declined, probably contributing to improved infant mortality rates. PMID:21221364

The association of birth weight with cardiovascular risk factors and mental problems among Iranian school-aged children: the CASPIAN-III study.

PubMed

Azadbakht, Leila; Kelishadi, Roya; Saraf-Bank, Sahar; Qorbani, Mostafa; Ardalan, Gelayol; Heshmat, Ramin; Taslimi, Mahnaz; Motlagh, Mohammad Esmaeil

2014-02-01

Both high and low birth weights (HBW and LBW) are risk factors for adulthood diseases. The aim of this study was to investigate the association of birth weight with cardiovascular disease (CVD) risk factors and mental problems among Iranian school-aged children. This national multicenter study of school-aged children entitled CASPIAN III was conducted among 5528 students in ranging from ages 10 to 18 y. Biochemical indices and anthropometric measurements were collected. Mental health was assessed by questionnaire. To investigate the association between birth weight categories and CVD risk factors and mental problems, multivariate logistic regression was used. HBW adolescents were at higher risk for elevated diastolic blood pressure (DBP) (Ptrend < 0.05), low levels of high-density lipoprotein cholesterol (HDL-C) (Ptrend < 0.05), and lower risk for general obesity (Ptrend < 0.05) compared with the LBW category. HBW had no significant association with mental problems (Ptrend > 0.05) compared with LBW adolescents. The results of regression analysis, which considered normal birth weight as the reference group, showed that LBW students had lower risk for overweight and obesity (P < 0.01), as well as higher DBP (P < 0.05) but they were at higher risk for lower levels of HDL-C (P < 0.01). Furthermore, birth-weight categories had a U-shaped relationship with mental problems and sleep disorders (P < 0.05). Risk for confusion was higher among the LBW group (P < 0.05). Findings from this population-based study revealed a positive relation between birth weight categories and CVD risk factors. Compared with students born with normal weight, those born with HBW and LBW were at higher risk for mental problems, sleep disorders, and confusion. Copyright © 2014 Elsevier Inc. All rights reserved.

Race, ethnicity, concentrated poverty, and low birth weight disparities.

PubMed

Sims, Mario; Sims, Tammy L; Bruce, Marino A

2008-07-01

This study examines the extent to which the relationship between area socioeconomic position (SEP) and low birth weight (LBW) varies by race and ethnicity. A cross-sectional, secondary data analysis was performed with 1992-1994 Vital Statistics and 1990 U.S. Census data for selected metropolitan areas. Low birth weight (< 2500 grams) rates were calculated for non-Hispanic Black, Latino, and non-Hispanic White live singleton births. Concentrated poverty was defined as poor persons living in neighborhoods with 40% or more poverty in metropolitan areas. The results showed that the relationship between concentrated poverty and LBW varied by race and ethnicity. Concentrated poverty was significant for Latinos, even when controlling for maternal health and MSA-level factors. By contrast, maternal health characteristics, such as pre-term birth, teen birth and tobacco use, explained much of the variance in African-American and White LBW These findings extend the discussion about race, class, and health disparities to include Latinos and shows how the relationship between SEP and LBW can vary within an ethnic group.

Race, Ethnicity, Concentrated Poverty, and Low Birth Weight Disparities

PubMed Central

Sims, Mario; Sims, Tammy L.; Bruce, Marino A.

2016-01-01

This study examines the extent to which the relationship between area socioeconomic position (SEP) and low birth weight (LBW) varies by race and ethnicity. A cross-sectional, secondary data analysis was performed with 1992-1994 Vital Statistics and 1990 U.S. Census data for selected metropolitan areas. Low birth weight (< 2500 grams) rates were calculated for non-Hispanic Black, Latino, and non-Hispanic White live singleton births. Concentrated poverty was defined as poor persons living in neighborhoods with 40% or more poverty in metropolitan areas. The results showed that the relationship between concentrated poverty and LBW varied by race and ethnicity. Concentrated poverty was significant for Latinos, even when controlling for maternal health and MSA-level factors. By contrast, maternal health characteristics, such as pre-term birth, teen birth and tobacco use, explained much of the variance in African-American and White LBW. These findings extend the discussion about race, class, and health disparities to include Latinos and shows how the relationship between SEP and LBW can vary within an ethnic group. PMID:18807774

Growth of preterm infants fed nutrient-enriched or term formula after hospital discharge.

PubMed

Carver, J D; Wu, P Y; Hall, R T; Ziegler, E E; Sosa, R; Jacobs, J; Baggs, G; Auestad, N; Lloyd, B

2001-04-01

At hospital discharge, preterm infants may have low body stores of nutrients, deficient bone mineralization, and an accumulated energy deficit. This double-blind, randomized study evaluated the growth of premature infants with birth weights <1800 g who were fed a 22 kcal/fl oz nutrient-enriched postdischarge formula (PDF) or a 20 kcal/fl oz term-infant formula (TF) from hospital discharge to 12 months' corrected age (CA). Infants were randomized to PDF or TF a few days before hospital discharge with stratification by gender and birth weight (<1250 g or >/=1250 g). The formulas were fed to 12 months' CA. Growth was evaluated using analysis of variance controlling for site, feeding, gender, and birth weight group. Interaction effects were also assessed. Secondary analyses included a repeated measures analysis and growth modeling. One hundred twenty-five infants were randomized; 74 completed to 6 months' CA and 53 to 12 months' CA. PDF-fed infants weighed more than TF-fed infants at 1 and 2 months' CA, gained more weight from study day 1 to 1 and 2 months' CA, and were longer at 3 months' CA. There were significant interactions between feeding and birth weight group-among infants with birth weights <1250 g, those fed PDF weighed more at 6 months' CA, were longer at 6 months' CA, had larger head circumferences at term 1, 3, 6, and 12 months' CA, and gained more in head circumference from study day 1 to term and to 1 month CA. The repeated measures and growth modeling analyses confirmed the analysis of variance results. The PDF formula seemed to be of particular benefit for the growth of male infants. Infants fed the PDF consumed less formula and had higher protein intakes at several time points. Energy intakes, however, were not different. Growth was improved in preterm infants fed a nutrient-enriched postdischarge formula after hospital discharge to 12 months' CA. Beneficial effects were most evident among infants with birth weights <1250 g, particularly for head circumference measurements.

Low birth weight,very low birth weight rates and gestational age-specific birth weight distribution of korean newborn infants.

PubMed

Shin, Son-Moon; Chang, Young-Pyo; Lee, Eun-Sil; Lee, Young-Ah; Son, Dong-Woo; Kim, Min-Hee; Choi, Young-Ryoon

2005-04-01

To obtain the low birth weight (LBW) rate, the very low birth weight (VLBW) rate, and gestational age (GA)-specific birth weight distribution based on a large population in Korea, we collected and analyzed the birth data of 108,486 live births with GA greater than 23 weeks for 1 yr from 1 January to 31 December 2001, from 75 hospitals and clinics located in Korea. These data included birth weight, GA, gender of the infants, delivery type, maternal age, and the presence of multiple pregnancy. The mean birth weight and GA of a crude population are 3,188 +/-518 g and 38.7+/-2.1 weeks, respectively. The LBW and the VLBW rates are 7.2% and 1.4%, respectively. The preterm birth rate (less than 37 completed weeks of gestation) is 8.4% and the very preterm birth rate (less than 32 completed weeks of gestation) is 0.7%. The mean birth weights for female infants, multiple births, and births delivered by cesarean section were lower than those for male, singletons, and births delivered vaginally. The risk of delivering LBW or VLBW infant was higher for the teenagers and the older women (aged 35 yr and more). We have also obtained the percentile distribution of GA-specific birth weight in infants over 23 weeks of gestation.

[Risk factors for elevated serum total bile acid in preterm infants].

PubMed

Song, Yan-Ting; Wang, Yong-Qin; Zhao, Yue-Hua; Zhu, Hai-Ling; Liu, Qian; Zhang, Xiao; Gao, Yi-Wen; Zhang, Wei-Ye; Sang, Yu-Tong

2018-03-01

To study the risk factors for elevated serum total bile acid (TBA) in preterm infants. A retrospective analysis was performed for the clinical data of 216 preterm infants who were admitted to the neonatal intensive care unit. According to the presence or absence of elevated TBA (TBA >24.8 μmol/L), the preterm infants were divided into elevated TBA group with 53 infants and non-elevated TBA group with 163 infants. A univariate analysis and an unconditional multivariate logistic regression analysis were used to investigate the risk factors for elevated TBA. The univariate analysis showed that there were significant differences between the elevated TBA group and the non-elevated TBA group in gestational age at birth, birth weight, proportion of small-for-gestational-age infants, proportion of infants undergoing ventilator-assisted ventilation, fasting time, parenteral nutrition time, and incidence of neonatal respiratory failure and sepsis (P<0.05). The unconditional multivariate logistic regression analysis showed that low birth weight (OR=3.84, 95%CI: 1.53-9.64) and neonatal sepsis (OR=2.56, 95%CI: 1.01-6.47) were independent risk factors for elevated TBA in preterm infants. Low birth weight and neonatal sepsis may lead to elevated TBA in preterm infants.

Neonatal Mortality Risk Associated with Preterm Birth in East Africa, Adjusted by Weight for Gestational Age: Individual Participant Level Meta-Analysis

PubMed Central

Marchant, Tanya; Willey, Barbara; Katz, Joanne; Clarke, Siân; Kariuki, Simon; ter Kuile, Feiko; Lusingu, John; Ndyomugyenyi, Richard; Schmiegelow, Christentze; Watson-Jones, Deborah; Armstrong Schellenberg, Joanna

2012-01-01

Background Low birth weight and prematurity are amongst the strongest predictors of neonatal death. However, the extent to which they act independently is poorly understood. Our objective was to estimate the neonatal mortality risk associated with preterm birth when stratified by weight for gestational age in the high mortality setting of East Africa. Methods and Findings Members and collaborators of the Malaria and the MARCH Centers, at the London School of Hygiene & Tropical Medicine, were contacted and protocols reviewed for East African studies that measured (1) birth weight, (2) gestational age at birth using antenatal ultrasound or neonatal assessment, and (3) neonatal mortality. Ten datasets were identified and four met the inclusion criteria. The four datasets (from Uganda, Kenya, and two from Tanzania) contained 5,727 births recorded between 1999–2010. 4,843 births had complete outcome data and were included in an individual participant level meta-analysis. 99% of 445 low birth weight (<2,500 g) babies were either preterm (<37 weeks gestation) or small for gestational age (below tenth percentile of weight for gestational age). 52% of 87 neonatal deaths occurred in preterm or small for gestational age babies. Babies born <34 weeks gestation had the highest odds of death compared to term babies (odds ratio [OR] 58.7 [95% CI 28.4–121.4]), with little difference when stratified by weight for gestational age. Babies born 34–36 weeks gestation with appropriate weight for gestational age had just three times the likelihood of neonatal death compared to babies born term, (OR 3.2 [95% CI 1.0–10.7]), but the likelihood for babies born 34–36 weeks who were also small for gestational age was 20 times higher (OR 19.8 [95% CI 8.3–47.4]). Only 1% of babies were born moderately premature and small for gestational age, but this group suffered 8% of deaths. Individual level data on newborns are scarce in East Africa; potential biases arising due to the non-systematic selection of the individual studies, or due to the methods applied for estimating gestational age, are discussed. Conclusions Moderately preterm babies who are also small for gestational age experience a considerably increased likelihood of neonatal death in East Africa. Please see later in the article for the Editors' Summary. PMID:22904691

Neonatal outcomes for immigrant vs. native-born mothers in Taiwan: an epidemiological paradox.

PubMed

Xirasagar, Sudha; Fu, Jung-Chung; Liu, Jihong; Probst, Janice C; Lin, Duey-Perng

2011-02-01

In Taiwan, immigrant women by marriage face social discrimination due to widespread impressions that they give birth to low birth weight, high-risk, high cost babies due to their lower socioeconomic status, shorter stature, and lower pre-pregnant weight than native-born Taiwanese women. This study compared crude and adjusted birth outcomes of immigrant mothers (Chinese and Vietnamese) relative to native-born Taiwanese, and tested for the phenomenon of an epidemiological paradox of favorable neonatal outcomes among immigrants. Data from patient charts of all singleton live births during 2002-2007, weighing ≥500 and <4,000 g, and ≥20 weeks gestational age at a regional hospital in Kaohsiung, Taiwan, were used. Multiple regression analysis was used to test the hypothesis controlling for maternal characteristics (demographics, national origin, obstetric and prenatal factors) and neonatal characteristics (birth weight, gestational age). Of 3,267 births satisfying the inclusion criteria, 19.0% were to Chinese and Vietnamese mothers. Crude birth weight was lowest for Taiwanese mothers, who also had the highest rate of preterm delivery (<37 weeks). The adjusted birth weight for Chinese and Vietnamese mothers was 87.7 and 74.7 g higher, respectively than native-born Taiwanese (both P < 0.001). Chinese and Vietnamese mothers also had lower odds of preterm birth (ORs 0.46 and 0.47, respectively). Findings support paradoxically better neonatal outcomes among Chinese and Vietnamese immigrant mothers in Taiwan. Findings can be used to initiate public education to reverse the widespread negative perceptions and attitudes towards immigrant spouses in Taiwan.

Meta-analysis of lamb birth weight as influenced by pregnancy nutrition of multiparous ewes.

PubMed

Roca Fraga, Fernando J; Lagisz, Malgorzata; Nakagawa, Shinichi; Lopez-Villalobos, Nicolas; Blair, Hugh T; Kenyon, Paul R

2018-05-04

Across the literature, there is large variation in lamb birth weight responses to changes in the ewe pregnancy nutrition. Much of this heterogeneity has been attributed to several factors inherent to each experiment; however, the relative contribution of these experimental factors has not yet been quantified. This meta-analysis aimed to systematically review the variation in lamb birth weight responses across nutritional studies involving adult multiparous ewes. Effect-sizes for individual studies were estimated using the unbiased estimator Hedges' g, whereby positive and negative values indicate heavier and lighter treatment lambs vs. controls, respectively. Heterogeneity varied between early-, mid- and late-pregnancy undernutrition studies (I2total [early pregnancy] = 19.90%, I2total [midpregnancy] = 52.10%, I2total [late pregnancy] = 68.70%). The small average effects for early- (0.04, highest posterior density [HPD] interval = -0.22, 0.28) and mid-pregnancy undernutrition (-0.15, HPD interval = -0.35, 0.05) suggest that if farmers anticipate a potential feed shortage, ewes can be allowed to lose weight providing nutrition is resumed to adequate levels later in pregnancy. On the contrary, late-pregnancy undernutrition was associated with a significant decrease in lamb birth weight (-0.72, HPD interval = -0.86, -0.55). Thus, management practices should focus on ensuring adequate nutrition in late pregnancy. Increasing lamb birth weight could be possible by feeding ewes above their pregnancy maintenance requirement (0.23, HPD interval = 0.002, 0.48), though the number of studies is limited and further research is needed.

Maternal Obesity and Occurrence of Fetal Macrosomia: A Systematic Review and Meta-Analysis

PubMed Central

Gaudet, Laura; Ferraro, Zachary M.; Walker, Mark

2014-01-01

Objective. To determine a precise estimate for the contribution of maternal obesity to macrosomia. Data Sources. The search strategy included database searches in 2011 of PubMed, Medline (In-Process & Other Non-Indexed Citations and Ovid Medline, 1950–2011), and EMBASE Classic + EMBASE. Appropriate search terms were used for each database. Reference lists of retrieved articles and review articles were cross-referenced. Methods of Study Selection. All studies that examined the relationship between maternal obesity (BMI ≥30 kg/m2) (pregravid or at 1st prenatal visit) and fetal macrosomia (birth weight ≥4000 g, ≥4500 g, or ≥90th percentile) were considered for inclusion. Tabulation, Integration, and Results. Data regarding the outcomes of interest and study quality were independently extracted by two reviewers. Results from the meta-analysis showed that maternal obesity is associated with fetal overgrowth, defined as birth weight ≥ 4000 g (OR 2.17, 95% CI 1.92, 2.45), birth weight ≥4500 g (OR 2.77,95% CI 2.22, 3.45), and birth weight ≥90% ile for gestational age (OR 2.42, 95% CI 2.16, 2.72). Conclusion. Maternal obesity appears to play a significant role in the development of fetal overgrowth. There is a critical need for effective personal and public health initiatives designed to decrease prepregnancy weight and optimize gestational weight gain. PMID:25544943

Maternal education level and low birth weight: a meta-analysis.

PubMed

Silvestrin, Sonia; Silva, Clécio Homrich da; Hirakata, Vânia Naomi; Goldani, André A S; Silveira, Patrícia P; Goldani, Marcelo Z

2013-01-01

To assess the association between maternal education level and birth weight, considering the circumstances in which the excess use of technology in healthcare, as well as the scarcity of these resources, may result in similar outcomes. A meta-analysis of cohort and cross-sectional studies was performed; the studies were selected by systematic review in the MEDLINE database using the following Key**words socioeconomic factors, infant, low birth weight, cohort studies, cross-sectional studies. The summary measures of effect were obtained by random effect model, and its results were obtained through forest plot graphs. The publication bias was assessed by Egger's test, and the Newcastle-Ottawa scale was used to assess study quality. The initial search found 729 articles. Of these, 594 were excluded after reading the title and abstract; 21, after consensus meetings among the three reviewers; 102, after reading the full text; and three for not having the proper outcome. Of the nine final articles, 88.8% had quality ≥ six stars (Newcastle-Ottawa Scale), showing good quality studies. The heterogeneity of the articles was considered moderate. High maternal education showed a 33% protective effect against low birth weight, whereas medium degree of education showed no significant protection when compared to low maternal education. The hypothesis of similarity between the extreme degrees of social distribution, translated by maternal education level in relation to the proportion of low birth weight, was not confirmed. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Are neonatal intensive care resources located according to need? Regional variation in neonatologists, beds, and low birth weight newborns.

PubMed

Goodman, D C; Fisher, E S; Little, G A; Stukel, T A; Chang , C H

2001-08-01

Despite marked growth in neonatal intensive care during the past 30 years, it is not known if neonatologists and beds are preferentially located in regions with greater newborn risk. This study reports the relationship between regional measures of intensive care capacity and low birth weight infants using newly developed market-based regions of neonatal intensive care. Cross-sectional small-area analysis of 246 neonatal intensive care regions (NICRs). 1996 American Medical Association and American Osteopathic Association masterfiles data of clinically active neonatologists; 1999 American Academy of Pediatrics Section on Perinatal Pediatrics survey of directors of neonatal intensive care units in the United States with 100% response rate; 1995 linked birth/death data. The number of total births per neonatologist across NICRs ranged from 390 to 8197 (median: 1722) and the number of total births per intensive care bed ranged from 72 to 1319 (median: 317). The associations between capacity measures and low birth weight rates across NICRs were statistically significant but negligible (R(2): 0.04 for neonatologists; 0.05 for beds). NICRs in the quintile with the greatest neonatologist capacity (average of only 863 births per neonatologist) had very low birth weight (VLBW) rates of 1.5% while those in the quintile of lowest neonatologist capacity (average of 3718 births per neonatologist) had VLBW rates of 1.3%; a similar lack of meaningful difference in VLBW rates was noted across quintiles of intensive care bed capacity. Including midlevel providers and intermediate care beds to the analyses did not alter the findings. Neonatal intensive care capacity is not preferentially located in regions with greater newborn need as measured by low birth weight rates. Whether greater capacity affords benefits to the newborns remains unknown.

Recognition and home care of low birth weight neonates: a qualitative study of knowledge, beliefs and practices of mothers in Iganga-Mayuge Health and Demographic Surveillance Site, Uganda

PubMed Central

2014-01-01

Background Neonatal mortality has remained persistently high worldwide. In Uganda, neonatal deaths account for 50% of all infant deaths. Low birth weight is associated with a higher risk of death during the neonatal period. Failure to recognize low birth weight and inappropriate home care practices increase the risk of morbidity and mortality in this high risk group. This study explored mothers’ knowledge, beliefs and practices in recognising and providing home care for low birth weight babies. Methods The study was carried out in Eastern Uganda. In-depth interviews were conducted with sixteen mothers of small babies who delivered in health facilities (10) or at home (6) two months prior to the study. Interviews were conducted in mothers’ homes using the local language. Interviewer notes and audio recordings were transcribed and translated to English. Content analysis was done using Atlas-ti software. Results Recognition of low birth weight by mothers when a baby is not weighed was difficult. Mothers were aware of the causes of low birth weight though some mothers believed in the influence of supernatural powers. Mothers who delivered in hospital had better knowledge of appropriate home care practices for low birth weight babies compared to mothers who delivered at home or in a lower level health facility. Practices related to cord care and keeping the baby warm were good while poor practices were noted concerning initiation and exclusive breast feeding, and bathing the baby. Low birth weight was not appreciated as a danger sign in newborns and therefore mothers did not seek health care. Some mothers who initiated good care practices for low birth weight newborns in the facilities did not sustain them at home. Conclusions Recognition of low birth weight is still poor. This leads to inappropriate home care practices for these high risk newborns. Mothers’ knowledge and care practices can be improved through health education, and this should be extended to the community to reach mothers that deliver at home. Mechanisms to support mothers to sustain good practices should be put in place by taking advantage of existing village health teams and social support. PMID:24888464

Low birth weight and school readiness.

PubMed

Reichman, Nancy E

2005-01-01

In the United States black women have for decades been twice as likely as white women to give birth to babies of low birth weight who are at elevated risk for developmental disabilities. Does the black-white disparity in low birth weight contribute to the racial disparity in readiness? The author summarizes the cognitive and behavioral problems that beset many low birth weight children and notes that not only are the problems greatest for the smallest babies, but black babies are two to three times as likely as whites to be very small. Nevertheless, the racial disparities in low birth weight cannot explain much of the aggregate gap in readiness because the most serious birth weight-related disabilities affect a very small share of children. The author estimates that low birth weight explains at most 3-4 percent of the racial gap in IQ scores. The author applauds the post-1980 expansions of Medicaid for increasing rates of prenatal care use among poor pregnant women but stresses that standard prenatal medical care cannot improve aggregate birth outcomes substantially. Smoking cessation and nutrition are two prenatal interventions that show promise. Several early intervention programs have been shown to improve cognitive skills of low birth weight children. But even the most promising programs can narrow the readiness gap only a little because their benefits are greatest for heavier low birth weight children and because low birth weight explains only a small share of the gap. The author stresses the importance of reducing rates of low birth weight generally and of extending to all children who need them the interventions that have improved cognitive outcomes among low birth weight children. But because black infants are more likely to be born at the lowest birth weights, preventing low birth weight--when researchers learn how to--is likely to be more effective than early intervention in narrowing birth weight-related racial gaps in school readiness.

Factors affecting birth weight in sheep: maternal environment

PubMed Central

Gardner, D S; Buttery, P J; Daniel, Z; Symonds, M E

2007-01-01

Knowledge of factors affecting variation in birth weight is especially important given the relationship of birth weight to neonatal and adult health. The present study utilises two large contemporary datasets in sheep of differing breeds to explore factors that influence weight at term. For dataset one (Study 1; n = 154 Blue-faced Leicester×Swaledale (Mule) and 87 Welsh Mountain ewes, 315 separate cases of birth weight), lamb birth weight as the outcome measure was related to maternal characteristics and individual energy intake of the ewe during specified periods of gestation, i.e. early (1-30 days; term ∼147 days gestation), mid (31-80 days) or late (110-147 days) pregnancy. For dataset two (Study 2; n = 856 Mule ewes and 5821 cases of birth weight), we investigated using multilevel modelling the influence of ewe weight, parity, barrenness, lamb sex, litter size, lamb mortality and year of birth on lamb birth weight. For a subset of these ewes (n = 283), the effect of the ewes’ own birth weight was also examined. Interactions between combinations of variables were selectively investigated. Litter size, as expected, had the single greatest influence on birth weight with other significant effects being year of birth, maternal birth weight, maternal nutrition, sex of the lamb, ewe barrenness and maternal body composition at mating. The results of the present study have practical implications not only for sheep husbandry but also for the increased knowledge of factors that significantly influence variation in birth weight; as birth weight itself has become a significant predictor of later health outcomes. PMID:17244755

PM2.5 exposure and birth outcomes: use of satellite- and monitor-based data.

PubMed

Hyder, Ayaz; Lee, Hyung Joo; Ebisu, Keita; Koutrakis, Petros; Belanger, Kathleen; Bell, Michelle Lee

2014-01-01

Air pollution may be related to adverse birth outcomes. Exposure information from land-based monitoring stations often suffers from limited spatial coverage. Satellite data offer an alternative data source for exposure assessment. We used birth certificate data for births in Connecticut and Massachusetts, United States (2000-2006). Gestational exposure to PM2.5 was estimated from US Environmental Protection Agency monitoring data and from satellite data. Satellite data were processed and modeled by using two methods-denoted satellite (1) and satellite (2)-before exposure assessment. Regression models related PM2.5 exposure to birth outcomes while controlling for several confounders. Birth outcomes were mean birth weight at term birth, low birth weight at term (<2500 g), small for gestational age (SGA, <10th percentile for gestational age and sex), and preterm birth (<37 weeks). Overall, the exposure assessment method modified the magnitude of the effect estimates of PM2.5 on birth outcomes. Change in birth weight per interquartile range (2.41 μg/m) increase in PM2.5 was -6 g (95% confidence interval = -8 to -5), -16 g (-21 to -11), and -19 g (-23 to -15), using the monitor, satellite (1), and satellite (2) methods, respectively. Adjusted odds ratios, based on the same three exposure methods, for term low birth weight were 1.01 (0.98-1.04), 1.06 (0.97-1.16), and 1.08 (1.01-1.16); for SGA, 1.03 (1.01-1.04), 1.06 (1.03-1.10), and 1.08 (1.04-1.11); and for preterm birth, 1.00 (0.99-1.02), 0.98 (0.94-1.03), and 0.99 (0.95-1.03). Under exposure assessment methods, we found associations between PM2.5 exposure and adverse birth outcomes particularly for birth weight among term births and for SGA. These results add to the growing concerns that air pollution adversely affects infant health and suggest that analysis of health consequences based on satellite-based exposure assessment can provide additional useful information.

Born Too Soon: What Can We Expect? Nature of Home Literacy Experiences for Children with Very Low Birth Weight

ERIC Educational Resources Information Center

Ragusa, G.

2009-01-01

This study documents the home literacy experiences of children born with very low birth weight (VLBW). The study's design was modelled after Purcell-Gates' study of social domains mediated by print as home literacy experiences. A design combining purposeful sampling, semi-structured data collection and descriptive case study analysis was employed…

Refractive Status at Birth: Its Relation to Newborn Physical Parameters at Birth and Gestational Age

PubMed Central

Varghese, Raji Mathew; Sreenivas, Vishnubhatla; Puliyel, Jacob Mammen; Varughese, Sara

2009-01-01

Background Refractive status at birth is related to gestational age. Preterm babies have myopia which decreases as gestational age increases and term babies are known to be hypermetropic. This study looked at the correlation of refractive status with birth weight in term and preterm babies, and with physical indicators of intra-uterine growth such as the head circumference and length of the baby at birth. Methods All babies delivered at St. Stephens Hospital and admitted in the nursery were eligible for the study. Refraction was performed within the first week of life. 0.8% tropicamide with 0.5% phenylephrine was used to achieve cycloplegia and paralysis of accommodation. 599 newborn babies participated in the study. Data pertaining to the right eye is utilized for all the analyses except that for anisometropia where the two eyes were compared. Growth parameters were measured soon after birth. Simple linear regression analysis was performed to see the association of refractive status, (mean spherical equivalent (MSE), astigmatism and anisometropia) with each of the study variables, namely gestation, length, weight and head circumference. Subsequently, multiple linear regression was carried out to identify the independent predictors for each of the outcome parameters. Results Simple linear regression showed a significant relation between all 4 study variables and refractive error but in multiple regression only gestational age and weight were related to refractive error. The partial correlation of weight with MSE adjusted for gestation was 0.28 and that of gestation with MSE adjusted for weight was 0.10. Birth weight had a higher correlation to MSE than gestational age. Conclusion This is the first study to look at refractive error against all these growth parameters, in preterm and term babies at birth. It would appear from this study that birth weight rather than gestation should be used as criteria for screening for refractive error, especially in developing countries where the incidence of intrauterine malnutrition is higher. PMID:19214228

Perinatal outcome and long-term follow-up of extremely low birth weight infants depending on the mode of delivery.

PubMed

Minguez-Milio, José Angel; Alcázar, Juan Luis; Aubá, María; Ruiz-Zambrana, Alvaro; Minguez, José

2011-10-01

To assess the effect of the mode of delivery (vaginal or cesarean section) on survival, morbidity, and long-term psychomotor development of extremely low birth weight (ELBW) infants. A longitudinal observational study including 138 ELBW infants (73 born by c-section and 65 vaginally) was conducted. We analyzed the survival and short-term morbidity. We also studied the long-term neurocognitive and motor development using the McCarthy Scales of Children's Abilities (MSCA). Mortality was significantly higher in newborns delivered vaginally (49.3%) than those delivered by c-section (23.1%). Newborns delivered vaginally had a higher incidence of retinopathy and peri-intraventricular hemorrhage (P-IVH). Children who died had lower gestational age at birth and lower birth weight. After multivariate analysis only birth weight, gestational age at birth and P-IVH were independently associated to mortality. Regarding the long-term evaluation (MSCA), we observed that children born by c-section had lower incidence of abnormal results. The mode of delivery does not affect survival. Cesarean section provides lower morbidity and better prognosis for neurodevelopment long-term outcome in ELBW infants.

Predictors of excess birth weight in Brazil: a systematic review.

PubMed

Czarnobay, Sandra Ana; Kroll, Caroline; Schultz, Lidiane F; Malinovski, Juliana; Mastroeni, Silmara Salete de Barros Silva; Mastroeni, Marco Fabio

2018-05-19

To describe the main predictors for excess birth weight in Brazilian children. Systematic review carried out in the bibliographic databases: PubMed/MEDLINE, Cochrane, Scopus, Web of Science, and LILACS. The research in the gray literature was performed using the Google Scholar database. The bias risk analysis was adapted from the Downs and Black scale, used to evaluate the methodology of the included studies. Using the classifications of fetal macrosomia (>4000g or ≥4000g) and large for gestational age (above the 90th percentile), 64 risk factors for excess birth weight were found in 33 scientific articles in the five regions of the country. Of the 64 risk factors, 31 were significantly associated with excess birth weight, with excess gestational weight gain, pre-gestational body mass index ≥25kg/m 2 , and gestational diabetes mellitus being the most prevalent. The main predictors for excess birth weight in Brazil are modifiable risk factors. The implementation of adequate nutritional status in the gestational period and even after childbirth appears to be due to the quality and frequency of the follow-up of the mothers and their children by public health agencies. Copyright © 2018 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Low birth weight among term newborns in Wolaita Sodo town, South Ethiopia: a facility based cross-sectional study.

PubMed

Kastro, Samson; Demissie, Tsegaye; Yohannes, Bereket

2018-05-11

In low income countries, many low birth weight newborns often miss the chance for survival sooner or later. Others who survive would also face increased risks in later life. Though not adequately documented in Ethiopia, maternal factors pose the main risk. This study was aimed to estimate the proportion of low birth weight among term singletons without congenital malformations and factors associated with it in Wolaita Sodo town in South Ethiopia. We did a facility based survey involving 432 postpartum women with their term newborns. Data was collected through face to face interview from March to April in 2016. The outcome measure was newborn birth weight. Bivariate logistic regression was applied to look for crude associations. Multivariate logistic regression analysis was done to adjust for potential confounders to identify independent predictors. Adjusted Odds Ratio (AOR) and 95% confidence intervals (CI), and statistical significance at P < 0.05 were reported. The proportion of term low birth weight was 8.1% in the study area. Women who had less education (AOR = 6.23; 95% CI = 1.68, 23.1), house wives (AOR = 5.85; 95% CI = 1.40, 24.3) and not frequently consuming fruits during pregnancy (AOR 11.3; 95% CI = 1.98, 64.9) had a higher risk of having term low birth weight newborns. We documented a lesser odds of those from rural settings to have low birth weight newborns as compared to their counter urban equivalents (AOR = 0.06; 95% CI = 0.006, 0.6). Dietary counselling to pregnant mothers specific diet and nutrition including fruit diets in particular might contribute to reduce the risk of term low birth weight. Better education might have enabled women to prefer diets and their job engagements might also have capacitated them to decide on dietary preferences.

Effect of rotating shift work on childbearing and birth weight: a study of women working in a semiconductor manufacturing factory.

PubMed

Lin, Yu-Cheng; Chen, Mei-Huei; Hsieh, Chia-Jung; Chen, Pau-Chung

2011-05-01

Stable circadian rhythm is important for both maternal and fetal health. This retrospective analysis of women in a semiconductor factory evaluated the effect of shift work exposure on childbearing and birth weight. Records of 440 female employees (initial mean age: 28.4 years) including 111 mothers who had 158 live births during the period of observation (1997-2007) were reviewed. The data analyzed included maternal age, general health condition, highest educational level, life-style and occupational factors, as well as newborn gender, birth weight, birth order and gestational age. The childbearing rates of female workers on three different work schedules (consistent daytime work (CDW), intermittent (i-) or persistent (p-) rotating shift works (RSW)) were 32.1%, 20.0% and 25.4%, respectively (P=0.047). After controlling for potential confounding factors, childbearing rates among women with CDW exceeded those of shift workers (odds ratio (OR), 1.7; 95% confidence interval (CI), 1.0-3.0). The birth weights of newborns from mothers on the three work schedules (CDW, i-RSW and p-RSW) were significantly different (3271.7±395.4, 3251.3±460.9, and 2998.5±381.2 g, respectively (P<0.01). Newborns within the lightest birth weight quintile were significantly more likely to be born to mothers with exposure to p-RSW (OR, 4.3; 95% CI, 1.1-16.8). Rotating shift work exposure was significantly associated with decreased childbearing and lighter birth weight in women working in this semiconductor manufacturing factory. Work schedules should be carefully planned for female employees who are pregnant or preparing for pregnancy. Prenatal evaluations for mothers with persistent day-night rotating shift work exposures are especially necessary.

Birth weight, maternal weight and childhood leukaemia

PubMed Central

McLaughlin, C C; Baptiste, M S; Schymura, M J; Nasca, P C; Zdeb, M S

2006-01-01

There is mounting evidence that childhood leukaemia is associated with high birth weight, but few studies have examined the relationship between leukaemia and other perinatal factors that influence birth weight, such as maternal weight or gestational weight gain. This case-cohort study included 916 acute lymphocytic leukaemia (ALL) and 154 acute myeloid leukaemia (AML) cases diagnosed prior to age 10 years between 1985 and 2001 and born in New York State excluding New York City between 1978 and 2001. Controls (n=9686) were selected from the birth cohorts for the same years. Moderate increased risk of both ALL and AML was associated with birth weight 3500 g or more. For ALL, however, there was evidence of effect modification with birth weight and maternal prepregnancy weight. High birth weight was associated with ALL only when the mother was not overweight while heavier maternal weight was associated with ALL only when the infant was not high birth weight. Increased pregnancy-related weight gain was associated with ALL. For AML, birth weight under 3000 g and higher prepregnancy weight were both associated with increased risk. These findings suggest childhood leukaemia may be related to factors influencing abnormal fetal growth patterns. PMID:16736025

[Description and evaluation of creative thinking in preterm low birth weight infants].

PubMed

Parisi, L; Di Filippo, T; Firrigno, L; La Grutta, S; Testa, D; Roccella, M

2007-04-01

Since the 1950s, the problem of how to evaluate creativity has been addressed in studies on the definition of measurement criteria and on the relationship between intelligence and creative thinking. Many revealed cognitive and relational disorders in preterm infants, particularly in preterm very low birth weight infants (birth weight <1500 g) and in infants with serious complications. This study describes the development of creative thinking in a group of children born preterm. The study sample was 43 children (21 males, 22 females; age range 6-11 years), regularly attending school, born with low birth weight (1050-2450 g) at 29-32 weeks gestational age, and compared with a control group with birth weight >2500 g. The test battery included: Torrance Test of Creative Thinking (TCTT); WISC-R intelligence test; Goodenough Human Figure Drawing Test. Statistical analysis (Mann-Whitney U test) showed a statistically significant difference (P>0.05) between the 2 groups; scores for figure originality, figure fluidity and figure elaboration were consistently higher in the control group. Within the low birth weight group, there was a significant correlation (Spearman r) between verbal IQ and verbal fluidity and verbal flexibility subscale scores and between IQ performance and figure elaboration. Scores on the figure drawing tests showed higher creative ability in the control group. In children born preterm with low birth weight, emotive dynamics and flow of affection may influence the channels of communication between child and family. The low figure originality subscale scores support the hypothesis that psychodynamic and relational factors (worry about the preterm condition, overprotective behaviour by parents and others) could lead to diminished autonomy, flexibility and manipulatory interest in the child.

Describing differences in weight and length growth trajectories between white and Pakistani infants in the UK: analysis of the Born in Bradford birth cohort study using multilevel linear spline models.

PubMed

Fairley, Lesley; Petherick, Emily S; Howe, Laura D; Tilling, Kate; Cameron, Noel; Lawlor, Debbie A; West, Jane; Wright, John

2013-04-01

To describe the growth pattern from birth to 2 years of UK-born white British and Pakistani infants. Birth cohort. Bradford, UK. 314 white British boys, 383 Pakistani boys, 328 white British girls and 409 Pakistani girls. Weight and length trajectories based on repeat measurements from birth to 2 years. Linear spline multilevel models for weight and length with knot points at 4 and 9 months fitted the data well. At birth Pakistani boys were 210 g lighter (95% CI -290 to -120) and 0.5 cm shorter (-1.04 to 0.02) and Pakistani girls were 180 g lighter (-260 to -100) and 0.5 cm shorter (-0.91 to -0.03) than white British boys and girls, respectively. Pakistani infants gained length faster than white British infants between 0 and 4 months (+0.3 cm/month (0.1 to 0.5) for boys and +0.4 cm/month (0.2 to 0.6) for girls) and gained more weight per month between 9 and 24 months (+10 g/month (0 to 30) for boys and +30 g/month (20 to 40) for girls). Adjustment for maternal height attenuated ethnic differences in weight and length at birth, but not in postnatal growth. Adjustment for other confounders did not explain differences in any outcomes. Pakistani infants were lighter and had shorter predicted mean length at birth than white British infants, but gained weight and length quicker in infancy. By age 2 years both ethnic groups had similar weight, but Pakistani infants were on average taller than white British infants.

Influence of prematurity and birth weight on the concentration of α-tocopherol in colostrum milk

PubMed Central

Grilo, Evellyn Câmara; de Lira, Larissa Queiroz; Dimenstein, Roberto; Ribeiro, Karla Danielly da S.

2013-01-01

OBJECTIVE: To assess vitamin E levels in the breast milk, analyzing the prematurity and the birth weight influence in α-tocopherol concentration of colostrum milk. METHODS: Cross-sectional study, in which the colostrum was collected from 93 nursing mothers in a public maternity of Natal, Rio Grande do Norte, Northeast Brazil. The newborns were classified based on gestational age and birth weight. The analysis of α-tocopherol in the milk was carried out by high performance liquid chromatography. RESULTS: The α-tocopherol concentration in the colostrum of lactating women whose children were born at term was 1,093.6±532.4µg/dL; for preterm infants, the concentration was 1,321.6±708.5µg/dL (p=0.109). In the preterm group, the α-tocopherol concentration in the colostrum of lactating women whose children were born with low and normal birth weight was 1,316.0±790.7 and 1,327.2±655.0µg/dL, respectively (p=0.971). In the term group, the α-tocopherol levels were higher in mothers of children with birth weight >4000g, being 1,821.0±575.4µg/dL, compared to 869.5±532.1µg/dL and 1,039.6±477.5µg/dL with low and adequate birth weight, respectively (p>0.05). CONCLUSIONS: Prematurity did not influence α-tocopherol levels in the colostrum milk. Mothers who had macrossomic term neonates presented increased α-tocopherol levels. These results indicate that birth weight can influence α-tocopherol leves in the colostrum milk. PMID:24473952

Audit of Cardiac Surgery Outcomes for Low Birth Weight and Premature Infants.

PubMed

Alarcon Manchego, Peter; Cheung, Michael; Zannino, Diana; Nunn, Russell; D'Udekem, Yves; Brizard, Christian

2018-01-01

The burden of disease associated with cardiac surgery in preterm and low birth weight infants is increasing. This retrospective study aimed to compare the mortality and morbidity of cardiac surgery in low birth weight and preterm infants with that of a case-matched normal population. This was a single-center audit of cardiac surgery interventions at a tertiary pediatric center in Melbourne, Australia. Subjects underwent intervention in the first 3 months of life and were preterm (<37 weeks' gestation) or <2500 g at birth. Subjects were case-matched with 2 controls of term gestation and appropriate birth weight with the same primary diagnosis and intervention. Principal outcomes were mortality and complications in the 6 months following intervention. A total of 513 participants were included for analysis in the 13-year study period. There was an increased risk of mortality (odds ratio 6.26; 95% confidence interval (3.19, 12.3)) and rate of complications (odds ratio 2.29; 95% confidence interval (1.38, 3.78)) in low birth weight and premature infants compared with the control population. Patients who did not survive were more likely to have required extracorporeal membrane oxygenation (relative risk [RR] 6.6, P < 0.001), developed postoperative sepsis (RR 2.6, P = 0.012), and undergone unplanned reintervention (RR 2.3, P < 0.001) compared with survivors. Preterm and low birth weight patients had twice the RR of developing complications and 6 times the risk of mortality in the 6 months following cardiac intervention compared with a matched population. Observed trends suggest delaying surgery in clinically stable infants beyond 35 weeks corrected gestational age and 2500-g weight may result in improved survival. Copyright © 2018 Elsevier Inc. All rights reserved.

[Growth in terms of length of Chilean infants of low socioeconomic status: 1978-1992].

PubMed

Pizarro, F; Olivares, M; Hertrampf, E; Walter, T

1996-06-01

In Chile infant malnutrition is better reflected by the length/age indicator than by weight/length. In this study we will present the progression of length during the first year of life from the year 1978 through 1992 of infants of low socioeconomic status. We selected healthy infants with > 3000 g birth weight and birth length > 0.5 z. According to type of milk feedings they were defined as CM (cow milk) those who were weaned before 4 months of life and EM (exclusive breast milk) those who continued exclusive breast milk (as only source of milk solids permitted) past 6 months. Infants CM of the 1978-80 cohort had a length at birth z +0.21 reaching 1 year with z -0.65, a loss of 0.86 z. Infants from the cohorts of 1982-86 and 1988-92 fell from z +0.15 to z -0.37 (a loss of -0.52 z) and +0.16 to -0.19 (a loss of -0.45 z) between birth and 12 months respectively. EBM infants length also fell significantly (delta z: -1.12, -0.69 and 0.59 respectively). Proteincalorie nutrition was adequate confirmed with weight/age or length/weight curves with means of +0.52 throughout the first year. Analysis of the length curves by regression shows that the slopes of the 3 cohorts are significantly different (< 0.01) for CM and EBM favoring the most recent cohorts. Multiple regression analysis identified association of length at 1 year with birth weight (p < 0.05), birth length (p < 0.01) and socioeconomic index (p < 0.01). We suggest that there is an improvement in the trend of Chilean infants growth in length for the past 20 years, likely due to improvement in socioeconomic level.

Pattern and determinants of birth weight in Oman.

PubMed

Islam, M M; ElSayed, M K

2015-12-01

The aim of this study was to analyse the pattern of birth weight (BW) and identify the factors affecting BW and the risk factors of low birth weight (LBW) in Oman. The data for the study came from the 2000 Oman National Health Survey conducted by the Ministry of Health. The survey covered a nationally representative sample of 2037 ever married Omani women of reproductive age. Data on birth weight were gathered from health cards of the infants born within five years before the survey date. The study considered 977 singleton live births for whom data on birth weights were available. LBW was defined as BW less than 2500 g. Descriptive statistics, analysis of variance, multivariate linear regression and logistic regression models were used for data analysis. The mean BW was found to be 3.09 (SD 0.51) kg. BW was found to be significantly lower among the infants with the following characteristics: born in Ad-Dhakhliyah region, born in rural areas, and whose mothers had low economic status, low parity (0-2), and late initiation of antenatal care (ANC) visit. The incidence of LBW was found to be 9% in Oman in 2000. Mother's education, economic status, region of residence, late initiation of first ANC visit and experience of pregnancy complications appeared as the significant determinants of LBW in Oman. In contrast to most other studies, this study demonstrates that mothers with an advanced level of education (secondary and above) are more likely to have infants with LBW in Oman. The study findings highlight the need of intervention for specific groups of women with higher risk of adverse BW outcomes. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Estimation of Fetal Weight during Labor: Still a Challenge.

PubMed

Barros, Joana Goulão; Reis, Inês; Pereira, Isabel; Clode, Nuno; Graça, Luís M

2016-01-01

To evaluate the accuracy of fetal weight prediction by ultrasonography labor employing a formula including the linear measurements of femur length (FL) and mid-thigh soft-tissue thickness (STT). We conducted a prospective study involving singleton uncomplicated term pregnancies within 48 hours of delivery. Only pregnancies with a cephalic fetus admitted in the labor ward for elective cesarean section, induction of labor or spontaneous labor were included. We excluded all non-Caucasian women, the ones previously diagnosed with gestational diabetes and the ones with evidence of ruptured membranes. Fetal weight estimates were calculated using a previously proposed formula [estimated fetal weight = 1687.47 + (54.1 x FL) + (76.68 x STT). The relationship between actual birth weight and estimated fetal weight was analyzed using Pearson's correlation. The formula's performance was assessed by calculating the signed and absolute errors. Mean weight difference and signed percentage error were calculated for birth weight divided into three subgroups: < 3000 g; 3000-4000 g; and > 4000 g. We included for analysis 145 cases and found a significant, yet low, linear relationship between birth weight and estimated fetal weight (p < 0.001; R2 = 0.197) with an absolute mean error of 10.6%. The lowest mean percentage error (0.3%) corresponded to the subgroup with birth weight between 3000 g and 4000 g. This study demonstrates a poor correlation between actual birth weight and the estimated fetal weight using a formula based on femur length and mid-thigh soft-tissue thickness, both linear parameters. Although avoidance of circumferential ultrasound measurements might prove to be beneficial, it is still yet to be found a fetal estimation formula that can be both accurate and simple to perform.

Birth weight and infant growth: optimal infant weight gain versus optimal infant weight.

PubMed

Xiong, Xu; Wightkin, Joan; Magnus, Jeanette H; Pridjian, Gabriella; Acuna, Juan M; Buekens, Pierre

2007-01-01

Infant growth assessment often focuses on "optimal" infant weights and lengths at specific ages, while de-emphasizing infant weight gain. Objective of this study was to examine infant growth patterns by measuring infant weight gain relative to birth weight. We conducted this study based on data collected in a prospective cohort study including 3,302 births with follow up examinations of infants between the ages of 8 and 18 months. All infants were participants in the Louisiana State Women, Infant and Children Supplemental Food Program between 1999 and 2001. Growth was assessed by infant weight gain percentage (IWG%, defined as infant weight gain divided by birth weight) as well as by mean z-scores and percentiles for weight-for-age, length-for-age, and weight-for-length calculated based on growth charts published by the U.S. Centers for Disease Control (CDC). An inverse relationship was noted between birth weight category and IWG% (from 613.9% for infants with birth weights <1500 g to 151.3% for infants with birth weights of 4000 g or more). In contrast, low birth weight infants had lower weight-for-age, weight-for-length z-scores and percentiles compared to normal birth weight infants according to CDC growth charts. Although low birth weight infants had lower anthropometric measures compared to a national reference population, they had significant catch-up growth; High birth weight infants had significant slow-down growth. We suggest that growth assessments should compare infants' anthropometric data to their own previous growth measures as well as to a reference population. Further studies are needed to identify optimal ranges of infant weight gain.

Culture media influenced laboratory outcomes but not neonatal birth weight in assisted reproductive technology.

PubMed

Yin, Tai-lang; Zhang, Yi; Li, Sai-jiao; Zhao, Meng; Ding, Jin-li; Xu, Wang-ming; Yang, Jing

2015-12-01

Whether the type of culture media utilized in assisted reproductive technology has impacts on laboratory outcomes and birth weight of newborns in in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) was investigated. A total of 673 patients undergoing IVF/ICSI and giving birth to live singletons after fresh embryo transfer on day 3 from Jan. 1, 2010 to Dec. 31, 2012 were included. Three types of culture media were used during this period: Quinn's Advantage (QA), Single Step Medium (SSM), and Continuous Single Culture medium (CSC). Fertilization rate (FR), normal fertilization rate (NFR), cleavage rate (CR), normal cleavage rate (NCR), good-quality embryo rate (GQER) and neonatal birth weight were compared using one-way ANOVA and χ (2) tests. Multiple linear regression analysis was performed to determine the impact of culture media on laboratory outcomes and birth weight. In IVF cycles, GQER was significantly decreased in SSM medium group as compared with QA or CSC media groups (63.6% vs. 69.0% in QA; vs. 71.3% in CSC, P=0.011). In ICSI cycles, FR, NFR and CR were significantly lower in CSC medium group than in other two media groups. No significant difference was observed in neonatal birthweight among the three groups (P=0.759). Multiple linear regression analyses confirmed that the type of culture medium was correlated with FR, NFR, CR and GQER, but not with neonatal birth weight. The type of culture media had potential influences on laboratory outcomes but did not exhibit an impact on the birth weight of singletons in ART.

Lamb survival analysis from birth to weaning in Iranian Kermani sheep.

PubMed

Barazandeh, Arsalan; Moghbeli, Sadrollah Molaei; Vatankhah, Mahmood; Hossein-Zadeh, Navid Ghavi

2012-04-01

Survival records from 1,763 Kermani lambs born between 1996 and 2004 from 294 ewes and 81 rams were used to determine genetic and non-genetic factors affecting lamb survival. Traits included were lamb survival across five periods from birth to 7, 14, 56, 70, and 90 days of age. Traits were analyzed under Weibull proportional hazard sire models. Several binary analyses were also conducted using animal models. Statistical models included the fixed class effects of sex of lamb, month and year of birth, a covariate effect of birth weight, and random genetic effects of both sire (in survival analyses) and animal (in binary analyses). The average survival to 90 days of age was 94.8%. Hazard rates ranged from 1.00 (birth to 90 days of age) to 1.73 (birth to 7 days of age) between the two sexes indicating that male lambs were at higher risk of mortality than females (P < 0.01). This study also revealed a curvilinear relationship between lamb survival and lamb birth weight, suggesting that viability and birth weight could be considered simultaneously in the selection programs to obtain optimal birth weight in Kermani lambs. Estimates of heritabilities from survival analyses were medium and ranged from 0.23 to 0.29. In addition, heritability estimates obtained from binary analyses were low and varied from 0.04 to 0.09. The results of this study suggest that progress in survival traits could be possible through managerial strategies and genetic selection.

[A cohort study on the impacts of pre-pregnancy maternal body mass index, gestational weight gain on neonate birth status and perinatal outcomes in Fujian province].

PubMed

Li, Yanhua; Chen, Xiaomei; Chen, Shuixian; Wu, Jiangnan; Zhuo, Xiuyun; Zheng, Qiaoling; Wei, Xiuqing; Zhang, Ronghua; Huang, Huiqing; Zheng, Cuixian; Lin, Juan

2014-06-01

To study the impacts of pre-pregnancy maternal BMI and gestational weight gain(GWG) on pregnancy outcomes. We adopted a prospective cohort study with cluster sampling in single pregnant women, who were not with hypertension, diabetes, hyperlipidemia or other diseases in the previous history, neither did they have diseases of heart, liver, kidney, thyroid etc. related to current pregnancy. Those pregnant women who visited the prenatal nutrition clinic under 'informed consent' were surveyed with questionnaire to track their peri-natal complications, delivery mode and neonate birth outcomes etc. Pearson and partial correlations, chi-square test and binary logistic regression were used to study the association between pre-pregnancy maternal BMI, GWG and pregnancy outcomes. A total of 623 pregnant women were recruited in the cohort, with 592 (95%) of them eligible for analysis. Results from the Multivariate Logistic Regression analysis indicated that, after controlling the potential confounding factors, when compared to women with pre-pregnancy BMI between 18.5 and 24.0, the odds ratios (ORs) for low birth ponderal index (PI) were 2.34 [95% confidence interval (CI), 1.24-4.42)]among those with BMI<18.5, respectively, while 2.73 (1.12-6.68) for high birth PI among those with BMI > 24.0. Similarly, when compared to pregnant women with normal GWG(defined as weight gain range from P15 to P85 by stratification of pre-pregnancy BMI), low GWG (P 85)appeared the risk factor for high birth weight, high birth PI, and gestational diabetes mellitus, with ORs as 3.83(1.74-8.44), 2.39(1.14-5.01)and 2.21(1.07-4.55), respectively. Low or high pre-pregnancy maternal BMI and GWG were associated with adverse pregnancy outcomes.

Associations between birth size and later height from infancy through adulthood: An individual based pooled analysis of 28 twin cohorts participating in the CODATwins project.

PubMed

Jelenkovic, Aline; Yokoyama, Yoshie; Sund, Reijo; Hur, Yoon-Mi; Harris, Jennifer R; Brandt, Ingunn; Nilsen, Thomas Sevenius; Ooki, Syuichi; Ullemar, Vilhelmina; Almqvist, Catarina; Magnusson, Patrik K E; Saudino, Kimberly J; Stazi, Maria A; Fagnani, Corrado; Brescianini, Sonia; Nelson, Tracy L; Whitfield, Keith E; Knafo-Noam, Ariel; Mankuta, David; Abramson, Lior; Cutler, Tessa L; Hopper, John L; Llewellyn, Clare H; Fisher, Abigail; Corley, Robin P; Huibregtse, Brooke M; Derom, Catherine A; Vlietinck, Robert F; Bjerregaard-Andersen, Morten; Beck-Nielsen, Henning; Sodemann, Morten; Krueger, Robert F; McGue, Matt; Pahlen, Shandell; Alexandra Burt, S; Klump, Kelly L; Dubois, Lise; Boivin, Michel; Brendgen, Mara; Dionne, Ginette; Vitaro, Frank; Willemsen, Gonneke; Bartels, Meike; van Beijsterveld, Catharina E M; Craig, Jeffrey M; Saffery, Richard; Rasmussen, Finn; Tynelius, Per; Heikkilä, Kauko; Pietiläinen, Kirsi H; Bayasgalan, Gombojav; Narandalai, Danshiitsoodol; Haworth, Claire M A; Plomin, Robert; Ji, Fuling; Ning, Feng; Pang, Zengchang; Rebato, Esther; Tarnoki, Adam D; Tarnoki, David L; Kim, Jina; Lee, Jooyeon; Lee, Sooji; Sung, Joohon; Loos, Ruth J F; Boomsma, Dorret I; Sørensen, Thorkild I A; Kaprio, Jaakko; Silventoinen, Karri

2018-05-01

There is evidence that birth size is positively associated with height in later life, but it remains unclear whether this is explained by genetic factors or the intrauterine environment. To analyze the associations of birth weight, length and ponderal index with height from infancy through adulthood within mono- and dizygotic twin pairs, which provides insights into the role of genetic and environmental individual-specific factors. This study is based on the data from 28 twin cohorts in 17 countries. The pooled data included 41,852 complete twin pairs (55% monozygotic and 45% same-sex dizygotic) with information on birth weight and a total of 112,409 paired height measurements at ages ranging from 1 to 69 years. Birth length was available for 19,881 complete twin pairs, with a total of 72,692 paired height measurements. The association between birth size and later height was analyzed at both the individual and within-pair level by linear regression analyses. Within twin pairs, regression coefficients showed that a 1-kg increase in birth weight and a 1-cm increase in birth length were associated with 1.14-4.25 cm and 0.18-0.90 cm taller height, respectively. The magnitude of the associations was generally greater within dizygotic than within monozygotic twin pairs, and this difference between zygosities was more pronounced for birth length. Both genetic and individual-specific environmental factors play a role in the association between birth size and later height from infancy to adulthood, with a larger role for genetics in the association with birth length than with birth weight. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

[The influence of previous pregnancy terminations, miscarriages and still-births on the incidence of babies with low birth weight and premature births as well as a somatic classification of newborns].

PubMed

Voigt, M; Olbertz, D; Fusch, C; Krafczyk, D; Briese, V; Schneider, K T M

2008-02-01

The influence of previous interruptions, miscarriages and IUFD on the IUGR and preterm rate as well as on the somatic staging (gestational age and birth weight) of the new born is a subject of controversial discussion in the literature. The present paper attempts to quantify these risks of the medical history. 2 282 412 singleton pregnancies of the period 1995 to 2000 were evaluated from the German Perinatal Database. For the analysis 1 065 202 pregnancies (46.7 %) of those mothers without any live birth in the medical history were assessed. To exclude any influence from previous abortions patients with previous miscarriages and IUFDs were excluded. The control collective were new borns whose mothers had suffered neither from miscarriages nor from abortions or IUFD. Previous interruptions, miscarriages and IUFD influence the rate of new borns with low birth weight and increase the rate of prematurity. With increasing numbers of isolated or combined risks in the medical history, the rate of newborns with a low birth weight or with prematurity is increased. The lowest risk was found after one interruption, the highest rate with two or more IUFDs. Interruptions, miscarriages or IUFD are not risk factors for IUGR or SGA. Previous interruptions, miscarriages and IUFD are relevant risk factors for prematurity and are related with low birth weight of the new borns. Pregnant women with such risk factors have to been considered as risk pregnancies and need intensive surveillance.

Association of Maternal Smoking During Pregnancy and Birth Weight With Retinal Nerve Fiber Layer Thickness in Children Aged 11 or 12 Years: The Copenhagen Child Cohort 2000 Eye Study.

PubMed

Ashina, Håkan; Li, Xiao Qiang; Olsen, Else Marie; Skovgaard, Anne Mette; Larsen, Michael; Munch, Inger Christine

2017-04-01

Both maternal smoking during pregnancy and low birth weight have been implicated in impaired development of the retina. To investigate the associations of maternal smoking during pregnancy and low birth weight with retinal nerve fiber layer (RNFL) thickness in preadolescent children. The Copenhagen Child Cohort 2000 Eye Study is a prospective, population-based, birth cohort study that included all children (n = 6090) born in 2000 in Copenhagen, Denmark. Maternal smoking data were collected through parental interviews. Birth weight, pregnancy, and medical history data were obtained from the Danish Medical Birth Registry. As a follow-up, the study performed eye examinations on 1406 of these children from May 1, 2011, to October 31, 2012, when the children were aged 11 or 12 years. The participants were predominantly (1296 [92.4%]) of European descent. Study data were analyzed from June 1, 2016, to October 1, 2016. Peripapillary RNFL thickness measured using optical coherence tomography at the 11- or 12-year examination. Of the 1406 children in the study, 1323 were included in the analysis (mean [SD] age was 11.7 [0.4] years; 633 [47.8%] were boys and 690 [52.2%] were girls). The mean (SD) RNFL thickness was 104 (9.6) μm. In 227 children whose mothers had smoked during pregnancy, the peripapillary RNFL was 5.7 μm (95% CI, 4.3-7.1 μm; P < .001) thinner than in children whose mothers had not smoked after correction for age, sex, birth weight, height, body weight, Tanner stage of pubertal development, axial length, and spherical equivalent refractive error. In low-birth-weight children (<2500 g), the RNFL was 3.5 μm (95% CI, 0.6-6.3 μm; P = .02) thinner than in normal-birth-weight children after adjustment for all variables. Exposure to maternal smoking during uterine life and low birth weight were independently associated with having a thinner RNFL at age 11 or 12 years. These observations support previous findings that intrauterine and perinatal factors can have long-lasting effects on the retina and the optic nerve. The results of this study add evidence to existing recommendations to avoid smoking during pregnancy and support measures that promote maternal and fetal health.

An Evidence-Based Approach to Defining Fetal Macrosomia.

PubMed

Froehlich, Rosemary; Simhan, Hyagriv N; Larkin, Jacob C

2016-04-01

This study aims to determine the risk of adverse outcomes associated with the current diagnostic criteria for fetal macrosomia. Study We evaluated three techniques for characterizing birth weight as a predictor of shoulder dystocia or third- or fourth-degree laceration in 79,879 vaginal deliveries. First, we compared deliveries with birth weights above or below 4,500 g. We then performed logistic regression using birth weight as a continuous predictor, both with and without fractional polynomial transformation. Finally, we calculated the number of cesarean sections required to prevent one incident of the interrogated outcomes (number needed to treat [NNT]). Rates of adverse intrapartum outcomes increase incrementally with increasing birth weight and are predicted most accurately with logistic regression following fractional polynomial transformation. The NNT for third- or fourth-degree laceration dropped from 14.3 (95% confidence interval [CI], 13.9-14.7) at a birth weight of 3,500 g to 6.4 (95% CI, 6.1-6.8) at 4,500 g and, for shoulder dystocia, from 54.9 (95% CI, 51.5-58.6) at 3,500 g to 5.6 (95% CI, 5.2-6.0) at 4,500 g. The conventional distinction between "normal" and "macrosomic" does not reflect the incremental effect of increasing birth weight on the risk of obstetric morbidity. Outcomes analysis can inform fetal growth standards to better reflect relevant thresholds of risk. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

[A co-twin control study on birth weight, overweight and obesity among children younger than 18 years old in China].

PubMed

Liu, Qingqing; Yu, Canqing; Gao, Wenjing; Cao, Weihua; Lyu, Jun; Wang, Shengfeng; Pang, Zengchang; Cong, Liming; Dong, Zhong; Wu, Fan; Wang, Hua; Wu, Xianping; Wang, Dezheng; Wang, Binyou; Li, Liming

2016-04-01

To analyze the associations between birth weight and overweight/obesity among children. A total of 8 267 twin pairs younger than 18 years old from the Chinese National Twin Registry were included in the study. Associations between birth weight, childhood BMI and overweight/obesity were explored by this co-twin control study. After adjusting for sex and zygosity, when birth weight had an increase of 0.5 kg per fold, the OR values for overweight and obesity were 1.87(95%CI: 1.40-2.48) for 2-6 year olds, 1.69 (95%CI: 1.16-2.46) for 6-12 year olds and 1.28 (95%CI: 0.80-2.07) for 12-18 year olds. from the stratified analysis in the 2-6 year-olds, statistically significant differences were seen. When birth weight increased 0.5 kg per fold, the risk of overweight and obesity increased by 0.87 times among the dizygotic twins, more than that of the monozygotic twins (OR=1.86, 95%CI:1.24-2.81). The risk for male twins was 1.12 times higher than that of female twins (OR=1.65, 95%CI:1.11-2.44). Birth weight seemed associated with overweight and obesity for kids at early childhood or at age for schools. However, guidance on the implementation of public health interventions is still needed on these children.

Maternal anthropometry and infant feeding practices in Israel in relation to growth in infancy: the North African Infant Feeding Study.

PubMed

Fawzi, W W; Forman, M R; Levy, A; Graubard, B I; Naggan, L; Berendes, H W

1997-06-01

Relations between maternal anthropometric status during pregnancy and infant feeding practices and growth from birth through the first 6 mo of life were examined in a cohort of 351 Israeli mother-infant pairs of North African descent. Maternal weight, height, and triceps skinfold thicknesses were determined at 6 and 9 mo of pregnancy, while infants' weights and lengths were measured at birth and at 1, 2, 3, and 6 mo of age with concurrent collection of age-specific maternal-reported infant feeding data. On the basis of multiple-linear-regression analysis that adjusted for potential covariates, mean maternal weight at the first prenatal visit and at 6 and 9 mo of pregnancy were positively associated with birth length (P for trend in all cases < 0.0001) and with linear growth between birth and 1, 3, and 6 mo of age. Maternal skinfold thickness at 9 mo of pregnancy and maternal height were also significantly associated with birth length. Moreover, maternal height, weight, and skinfold thickness at 6 and 9 mo of pregnancy were positively associated with mean birth weight. After adjustment for morbidity in the past month and other covariates, infants breast-fed exclusively had greater attained weight and weight gain in the first 3 mo compared with infants who were bottle-fed exclusively, breast-fed and bottle-fed, or solid-fed exclusively. These findings underscore the need for programs that improve the nutritional status of women before, during, and after pregnancy, and encourage exclusive breast-feeding of infants for at least the first 3 mo of life.

Is the economic crisis affecting birth outcome in Spain? Evaluation of temporal trend in underweight at birth (2003-2012).

PubMed

Varea, Carlos; Terán, José Manuel; Bernis, Cristina; Bogin, Barry; González-González, Antonio

2016-01-01

There is growing evidence of the impact of the current European economic crisis on health. In Spain, since 2008, there have been increasing levels of impoverishment and inequality, and important cuts in social services. The objective is to evaluate the impact of the economic crisis on underweight at birth in Spain. Trends in underweight at birth were examined between 2003 and 2012. Underweight at birth is defined as a singleton, term neonatal weight lesser than -2 SD from the median weight at birth for each sex estimated by the WHO Standard Growth Reference. Using data from the Statistical Bulletin of Childbirth, 2 933 485 live births born to Spanish mothers have been analysed. Descriptive analysis, seasonal decomposition analysis and crude and adjusted logistic regression including individual maternal and foetal variables as well as exogenous economic indicators have been performed. Results demonstrate a significant increase in the prevalence of underweight at birth from 2008. All maternal-foetal categories were affected, including those showing the lowest prevalence before the crisis. In the full adjusted logistic regression, year-on-year GDP per capita remains predictive on underweight at birth risk. Previous trends in maternal socio-demographic profiles and a direct impact of the crisis are discussed to explain the trends described.

High Birth Weight and Cognitive Outcomes. NBER Working Paper No. 14524

ERIC Educational Resources Information Center

Cesur, Resul; Rashad, Inas

2008-01-01

While the effects of low birth weight have long been explored, those of high birth weight have been essentially ignored. Economists have analyzed the negative effects that low birth weight might have on subsequent school outcomes, while taking into account unobserved characteristics that may be common to families with low birth weight babies and…

Higher gestational weight gain is associated with increasing offspring birth weight independent of maternal glycemic control in women with type 1 diabetes.

PubMed

Secher, Anna L; Parellada, Clara B; Ringholm, Lene; Asbjörnsdóttir, Björg; Damm, Peter; Mathiesen, Elisabeth R

2014-10-01

We evaluate the association between gestational weight gain and offspring birth weight in singleton term pregnancies of women with type 1 diabetes. One hundred fifteen consecutive women referred at <14 weeks were retrospectively classified as underweight (prepregnancy BMI <18.5 kg/m(2); n = 1), normal weight (18.5-24.9; n = 65), overweight (25.0-29.9; n = 39), or obese (≥30.0; n = 10). Gestational weight gain was categorized as excessive, appropriate, or insufficient according to the Institute of Medicine recommendations for each BMI class. Women with nephropathy, preeclampsia, and/or preterm delivery were excluded because of restrictive impact on fetal growth and limited time for total weight gain. HbA1c was comparable at ∼6.6% (49 mmol/mol) at 8 weeks and ∼6.0% (42 mmol/mol) at 36 weeks between women with excessive (n = 62), appropriate (n = 37), and insufficient (n = 16) gestational weight gain. Diabetes duration was comparable, and median prepregnancy BMI was 25.3 (range 18-41) vs. 23.5 (18-31) vs. 22.7 (20-30) kg/m(2) (P = 0.05) in the three weight gain groups. Offspring birth weight and birth weight SD score decreased across the groups (3,681 [2,374-4,500] vs. 3,395 [2,910-4,322] vs. 3,295 [2,766-4,340] g [P = 0.02] and 1.08 [-1.90 to 3.25] vs. 0.45 [-0.83 to 3.18] vs. -0.02 [-1.51 to 2.96] [P = 0.009], respectively). In a multiple linear regression analysis, gestational weight gain (kg) was positively associated with offspring birth weight (g) (β = 19; P = 0.02) and birth weight SD score (β = 0.06; P = 0.008) when adjusted for prepregnancy BMI, HbA1c at 36 weeks, smoking, parity, and ethnicity. Higher gestational weight gain in women with type 1 diabetes was associated with increasing offspring birth weight independent of glycemic control and prepregnancy BMI. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Selected preconception health indicators and birth weight disparities in a national study.

PubMed

Strutz, Kelly L; Richardson, Liana J; Hussey, Jon M

2014-01-01

This analysis explored the effect of timing, sequencing, and change in preconception health across adolescence and young adulthood on racial/ethnic disparities in birth weight in a diverse national cohort of young adult women. Data came from Waves I (1994-1995), III (2001-2002), and IV (2007-2008) of the National Longitudinal Study of Adolescent Health. Eligibility was restricted to all singleton live births to female non-Hispanic White, non-Hispanic Black, Mexican-origin Latina, or Asian/Pacific Islander participants (n = 3,014) occurring between the Wave III (ages 18-26 years) and IV (ages 24-32 years) interviews. Birth weight was categorized into low (<2,500 g), normal (2,500-4,000 g), and macrosomic (>4,000 g). Preconception health indicators were cigarette smoking, heavy alcohol consumption, overweight or obesity, and inadequate physical activity, measured in adolescence (Wave I, ages 11-19 years) and early adulthood (Wave III) and combined into four-category variables to capture the timing and sequencing of exposure. Measures of preconception health did not explain the Black-White disparity in low birth weight, which increased after adjustment for confounders (odds ratio [OR], 2.17; 95% confidence interval [CI], 1.33-3.53) and effect modification by overweight/obesity (OR, 3.58; 95% CI, 1.65-7.78). A positive association between adult-onset overweight/obesity and macrosomia was modified by race (OR, 3.83; 95% CI, 1.02-14.36 for Black women). This longitudinal analysis provides new evidence on preconception health and racial/ethnic disparities in birth weight. Specifically, it indicates that interventions focused on prevention of overweight/obesity and maintenance of healthy weight during the transition to adulthood, especially among Black females, may be warranted. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Positive effect of human milk feeding during NICU hospitalization on 24 month neurodevelopment of very low birth weight infants: an Italian cohort study.

PubMed

Gibertoni, Dino; Corvaglia, Luigi; Vandini, Silvia; Rucci, Paola; Savini, Silvia; Alessandroni, Rosina; Sansavini, Alessandra; Fantini, Maria Pia; Faldella, Giacomo

2015-01-01

The aim of this study was to determine the effect of human milk feeding during NICU hospitalization on neurodevelopment at 24 months of corrected age in very low birth weight infants. A cohort of 316 very low birth weight newborns (weight ≤ 1500 g) was prospectively enrolled in a follow-up program on admission to the Neonatal Intensive Care Unit of S. Orsola Hospital, Bologna, Italy, from January 2005 to June 2011. Neurodevelopment was evaluated at 24 months corrected age using the Griffiths Mental Development Scale. The effect of human milk nutrition on neurodevelopment was first investigated using a multiple linear regression model, to adjust for the effects of gestational age, small for gestational age, complications at birth and during hospitalization, growth restriction at discharge and socio-economic status. Path analysis was then used to refine the multiple regression model, taking into account the relationships among predictors and their temporal sequence. Human milk feeding during NICU hospitalization and higher socio-economic status were associated with better neurodevelopment at 24 months in both models. In the path analysis model intraventricular hemorrhage-periventricular leukomalacia and growth restriction at discharge proved to be directly and independently associated with poorer neurodevelopment. Gestational age and growth restriction at birth had indirect significant effects on neurodevelopment, which were mediated by complications that occurred at birth and during hospitalization, growth restriction at discharge and type of feeding. In conclusion, our findings suggest that mother's human milk feeding during hospitalization can be encouraged because it may improve neurodevelopment at 24 months corrected age.

Effects of fine particulate matter and its constituents on low birth weight among full-term infants in California

DOE Office of Scientific and Technical Information (OSTI.GOV)

Basu, Rupa, E-mail: Rupa.Basu@oehha.ca.gov; Harris, Maria; Sie, Lillian

Relationships between prenatal exposure to fine particles (PM{sub 2.5}) and birth weight have been observed previously. Few studies have investigated specific constituents of PM{sub 2.5}, which may identify sources and major contributors of risk. We examined the effects of trimester and full gestational prenatal exposures to PM{sub 2.5} mass and 23 PM{sub 2.5} constituents on birth weight among 646,296 term births in California between 2000 and 2006. We used linear and logistic regression models to assess associations between exposures and birth weight and risk of low birth weight (LBW; <2500 g), respectively. Models were adjusted for individual demographic characteristics, apparentmore » temperature, month and year of birth, region, and socioeconomic indicators. Higher full gestational exposures to PM{sub 2.5} mass and several PM{sub 2.5} constituents were significantly associated with reductions in term birth weight. The largest reductions in birth weight were associated with exposure to vanadium, sulfur, sulfate, iron, elemental carbon, titanium, manganese, bromine, ammonium, zinc, and copper. Several of these PM{sub 2.5} constituents were associated with increased risk of term LBW. Reductions in birth weight were generally larger among younger mothers and varied by race/ethnicity. Exposure to specific constituents of PM{sub 2.5}, especially traffic-related particles, sulfur constituents, and metals, were associated with decreased birth weight in California. -- Highlights: • Examine full gestational and trimester fine particle and its constituents on term birth weight. • Fine particles and several of its constituents associated with birth weight reductions. • Largest reductions for traffic-related particles, sulfur constituents, and metals. • Greater birth weight reductions for younger mothers, and varied by race/ethnicity.« less

Trends and racial differences in birth weight and related survival.

PubMed

Alexander, G R; Tompkins, M E; Allen, M C; Hulsey, T C

1999-06-01

In the past two decades, infant mortality rates in the United States declined in African-American and White populations. Despite this, racial disparities in infant mortality rates have increased and rates of low birth weight deliveries have shown little change. In this study, we examine temporal changes in birth weight distributions, birth weight specific neonatal mortality, and the birth weight threshold for an adverse risk of survival within both racial groups in order to explore the mechanisms for the disparities in infant mortality rates. Single live births born to South Carolina resident mothers between 1975 and 1994 and considered White or African-American based on the mother's report of maternal race on the birth certificate were selected for investigation. We define the birth weight threshold for adverse survival odds as the birth weight at which 50% or more of infants in the population died within the first month of life. Despite significant increases in very low birth weight percentages, neonatal mortality rates markedly declined. Birth weight specific neonatal mortality decreased for both races, although greater reductions accrued to White low birth weight infants. By the end of the study period, the birth weight at which over 50% of newborns died within the first month of life was 696 g for Whites and 673 g for African-Americans. The ongoing decline in neonatal mortality is mainly due to reductions in birth weight specific neonatal mortality, probably related to high-risk obstetric and neonatal care. Technological developments in these areas may have differentially benefited Whites, resulting in an increasing racial disparity in mortality rates. Moreover, the relatively greater and increasing mortality risk from postmaturity and macrosomia in infants of African-America mothers may further exacerbate the racial gap in infant mortality.

Air pollutants associated with insufficient birth weight.

PubMed

Santos, Veridiana de Paula; Medeiros, Andréa Paula Peneluppi de; Lima, Thaiza Agostini Cordoba de; Nascimento, Luiz Fernando Costa

2016-03-01

A growing number of studies have shown consistent evidence of the harmful effects of air pollution on human health, as well as its effects on newborn weight. The objective of this study is to evaluate the effect of air pollution on birth weight, more specifically the insufficient birth weight (identified between 2,500 and 2,999 grams). This was a cross-sectional study based on data gathered from all babies born to mothers living in São José dos Campos, São Paulo, Brazil, between the years of 2006 to 2010. The association between maternal exposure to air pollution and birth weight was examined using logistic regression (both univariate and multivariate) to consider the average concentration of each pollutant during the 1st and 3rd trimesters and the months of the 1st trimester. Of the 39,453 total live births during the study period, 10,542 (26.7%) newborns had insufficient weight. In multiple logistic analysis, maternal exposure to particulate matter in the 1st and 3rd trimester of pregnancy had a greater chance for insufficient weight. There is a chance of 1.07 (95%CI 1.00 - 1.14) for an insufficient weight scenario for exposure (to the 2nd quartile) of particulate matter in the 1st trimester and 1.10 (95%CI 1.04 - 1.18) for exposure (the 3rd quartile) in the 3rd trimester. The survey results indicate that maternal exposure to air pollution in the 1st and 3rd trimesters of pregnancy for residents of São José dos Campos create considerable potential to cause insufficient weight.

Effect of hospital nutrition support on growth velocity and nutritional status of low birth weight infants.

PubMed

Azzeh, Firas S; Alazzeh, Awfa Y; Dabbour, Ibrahim R; Jazar, Abdelelah S; Obeidat, Ahmed A

2014-10-01

Infants with low birth weights are provided with hospital nutrition support to enhance their survivability and body weights. However, different hospitals have different nutrition support formulas. Therefore, the effectiveness of these nutrition support formulas should be investigated. To assess the effect of hospital nutrition support on growth velocity and nutritional status of low birth weight infants at Al-Noor hospital, Saudi Arabia. A cross-sectional study was conducted between October, 2010 and December, 2012. Three hundred newborns were recruited from Al-Noor Hospital in Makkah city, Saudi Arabia. Infants were selected according to their birth weights and were divided equally into three groups; (i) Low Birth Weight (LBW) infants (1501- 2500 g birth weight), (ii) Very Low Birth Weight (VLBW) infants (1001-1500 g birth weight) and (iii) Extremely Low Birth Weight (ELBW) infants (< 1000 g birth weight). Data were collected at birth and at discharged. Infants' weights were recorded and growth velocity was calculated. Some biochemical tests and mineral levels were measured. Body mass index values of VLBW and ELBW groups were lower (p < 0.05) than LBW group. The growth velocity of infants in all groups ranged between 8.7 to 10.2 g/kg/d with no differences (p > 0.05) were observed among groups. Serum calcium, phosphorus and potassium levels at discharge were higher (p < 0.05) than that at birth for ELBW and VLBW groups; while sodium level decreased in ELBW group to be within normal ranges. Albumin level was improved (p < 0.05) in ELBW group. Health care management for low birth weight infants in Al-Noor Hospital was not sufficient to achieve normal growth rate for low birth weight infants, while biochemical indicators were remarkably improved in all groups. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Relationships between neonatal weight, limb lengths, skinfold thicknesses, body breadths and circumferences in an Australian cohort.

PubMed

Pomeroy, Emma; Stock, Jay T; Cole, Tim J; O'Callaghan, Michael; Wells, Jonathan C K

2014-01-01

Low birth weight has been consistently associated with adult chronic disease risk. The thrifty phenotype hypothesis assumes that reduced fetal growth impacts some organs more than others. However, it remains unclear how birth weight relates to different body components, such as circumferences, adiposity, body segment lengths and limb proportions. We hypothesized that these components vary in their relationship to birth weight. We analysed the relationship between birth weight and detailed anthropometry in 1270 singleton live-born neonates (668 male) from the Mater-University of Queensland Study of Pregnancy (Brisbane, Australia). We tested adjusted anthropometry for correlations with birth weight. We then performed stepwise multiple regression on birth weight of: body lengths, breadths and circumferences; relative limb to neck-rump proportions; or skinfold thicknesses. All analyses were adjusted for sex and gestational age, and used logged data. Circumferences, especially chest, were most strongly related to birth weight, while segment lengths (neck-rump, thigh, upper arm, and especially lower arm and lower leg) were relatively weakly related to birth weight, and limb lengths relative to neck-rump length showed no relationship. Skinfolds accounted for 36% of birth weight variance, but adjusting for size (neck-rump, thigh and upper arm lengths, and head circumference), this decreased to 10%. There was no evidence that heavier babies had proportionally thicker skinfolds. Neonatal body measurements vary in their association with birth weight: head and chest circumferences showed the strongest associations while limb segment lengths did not relate strongly to birth weight. After adjusting for body size, subcutaneous fatness accounted for a smaller proportion of birth weight variance than previously reported. While heavier babies had absolutely thicker skinfolds, this was proportional to their size. Relative limb to trunk length was unrelated to birth weight, suggesting that limb proportions at birth do not index factors relevant to prenatal life.

Relationships between Neonatal Weight, Limb Lengths, Skinfold Thicknesses, Body Breadths and Circumferences in an Australian Cohort

PubMed Central

Pomeroy, Emma; Stock, Jay T.; Cole, Tim J.; O'Callaghan, Michael; Wells, Jonathan C. K.

2014-01-01

Background Low birth weight has been consistently associated with adult chronic disease risk. The thrifty phenotype hypothesis assumes that reduced fetal growth impacts some organs more than others. However, it remains unclear how birth weight relates to different body components, such as circumferences, adiposity, body segment lengths and limb proportions. We hypothesized that these components vary in their relationship to birth weight. Methods We analysed the relationship between birth weight and detailed anthropometry in 1270 singleton live-born neonates (668 male) from the Mater-University of Queensland Study of Pregnancy (Brisbane, Australia). We tested adjusted anthropometry for correlations with birth weight. We then performed stepwise multiple regression on birth weight of: body lengths, breadths and circumferences; relative limb to neck-rump proportions; or skinfold thicknesses. All analyses were adjusted for sex and gestational age, and used logged data. Results Circumferences, especially chest, were most strongly related to birth weight, while segment lengths (neck-rump, thigh, upper arm, and especially lower arm and lower leg) were relatively weakly related to birth weight, and limb lengths relative to neck-rump length showed no relationship. Skinfolds accounted for 36% of birth weight variance, but adjusting for size (neck-rump, thigh and upper arm lengths, and head circumference), this decreased to 10%. There was no evidence that heavier babies had proportionally thicker skinfolds. Conclusions Neonatal body measurements vary in their association with birth weight: head and chest circumferences showed the strongest associations while limb segment lengths did not relate strongly to birth weight. After adjusting for body size, subcutaneous fatness accounted for a smaller proportion of birth weight variance than previously reported. While heavier babies had absolutely thicker skinfolds, this was proportional to their size. Relative limb to trunk length was unrelated to birth weight, suggesting that limb proportions at birth do not index factors relevant to prenatal life. PMID:25162658

Development skills of children born premature with low and very low birth weight.

PubMed

Ribeiro, Camila da Costa; Pachelli, Mariane Regina de Oliveira; Amaral, Natalie Camillo de Oliveira; Lamônica, Dionísia Aparecida Cusin

2017-01-30

To compare the performance of children born premature with low birth weight (LBW) and very low birth-weight (VLBW) with that of children born at term, within the age range of one to three years, regarding child development in the gross motor, fine motor-adaptive, personal-social and language domains. This is a cross-sectional study in a cohort of 150 infants born premature (experimental group) and at term (control group) divided into eight groups with respect to weight (low birth weight: <2500 grams and very low birth weight: <1500 grams) and age range (aged 12 to 24 and 25 to 36 months). The control groups were paired with the experimental groups as for gender, chronological age, and socioeconomic level. Assessment comprised the application of anamnesis protocol, socioeconomic classification, and Denver Developmental Screening Test (DDST-II). Corrected age was calculated for premature children up to 24 months of age. Descriptive statistical analysis and the Student's t-test were used. No statistically significant difference was found in the comparison between the groups of infants born premature and at term for all domains evaluated. The performance of infants born premature was lower than that of infants born at term regarding the gross motor, fine motor-adaptive, personal-social and language domains. In this study, the preterm groups presented different performances, i.e., normative, average, and below average performances were observed within the same group.

Birth weight, current anthropometric markers, and high sensitivity C-reactive protein in Brazilian school children.

PubMed

Boscaini, Camile; Pellanda, Lucia Campos

2015-01-01

Studies have shown associations of birth weight with increased concentrations of high sensitivity C-reactive protein. This study assessed the relationship between birth weight, anthropometric and metabolic parameters during childhood, and high sensitivity C-reactive protein. A total of 612 Brazilian school children aged 5-13 years were included in the study. High sensitivity C-reactive protein was measured by particle-enhanced immunonephelometry. Nutritional status was assessed by body mass index, waist circumference, and skinfolds. Total cholesterol and fractions, triglycerides, and glucose were measured by enzymatic methods. Insulin sensitivity was determined by the homeostasis model assessment method. Statistical analysis included chi-square test, General Linear Model, and General Linear Model for Gamma Distribution. Body mass index, waist circumference, and skinfolds were directly associated with birth weight (P < 0.001, P = 0.001, and P = 0.015, resp.). Large for gestational age children showed higher high sensitivity C-reactive protein levels (P < 0.001) than small for gestational age. High birth weight is associated with higher levels of high sensitivity C-reactive protein, body mass index, waist circumference, and skinfolds. Large for gestational age altered high sensitivity C-reactive protein and promoted additional risk factor for atherosclerosis in these school children, independent of current nutritional status.

The Role of Placental 11-Beta Hydroxysteroid Dehydrogenase Type 1 and Type 2 Methylation on Gene Expression and Infant Birth Weight.

PubMed

Green, Benjamin B; Armstrong, David A; Lesseur, Corina; Paquette, Alison G; Guerin, Dylan J; Kwan, Lauren E; Marsit, Carmen J

2015-06-01

Maternal stress has been linked to infant birth weight outcomes, which itself may be associated with health later in life. The placenta acts as a master regulator for the fetal environment, mediating intrauterine exposures to stress through the activity of genes regulating glucocorticoids, including the 11beta-hydroxysteroid dehydrogenase (HSD11B) type 1 and 2 genes, and so we hypothesized that variation in these genes will be associated with infant birth weight. We investigated DNA methylation levels at six sites across the two genes, as well as mRNA expression for each, and the relationship to infant birth weight. Logistic regressions correcting for potential confounding factors revealed a significant association between methylation at a single CpG site within HSD11B1 and being born large for gestational age. In addition, our analysis identified correlations between methylation and gene expression, including sex-specific transcriptional regulation of HSD11B2. Our work is one of the first comprehensive views of DNA methylation and expression in the placenta for both HSD11B types 1 and 2, linking epigenetic alterations with the regulation of fetal stress and birth weight outcomes. © 2015 by the Society for the Study of Reproduction, Inc.

High oestradiol concentration after ovarian stimulation is associated with lower maternal serum beta-HCG concentration and neonatal birth weight.

PubMed

Liu, Suying; Kuang, Yanping; Wu, Yu; Feng, Yun; Lyu, Qifeng; Wang, Li; Sun, Yijuan; Sun, Xiaoxi

2017-08-01

In this retrospective study, the relationship between maternal serum oestradiol and progesterone levels after fresh embryo transfer or frozen embryo transfer (FET), and serum beta-HCG levels in early pregnancy and neonatal birth weight was examined. Included for analysis were 5643 conceived singletons: 2610 after FET and 3033 after fresh embryo transfer. Outcome measures included maternal serum oestradiol, progesterone, beta-HCG levels during the peri-implantation period, birth weight and small-for-gestational-age (SGA). Results at 4, 5 and 6 weeks' gestation were as follows: serum oestradiol and progesterone levels were significantly higher in women who underwent fresh embryo transfer compared with FET (all P < 0.0001 except progesterone at 6 weeks; P = 0.009); for fresh embryo transfers, serum beta-HCG levels were significantly lower than in women who underwent FET (P < 0.0001); beta-HCG levels were negatively correlated with serum oestradiol; and birth weight was negatively correlated with serum oestradiol. Incidence of SGA in fresh embryo transfer was increased significantly compared with FET (P < 0.001). Higher maternal oestradiol levels after fresh embryo transfer was correlated with lower beta-HCG in early pregnancy, lower birth weight and higher incidence of SGA. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

The level of physical fitness in children aged 6-7years with low birthweight.

PubMed

Cieśla, Elżbieta; Zaręba, Monika; Kozieł, Sławomir

2017-08-01

Level of physical fitness is related to the functional status of most of the bodily functions and so it appears to be very important to identify perinatal factors influencing physical fitness. The purpose of this study was to determine the influence of birth weight on the level of physical fitness in children 6-7years of age. Physical fitness was assessed using EUROFIT tests in 28,623 children, aged 6-7years, from rural areas in Poland. Children below the 10th percentile for birth weight for gestational age were defined as small for gestational age (SGA). The influence of birth weight on parameters of fitness was assessed by means of covariance analysis. With the controls of age, sex and body size, children of low birth weight have shown significantly lower levels of body flexibility and running speed. The leg strength of children with SGA turned out to be significantly lower only in 7-year-old boys. This study has revealed the significant influence of birth weight on physical fitness. The results suggest the importance of early intervention and its possible benefits for developing and maintaining the proper level of physical fitness further in life. Copyright © 2017. Published by Elsevier B.V.

Relation between Birth Weight and Intraoperative Hemorrhage during Cesarean Section in Pregnancy with Placenta Previa

PubMed Central

Ishibashi, Hiroki; Takano, Masashi; Sasa, Hidenori; Furuya, Kenichi

2016-01-01

Background Placenta previa, one of the most severe obstetric complications, carries an increased risk of intraoperative massive hemorrhage. Several risk factors for intraoperative hemorrhage have been identified to date. However, the correlation between birth weight and intraoperative hemorrhage has not been investigated. Here we estimate the correlation between birth weight and the occurrence of intraoperative massive hemorrhage in placenta previa. Materials and Methods We included all 256 singleton pregnancies delivered via cesarean section at our hospital because of placenta previa between 2003 and 2015. We calculated not only measured birth weights but also standard deviation values according to the Japanese standard growth curve to adjust for differences in gestational age. We assessed the correlation between birth weight and the occurrence of intraoperative massive hemorrhage (>1500 mL blood loss). Receiver operating characteristic curves were constructed to determine the cutoff value of intraoperative massive hemorrhage. Results Of 256 pregnant women with placenta previa, 96 (38%) developed intraoperative massive hemorrhage. Receiver-operating characteristic curves revealed that the area under the curve of the combination variables between the standard deviation of birth weight and intraoperative massive hemorrhage was 0.71. The cutoff value with a sensitivity of 81.3% and specificity of 55.6% was −0.33 standard deviation. The multivariate analysis revealed that a standard deviation of >−0.33 (odds ratio, 5.88; 95% confidence interval, 3.04–12.00), need for hemostatic procedures (odds ratio, 3.31; 95% confidence interval, 1.79–6.25), and placental adhesion (odds ratio, 12.68; 95% confidence interval, 2.85–92.13) were independent risk of intraoperative massive hemorrhage. Conclusion In patients with placenta previa, a birth weight >−0.33 standard deviation was a significant risk indicator of massive hemorrhage during cesarean section. Based on this result, further studies are required to investigate whether fetal weight estimated by ultrasonography can predict hemorrhage during cesarean section in patients with placental previa. PMID:27902772

Relation between Birth Weight and Intraoperative Hemorrhage during Cesarean Section in Pregnancy with Placenta Previa.

PubMed

Soyama, Hiroaki; Miyamoto, Morikazu; Ishibashi, Hiroki; Takano, Masashi; Sasa, Hidenori; Furuya, Kenichi

2016-01-01

Placenta previa, one of the most severe obstetric complications, carries an increased risk of intraoperative massive hemorrhage. Several risk factors for intraoperative hemorrhage have been identified to date. However, the correlation between birth weight and intraoperative hemorrhage has not been investigated. Here we estimate the correlation between birth weight and the occurrence of intraoperative massive hemorrhage in placenta previa. We included all 256 singleton pregnancies delivered via cesarean section at our hospital because of placenta previa between 2003 and 2015. We calculated not only measured birth weights but also standard deviation values according to the Japanese standard growth curve to adjust for differences in gestational age. We assessed the correlation between birth weight and the occurrence of intraoperative massive hemorrhage (>1500 mL blood loss). Receiver operating characteristic curves were constructed to determine the cutoff value of intraoperative massive hemorrhage. Of 256 pregnant women with placenta previa, 96 (38%) developed intraoperative massive hemorrhage. Receiver-operating characteristic curves revealed that the area under the curve of the combination variables between the standard deviation of birth weight and intraoperative massive hemorrhage was 0.71. The cutoff value with a sensitivity of 81.3% and specificity of 55.6% was -0.33 standard deviation. The multivariate analysis revealed that a standard deviation of >-0.33 (odds ratio, 5.88; 95% confidence interval, 3.04-12.00), need for hemostatic procedures (odds ratio, 3.31; 95% confidence interval, 1.79-6.25), and placental adhesion (odds ratio, 12.68; 95% confidence interval, 2.85-92.13) were independent risk of intraoperative massive hemorrhage. In patients with placenta previa, a birth weight >-0.33 standard deviation was a significant risk indicator of massive hemorrhage during cesarean section. Based on this result, further studies are required to investigate whether fetal weight estimated by ultrasonography can predict hemorrhage during cesarean section in patients with placental previa.

Maternal pesticide use and birth weight in the agricultural health study.

PubMed

Sathyanarayana, Sheela; Basso, Olga; Karr, Catherine J; Lozano, Paula; Alavanja, Michael; Sandler, Dale P; Hoppin, Jane A

2010-04-01

Studies examining the association between maternal pesticide exposure and low birth weight yield conflicting results. The authors examined the association between maternal pesticide use and birth weight among women in the Agricultural Health Study, a large study of pesticide applicators and their spouses in Iowa and North Carolina. The authors evaluated self-reported pesticide use of 27 individual pesticides in relation to birth weight among 2246 farm women whose most recent singleton birth occurred within 5 years of enrollment (1993-1997). The authors used linear regression models adjusted for site, preterm birth, medical parity, maternal body mass index, height, and smoking. The results showed that mean infant birth weight was 3586 g (+/- 546 g), and 3% of the infants were low birth weight (<2500 g). First-trimester pesticide-related tasks were not associated with birth weight. Ever use of the pesticide carbaryl was associated with decreased birth weight (-82 g, 95% confidence interval [CI] = -132, -31). This study thus provides limited evidence about pesticide use as a modulator of birth weight. Overall, the authors observed no associations between birth weight and pesticide-related activities during early pregnancy; however, the authors have no data on temporal specificity of individual pesticide exposures prior to or during pregnancy and therefore cannot draw conclusions related to these exposure windows. Given the widespread exposure to pesticide products, additional evaluation of maternal pregnancy exposures at specific time windows and subsequent birth outcomes is warranted.

Birth weight and stuttering: Evidence from three birth cohorts.

PubMed

McAllister, Jan; Collier, Jacqueline

2014-03-01

Previous studies have produced conflicting results with regard to the association between birth weight and developmental stuttering. This study sought to determine whether birth weight was associated with childhood and/or adolescent stuttering in three British birth cohort samples. Logistic regression analyses were carried out on data from the Millenium Cohort Study (MCS), British Cohort Study (BCS70) and National Child Development Study (NCDS), whose initial cohorts comprised over 56,000 individuals. The outcome variables were parent-reported stuttering in childhood or in adolescence; the predictors, based on prior research, were birth weight, sex, multiple birth status, vocabulary score and mother's level of education. Birth weight was analysed both as a categorical variable (low birth weight, <2500g; normal range; high birth weight, ≥4000g) and as a continuous variable. Separate analyses were carried out to determine the impact of birth weight and the other predictors on stuttering during childhood (age 3, 5 and 7 and MCS, BCS70 and NCDS, respectively) or at age 16, when developmental stuttering is likely to be persistent. None of the multivariate analyses revealed an association between birth weight and parent-reported stuttering. Sex was a significant predictor of stuttering in all the analyses, with males 1.6-3.6 times more likely than females to stutter. Our results suggest that birth weight is not a clinically useful predictor of childhood or persistent stuttering. Copyright © 2013 Elsevier Inc. All rights reserved.

Do perinatal and early life exposures influence the risk of malignant melanoma? A Northern Ireland birth cohort analysis.

PubMed

O'Rorke, M A; Black, C; Murray, L J; Cardwell, C R; Gavin, A T; Cantwell, M M

2013-03-01

Intrauterine, early life and maternal exposures may have important consequences for cancer development in later life. The aim of this study was to examine perinatal and birth characteristics with respect to Cutaneous malignant melanoma (CMM) risk. The Northern Ireland Child Health System database was used to examine gestational age adjusted birth weight, infant feeding practices, parental age and socioeconomic factors at birth in relation to CMM risk amongst 447,663 infants delivered between January 1971 and December 1986. Follow-up of histologically verified CMM cases was undertaken from the beginning of 1993 to 31st December 2007. Multivariable adjusted unconditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) of CMM risk. A total of 276 CMM cases and 440,336 controls contributed to the final analysis. In reference to normal (gestational age-adjusted) weight babies, those heaviest at birth were twice as likely to develop CMM OR 2.4 (95% CI 1.1-5.1). Inverse associations with CMM risk were observed with younger (<25 years) parental age at birth and both a higher birth order and greater household density OR 0.61 (95% CI 0.37-0.99) and OR 0.56 (95% CI 0.30-1.0) respectively. This large study of early onset melanoma supports a positive association with higher birth weight (imperatively gestational age adjusted) and CMM risk which may be related to factors which drive intrauterine foetal growth. Strong inverse associations observed with higher birth order and household density suggest that early-life immune modulation may confer protection; findings which warrant further investigation in prospective analyses. Copyright © 2012 Elsevier Ltd. All rights reserved.

Servo-control for maintaining abdominal skin temperature at 36C in low birth weight infants.

PubMed

Sinclair, J C

2000-01-01

Randomized trials have shown that the neonatal mortality rate of low birth-weight babies can be reduced by keeping them warm. For low birth-weight babies nursed in incubators, warm conditions may be achieved either by heating the air to a desired temperature, or by servo-controlling the baby's body temperature at a desired set-point. In low birth weight infants, to determine the effect on death and other important clinical outcomes of targeting body temperature rather than air temperature as the end-point of control of incubator heating. Standard search strategy of the Cochrane Neonatal Collaborative Review Group. Randomized or quasi-randomized trials which test the effects of having the heat output of the incubator servo-controlled from body temperature compared with setting a constant incubator air temperature. Trial methodologic quality was systematically assessed. Outcome measures included death, timing of death, cause of death, and other clinical outcomes. Categorical outcomes were analyzed using relative risk and risk difference. Meta-analysis assumed a fixed effect model. Compared to setting a constant incubator air temperature of 31.8C, servo-control of abdominal skin temperature at 36C reduces the neonatal death rate among low birth weight infants: relative risk 0.72 (95% CI 0.54, 0.97); risk difference -12.7% (95% CI -1.6, -23.9). This effect is even greater among VLBW infants. During at least the first week after birth, low birth weight babies should be provided with a carefully regulated thermal environment that is near the thermoneutral point. For LBW babies in incubators, this can be achieved by adjusting incubator temperature to maintain an anterior abdominal skin temperature of at least 36C, using either servo-control or frequent manual adjustment of incubator air temperature.

Placental weight and foetal growth rate as predictors of ischaemic heart disease in a Swedish cohort.

PubMed

Heshmati, A; Koupil, I

2014-06-01

Studies on placental size and cardiovascular disease have shown inconsistent results. We followed 10,503 men and women born in Uppsala, Sweden, 1915-1929 from 1964 to 2008 to assess whether birth characteristics, including placental weight and placenta/birth weight ratio, were predictive of future ischaemic heart disease (IHD). Adjustments were made for birth cohort, age, sex, mother's parity, birth weight, gestational age and social class at birth. Placental weight and birth weight were negatively associated with IHD. The effect of placental weight on IHD was stronger in individuals from medium social class at birth and in those with low education. Men and women from non-manual social class at birth had the lowest risk for IHD as adults. We conclude that low foetal growth rate rather than placental weight was more predictive of IHD in the Swedish cohort. However, the strong effect of social class at birth on risk for IHD did not appear to be mediated by foetal growth rate.

Apolipoprotein E Genotype in Very Preterm Neonates with Intrauterine Growth Restriction: An Analysis of the German Neonatal Network Cohort.

PubMed

Norda, Stephen; Rausch, Tanja K; Orlikowsky, Thorsten; Hütten, Matthias; Schulz, Sören; Göpel, Wolfgang; Pecks, Ulrich

2017-01-01

Aim. Cord blood of intrauterine growth restricted (IUGR) neonates displays lipid changes towards atherosclerotic profiles. Apolipoprotein E (ApoE) and its isoforms (e2, e3, and e4) are involved in the regulation of lipid metabolism. Specifically, ApoE e4 has been associated with atherosclerotic diseases, while e2 has a favorable effect. We therefore hypothesized that ApoE e4 haplotype is frequently observed in IUGR neonates and contributes to impaired fetal growth and the association of IUGR with cardiovascular and metabolic diseases later in life. Methods. A cohort of 4885 preterm infants (≥22+0 and <32+0 weeks of gestation and birth weight below 1500 g) from the GNN study cohort was analyzed. Neonates were categorized into subgroups of <3rd, 3rd-10th, and >10th birth weight percentile. Analysis of the single nucleotides rs429358 and rs7412, identifying the ApoE genotype, was carried out using TaqMan® SNP genotyping assays. The proportional odds model was used to assess data. Results. No association was found between genotype and birth weight percentiles in each of the subgroups. Conclusion. ApoE genotype and low birth weight depict two distinct risk factors for cardiovascular disease without being directly associated.

Effect of Women's Decision-Making Autonomy on Infant's Birth Weight in Rural Bangladesh

PubMed Central

Sharma, Arpana

2013-01-01

Background. Low birth weight (LBW), an outcome of maternal undernutrition, is a major public health concern in Bangladesh where the problem is most prominent. Women's decision-making autonomy is likely an important factor influencing maternal and child health outcomes. The aim of the study was to assess the effect of women's decision-making autonomy on infant's birth weight (BW). Methods. The study included data of 2175 enrolled women (14–45 years of age) from the Maternal and Infant Nutritional Intervention in Matlab (MINIMat-study) in Bangladesh. Pearson's chi-square test, analysis of covariance (ANCOVA), and logistic regression analysis were applied at the collected data. Results. Women with lowest decision-making autonomy were significantly more likely to have a low birth weight (LBW) child, after controlling for maternal age, education (woman's and her husband's), socioeconomic status (SES) (odds ratio (OR) = 1.4; 95% confidence interval (CI) 1.0, 1.8). BW was decreased significantly among women with lowest decision making autonomy after adjusting for all confounders. Conclusion. Women's decision-making autonomy has an independent effect on BW and LBW outcome. In addition, there is a need for further exploration to identify sociocultural attributes and gender related determinants of women decision-making autonomy in this study setting. PMID:24575305

Prevalence of helminth infestation during pregnancy and its association with maternal anemia and low birth weight.

PubMed

Aderoba, Adeniyi K; Iribhogbe, Oseihie I; Olagbuji, Biodun N; Olokor, Oghenefegor E; Ojide, Chiedozie K; Ande, Adedapo B

2015-06-01

To determine the prevalence of helminth infestation during pregnancy and the associated risks of adverse maternal and infant outcomes. A cross-sectional study of women with a singleton pregnancy of at least 34 weeks was conducted at a teaching hospital in Benin City, Nigeria, between April 1 and September 30, 2010. Socioeconomic and clinical data were obtained. Stool samples were used to determine helminth infection. Birth weight was recorded at delivery. Multivariable analysis was used to assess the link between helminth infestation and maternal and perinatal outcomes. Among 178 women, 31 (17.4%) had a helminth infestation (15 [8.4%] had ascariasis, 8 [4.5%] trichuriasis, and 25 [14.0%] hookworm infestation). Multivariate analysis found that helminth infestations was associated with maternal anemia (adjusted odds ratio 12.4; 95% confidence interval 4.2-36.3) and low birth weight (adjusted odds ratio 6.8; 95% confidence interval 2.1-21.9). Approximately one in five women had a helminth infestation in the third trimester of pregnancy. Maternal helminth infestation significantly increased the risks of maternal anemia and low birth weight, indicating that routine administration of anthelminthic drugs during early pregnancy might improve perinatal outcomes. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Dipyrone use during pregnancy and adverse perinatal events.

PubMed

da Silva Dal Pizzol, Tatiane; Schüler-Faccini, Lavínia; Mengue, Sotero Serrate; Fischer, Maria Isabel

2009-03-01

To evaluate the risk of adverse perinatal events among newborns exposed to dipyrone during gestation. The present study is a secondary analysis of Brazilian study of gestational diabetes (EBDG), a cohort of women attended at healthcare units of the Brazilian national health system (SUS) located in six Brazilian state capitals, between February 1991 and June 1995. A total number of 5,564 women aged 20 years and over who were between their 21st and 28th week of pregnancy were followed up. A structured questionnaire was used to obtain data on the pregnant women, their pregnancies, and their use of medications. Other data and the outcomes congenital abnormalities, intrauterine death, preterm birth, or low birth weight were obtained from the medical records. To estimate the odds ratios after adjustment for the potential confounding factors, logistic regression modeling was developed. Congenital abnormalities, intrauterine death, preterm birth, and low birth weight. Dipyrone use was reported by 555 pregnant women (11.5%). Their exposure to this medication did not present any association with the outcomes of congenital abnormalities (OR 1.11; 95% CI, 0.58-2.10), intrauterine death (OR 0.69; 95% CI, 0.33-1.43), preterm birth (OR 0.94; 95% CI, 0.73-1.20), or low birth weight (OR 0.88; 95% CI, 0.64-1.22), in the crude analysis. This absence of associations was maintained after performing logistic regression analysis. The data suggest that the exposure to dipyrone during pregnancy does not increase the risk of congenital abnormalities and other adverse events as outcomes from pregnancy.

Lower birth weight and diet in Taiwanese girls more than boys predicts learning impediments.

PubMed

Lee, Meei-Shyuan; Huang, Lin-Yuan; Chang, Yu-Hung; Huang, Susana Tzy-Ying; Yu, Hsiao-Li; Wahlqvist, Mark L

2012-01-01

Possible links between lower birth weight, childhood diet, and learning in Taiwan are evaluated. The population representative Elementary School Children's Nutrition and Health Survey in Taiwan 2001-2002 and the national birth registry were used to examine school and social performance using the modified Scale for Assessing Emotional Disturbance questionnaires in relation to diet quality by the Youth Healthy Eating Index-Taiwan and birth weight of children aged 6-13 years (n=2283). Lower birth weight (≤15th percentile: ≤2850 g for boys and ≤2700 g for girls) children were mostly from mountainous areas and of indigenous descent. Compared to normal birth weight, lower birth weight girls experienced greater inability to learn and weaker overall competence. Better diet quality predicted more favorable emotional and behavioral outcomes in lower birth weight girls, and this persisted with adjustment for covariates. None of these findings were evident among boys. Girls' cognitive and social development appears to be susceptible to diet quality and birth weight, such that the adverse risk of lower birth weight on school performance may be offset by improved diet. Copyright © 2012 Elsevier Ltd. All rights reserved.

Characteristics of Line 1 Hereford females resulting from selection by independent culling levels for below-average birth weight and high yearling weight or by mass selection for high yearling weight.

PubMed

MacNeil, M D; Urick, J J; Decoudu, G

2000-09-01

Simultaneous selection for low birth weight and high yearling weight has been advocated to improve efficiency of beef production. Two sublines of Line 1 Hereford cattle were established by selection either for below-average birth weight and high yearling weight (YB) or for high yearling weight alone (YW). Direct effects on birth weight and yearling weight diverged between sublines with approximately four generations of selection. The objective of this study was to estimate genetic trends for traits of the cows. A three-parameter growth curve [Wt = A(1 - b0e(-kt))] was fitted to age (t, d)-weight (W, kg) data for cows surviving past 4.5 yr of age (n = 738). The resulting parameter estimates were analyzed simultaneously with birth weight and yearling weight using multiple-trait restricted maximum likelihood methods. To estimate maternal additive effects on calf gain from birth to weaning (MILK) the two-trait model previously used to analyze birth weight and yearling weight was transformed to the equivalent three-trait model with birth weight, gain from birth to weaning, and gain from weaning to yearling as dependent variables. Heritability estimates were 0.32, 0.27, 0.10, and 0.20 for A, b0, k, and MILK, respectively. Genetic correlations with direct effects on birth weight were 0.34, -0.11, and 0.55 and with direct effects on yearling weight were 0.65, -0.17, and 0.11 for A, b0, and k, respectively. Genetic trends for YB and YW, respectively, were as follows: A (kg/generation), 8.0+/-0.2 and 10.1+/-0.2; b0 (x 1,000), -1.34+/-0.07 and -1.16+/-0.07; k (x 1,000), -14.3+/-0.1 and 4.3+/-0.1; and MILK (kg), 1.25+/-0.05 and 1.89+/-0.05. Beef cows resulting from simultaneous selection for below-average birth weight and increased yearling weight had different growth curves and reduced genetic trend in maternal gain from birth to weaning relative to cows resulting from selection for increased yearling weight.

Patent ductus arteriosus and indomethacin treatment as independent risk factors for plus disease in retinopathy of prematurity.

PubMed

Tsui, Irena; Ebani, Edward; Rosenberg, Jamie B; Lin, Juan; Angert, Robert M; Mian, Umar

2013-01-01

To examine whether clinically significant patent ductus arteriosus (PDA) or indomethacin treatment are associated with plus disease or retinopathy of prematurity (ROP) requiring treatment. Retrospective, cross-sectional study. Charts were reviewed for gestational age, birth weight, birth head circumference, birth length, maternal characteristics, gender, bronchopulmonary dysplasia, neurologic comorbidities, PDA and its treatments, gastrointestinal comorbidities, blood transfusions, and sepsis. Main outcome measures were increased rates of plus disease or ROP requiring treatment. A total of 450 premature infants screened for ROP in a mid-sized, urban neonatal intensive care unit were included. On univariate analysis, gestational age, birth weight, birth head circumference, birth length, bronchopulmonary dysplasia, neurologic comorbidities, PDA and its treatments, gastrointestinal comorbidities, and sepsis were significantly correlated to plus disease and ROP requiring treatment. PDA was significantly associated with bronchopulmonary dysplasia, neurologic comorbidities, sepsis, and blood transfusions (P < .0001). With type 3 multivariate analysis, only gestational age and bronchopulmonary dysplasia were independent risk factors for ROP. PDA and indomethacin were associated with plus disease and ROP requiring treatment on univariate analysis but this was not significant after adjusting for other risk factors. PDA was also strongly related to bronchopulmonary dysplasia and blood transfusions, which may explain its effect on ROP. Copyright 2013, SLACK Incorporated.

Health Service Use and Costs Associated with Low Birth Weight--A Population Level Analysis.

PubMed

Thanh, Nguyen Xuan; Toye, Jennifer; Savu, Anamaria; Kumar, Manoj; Kaul, Padma

2015-09-01

To examine differences in health services utilization (HSU) costs in the first year of life between low birth weight (LBW) and normal birth weight (NBW) infants, identify maternal and child characteristics associated with HSU costs, and estimate annual HSU cost of LBW infants for the province of Alberta, Canada. A retrospective cohort study including all live births between 2004 and 2010. Data from the Alberta Perinatal Health Program database were linked to health care administrative data including inpatient, outpatient, and practitioner claims to identify HSU within the first year of life. One-year HSU costs among LBW infants (n = 16,209) were $33,096 compared with $3942 among NBW infants (n = 189,586). There was a strong negative correlation between HSU costs and increasing birth weight, with health care costs among extreme LBW (<1000 g), very LBW (1000 and 1499 g), and moderate LBW (1500 and 2499 g) of $117,000, $84,000, and, $20,000, respectively. Maternal characteristics such as high prepregnancy weight, aboriginal status, and lower socioeconomic status were associated with higher HSU costs among the infants. LBW accounted for 7% of all infants but 37% of the total costs, amounting to $108 million annually. Compared with NBW infants, LBW infants consume more health resources not only in terms of initial hospitalization but also of re-hospitalizations, outpatient, and physician visits during the first year of their life. Interventions targeting social determinants of health are required to improve birth weight outcomes in Alberta. Copyright © 2015 Elsevier Inc. All rights reserved.

Exposure to trihalomethanes through different water uses and birth weight, small for gestational age, and preterm delivery in Spain.

PubMed

Villanueva, Cristina M; Gracia-Lavedán, Esther; Ibarluzea, Jesús; Santa Marina, Loreto; Ballester, Ferran; Llop, Sabrina; Tardón, Adonina; Fernández, Mariana F; Freire, Carmen; Goñi, Fernando; Basagaña, Xavier; Kogevinas, Manolis; Grimalt, Joan O; Sunyer, Jordi

2011-12-01

Evidence associating exposure to water disinfection by-products with reduced birth weight and altered duration of gestation remains inconclusive. We assessed exposure to trihalomethanes (THMs) during pregnancy through different water uses and evaluated the association with birth weight, small for gestational age (SGA), low birth weight (LBW), and preterm delivery. Mother-child cohorts set up in five Spanish areas during the years 2000-2008 contributed data on water ingestion, showering, bathing, and swimming in pools. We ascertained residential THM levels during pregnancy periods through ad hoc sampling campaigns (828 measurements) and regulatory data (264 measurements), which were modeled and combined with personal water use and uptake factors to estimate personal uptake. We defined outcomes following standard definitions and included 2,158 newborns in the analysis. Median residential THM ranged from 5.9 μg/L (Valencia) to 114.7 μg/L (Sabadell), and speciation differed across areas. We estimated that 89% of residential chloroform and 96% of brominated THM uptakes were from showering/bathing. The estimated change of birth weight for a 10% increase in residential uptake was -0.45 g (95% confidence interval: -1.36, 0.45 g) for chloroform and 0.16 g (-1.38, 1.70 g) for brominated THMs. Overall, THMs were not associated with SGA, LBW, or preterm delivery. Despite the high THM levels in some areas and the extensive exposure assessment, results suggest that residential THM exposure during pregnancy driven by inhalation and dermal contact routes is not associated with birth weight, SGA, LBW, or preterm delivery in Spain.

The impact of birth weight on cardiovascular disease risk in the Women's Health Initiative

PubMed Central

Smith, CJ; Ryckman, KK; Barnabei, Vanessa M.; Howard, Barbara; Isasi, Carmen R.; Sarto, Gloria; Tom, Sarah E.; Van Horn, Linda; Wallace, Robert; Robinson, Jennifer G

2016-01-01

Background and Aims Cardiovascular disease (CVD) is among the leading causes of morbidity and mortality worldwide. Traditional risk factors predict 75-80% of an individual's risk of incident CVD. However, the role of early life experiences in future disease risk is gaining attention. The Barker hypothesis proposes fetal origins of adult disease, with consistent evidence demonstrating the deleterious consequences of birth weight outside the normal range. In this study, we investigate the role of birth weight in CVD risk prediction. Methods and Results The Women's Health Initiative (WHI) represents a large national cohort of post-menopausal women with 63 815 participants included in this analysis. Univariable proportional hazards regression analyses evaluated the association of 4 self-reported birth weight categories against 3 CVD outcome definitions, which included indicators of coronary heart disease, ischemic stroke, coronary revascularization, carotid artery disease and peripheral arterial disease. The role of birth weight was also evaluated for prediction of CVD events in the presence of traditional risk factors using 3 existing CVD risk prediction equations: one body mass index (BMI)-based and two laboratory-based models. Low birth weight (LBW) (< 6 lbs.) was significantly associated with all CVD outcome definitions in univariable analyses (HR=1.086, p=0.009). LBW was a significant covariate in the BMI-based model (HR=1.128, p<0.0001) but not in the lipid-based models. Conclusion LBW (<6 lbs.) is independently associated with CVD outcomes in the WHI cohort. This finding supports the role of the prenatal and postnatal environment in contributing to the development of adult chronic disease. PMID:26708645

Worldwide prevalence of adverse pregnancy outcomes associated with in vitro fertilization/intracytoplasmic sperm injection among multiple births: a systematic review and meta-analysis based on cohort studies.

PubMed

Qin, Jia-Bi; Sheng, Xiao-Qi; Wang, Hua; Chen, Guo-Chong; Yang, Jing; Yu, Hong; Yang, Tu-Bao

2017-03-01

To perform a systematic review and meta-analysis of reported estimates of adverse pregnancy outcomes among multiple births conceived with in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). PubMed, Google Scholar, Cochrane Libraries and Chinese databases were searched through May 2016 for cohort studies assessing adverse pregnancy outcomes associated with IVF/ICSI multiple births. Random-effects meta-analyses were used to calculate pooled estimates of adverse pregnancy outcomes and, where appropriate, heterogeneity was explored in group-specific analyses. Sixty-four studies, with 60,210 IVF/ICSI multiple births and 146,737 spontaneously conceived multiple births, were selected for analysis. Among IVF/ICSI multiple births, the pooled estimates were 51.5% [95% confidence interval (CI): 48.7-54.3] for preterm birth, 12.1% (95% CI: 10.4-14.1) for very preterm birth, 49.8% (95% CI: 47.6-52.0) for low birth weight, 8.4% (95% CI: 7.1-9.9) for very low birth weight, 16.2% (95% CI: 12.9-20.1) for small for gestational age, 3.0% (95% CI: 2.5-3.7) for perinatal mortality and 4.7% (95% CI: 4.0-5.6) for congenital malformations. When the data were restricted to twins, the pooled estimates also showed a high prevalence of adverse outcomes. There was a similar prevalence of poor outcomes among multiple births conceived with IVF/ICSI and naturally (all P ≥ 0.0792). Significant differences in different continents, countries, and income groups were found. The IVF/ICSI multiple pregnancies have a high prevalence of adverse pregnancy outcomes. However, population-wide prospective adverse outcomes registries covering the entire world population for IVF/ICSI pregnancies are needed to determine the exact perinatal prevalence.

Monitoring low birth weight: an evaluation of international estimates and an updated estimation procedure.

PubMed Central

Blanc, Ann K.; Wardlaw, Tessa

2005-01-01

OBJECTIVE: To critically examine the data used to produce estimates of the proportion of infants with low birth weight in developing countries and to describe biases in these data. To assess the effect of adjustment procedures on the estimates and propose a modified estimation procedure for international reporting purposes. METHODS: Mothers' reports about their recent births in 62 nationally representative Demographic and Health Surveys (DHS) conducted between 1990 and 2000 were analysed. The proportion of infants weighed at birth, characteristics of those weighed, extent of misreporting, and mothers' subjective assessments of their children's size at birth were examined. FINDINGS: In many developing countries the majority of infants were not weighed at birth. Those who were weighed were more likely to have mothers who live in urban areas and are educated, and to be born in a medical facility with assistance from medically trained personnel. Birth weights reported by mothers are "heaped" on multiples of 500 grams. CONCLUSION: Current survey-based estimates of the prevalence of low birth weight are biased substantially downwards. Two adjustments to reported data are recommended: a weighting procedure that combines reported birth weights with mothers' assessment of the child's size at birth, and categorization of one-quarter of the infants reported to have a birth weight of exactly 2500 grams as having low birth weight. Averaged over all surveys, these procedures increased the proportion classified as having low birth weight by 25%. We also recommend that the proportion of infants not weighed at birth be routinely reported. Efforts are needed to increase the weighing of newborns and the recording of their weights. PMID:15798841

Effects of Birth Weight on Anterior Segment Measurements in Full-Term Children Without Low Birth Weight by Dual-Scheimpflug Analyzer.

PubMed

Yeter, Volkan; Aritürk, Nurşen; Bİrİncİ, Hakki; Süllü, Yüksel; Güngör, İncİ

2015-10-01

To evaluate the effects of birth weight on ocular anterior segment parameters in full-term children without low birth weight using the Galilei Dual-Scheimpflug Analyzer. Retrospective cohort study. The right eyes from 110 healthy children, 3-6 years of age, were scanned with the Galilei Dual-Scheimpflug Analyzer. A total of 78 eyes were measured in full-term children with birth weight of >2500 g. Central, paracentral, pericentral, and the thinnest corneal thicknesses; anterior and posterior keratometry (average, steep, flat); axial curvatures; asphericity of cornea; anterior chamber depth and volume; and iridocorneal angle values were measured. Axial length, lens thickness, and vitreous length were obtained by ultrasound biometry. The mean age of children was 55.86 ± 12.52 (mean ± SD) months. Mean birth weight and gestational age were 3426.3 ± 545 g and 39.4 ± 1.2 weeks, respectively. Although lens thickness, vitreous length, axial length, and anterior chamber volume were moderately correlated with birth weight (P < .05), there was no relationship between birth weight and anterior chamber depth. With the exception of pericentral corneal thickness, all regions of corneal thicknesses were correlated with birth weight (P < .05). Birth weight was negatively correlated with anterior curvature (P < .05) and had no relationship to posterior curvature. While central and paracentral axial curvatures correlated with birth weight (P < .05), pericentral axial curvature did not. Preschoolers who were born heavier had thicker cornea and lens, longer axial length, and flatter corneal curve. The thicknesses and axial curves of central cornea within 7 mm may be particularly associated with birth weight. Copyright © 2015 Elsevier Inc. All rights reserved.

[The effect of air pollutants on birth weight in medium-sized towns in the state of São Paulo].

PubMed

Santos, Veridiana de Paula; de Medeiros, Andréa Paula Peneluppi; de Lima, Thaiza Agostini Córdoba; Nascimento, Luiz Fernando Costa

2014-12-01

To investigate the effect of air pollution on birth weight in a medium-sized town in the State of São Paulo, Southeast Brazil. Cross-sectional study using data of live births to mothers residing in São José dos Campos from 2005 to 2009. Data was obtained from the Department of Information and Computing of the Brazilian Unified Health System. Air pollutant data (PM, SO and O) and daily averages of their concentrations were obtained from the Environmental Sanitation & Technology Company. Statistical analysis was performed by linear and logistic regressions using the Excel and STATA v.7 software programs. Maternal exposure to air pollutants was not associated with low birth weight, with the exception of exposure to SO within the last month of pregnancy (OR=1,25; IC95% 1,00-1,56). Maternal exposure to PM and SO during the last month of pregnancy led to lower weight at birth (0.28 g and 3.15 g, respectively) for each 1mg/m(3) increase in the concentration of these pollutants, but without statistical significance. This study failed to identify a statistically significant association between the levels of air pollutants and birth weight, with the exception of exposure to SO within the last month of pregnancy. Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

Gene expression profiling in the Cynomolgus macaque Macaca fascicularis shows variation within the normal birth range

PubMed Central

2011-01-01

Background Although an adverse early-life environment has been linked to an increased risk of developing the metabolic syndrome, the molecular mechanisms underlying altered disease susceptibility as well as their relevance to humans are largely unknown. Importantly, emerging evidence suggests that these effects operate within the normal range of birth weights and involve mechanisms of developmental palsticity rather than pathology. Method To explore this further, we utilised a non-human primate model Macaca fascicularis (Cynomolgus macaque) which shares with humans the same progressive history of the metabolic syndrome. Using microarray we compared tissues from neonates in the average birth weight (50-75th centile) to those of lower birth weight (5-25th centile) and studied the effect of different growth trajectories within the normal range on gene expression levels in the umbilical cord, neonatal liver and skeletal muscle. Results We identified 1973 genes which were differentially expressed in the three tissue types between average and low birth weight animals (P < 0.05). Gene ontology analysis identified that these genes were involved in metabolic processes including cellular lipid metabolism, cellular biosynthesis, cellular macromolecule synthesis, cellular nitrogen metabolism, cellular carbohydrate metabolism, cellular catabolism, nucleotide and nucleic acid metabolism, regulation of molecular functions, biological adhesion and development. Conclusion These differences in gene expression levels between animals in the upper and lower percentiles of the normal birth weight range may point towards early life metabolic adaptations that in later life result in differences in disease risk. PMID:21999700

Repeat surfactant therapy for postsurfactant slump.

PubMed

Katz, L A; Klein, J M

2006-07-01

To evaluate repeat surfactant therapy for the treatment of respiratory failure associated with postsurfactant slump in extremely low birth weight infants (ELBW) by characterizing the population of premature infants who develop postsurfactant slump and measuring their response to a secondary course of surfactant therapy. A retrospective analysis of a cohort of all patients admitted over a 3-year period with birth weights <1000 g (ELBW infants). Information was collected by chart review and the patients were categorized into three distinct groups for analysis. Initial surfactant only, patients who received surfactant replacement therapy only for respiratory distress syndrome (RDS); repeat surfactant, patients who received both initial surfactant replacement for RDS and repeat surfactant therapy for postsurfactant slump (defined as respiratory failure after 6 days of age), and no surfactant, patients in whom no surfactant was ever administered. A respiratory severity score (RSS) was used to measure the severity of lung disease and response to surfactant therapy. Over 3 years, there were 165 ELBW infants who could develop postsurfactant slump and be eligible for repeat surfactant therapy. There were 39 infants who never received any surfactant therapy estimated gestational age (EGA) 27.7 +/- 1.7, birth weight 856 +/- 109 g) either at birth or after 6 days of life. There were 126 patients treated for RDS with initial surfactant replacement therapy (EGA 25.6 +/- 1.9 weeks, birth weight 713 +/- 179 g). Out of these RDS patients, 101 improved with an initial course of surfactant therapy (EGA 26 +/- 1.8, birth weight 751 +/- 143 g), but 25 (20% of the patients with RDS) developed postsurfactant slump and received a repeat course of surfactant therapy (EGA 24.7 +/- 1.2, birth weight 647 +/- 120 g). The repeat surfactant group (postsurfactant slump) was significantly more premature and had significantly lower birth weights compared to both the initial surfactant only group and the no surfactant ever group. Logistic regression analysis revealed that lack of antenatal steroids, earlier gestational age, and the receiving of 2 or more doses of surfactant to treat the initial RDS were significantly associated with receiving repeat surfactant therapy for postsurfactant slump. Of the 25 patients treated with a repeat course of surfactant therapy more than 70% of patients (n = 18) had an improvement in their lung disease with a 15% reduction in their RSS. This improvement was significant at all time points evaluated (12, 24, and 48 h). We found that a repeat course of surfactant therapy, after day of life 6, led to a significant improvement in hypoxemic respiratory failure in premature infants with postsurfactant slump. Infants who received repeat surfactant therapy were born at a significantly earlier gestational age, had significantly smaller birth weight and had significantly worse lung disease. They were significantly less likely to have received antenatal steroids and were significantly more likely to have received multiple doses of surfactant to treat their initial RDS. A repeat course of surfactant therapy for patients with postsurfactant slump appeared beneficial in the short-term. These initial findings would support performing randomized control trials of repeat surfactant therapy for postsurfactant slump.

Neurodevelopmental Outcomes of Extremely Low Birth Weight Infants with Spontaneous Intestinal Perforation or Surgical Necrotizing Enterocolitis

PubMed Central

Wadhawan, Rajan; Oh, William; Hintz, Susan R; Blakely, Martin L; Das, Abhik; Bell, Edward F.; Saha, Shampa; Laptook, Abbot R.; Shankaran, Seetha; Stoll, Barbara J.; Walsh, Michele C.; Higgins, Rosemary D.

2013-01-01

Objective To determine if extremely low birth weight infants with surgical necrotizing enterocolitis have a higher risk of death or neurodevelopmental impairment and neurodevelopmental impairment among survivors (secondary outcome) at 18–22 months corrected age compared to infants with spontaneous intestinal perforation and infants without necrotizing enterocolitis or spontaneous intestinal perforation. Study Design Retrospective analysis of the Neonatal Research Network very low birth weight registry, evaluating extremely low birth weight infants born between 2000–2005. The study infants were designated into 3 groups: 1) Spontaneous intestinal perforation without necrotizing enterocolitis; 2) Surgical necrotizing enterocolitis (Bell's stage III); and 3) Neither spontaneous intestinal perforation nor necrotizing enterocolitis. Multivariate logistic regression analysis was performed to evaluate the association between the clinical group and death or neurodevelopmental impairment, controlling for multiple confounding factors including center. Results Infants with surgical necrotizing enterocolitis had the highest rate of death prior to hospital discharge (53.5%) and death or neurodevelopmental impairment (82.3%) compared to infants in the spontaneous intestinal perforation group (39.1% and 79.3%) and no necrotizing enterocolitis/no spontaneous intestinal perforation group (22.1% and 53.3%; p<0.001). Similar results were observed for neurodevelopmental impairment among survivors. On logistic regression analysis, both spontaneous intestinal perforation and surgical necrotizing enterocolitis were associated with increased risk of death or neurodevelopmental impairment (adjusted OR 2.21, 95% CI: 1.5, 3.2 and adjusted OR 2.11, 95% CI: 1.5, 2.9 respectively) and neurodevelopmental impairment among survivors (adjusted OR 2.17, 95% CI: 1.4, 3.2 and adjusted OR 1.70, 95% CI: 1.2, 2.4 respectively). Conclusions Spontaneous intestinal perforation and surgical necrotizing enterocolitis are associated with a similar increase in the risk of death or neurodevelopmental impairment and neurodevelopmental impairment among extremely low birth weight survivors at 18–22 months corrected age. PMID:24135709

Prenatal exposure to cannabis and maternal and child health outcomes: a systematic review and meta-analysis.

PubMed

Gunn, J K L; Rosales, C B; Center, K E; Nuñez, A; Gibson, S J; Christ, C; Ehiri, J E

2016-04-05

To assess the effects of use of cannabis during pregnancy on maternal and fetal outcomes. 7 electronic databases were searched from inception to 1 April 2014. Studies that investigated the effects of use of cannabis during pregnancy on maternal and fetal outcomes were included. Case-control studies, cross-sectional and cohort studies were included. Data synthesis was undertaken via systematic review and meta-analysis of available evidence. All review stages were conducted independently by 2 reviewers. Maternal, fetal and neonatal outcomes up to 6 weeks postpartum after exposure to cannabis. Meta-analyses were conducted on variables that had 3 or more studies that measured an outcome in a consistent manner. Outcomes for which meta-analyses were conducted included: anaemia, birth weight, low birth weight, neonatal length, placement in the neonatal intensive care unit, gestational age, head circumference and preterm birth. 24 studies were included in the review. Results of the meta-analysis demonstrated that women who used cannabis during pregnancy had an increase in the odds of anaemia (pooled OR (pOR)=1.36: 95% CI 1.10 to 1.69) compared with women who did not use cannabis during pregnancy. Infants exposed to cannabis in utero had a decrease in birth weight (low birth weight pOR=1.77: 95% CI 1.04 to 3.01; pooled mean difference (pMD) for birth weight=109.42 g: 38.72 to 180.12) compared with infants whose mothers did not use cannabis during pregnancy. Infants exposed to cannabis in utero were also more likely to need placement in the neonatal intensive care unit compared with infants whose mothers did not use cannabis during pregnancy (pOR=2.02: 1.27 to 3.21). Use of cannabis during pregnancy may increase adverse outcomes for women and their neonates. As use of cannabis gains social acceptance, pregnant women and their medical providers could benefit from health education on potential adverse effects of use of cannabis during pregnancy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Effects of physical activity during pregnancy and gestational weight gain on newborn weight and length at birth in Warmińsko-Mazurskie province.

PubMed

Przybyłowicz, Katarzyna; Przybyłowicz, Mariusz; Grzybiak, Marek; Janiszewska, Katarzyna

2014-01-01

Epidemiological research has identified a relationship between maternal physical activity, early nutrition and infant birth weight with likelihood of developing future diseases. The aim of the study was to determine a relationship between gestational weight gain and physical activity during pregnancy to the nutritional status of newborns. The presented study was conducted in the period from February 2010 until November 2012 in the gynecological and obstetric clinics in Warmińsko-Mazurskie voivodeship with various levels of reference. The research subjects included 510 women in the puerperal period aged 18-36. The scope of the research included an assessment of the selected anthropometric parameters of both pregnant women (body mass, height, BMI, gestational weight gain) and newborns (infant birth weight, infant length, Ponderal Index), as well as an analysis of the connections between the gestational weight gain, physical activity during pregnancy and anthropometric parameters of newborns. In the study group there was a significant percentage of women characterised by an inactive lifestyle and excessive gestational weight gain. There were significantly higher neonatal birth anthropometric parameters in women with abnormal excessive gestational weight gain than in women with normal and inappropriate - low gestational weight gain. The highest percentage of women with appropriate weight gain was observed in the group of women who are physically active, although this requires confirmation in larger population. Our studies have not shown statistically significant differences between the gestational weight gain and nutritional status of newborns in relation to the level of physical activity of pregnant women.

Minimal Impact by Antenatal Subpatent Plasmodium falciparum Infections on Delivery Outcomes in Malawian Women: A Cohort Study.

PubMed

Taylor, Steve M; Madanitsa, Mwayiwawo; Thwai, Kyaw-Lay; Khairallah, Carole; Kalilani-Phiri, Linda; van Eijk, Anna M; Mwapasa, Victor; Ter Kuile, Feiko O; Meshnick, Steven R

2017-08-01

Antenatal malaria screening with a rapid diagnostic test (RDT) and treatment only of women with positive RDT findings may potentially prevent low birth weight resulting from malaria. The consequences of subpatent antenatal infections below the detection limit of RDTs are incompletely understood. In Malawi, pregnant women of any gravidity status were tested at each antenatal visit for Plasmodium falciparum, using an RDT and polymerase chain reaction analysis, and were followed until delivery. Associations between antenatal infections and delivery outcomes were assessed with Poisson regression or analysis of variance. Compared with women with no detected antenatal P. falciparum infection, women with positive RDT findings delivered babies with a lower mean birth weight (2960 vs 2867 g; mean difference, -93 g [95% confidence interval {CI}, -27 to -159]; P = .006); this was not observed among women with only subpatent infections (mean birth weight, 3013 g; mean difference, 54 [95% CI, -33-140]; P = .2268). These differences were apparent early in pregnancy, during the second trimester: compared with uninfected women, women with positive RDT findings delivered babies with a lower mean birth weight (mean difference, -94 g [95% CI, -31 to -156]; P = .003), but women with subpatent infections did not (mean difference, 36 g [95% CI, -49-122]; P = .409). Subpatent antenatal P. falciparum infections were not associated with adverse delivery outcomes. The association of patent infections at enrollment with low birth weight suggests the importance of preventing P. falciparum infection early in pregnancy. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Ultrasonic prediction of term birth weight in Hispanic women. Accuracy in an outpatient clinic.

PubMed

Nahum, Gerard G; Pham, Krystle Q; McHugh, John P

2003-01-01

To investigate the accuracy of ultrasonic fetal biometric algorithms for estimating term fetal weight. Ultrasonographic fetal biometric assessments were made in 74 Hispanic women who delivered at 37-42 weeks of gestation. Measurements were taken of the fetal biparietal diameter, head circumference, abdominal circumference and femur length. Twenty-seven standard fetal biometric algorithms were assessed for their accuracy in predicting fetal weight. Results were compared to those obtained by merely guessing the mean term birth weight in each case. The correlation between ultrasonically predicted and actual birth weights ranged from 0.52 to 0.79. The different ultrasonic algorithms estimated fetal weight to within +/- 8.6-15.0% (+/- 295-520 g) of actual birth weight as compared with +/- 13.6% (+/- 449 g) for guessing the mean birth weight in each case (mean +/- SD). The mean absolute prediction errors for 17 of the ultrasonic equations (63%) were superior to those obtained by guessing the mean birth weight by 3.2-5.0% (96-154 g) (P < .05). Fourteen algorithms (52%) were more accurate for predicting fetal weight to within +/- 15%, and 20 algorithms (74%) were more accurate for predicting fetal weight to within +/- 10% of actual birth weight than simply guessing the mean birth weight (P < .05). Ten ultrasonic equations (37%) showed significant utility for predicting fetal weight > 4,000 g (likelihood ratio > 5.0). Term fetal weight predictions using the majority of sonographic fetal biometric equations are more accurate, by up to 154 g and 5%, than simply guessing the population-specific mean birth weight.

GFR estimated from cystatin C versus creatinine in children born small for gestational age.

PubMed

Franco, Maria C P; Nishida, Sônia K; Sesso, Ricardo

2008-06-01

Low birth weight caused by intrauterine growth restriction may be a risk factor for renal impairment in the adult life. A cross-sectional study. 71 children aged 8 to 13 years living in the community of São Paulo, Brazil, were included in the study. Gestational age was within the normal range. Birth weight (range, 2,052 to 3,560 g) divided into quartiles: 2,500 g or less; 2,501 to 2,740 g; 2,741 to 3,000 g; and greater than 3,000 g. Birth weight ascertained by birth records in 43 and by recall in 28 participants. Cystatin C, creatinine, and glomerular filtration rate (GFR) estimated by equations using cystatin C (eGFR(cys)) or creatinine (eGFR(cr)). Overall, mean serum creatinine level was 0.8 +/- 0.01 (SE) mg/dL (range, 0.7 to 1.1 mg/dL); mean plasma cystatin C level was 0.9 +/- 0.02 mg/L (range, 0.5 to 1.6 mg/L), and eGFR(cr) and eGFR(cys) were 102.4 +/- 2.16 (range, 66 to 140) and 91.8 +/- 2.46 mL/min/1.73 m(2) (range, 49 to 139 mL/min/1.73 m(2)), respectively. No differences were found for serum creatinine or eGFR(cr) values among the birth-weight quartiles. There was a significant linear trend of increasing cystatin C levels (decreasing eGFR(cys)) in the lower birth-weight quartile groups (P = 0.002 and P = 0.02, respectively). Systolic blood pressure correlated with plasma cystatin C level (r = 0.31; P = 0.008) and eGFR(cys) (r = -0.26; P = 0.028). Covariance analysis adjusting for age, sex, body mass index for age compared with standards of the National Center for Health Statistics and expressed as a z score, and systolic blood pressure showed that cystatin C values remained greater in the lowest than highest birth-weight quartile (1.01 +/- 0.05 versus 0.83 +/- 0.05 mg/L; P = 0.02). Ascertainment of birth weight by recall in some participants. Lack of measurement of microalbuminuria, absence of direct GFR measurement, and small sample size. Lower birth weight is associated with higher levels of cystatin C but not creatinine in 8-13 yr. old children born full-term.

PM2.5 exposure and birth outcomes: Use of satellite- and monitor-based data

PubMed Central

Hyder, Ayaz; Lee, Hyung Joo; Ebisu, Keita; Koutrakis, Petros; Belanger, Kathleen; Bell, Michelle Lee

2014-01-01

Background Air pollution may be related to adverse birth outcomes. Exposure information from land-based monitoring stations often suffers from limited spatial coverage. Satellite data offer an alternative data source for exposure assessment. Methods We used birth certificate data for births in Connecticut and Massachusetts, U.S. (2000-2006). Gestational exposure to PM2.5 was estimated from US Environmental Protection Agency monitoring data and from satellite data. Satellite data were processed and modeled using 2 methods – denoted satellite (1) and satellite (2) – before exposure assessment. Regression models related PM2.5 exposure to birth outcomes while controlling for several confounders. Birth outcomes were mean birth weight at term birth, low birth weight at term (LBW <2500g), small for gestational age (SGA, <10th percentile for gestational age and sex), and preterm birth (<37 weeks). Results Overall, the exposure assessment method modified the magnitude of the effect estimates of PM2.5 on birth outcomes. Change in birth weight per inter-quartile range (2.41 μg/m3)-increase in PM2.5 was -6g (95% confidence interval = -8 to -5), -16g (-21 to -11) and -19g (-23 to -15), using the monitor, satellite (1) and satellite (2) methods, respectively. Adjusted odds ratios, based on the same 3 exposure methods, for term LBW were 1.01 (0.98 to 1.04), 1.06 (0.97 to 1.16), and 1.08 (1.01 to 1.16); for SGA, 1.03 (1.01 to 1.04), 1.06 (1.03 to 1.10) and 1.08 (1.04 to 1.11); and for preterm birth, 1.00 (0.99 to 1.02), 0.98 (0.94 to 1.03) and 0.99 (0.95 to 1.03). Conclusions Under exposure assessment methods, we found associations between PM2.5 exposure and adverse birth outcomes particularly for birth weight among term births and for SGA. These results add to the growing concerns that air pollution adversely affects infant health and suggest that analysis of health consequences based on satellite-based exposure assessment can provide additional useful information. PMID:24240652

Lipid-based nutrient supplement increases the birth size of infants of primiparous women in Ghana.

PubMed

Adu-Afarwuah, Seth; Lartey, Anna; Okronipa, Harriet; Ashorn, Per; Zeilani, Mamane; Peerson, Janet M; Arimond, Mary; Vosti, Stephen; Dewey, Kathryn G

2015-04-01

The International Lipid-Based Nutrient Supplements Project developed a small-quantity (20 g/d) lipid-based nutrient supplement (LNS) for pregnant and lactating women. We evaluated the effects of prenatal LNS supplementation on fetal growth. In a community-based, partially double-blind, individually randomized controlled trial, 1320 women ≤20 wk pregnant received 60 mg Fe/400 μg folic acid (IFA), or 1-2 Recommended Dietary Allowances of 18 micronutrients, including 20 mg Fe (MMN), or LNS with the same micronutrients as the MMN group, plus 4 minerals and macronutrients contributing 118 kcal (LNS) daily until delivery. Fetal growth was compared across groups by using intention-to-treat analysis. The primary outcome was birth length. This analysis included 1057 women (IFA = 349, MMN = 354, LNS = 354). Groups did not differ significantly in mean birth length, length-for-age z score (LAZ), head circumference, or percentage low birth length but differed in mean birth weight (P = 0.044), weight-for-age z score (WAZ; P = 0.046), and BMI-for-age z score (BMIZ; P = 0.040), with a trend toward differences in low birth weight (P = 0.069). In pairwise comparisons, the LNS group had greater mean birth weight (+85 g; P = 0.040), WAZ (+0.19; P = 0.045), and BMIZ (+0.21; P = 0.035) and a lower risk of low birth weight (RR: 0.61, 95% CI: 0.39, 0.96; P = 0.032) than did the IFA group. The other group differences were not significant. The effect of intervention was modified by mother's parity, age, height, baseline hemoglobin, household food insecurity, and child sex, with parity being the most consistent modifier. Among primiparous women (IFA = 131; MMN = 110; LNS = 128), the LNS group had greater mean birth length (+0.91 cm; P = 0.001), LAZ (+0.47; P = 0.001), weight (+237 g; P < 0.001), WAZ (+0.56; P < 0.001), BMIZ (+0.52; P < 0.001), head circumference (0.50 cm; P = 0.017), and head circumference-for-age z score (+0.40; P = 0.022) than did the IFA group; similar differences were found when comparing the LNS and MMN groups among primiparous women, and no group differences were found among multiparous women. Prenatal LNS supplementation can improve fetal growth among vulnerable women in Ghana, particularly primiparous women. This trial was registered at clinicaltrials.gov as NCT00970866. © 2015 American Society for Nutrition.

Cerebral palsy rates by birth weight, gestation and severity in North of England, 1991-2000 singleton births.

PubMed

Glinianaia, Svetlana V; Rankin, Judith; Colver, Allan

2011-02-01

To investigate changes in rates of cerebral palsy (CP) by birth weight, gestational age, severity of disability, clinical subtype and maternal age in the North of England, 1991-2000. Data on 908 cases of CP (816 singletons, 92 multiples) were analysed from the prospective population-based North of England Collaborative Cerebral Palsy Survey. Severity of disability, measured as a Lifestyle Assessment Score (LAS), was derived from the lifestyle assessment questionnaire. CP rates by birth weight, gestational age, birth weight standardised for gestational age and sex, severity of disability and maternal age were compared between 1991-1995 and 1996-2000 using rate ratios (RR). The prevalence of CP in singletons was 2.46 (95% CI 2.29 to 2.63) per 1000 neonatal survivors compared to 11.06 per 1000 (95% CI 8.81 to 13.3) in multiples (RR 4.49, 95% CI 3.62 to 5.57), with no significant change between quinquennia. The singleton CP rates were higher for lower birth weight groups than birth weight ≥2500 g; and there were no significant changes for any birth weight group between quinquennia. There were also no changes in rates of more severe disability (LAS≥30%) by birth weight, gestation or clinical subtype. For preterm and term births the patterns of Z-score of birth weight-for-gestation are similar, with CP rates increasing as Z-score deviates from the optimal weight-for-gestation, which is about 1 SD above the mean. In contrast to increasing rates in previous years, rates of CP and more severe CP were stable by birth weight, gestational age and clinical subtype for 1991-2000.

Birth Weight, School Sports Ability, and Adulthood Leisure-Time Physical Activity.

PubMed

Elhakeem, Ahmed; Cooper, Rachel; Bann, David; Kuh, Diana; Hardy, Rebecca

2017-01-01

This study aimed to examine the associations of birth weight with ability in school sports in adolescence and participation in leisure-time physical activity (LTPA) across adulthood and to investigate whether associations between birth weight and LTPA change with age. Study participants were British singletons born in 1946 and followed up to age 68 yr (the Medical Research Council National Survey of Health and Development). Birth weights were extracted from birth records. Teacher reports of ability in school sports were collected at age 13 yr. LTPA was self-reported at ages 36, 43, 53, 60-64, and 68 yr and categorized at each age as participating in sports, exercise, and other vigorous LTPA at least once per month versus no participation. Associations were examined using standard and mixed-effects logistic regression models. Relevant data were available for 2739 study participants (50.1% female). When compared with the low birth weight group (≤2.50 kg), those with heavier birth weights were more likely to be rated as above average or average at school sports (vs below average); fully adjusted odds ratio = 1.78 (95% confidence interval = 1.14-2.77). Across adulthood, those with heavier birth weights were more likely to participate in LTPA than those with low birth weight; fully adjusted odds ratio of LTPA across adulthood = 1.52 (95% confidence interval = 1.09-2.14). This association did not vary by age (P = 0.5 for birth weight by age interaction). Low birth weight was associated with lower ability in school sports and with nonparticipation in LTPA across adulthood. Identifying the underlying developmental and social processes operating across life for low birth weight infants may inform the design of appropriate interventions to support participation in LTPA across life.

Assessing the value of customized birth weight percentiles.

PubMed

Hutcheon, Jennifer A; Walker, Mark; Platt, Robert W

2011-02-15

Customized birth weight percentiles are weight-for-gestational-age percentiles that account for the influence of maternal characteristics on fetal growth. Although intuitively appealing, the incremental value they provide in the identification of intrauterine growth restriction (IUGR) over conventional birth weight percentiles is controversial. The objective of this study was to assess the value of customized birth weight percentiles in a simulated cohort of 100,000 infants aged 37 weeks whose IUGR status was known. A cohort of infants with a range of healthy birth weights was first simulated on the basis of the distributions of maternal/fetal characteristics observed in births at the Royal Victoria Hospital in Montreal, Canada, between 2000 and 2006. The occurrence of IUGR was re-created by reducing the observed birth weights of a small percentage of these infants. The value of customized percentiles was assessed by calculating true and false positive rates. Customizing birth weight percentiles for maternal characteristics added very little information to the identification of IUGR beyond that obtained from conventional weight-for-gestational-age percentiles (true positive rates of 61.8% and 61.1%, respectively, and false positive rates of 7.9% and 8.5%, respectively). For the process of customization to be worthwhile, maternal characteristics in the customization model were shown through simulation to require an unrealistically strong association with birth weight.

Ex-Premature Infant Boys with Hypospadias are Similar in Size to Age-Matched, Ex-Premature Infant Boys Without Hypospadias

PubMed Central

Hsieh, Michael H.; Alonzo, David G.; Gonzales, Edmond T.; Jones, Eric A.; Cisek, Lars J.; Roth, David R.

2010-01-01

OBJECTIVE Studies have postulated that hypospadias, prematurity, and low birth weight are linked by defects in androgen signaling. To determine whether premature, hypospadiac boys are small and remain so, we compared their size at birth and at hypospadias repair to premature boys who underwent post-neonatal circumcision. METHODS We identified premature boys admitted to Texas Children's Hospital who underwent either hypospadias repair or circumcision after 4 months of age. Age, weight, and height at birth and surgery were recorded. RESULTS Fifty-four boys had hypospadias and 34 did not. For hypospadiac boys, the mean birth weight and age, height, and weight at surgery were lower than for boys without hypospadias. More importantly, length-for-age and weight-for-age percentiles were also lower for hypospadiac boys. When subset analysis was performed on boys younger than 2 years at surgery, however, there were no significant differences in height or weight between hypospadiac and nonhypospadiac boys. CONCLUSION Our series suggests that premature, hypospadiac boys are born smaller than age-matched, non-hypospadiac controls. However, there were no age-corrected size differences between hypospadiac and non-hypospadiac boys at surgery. This implies that hypospadiac boys exhibit postneonatal ‘rebound’ growth. Global growth deficits, if any, do not persist in hypospadiac boys. PMID:20833109

Birth weight and obstetric complications determine age at onset in first episode of psychosis.

PubMed

Rubio-Abadal, E; Ochoa, S; Barajas, A; Baños, I; Dolz, M; Sanchez, B; Del Cacho, N; Carlson, J; Huerta-Ramos, E; Usall, J

2015-06-01

Earlier age at onset of psychosis (AOP) has been associated with poor social adjustment and clinical outcome. Genetic and environmental factors such as obstetric complications, parental history of psychosis, advanced paternal age at time of birth, low birth weight and gestational age, and use of drugs have been described as bringing AOP forward. This study aims to evaluate the relationship between AOP and these factors in a sample of first episode of psychosis (FEP) patients. Clinical and sociodemographic data, age at FEP, age of parents at birth, parental history of psychosis, drug-use habits of the mother during pregnancy and of the patient before psychotic onset, and Lewis and Murray obstetric complication scale were obtained from 90 patients with FEP. Statistical analysis was performed by means of Pearson correlations, Chi-square tests, Student T-test analyses and a linear regression model using SPSS version 22. Pre-eclampsia, need for incubator at birth, use of forceps, parental history of psychosis, and low birth weight were associated with an earlier AOP. Use of forceps and birth weight are the variables which best predict AOP in FEP. Stimulant drugs, which were mostly used together with cannabis and cocaine, were the only substances associated with an earlier AOP. Our findings are consistent with previous study results and underline the role of the prenatal period in the development of psychosis and the importance of careful monitoring of pregnancy and delivery, especially in cases with familial history. Copyright © 2015 Elsevier Ltd. All rights reserved.

Nursing Student Birth Doulas' Influence On the Childbearing Outcomes of Vulnerable Populations.

PubMed

Van Zandt, Shirley E; Kim, Soohyun; Erickson, Amanda

2016-01-01

Of 1,511 women served by nursing student birth doulas (Birth Companions) between 1998 and 2014, 34.5% were identified as vulnerable (refugees, non-English speakers, teens, low income, low education). This retrospective evaluation of the Birth Companions Program showed that vulnerable mothers had more epidurals and smaller babies, and attempted breastfeeding less frequently than nonvulnerable. There was no difference in the frequency of caesarean births, pitocin induction/augmentation, low birth weight, or preterm newborns among the vulnerable women. Birth Companion interventions may have a role in influencing these outcomes. The Birth Companions program will use this analysis to identify additional services for these populations.

Glutathione S-transferase (GSTM1, GSTT1) gene polymorphisms, maternal gestational weight gain, bioimpedance factors and their relationship with birth weight: a cross-sectional study in Romanian mothers and their newborns.

PubMed

Mărginean, Claudiu; Bănescu, Claudia Violeta; Mărginean, Cristina Oana; Tripon, Florin; Meliţ, Lorena Elena; Iancu, Mihaela

2017-01-01

The aim of this study was to assess the relationship between mother-child GSTM1, GSTT1 gene polymorphisms, maternal weight gain, maternal bioimpedance parameters and newborn's weight, in order to identify the factors that influence birth weight. We performed a cross-sectional study on 405 mothers and their newborns, evaluated in an Obstetrics and Gynecology Tertiary Hospital from Romania. Newborns whose mothers had the null genotype of GSTT1 gene polymorphism were more likely to gain a birth weight of >3 kg, compared to newborns whose mothers had the T1 genotype (odds ratio - OR: 2.14, 95% confidence interval - CI: [1.03; 4.44]). Also, the null genotype of GSTM1 gene polymorphism in both mothers and newborns was associated with a higher birth weight. Gestational weight gain was positively associated with newborn's birth weight (p<0.001). The increased mother's fat mass (%) and basal metabolism rate were also independent factors for a birth weight of more than 3 kg (p=0.006 and p=0.037). The null genotype of GSTT1 gene polymorphism in mothers and the null genotype of GSTM1 in mothers and newborns had a positive effect on birth weight. Also, increased maternal fat mass and basal metabolism rate were associated with increased birth weight. We conclude that maternal GSTM1÷GSTT1 gene polymorphisms present an impact on birth weight, being involved in the neonatal nutritional status. The clinical relevance of our study is sustained by the importance of identifying the factors that influence birth weight, which can be triggers for childhood obesity.

Does culture medium influence offspring birth weight?

PubMed

Carrasco, Beatriz; Boada, Montserrat; Rodríguez, Ignacio; Coroleu, Buenaventura; Barri, Pedro N; Veiga, Anna

2013-11-01

To determine whether the type of medium used to culture human embryos in vitro influences neonatal birth weight after IVF/intracytoplasmic sperm injection (ICSI). A prospective study and a retrospective study. Private assisted reproduction center. The prospective study included 449 IVF/ICSI cycles from August to December 2008. The retrospective analysis was performed for 2,518 IVF/ICSI cycles from October 2006 to December 2010. In the prospective study, patients were randomized for embryo culture in Cook or Vitrolife medium. The retrospective study was performed with three different culture media (MediCult, Cook, and Vitrolife). Mean birth weight, adjusted for gestational age and gender (z score) of newborns. In the prospective study, the average z score was -0.19 ± 0.85 in Cook and 0.08 ± 1.40 in Vitrolife. In the retrospective study, the z scores obtained in each group were as follows: Cook, -0.14 ± 0.96; MediCult, 0.06 ± 1.13; and Vitrolife, 0.03 ± 1.05. No significant differences were observed regarding the birth weight of children born in the different groups in both studies. The results do not show any relationship between the medium used for in vitro culture and mean birth weight adjusted for gestational age and gender of singletons born after IVF/ICSI. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Influence of gestational weight gain on low birth weight in short-statured South Indian pregnant women.

PubMed

Shivakumar, Nirupama; Dwarkanath, Pratibha; Bosch, Ronald; Duggan, Christopher; Kurpad, Anura V; Thomas, Tinku

2018-05-01

India contributes to one-third of the global burden of low birth weight (LBW) neonates, which is associated with increased risk of mortality and adverse consequences on long-term health. Factors leading to LBW are multidimensional and maternal short stature is an important component with an inter-generational effect. On the contrary gestational weight gain (GWG) shows an independent positive influence on birth weight. The aim of the present study therefore was to determine the influence of GWG on birth weight in short pregnant women. A prospective observational cohort of 1254 pregnant women was studied. Total, second and third trimester GWG per week were computed. Women were divided into two groups, "short" and "not-short", using a cut off of 152 cm that corresponded to the 25th percentile for height in the cohort. Association of tertiles of GWG with LBW was examined using log binomial regression analysis. "Short" women in highest tertile of total GWG had a significantly reduced adjusted relative risk (ARR 0.37, 95% confidence interval 0.16-0.83, P = 0.016) for LBW, compared to the lowest tertile. However, there was no significant increase in risk for cesarean section (CS) with increasing tertiles of total GWG. In women with height <152 cm a significant reduced risk for LBW was observed with the greatest total GWG, without a significant increase in the risk for CS. This suggests that improving GWG in short women may be beneficial for the birth weight of the offspring.

Effect of Zinc Supplementation on Pregnancy and Infant Outcomes: A Systematic Review

PubMed Central

Chaffee, Benjamin W.; King, Janet C.

2013-01-01

Poor maternal zinc status has been associated with foetal loss, congenital malformations, intrauterine growth retardation, reduced birth weight, prolonged labour and preterm or post-term deliveries. A meta-analysis completed in 2007 showed that maternal zinc supplementation resulted in a small but significant reduction in preterm birth. The purposes of this analysis are to update that previous review and expand the scope of assessment to include maternal, infant and child health outcomes. Electronic searches were carried out to identify peer-reviewed, randomised controlled trials where daily zinc supplementation was given for at least one trimester of pregnancy. The co-authors applied the study selection criteria, assessed trial quality and abstracted data. A total of 20 independent intervention trials involving more than 11 000 births were identified. The 20 trials took place across five continents between 1977 and 2008. Most studies assessed the zinc effect against a background of other micronutrient supplements, but five were placebo-controlled trials of zinc alone. The provided dose of supplemental zinc ranged from 5 to 50 mg/day. Only the risk of preterm birth reached statistical significance (summary relative risk 0.86 [95% confidence interval 0.75, 0.99]). There was no evidence that supplemental zinc affected any parameter of foetal growth (risk of low birth weight, birth weight, length at birth or head circumference at birth). Six of the 20 trials were graded as high quality. The evidence that maternal zinc supplementation lowers the risk of preterm birth was graded low; evidence for a positive effect on other foetal outcomes was graded as very low. The effect of zinc supplementation on preterm birth, if causal, might reflect a reduction in maternal infection, a primary cause of prematurity. While further study would be needed to explore this possibility in detail, the overall public health benefit of zinc supplementation in pregnancy appears limited. PMID:22742606

Can In Utero Exposures Program an Increased Risk for ...

EPA Pesticide Factsheets

In the early 1990's, David Barker and his colleagues studied the relationship between the incidence of coronary heart disease and birth weight in a population of adult men and women in Hertfordshire, England. They found an inverse correlation between the incidence of coronary heart disease and birth weight -the lower the weight at birth, the higher the risk of coronary heart disease in adulthood. Importantly, this was not simply a problem of low birth weight or premature birth, as the inverse relationship was evident among full-term births within a normal birth weight range (i.e., 5-10 pounds). Subsequent studies by this group and others expanded the range of adult diseases inversely correlated with birth weight to include hypertension, diabetes, and obesity. These are components of the metabolic syndrome, and all contribute to increased risk of coronary heart disease. Since that time, a number of studies around the world have corroborated these findings. The

Calorie and protein-enriched formula versus standard term formula for improving growth and development in preterm or low birth weight infants following hospital discharge.

PubMed

Henderson, G; Fahey, T; McGuire, W

2005-04-18

Preterm and low birth weight infants are often growth-restricted at hospital discharge. Feeding infants post-hospital discharge with calorie and protein-enriched formula milk might facilitate "catch-up" growth and improve development. To review the evidence from randomised controlled trials that feeding following hospital discharge with calorie and protein-enriched formula compared with standard term formula improves growth and development for preterm or low birth weight infants. We used the standard search strategy of the Cochrane Neonatal Review Group. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 4, 2004), MEDLINE (1966 - December 2004), EMBASE (1980 - December 2004), CINAHL (1982 - December 2004), conference proceedings, and previous reviews. Randomised or quasi-randomised controlled trials that compared the effect of feeding preterm or low birth weight infants post-hospital discharge with calorie and protein-enriched formula compared with standard term formula. We extracted data using the standard methods of the Cochrane Neonatal Review Group, with separate evaluation of trial quality and data extraction by two authors, and synthesis of data using weighted mean difference and a fixed effects model for meta-analysis. We found six trials that were eligible for inclusion. These recruited a total of 424 infants and were generally of good methodological quality. These trials found little evidence that feeding with calorie and protein-enriched formula milk affected growth and development. Because of differences in the way individual trials measured and presented outcomes, data synthesis was limited. Meta-analysis of data from two trials found a statistically significant effect on crown-heel length at 18 months post-term (weighted mean difference 9.7 millimetres (95% confidence interval 3.2 to 16.2)), but not on weight or head circumference. Meta-analysis of data from the two trials that assessed neurodevelopment at 18 months post-term did not reveal a statistically significant difference in either Bayley Mental Development Index (weighted mean difference 0.23 (95% confidence interval -2.99 to 3.45)) or Psychomotor Development Index (weighted mean difference 0.56 (95% confidence interval -1.95 to 3.07)). There are not yet any data on growth or development through later childhood. The limited available data do not provide strong evidence that feeding preterm or low birth weight infants following hospital discharge with calorie and protein-enriched formula compared with standard term formula affects growth rates or development up to 18 months post-term.

Creation and validation of the Singapore birth nomograms for birth weight, length and head circumference based on a 12-year birth cohort.

PubMed

Poon, Woei Bing; Fook-Chong, Stephanie M C; Ler, Grace Y L; Loh, Zhi Wen; Yeo, Cheo Lian

2014-06-01

Both gestation and birth weight have significant impact on mortality and morbidity in newborn infants. Nomograms at birth allow classification of infants into small for gestational age (SGA) and large for gestational age (LGA) categories, for risk stratification and more intensive monitoring. To date, the growth charts for preterm newborn infants in Singapore are based on the Fenton growth charts, which are constructed based on combining data from various Western growth cohorts. Hence, we aim to create Singapore nomograms for birth weight, length and head circumference at birth, which would reflect the norms and challenges faced by local infants. Growth parameters of all babies born or admitted to our unit from 2001 to 2012 were retrieved. Following exclusion of outliers, nomograms for 3 percentiles of 10th, 50th, and 90th were generated for the gestational age (GA) ranges of 25 to 42 weeks using quantile regression (QR) combined with the use of restricted cubic splines. Various polynomial models (second to third degrees) were investigated for suitability of fit. The optimum QR model was found to be a third degree polynomial with a single knotted cubic spline in the mid-point of the GA range, at 33.5 weeks. Check for goodness of fit was done by visual inspection first. Next, check was performed to ensure the correct proportion: 10% of all cases fall above the upper 90th percentile and 10% fall below the lower 10th percentile. Furthermore, an alternative formula-based method of nomogram construction, using mean, standard deviation (SD) and assumption of normality at each gestational age, was used for counterchecking. A total of 13,403 newborns were included in the analysis. The new infant-foetal growth charts with respect to birth weight, heel-crown length and occipitofrontal circumference from 25 to 42 weeks gestations with the 10th, 50th and 90th were presented. Nomograms for birth weight, length and head circumference at birth had significant impact on neonatal practice and validation of the Singapore birth nomograms against Fenton growth charts showed better sensitivity and comparable specificity, positive and negative predictive values.

Subjective Social Status, Mental and Psychosocial Health, and Birth Weight Differences in Mexican-American and Mexican Immigrant Women.

PubMed

Fleuriet, K Jill; Sunil, T S

2015-12-01

Recent Mexican immigrant women on average have an unexpectedly low incidence of low birth weight (LBW). Birth weights decline and LBW incidence increases in post-immigrant generations. This pilot project tested the hypothesis that subjective social status (SSS) of pregnant women predicts variation in birth weight between Mexican immigrant and Mexican-American women. 300 low-income pregnant Mexican immigrant and Mexican-American women in South Texas were surveyed for SSS, depression, pregnancy-related anxiety, perceived social stress and self-esteem and subsequent birth weight. No significant difference in SSS levels between pregnant Mexican immigrant and Mexican-American women were found. However, SSS better predicted variation in birth weight across both groups than mental and psychosocial health variables. Results suggest distinct relationships among SSS, mental and psychosocial health that could impact birth weight. They underscore the relevance of a multilevel, biopsychosocial analytical framework to studying LBW.

Linking climate change and health outcomes: Examining the relationship between temperature, precipitation and birth weight in Africa

USGS Publications Warehouse

Grace, Kathryn; Davenport, Frank; Hanson, Heidi; Funk, Christopher C.; Shukla, Shraddhanand

2015-01-01

This paper examined the relationship between birth weight, precipitation, and temperature in 19 African countries. We matched recorded birth weights from Demographic and Health Surveys covering 1986 through 2010 with gridded monthly precipitation and temperature data derived from satellite and ground-based weather stations. Observed weather patterns during various stages of pregnancy were also used to examine the effect of temperature and precipitation on birth weight outcomes. In our empirical model we allowed the effect of weather factors to vary by the dominant food production strategy (livelihood zone) in a given region as well as by household wealth, mother's education and birth season. This allowed us to determine if certain populations are more or less vulnerable to unexpected weather changes after adjusting for known covariates. Finally we measured effect size by observing differences in birth weight outcomes in women who have one low birth weight experience and at least one healthy birth weight baby. The results indicated that climate does indeed impact birth weight and at a level comparable, in some cases, to the impact of increasing women's education or household electricity status.

Increased numbers of total nucleated and CD34+ cells in blood group O cord blood: an analysis of neonatal innate factors in the Korean population.

PubMed

Lee, Hye Ryun; Park, Jeong Su; Shin, Sue; Roh, Eun Youn; Yoon, Jong Hyun; Han, Kyou Sup; Kim, Byung Jae; Storms, Robert W; Chao, Nelson J

2012-01-01

We analyzed neonatal factors that could affect hematopoietic variables of cord blood (CB) donated from Korean neonates. The numbers of total nucleated cells (TNCs), CD34+ cells, and CD34+ cells/TNCs of CB in neonates were compared according to sex, gestational age, birth weight, birth weight centile for gestational age, and ABO blood group. With 11,098 CB units analyzed, blood group O CB showed an increased number of TNCs, CD34+ cells, and CD34+ cells/TNCs compared with other blood groups. Although TNC counts were lower in males, no difference in the number of CD34+ cells was demonstrated because the number of CD34+ cells/TNCs was higher in males. An increase in the gestational age resulted in an increase in the number of TNCs and decreases in the number of CD34+ cells and CD34+ cells/TNCs. The numbers of TNCs, CD34+ cells, and CD34+ cells/TNCs increased according to increased birth weight centile as well as birth weight. CB with blood group O has unique hematologic variables in this large-scale analysis of Korean neonates, although the impact on the storage policies of CB banks or the clinical outcome of transplantation remains to be determined. © 2011 American Association of Blood Banks.

The Independent Importance of Pre-pregnancy Weight and Gestational Weight Gain for the Prevention of Large-for Gestational Age Brazilian Newborns.

PubMed

Mastroeni, Marco F; Czarnobay, Sandra A; Kroll, Caroline; Figueirêdo, Katherinne B W; Mastroeni, Silmara S B S; Silva, Jean C; Khan, Mohammad K A; Loehr, Sarah; Veugelers, Paul J

2017-04-01

Objectives To study the independent effect of pre-pregnancy weight, gestational weight gain (GWG), and other important risk factors on newborn birth weight. Methods Baseline data of 435 adult women and their singletons born between January and February 2012 at a public hospital in Brazil were used. Logistic regression was applied to determine the independent importance of pre-pregnancy weight and GWG for large for gestational age (LGA) newborns. Results Among all mothers, 37.9 % were overweight and obese before pregnancy and 45.3 % experienced excessive GWG. Among the newborns, 24.4 % were classified as LGA. Univariate analysis showed an association of family income, GWG, pre-pregnancy BMI and excessive GWG with LGA newborns. Smoking before and during pregnancy was associated with a decreased likelihood of giving birth to an LGA newborn compared to mothers who did not smoke. After adjustment for confounding variables, age at birth of first child, GWG, HbA1c and pre-pregnancy weight-GWG were significant and independent determinants of giving birth to an LGA newborn. Mothers with pre-pregnancy overweight and excessive GWG were more likely to deliver an LGA newborn (OR 2.54, P < 0.05) compared to mothers who were normal weight and experienced adequate GWG. Conclusions for Practice Age at first birth of child, GWG, HbA1c and pre-pregnancy overweight combined with excessive GWG are independent determinants of LGA newborns. The results of this study suggest that both primary prevention of overweight in women of childbearing age and management of GWG may be important strategies to reduce the number of LGA newborns and, consequently, the long-term public health burden of obesity.

[Birth weight difference in 3 biological variables in normal newborns].

PubMed

Lagos, R; Espinoza, R; Orellana, J; Echeverría, P

1999-12-01

The most important determinant of birth weight is gestational age. However, other biological variables may influence this parameter. To study the influence of maternal parity, height and neonatal gender on the birth weight of normal newborns in a public Hospital of Southern Chile. A computer registry of all deliveries attended in Temuco Hospital between 1993 and 1998 was analyzed. Normal deliveries giving birth to newborns of more than 2,500 g and from women who did not suffer from conditions that could influence birth weight, such as hypertension, undernutrition or smoking, were selected. From 27,736 deliveries, 12,580 were selected for the study. Male newborns with gestational ages from 37 to 42 weeks, had a higher weight than their female counterparts. Multiparous women and those with a height over 154 cm gave birth to newborns with a higher weight than nulliparous women or than those with a height of less than 154 cm. According to these results, birth weight must be corrected by gender and maternal features, to define those newborns that have a low birth weight for their gestational age.

High‐altitude ancestry protects against hypoxia‐associated reductions in fetal growth

PubMed Central

Julian, Colleen Glyde; Vargas, Enrique; Armaza, J Fernando; Wilson, Megan J; Niermeyer, Susan; Moore, Lorna G

2007-01-01

Objective The chronic hypoxia of high‐altitude (⩾2500 m) residence has been shown to decrease birth weight in all populations studied to date. However, multigenerational high‐altitude populations appear protected relative to newcomer groups. This study aimed to determine whether such protection exists independently of other factors known to influence fetal growth and whether admixed populations (ie, people having both high‐ and low‐altitude ancestry) show an intermediate level of protection. Design 3551 medical records from consecutive deliveries to Andean, European or Mestizo (ie, admixed) women at low, intermediate or high altitudes in Bolivia were evaluated for maternal characteristics influencing fetal growth as measured by birth weight and the frequency of small for gestational age births (SGA or ⩽10th percentile birth weight for gestational age and sex). Two‐way analysis of variance and χ2 tests were used to compare maternal and infant characteristics. The effects of ancestry or altitude on SGA and birth weight were assessed using logistic or linear regression models, respectively. Results Altitude decreased birth weight and increased SGA in all ancestry groups. Andean infants weighed more and were less often SGA than Mestizo or European infants at high altitude (13%, 16% and 33% respectively, p<0.01). After accounting for the influences of maternal hypertensive complications of pregnancy, parity, body weight, and number of prenatal visits, European relative to Andean ancestry increased the frequency of SGA at high altitude nearly fivefold. Conclusions Andean relative to European ancestry protects against altitude‐associated reductions in fetal growth. The intermediate protection seen in the admixed (Mestizo) group is consistent with the influence of genetic or other Andean‐specific protective characteristics. PMID:17329275

Analysis of MicroRNA Expression in Newborns with Differential Birth Weight Using Newborn Screening Cards

PubMed Central

Rodil-Garcia, Patricia; Arellanes-Licea, Elvira del Carmen; Montoya-Contreras, Angélica; Salazar-Olivo, Luis A.

2017-01-01

Birth weight is an early predictor for metabolic diseases and microRNAs (miRNAs) are proposed as fetal programming participants. To evaluate the use of dried blood spots (DBS) on newborn screening cards (NSC) as a source of analyzable miRNAs, we optimized a commercial protocol to recover total miRNA from normal birth weight (NBW, n = 17–20), low birth weight (LBW, n = 17–20) and high birth weight (macrosomia, n = 17–20) newborns and analyzed the relative expression of selected miRNAs by stem-loop RT-qPCR. The possible role of miRNAs on the fetal programming of metabolic diseases was explored by bioinformatic tools. The optimized extraction of RNA resulted in a 1.2-fold enrichment of miRNAs respect to the commercial kit. miR-33b and miR-375 were overexpressed in macrosomia 9.8-fold (p < 0.001) and 1.7-fold, (p < 0.05), respectively and miR-454-3p was overexpressed in both LBW and macrosomia (19.7-fold, p < 0.001 and 10.8-fold, p < 0.001, respectively), as compared to NBW. Potential target genes for these miRNAs are associated to cyclic-guanosine monophosphate (cGMP)-dependent protein kinase (PKG), mitogen-activated protein kinase (MAPK), type 2 diabetes, transforming growth factor-β (TGF-β)and Forkhead box O protein (FoxO) pathways. In summary, we improved a protocol for analyzing miRNAs from NSC and provide the first evidence that birth weight modifies the expression of miRNAs associated to adult metabolic dysfunctions. Our work suggests archived NSC are an invaluable resource in the search for fetal programming biomarkers. PMID:29182561

Obstetric characteristics of two Mayan populations in the highlands of Guatemala.

PubMed

Burket, Brent A

2017-10-01

The purpose of this study was to (1) describe and compare two obstetric Mayan populations in Guatemala, the Tz'utujil and the Kachiquel and (2) evaluate possible associations of demographics, wood fuel use, and obesity with pregnancy/newborn outcomes. This cross-sectional study interviewed participants at the time of routine obstetric ultrasounds at three institutions in Santiago Atitlán and one institution in San Lucas Tolimán. Data were collected from January 2010 to May 2013. Data entry and statistical analysis were performed using EPI Info TM 7.1.2.0 (CDC). The two populations were similar in maternal age, BMI, ownership of a phone, gravidity (number of times a women has been pregnant), history of spontaneous abortions, history of term pregnancies, newborn birth weights, cesarean section rate, and percentage of low-birth-weight newborns (LBW < 2500 g). Obesity was present in 22% of the combined surveyed populations. Low-birth-weight newborns and newborn macrosomia (newborn birth weight greater than 4000 g) were present in 5.5% and 3.7%, respectively. The newborn gender ratio (male to female) was equal to 0.92. The two populations differed in ownership of gas stoves and percentage of newborn macrosomia. Significant associations included: (1) female newborn gender and low birth weight, (2) obesity and newborn macrosomia, and (3) obesity and male gender. The two Mayan populations were similar in many of the obstetric variables. The percentage of low-birth-weight infants (5.5%) is considerably lower than reported prevalence data for Guatemala. The obstetric characteristics, differences, and similarities between these two Mayan populations should help in policy planning for obstetric care for these two populations and possibly other indigenous populations in Guatemala.

Predictors of adults' body mass index and the association with index child's infant birth weight, in the Lifeways Cross-Generation Cohort Study of a thousand families in the Republic of Ireland.

PubMed

McKey, S; Heinen, M; Mehegan, J; Somerville, R; Khalil, H; Segurado, R; Murrin, C; Kelleher, C C

2017-12-01

The Lifeways study is novel in having information on three generations of the same families. It is well established that infant birth weight (IBW) predicts individuals' risk of adult chronic disease and more recently studies report cross-generation transmission of risk patterns. The aims of this analysis were to examine whether adults' birth weights were associated with measures of own health status or social position and to relate adults' birth weights to that of the index child's IBW. Finally, we assessed whether birth weight of either adults or children was associated with adult body mass index (BMI) of parents and grandparents. We included 1075 children whose IBW was recorded at recruitment from hospital records and 2546 adult cohort members followed from 2001 until 2014. At baseline, a sub-group of 920 adults had reported own birth weight (RBW). Results showed male adults' RBW were significantly higher than females' (P=0.001). Mothers' RBW was significantly correlated with IBW (r=0.178, P<0.001). In mixed effects linear models with BMI as the outcome variable, of all adults, and in sub-groups of adults with RBW and of mothers only, the IBW was associated with adult BMI adjusting for other predictors. Adults' BMI was positively associated with age (P=0.013), index child's IBW (P=0.001), gender (P<0.001) but not own RBW, adjusting for family identification number. When mothers were removed from the adult models however, IBW ceased to be associated with BMI, a final model showed RBW being associated with adult BMI (P=0.04). There are cross-generational associations in the Lifeways cohort, the maternal association being stronger.

Birth Weight and Intelligence in Young Adulthood and Midlife.

PubMed

Flensborg-Madsen, Trine; Mortensen, Erik Lykke

2017-06-01

We examined the associations between birth weight and intelligence at 3 different adult ages. The Copenhagen Perinatal Cohort is comprised of children born in Copenhagen from 1959 to 1961. Information on birth weight and ≥1 tests of intelligence was available for 4696 members of the cohort. Intelligence was assessed at a mean age of 19 years with the Børge Priens Prøve test, at age 28 years with the Wechsler Adult Intelligence Scale, and at age 50 years with the Intelligenz-Struktur-Test 2000 R. Birth weight was significantly associated with intelligence at all 3 follow-up assessments, with intelligence scores increasing across 4 birth weight categories and declining for the highest birth weight category. The adjusted differences between those in the <2.5kg birth weight group and those in the 3.5 to 4.00kg group were >5 IQ points at all 3 follow-up assessments, corresponding to one-third of a SD. The association was stable from young adulthood into midlife,and not weaker at age 50 years. Adjustment for potential confounding factors, including infant socioeconomic status and gestational age, did not dilute the associations, and associations with intelligence were evident across the normal birth weight range and so were not accounted for by low birth weight only. The association between birth weight and intelligence is stable from young adulthood into midlife. These long-term cognitive consequences may imply that even small shifts in the distribution of birth size, in normal-sized infants as well, may have a large impact at the population level. Copyright © 2017 by the American Academy of Pediatrics.

Joint association of birth weight and physical activity/sedentary behavior with obesity in children ages 9-11 years from 12 countries.

PubMed

Qiao, Yijuan; Zhang, Tao; Liu, Hongyan; Katzmarzyk, Peter T; Chaput, Jean-Philippe; Fogelholm, Mikael; Johnson, William D; Kuriyan, Rebecca; Kurpad, Anura; Lambert, Estelle V; Maher, Carol; Maia, José A R; Matsudo, Victor; Olds, Timothy; Onywera, Vincent; Sarmiento, Olga L; Standage, Martyn; Tremblay, Mark S; Tudor-Locke, Catrine; Zhao, Pei; Hu, Gang

2017-06-01

To examine the joint association of birth weight and physical activity/sedentary time with childhood obesity in 12 countries. A cross-sectional study of 5,088 children aged 9 to 11 years was conducted. Birth weight was recalled by parents or guardians. Moderate-to-vigorous physical activity (MVPA) and sedentary behavior were objectively measured using accelerometry. The association of birth weight with the odds of obesity, central obesity, and high body fat was significant among children with either low MVPA or high sedentary time but not among children with either high MVPA or low sedentary time. In comparison with children with normal birth weight and high MVPA, children with high birth weight and low MVPA showed 4.48- to 5.18-fold higher odds of obesity, central obesity, and high body fat; children with normal birth weight and low MVPA showed 3.00- to 3.30-fold higher odds of obesity, central obesity, and high body fat, and children with high birth weight and high MVPA showed 1.16- to 1.68-fold higher odds of obesity, central obesity, and high body fat. High MVPA is more important than high birth weight as a correlate of obesity in children. © 2017 The Obesity Society.

Joint association of birth weight and physical/sedentary activity with obesity at children ages 9–11 years in 12 countries

PubMed Central

Qiao, Yijuan; Zhang, Tao; Liu, Hongyan; Katzmarzyk, Peter T.; Chaput, Jean-Philippe; Fogelholm, Mikael; Johnson, William D.; Kuriyan, Rebecca; Kurpad, Anura; Lambert, Estelle V.; Maher, Carol; Maia, José A.R.; Matsudo, Victor; Olds, Timothy; Onywera, Vincent; Sarmiento, Olga L.; Standage, Martyn; Tremblay, Mark S.; Tudor-Locke, Catrine; Zhao, Pei; Hu, Gang

2017-01-01

Objective To examine the joint association of birth weight and physical/sedentary activity time with obesity in 12 countries. Methods A cross-sectional study of 5,088 children aged 9–11 years was conducted. Birth weight was recalled by parents or guardians. Moderate-to-vigorous physical activity (MVPA) and sedentary behavior were objectively measured using accelerometry. Results The association of birth weight with the odds of obesity, central obesity and high body fat was significant among children with either low MVPA or high sedentary time but not among children with either high MVPA or low sedentary time. In comparison with children with normal birth weight and high MVPA, children with high birth weight and low MVPA showed 4.48–5.18 fold higher odds of obesity, central obesity, and high body fat; children with normal birth weight and low MVPA showed 3.00–3.30 fold higher odds of obesity, central obesity, and high body fat, and children with high birth weight and high MVPA showed 1.16–1.68 fold higher odds of obesity, central obesity, and high body fat. Conclusions High MVPA is more important than high birth weight as a correlate of obesity in children. PMID:28544795

Pain coping strategies: Neonatal intensive care unit survivors in adolescence.

PubMed

van Ganzewinkel, Christ-Jan; Been, Jasper V; Dieleman, Jeanne P; Katgert, Titia; Boelen-van der Loo, Tera; van der Pal, Sylvia M; van Dijk, Monique; Kramer, Boris W; Andriessen, Peter

2016-12-01

Data on long-term consequences of preterm birth on pain coping later in life are limited. To assess whether gestational age, birth weight and neonatal disease severity have effect on pain coping style in adolescents born preterm or with low birth weight. Observational, longitudinal study (Project On Preterm and SGA-infants, POPS-19). We analyzed data of 537 adolescents at the age of 19 years, who were born at a gestational age <32 weeks or with a birth weight <1500g. Participants completed the pain coping questionnaire (PCQ) that assesses pain coping strategies in three higher-order factors: approach ("to deal with pain"), problem-focused avoidance ("to disengage from pain") and emotion-focused avoidance ("expression of pain"). Furthermore, their pain coping effectiveness, pain controllability and emotional reactions to pain were assessed. All participants completed an IQ test. Univariate analysis showed no significant correlation between length of stay, sepsis and necrotizing enterocolitis and any of the higher-order factors. Approach was only correlated with IQ. Problem-focused avoidance was, in the multiple regression analysis (including gestational age, IVH and IQ), only correlated with IQ. For emotion-focused avoidance (including birth weight, SGA, IVH, respiratory support and IQ) three independent predictors remained: IVH was positively correlated, while respiratory support and IQ were negatively correlated with emotion-focused avoidance. Early neonatal characteristics and neonatal disease severity have limited effect on pain coping style in adolescence. Higher IQ was associated with the use of adaptive coping strategies, while maladaptive strategies were used less. Copyright © 2016. Published by Elsevier Ireland Ltd.

Decline in the negative association between low birth weight and cognitive ability.

PubMed

Goisis, Alice; Özcan, Berkay; Myrskylä, Mikko

2017-01-03

Low birth weight predicts compromised cognitive ability. We used data from the 1958 National Child Development Study (NCDS), the 1970 British Cohort Study (BCS), and the 2000-2002 Millennium Cohort Study (MCS) to analyze how this association has changed over time. Birth weight was divided into two categories, <2,500 g (low) and 2,500-4,500 g (normal) and verbal cognitive ability was measured at the age of 10 or 11 y. A range of maternal and family characteristics collected at or soon after the time of birth were considered. Linear regression was used to analyze the association between birth weight and cognitive ability in a baseline model and in a model that adjusted for family characteristics. The standardized difference (SD) in cognitive scores between low-birth-weight and normal-birth-weight children was large in the NCDS [-0.37 SD, 95% confidence interval (CI): -0.46, -0.27] and in the BCS (-0.34, 95% CI: -0.43, -0.25) cohorts, and it was more than halved for children born in the MCS cohort (-0.14, 95% CI: -0.22, -0.06). The adjustment for family characteristics did not explain the cross-cohort differences. The results show that the association between low birth weight and decreased cognitive ability has declined between the 1950s and 1970s birth cohorts and the 2000--2002 birth cohort, despite a higher proportion of the low-birth-weight babies having a very low birth weight (<1,500 g) in the more recent birth cohort. Advancements in obstetric and neonatal care may have attenuated the negative consequences associated with being born small.

Decline in the negative association between low birth weight and cognitive ability

PubMed Central

Özcan, Berkay; Myrskylä, Mikko

2017-01-01

Low birth weight predicts compromised cognitive ability. We used data from the 1958 National Child Development Study (NCDS), the 1970 British Cohort Study (BCS), and the 2000–2002 Millennium Cohort Study (MCS) to analyze how this association has changed over time. Birth weight was divided into two categories, <2,500 g (low) and 2,500–4,500 g (normal) and verbal cognitive ability was measured at the age of 10 or 11 y. A range of maternal and family characteristics collected at or soon after the time of birth were considered. Linear regression was used to analyze the association between birth weight and cognitive ability in a baseline model and in a model that adjusted for family characteristics. The standardized difference (SD) in cognitive scores between low-birth-weight and normal-birth-weight children was large in the NCDS [−0.37 SD, 95% confidence interval (CI): −0.46, −0.27] and in the BCS (−0.34, 95% CI: −0.43, −0.25) cohorts, and it was more than halved for children born in the MCS cohort (−0.14, 95% CI: −0.22, −0.06). The adjustment for family characteristics did not explain the cross-cohort differences. The results show that the association between low birth weight and decreased cognitive ability has declined between the 1950s and 1970s birth cohorts and the 2000--2002 birth cohort, despite a higher proportion of the low-birth-weight babies having a very low birth weight (<1,500 g) in the more recent birth cohort. Advancements in obstetric and neonatal care may have attenuated the negative consequences associated with being born small. PMID:27994141

Serum eotaxin-1 is increased in extremely-low-birth-weight infants with bronchopulmonary dysplasia or death.

PubMed

Kandasamy, Jegen; Roane, Claire; Szalai, Alexander; Ambalavanan, Namasivayam

2015-11-01

Early systemic inflammation in extremely-low-birth-weight (ELBW) infants is associated with an increased risk of bronchopulmonary dysplasia (BPD). Our objective was to identify circulating biomarkers and develop prediction models for BPD/death soon after birth. Blood samples from postnatal day 1 were analyzed for C-reactive protein (CRP) by enzyme-linked immunosorbent assay and for 39 cytokines/chemokines by a multiplex assay in 152 ELBW infants. The primary outcome was physiologic BPD or death by 36 wk. CRP, cytokines, and clinical variables available at ≤24 h were used for forward stepwise regression and Classification and Regression Tree (CART) analysis to identify predictors of BPD/death. Overall, 24% developed BPD and 35% died or developed BPD. Regression analysis identified birth weight and eotaxin (CCL11) as the two most significant variables. CART identified FiO2 at 24 h (11% BPD/death if FiO2 ≤28%, 49% if >28%) and eotaxin in infants with FiO2 > 28% (29% BPD/death if eotaxin was ≤84 pg/ml; 65% if >84) as variables most associated with outcome. Eotaxin measured on the day of birth is useful for identifying ELBW infants at risk of BPD/death. Further investigation is required to determine if eotaxin is involved in lung injury and pathogenesis of BPD.

Visual Perception and Visual-Motor Integration in Very Preterm and/or Very Low Birth Weight Children: A Meta-Analysis

ERIC Educational Resources Information Center

Geldof, C. J. A.; van Wassenaer, A. G.; de Kieviet, J. F.; Kok, J. H.; Oosterlaan, J.

2012-01-01

A range of neurobehavioral impairments, including impaired visual perception and visual-motor integration, are found in very preterm born children, but reported findings show great variability. We aimed to aggregate the existing literature using meta-analysis, in order to provide robust estimates of the effect of very preterm birth on visual…

Cognition and behavioural development in early childhood: the role of birth weight and postnatal growth.

PubMed

Huang, Cheng; Martorell, Reynaldo; Ren, Aiguo; Li, Zhiwen

2013-02-01

We evaluate the relative importance of birth weight and postnatal growth for cognition and behavioural development in 8389 Chinese children, 4-7 years of age. Method Weight was the only size measure available at birth. Weight, height, head circumference and intelligence quotient (IQ) were measured between 4 and 7 years of age. Z-scores of birth weight and postnatal conditional weight gain to 4-7 years, as well as height and head circumference at 4-7 years of age, were the exposure variables. Z-scores of weight at 4-7 years were regressed on birth weight Z-scores, and the residual was used as the measure of postnatal conditional weight gain. The outcomes were child's IQ, measured by the Chinese Wechsler Young Children Scale of Intelligence, as well as internalizing behavioural problems, externalizing behavioural problems and other behavioural problems, evaluated by the Child Behavior Checklist 4-18. Multivariate regressions were conducted to investigate the relationship of birth weight and postnatal growth variables with the outcomes, separately for preterm children and term children. Both birth weight and postnatal weight gain were associated with IQ among term children; 1 unit increment in Z-score of birth weight (∼450 g) was associated with an increase of 1.60 [Confidence interval (CI): 1.18-2.02; P < 0.001] points in IQ, and 1 unit increment in conditional postnatal weight was associated with an increase of 0.46 (CI: 0.06-0.86; P = 0.02) points in IQ, after adjustment for confounders; similar patterns were observed when Z-scores of postnatal height and head circumference at age 4-7 years were used as alternative measurements of postnatal growth. Effect sizes of relationships with IQ were smaller than 0.1 of a standard deviation in all cases. Neither birth weight nor postnatal growth indicators were associated with behavioural outcomes among term children. In preterm children, neither birth weight nor postnatal growth measures were associated with IQ or behavioural outcomes. Both birth weight and postnatal growth were associated with IQ but not behavioural outcomes for Chinese term children aged 4-7 years, but the effect sizes were small. No relation between either birth weight or postnatal growth and cognition or behavioural outcomes was observed among preterm children aged 4-7 years.

Influence of maternal age, birth-to-conception intervals and prior perinatal factors on perinatal outcomes.

PubMed

Farahati, M; Bozorgi, N; Luke, B

1993-10-01

This study evaluated the influence of prior perinatal factors on birth weight, length of gestation, and maternal pregravid and postpartum weights in subsequent pregnancies. The study sample included 47 women each with first, second and third pregnancies. Mean pregravid weight increased by 5.2 lb between the first and second pregnancies and by 4.4 lb between the second and third pregnancies. Total weight gain averaged 31 lb for the first pregnancy and 28.4 and 28.3 lb for the second and third pregnancies, respectively. Mean birth weight increased by 111 g between the first and second pregnancies and by 199 g between the second and third pregnancies. Mean gestational age was similar for all three pregnancies, averaging 39.5 weeks. Using stepwise forward multiple regression analyses, we determined that birth weight and length of gestation are both influenced significantly by prior birth weight and length of gestation; subsequent pregravid weight is influenced significantly by prior rate of gain, pregravid weight and postpartum weight; and postpartum weight is significantly influenced by prior rate of gain and birth weight. Comparisons across three pregnancies for the same woman showed that differences in birth-to-conception interval were not associated with higher postpartum weight or subsequent pregravid weight. These data indicate that in healthy, nonsmoking, low-risk women, the maternal and infant outcomes of pregnancies are significantly influenced by prior outcomes but not by either short birth-to-conception interval or greater maternal age.

Postdischarge growth assessment in very low birth weight infants.

PubMed

Park, Joon-Sik; Han, Jungho; Shin, Jeong Eun; Lee, Soon Min; Eun, Ho Seon; Park, Min-Soo; Park, Kook-In; Namgung, Ran

2017-03-01

The goal of nutritional support for very-low-birth-weight (VLBW) infants from birth to term is to match the in utero growth rates; however, this is rarely achieved. We evaluated postdischarge growth patterns and growth failure in 81 Korean VLBW infants through a retrospective study. Weight and height were measured and calculated based on age percentile distribution every 3 months until age 24 months. Growth failure was defined as weight and height below the 10th percentile at 24 months. For the subgroup analysis, small-for-gestational age (SGA) and extremely low birth weight (ELBW) infants were evaluated. The growth patterns based on the Korean, World Health Organization (WHO), or Centers for Disease Control and Prevention (CDC) standard were serially compared over time. At postconception age (PCA) 40 weeks, 47 (58%) and 45 infants (55%) showed growth failure in terms of weight and height, respectively. At PCA 24 months, 20 infants (24%) showed growth failure for weight and 14 (18%) for height. Growth failure rates were higher for the SGA infants than for the appropriate-weight-for-gestational age infants at PCA 24 months ( P =0.045 for weight and P =0.038 for height). Growth failure rates were higher for the ELBW infants than for the non-ELBW infants at PCA 24 months ( P <0.001 for weight and P =0.003 for height). Significant differences were found among the WHO, CDC, and Korean standards ( P <0.001). Advancements in neonatal care have improved the catch-up growth of VLBW infants, but this is insufficient. Careful observation and aggressive interventions, especially in SGA and ELBW infants, are needed.

Hepatitis B vaccination of premature infants: a reassessment of current recommendations for delayed immunization.

PubMed

Losonsky, G A; Wasserman, S S; Stephens, I; Mahoney, F; Armstrong, P; Gumpper, K; Dulkerian, S; West, D J; Gewolb, I H

1999-02-01

Current American Academy of Pediatrics and United States Public Health Service Immunization Practices Advisory Committee recommendations for hepatitis B immunization in premature infants weighing <2 kg at birth born to hepatitis B surface antigen (HBSAg)-negative mothers are to delay the initiation of vaccination until such infants reach 2 kg or until 2 months of age. This proposal to delay vaccination at birth in these low-risk infants was based on limited studies not conducted in the United States. We sought to reassess current recommendations to delay administration of hepatitis B vaccine in low-risk premature infants by determining the immunogenicity of early hepatitis B vaccination in a US population and identifying variables associated with poor immunogenicity. A total of 148 infants <37 weeks' gestation born to mothers negative for HBSAg were recruited at birth and stratified to three birth weight groups: <1000 g, 1000 to 1500 g, and >1500 g. Recombinant hepatitis B vaccine was administered within the first week of life, at 1 to 2 months of age, and at 6 to 7 months of age. Serum obtained at birth and after the second and third doses of vaccine was tested for antibody to HBSAg. Variables associated with poor response were sought prospectively by collecting demographic and clinical data. A total of 118 subjects (83%) completed the study. Postsecond dose sera were available for 117 infants and postthird dose sera were available for 112 infants. The seroprotection rate (attaining >/=10 mIU/mL HBS antibody) after two doses was low (25%) regardless of birth weight; infants weighing <1000 g at birth had the poorest response (11%). The seroprotection response rate after three doses of vaccine increased with birth weight; infants weighing 1500 g at birth (group 3; 84% response rate). The seroprotection response rate of group 3 infants after three doses of vaccine, although low, could not be differentiated from the response rates reported for full-term infants using 95% confidence intervals. Of all infants who did not achieve protective levels of antibody after three doses of vaccine, 96% (26/27) weighed <1700 g at birth. The geometric mean HBS antibody levels in responders were 88 and 386 mIU/mL after two and three doses, respectively. Of 36 children with a birth weight >1500 g, 33 (91%) achieved levels of HBS antibody >100 mIU/mL after three doses of vaccine, compared with 25/35 (71%) of infants with birth weight <1500 g. Using logistic regression analysis, nonresponders were more likely than were responders to have been treated with steroids (26% vs 9%) and to have had a low birth weight (1037 g vs 1455 g). In addition, the seroresponse rate of black infants was more likely than that of white infants to be associated with poor weight gain (falling off 2 percentile ranks in weight) in the first 6 months of life: 22% of black and 60% of white children who failed to gain weight adequately responded to vaccination, compared with 92% of black and 70% of white children who were growing adequately. Of interest, the only infant with a birth weight of >1700 g who did not make protective levels of specific antibody after three doses of vaccine was 2300 g at birth, but had inadequate weight gain in the first 6 months of life. This study supports current recommendations of the American Academy of Pediatrics and the Centers for Disease Control and Prevention for delaying the initiation of hepatitis B immunization beyond the first week of life for premature infants at low risk for hepatitis B infection, particularly in newborns weighing <1700 g at birth. In addition, we have identified variables other than birth weight that were associated with an inadequate immune response to early hepatitis B vaccination in premature infants, such as poor weight gain in the first 6 months of life

Birth weight predicts the risk of gestational diabetes mellitus and pregravid obesity.

PubMed

Ogonowski, Jarosław; Miazgowski, Tomasz; Engel, Karina; Celewicz, Zbigniew

2014-01-01

It has been suggested that birth weight may determine metabolic abnormalities later in life. The aim of the current study was to assess the association between birth weight and future risk of gestational diabetes mellitus (GDM) and pregravid obesity in a homogenous sample of Caucasian Polish women. In this retrospective study, we collected the medical reports of 787 women with GDM and 801 healthy pregnant women. We analyzed the following data: birth weight, age, pregravid weight, prior GDM, prior macrosomia, parity, and family history of diabetes. Birth weight was inversely associated with the risk of GDM; for each decrease in birth weight of 500 g, the risk increased by 11% (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.02-1.21). Birth weight was a strong predictor of GDM independent of other risk factors (OR, 1.19; 95% CI, 1.09-1.31), and it was positively correlated with pregravid weight (R = 0.21; P < 0.00001). An increase in birth weight of 500 g substantially increased the risk of overweight and obesity (OR, 1.17; 95% CI, 1.01-1.34 and OR, 1.35; 95% CI 1.11-1.64, respectively). Each of the traditional risk factors for GDM were also strong predictors of pregravid obesity: age (P < 0.0001), prior GDM (P < 0.01), prior macrosomia (P < 0.0001), multiparity (P < 0.0001), and maternal (but not paternal) history of diabetes (P < 0.0001). Among Caucasian Polish women, the risk of GDM is associated with low birth weight, and pregravid obesity is associated with high birth weight. Traditional risk factors for GDM, including maternal (but not paternal) history of diabetes, are also risk factors for pregravid obesity. Copyright © 2014 Elsevier Inc. All rights reserved.

Path analysis of risk factors leading to premature birth.

PubMed

Fields, S J; Livshits, G; Sirotta, L; Merlob, P

1996-01-01

The present study tested whether various sociodemographic, anthropometric, behavioral, and medical/physiological factors act in a direct or indirect manner on the risk of prematurity using path analysis on a sample of Israeli births. The path model shows that medical complications, primarily toxemia, chorioammionitis, and a previous low birth weight delivery directly and significantly act on the risk of prematurity as do low maternal pregnancy weight gain and ethnicity. Other medical complications, including chronic hypertension, preclampsia, and placental abruption, although significantly correlated with prematurity, act indirectly on prematurity through toxemia. The model further shows that the commonly accepted sociodemographic, anthropometric, and behavioral risk factors act by modifying the development of medical complications that lead to prematurity as opposed to having a direct effect on premature delivery. © 1996 Wiley-Liss, Inc. Copyright © 1996 Wiley-Liss, Inc.

Body size at birth and same-sex marriage in young adulthood.

PubMed

Frisch, Morten; Zdravkovic, Slobodan

2010-02-01

An unexplained excess of overweight has been reported among lesbians. In contrast, reports suggest that gay men may be, on average, slightly lighter and shorter than heterosexual men. We studied associations between weight, length, and body mass index (BMI) at birth and same-sex marriage in young adulthood among 818,671 Danes. We used linear regression to calculate differences in mean body measures at birth and Poisson regression analysis to calculate confounder-adjusted incidence rate ratios (IRR) of same-sex marriage according to body measures at birth. Overall, 739 persons entered same-sex marriage at age 18-32 years during 5.6 million person-years of follow-up. Birth year-adjusted mean body measures at birth were similar for same-sex married and other women. However, same-sex marriage rates were 65% higher among women of heavy birth weight (IRR = 1.65; 95% CI = 1.18-2.31, for > or =4000 vs. 3000-3499 g, p = .02), and rates were inversely associated with birth length (p (trend) = .04). For same-sex married men, birth year-adjusted mean weight (-72 g, p = .03), length (-0.3 cm, p = .04), and BMI (-0.1 kg/m(2), p = .09) at birth were lower than for other Danish men. Same-sex marriage rates were increased in men of short birth length (IRR = 1.45; 95% CI = 1.01-2.08, for < or =50 vs. 51-52 cm), although not uniformly so (p (trend) = .16). Our population-based findings suggest that overweight in lesbians may be partly rooted in constitutional factors. Novel findings of smaller average body measures at birth in same-sex marrying men need replication. Factors affecting intrauterine growth may somehow influence sexual and partner-related choices in adulthood.

Effects of birth weight and growth on childhood wheezing disorders: findings from the Born in Bradford Cohort.

PubMed

Mebrahtu, Teumzghi F; Feltbower, Richard G; Parslow, Roger C

2015-11-26

To examine the effects of birth weight and childhood growth on childhood wheezing disorders. We hypothesised that low birth weight and fast growth during early age would increase the risk of wheezing disorders. Observational secondary analysis of data from the Born in Bradford cohort. All children who were born at the Bradford Royal Infirmary hospital between March 2007 and December 2010 were eligible for the study. A total of 13,734 and 1598 children participated in the analyses of the effects of birth weight and growth on wheezing disorders, respectively. Wheezing disorders diagnosis (diagnosed as asthma or had wheezing symptom) during the ages of 0-7 years were the primary outcome measures. Diagnosis of asthma and occurrence of wheezing during the same period were secondary outcome measures. Birth weight was classified as normal (2.5-4.0 kg), low (<2.5 kg) and high (>4.0 kg). Growth mixture models were used to drive growth pattern outcomes which were classified as 'normal', 'fast' and 'slow' growth based on their velocities between birth and 36 months. The adjusted relative risks (RRs) of wheezing disorders diagnosis for the low and high birthweight children were 1.29 (95% CI 1.12 to 1.50; p=0.001) and 0.91 (95% CI 0.79 to 1.04; p=0.17), respectively. The adjusted RRs of wheezing disorders diagnosis were 1.30 (95% CI 0.56 to 3.06; p=0.54) and 0.60 (95% CI 0.16 to 2.18; p=0.44), respectively, for the 'fast' and 'slow' growth as compared with the 'normal' growth. Low birth weight is associated with an increased risk of wheezing disorders; however, there is a weak evidence that suggests high birthweight children have a reduced risk in this birth cohort. Low birth weight coupled with a slower growth until 3 months and a sharp growth between 3 and 12 months has an increased risk of wheezing disorders diagnosis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Better Diet Quality during Pregnancy Is Associated with a Reduced Likelihood of an Infant Born Small for Gestational Age: An Analysis of the Prospective New Hampshire Birth Cohort Study.

PubMed

Emond, Jennifer A; Karagas, Margaret R; Baker, Emily R; Gilbert-Diamond, Diane

2018-01-01

Birth weight has a U-shaped relation with chronic disease. Diet quality during pregnancy may impact fetal growth and infant birth weight, yet findings are inconclusive. We examined the relation between maternal diet quality during pregnancy and infant birth size among women enrolled in a prospective birth cohort. Women 18-45 y old with a singleton pregnancy were recruited at 24-28 wk of gestation from prenatal clinics in New Hampshire. Women completed a validated food frequency questionnaire at enrollment. Diet quality was computed as adherence to the Alternative Healthy Eating Index. Infant birth outcomes (sex, head circumference, weight, and length) were extracted from medical records. Weight-for-length z scores, low birth weight, macrosomia, and size for gestational age [small for gestational age (SGA) or large for gestational age (LGA)] were computed. Multivariable regression models fit each outcome on quartiles of diet quality, adjusted for covariates. Models were computed overall and stratified by smoking status. Analyses included 862 women and infants with complete data. Lower diet quality was associated with lower maternal education, being a smoker, prepregnancy obesity status, and lack of exercise during pregnancy. Overall, 3.4% of infants were born with a low birth weight, 12.1% with macrosomia, 4.6% were SGA, and 8.7% were LGA. In an adjusted model, increased diet quality appeared linearly associated with a reduced likelihood of SGA (P-trend = 0.03), although each quartile comparison did not reach statistical significance. Specifically, ORs for SGA were 0.89 (95% CI: 0.37, 2.15), 0.73 (95% CI: 0.28, 1.89), and 0.35 (95% CI: 0.11, 1.08) for each increasing quartile of diet quality compared to the lowest quartile. Similar trends for SGA were observed among non-smokers (n = 756; P-trend = 0.07). Also among non-smokers, increased diet quality was associated with lower infant birth weight (P-trend = 0.03) and a suggested reduction in macrosomia (P-trend = 0.07). Increased diet quality during pregnancy was related to a reduced risk of SGA in this cohort of pregnant women from New Hampshire. Additional studies are needed to elucidate the relation between maternal diet quality and macrosomia. © 2018 American Society for Nutrition. All rights reserved.

Servo-control for maintaining abdominal skin temperature at 36C in low birth weight infants.

PubMed

Sinclair, J C

2002-01-01

Randomized trials have shown that the neonatal mortality rate of low birth-weight babies can be reduced by keeping them warm. For low birth-weight babies nursed in incubators, warm conditions may be achieved either by heating the air to a desired temperature, or by servo-controlling the baby's body temperature at a desired set-point. In low birth weight infants, to determine the effect on death and other important clinical outcomes of targeting body temperature rather than air temperature as the end-point of control of incubator heating. Standard search strategy of the Cochrane Neonatal Review Group. Searches were made of the Cochrane Controlled Trials Register (CCTR) (Cochrane Library, Issue 4, 2001) and MEDLINE, 1966 to November 2001. Randomized or quasi-randomized trials which test the effects of having the heat output of the incubator servo-controlled from body temperature compared with setting a constant incubator air temperature. Trial methodologic quality was systematically assessed. Outcome measures included death, timing of death, cause of death, and other clinical outcomes. Categorical outcomes were analyzed using relative risk and risk difference. Meta-analysis assumed a fixed effect model. Two eligible trials were found. In total, they included 283 babies and 112 deaths. Compared to setting a constant incubator air temperature of 31.8C, servo-control of abdominal skin temperature at 36C reduces the neonatal death rate among low birth weight infants: relative risk 0.72 (95% CI 0.54, 0.97); risk difference -12.7% (95% CI -1.6, -23.9). This effect is even greater among VLBW infants. During at least the first week after birth, low birth weight babies should be provided with a carefully regulated thermal environment that is near the thermoneutral point. For LBW babies in incubators, this can be achieved by adjusting incubator temperature to maintain an anterior abdominal skin temperature of at least 36C, using either servo-control or frequent manual adjustment of incubator air temperature.

Possible role of birth weight on general and central obesity in Chinese children and adolescents: a cross-sectional study.

PubMed

Yuan, Zhe-Pin; Yang, Min; Liang, Li; Fu, Jun-Fen; Xiong, Feng; Liu, Ge-Li; Gong, Chun-Xiu; Luo, Fei-Hong; Chen, Shao-Ke; Zhang, Dan-Dan; Zhang, Shuai; Zhu, Yi-Min

2015-10-01

According to the developmental origins of health and disease theory, fetal nutrition is associated with obesity and chronic diseases in children and adults. However, previous findings regarding the association between birth weight and childhood obesity have been inconsistent. The aim of the present study was to investigate the relationship between birth weight and childhood obesity in China. The 16,580 subjects (8477 boys and 8103 girls) aged 7-17 years, who participated in this study were recruited from a cross-sectional study in six cities in China. Epidemiological data, including birth information, were collected through face-to-face interviews, and anthropometric indices were measured by trained physicians. Overweight and obese cases were defined using sex-specific and age-specific 85th and 95th percentile body mass index (BMI) cutoffs for Han children and adolescents. Central obesity was defined using sex-specific waist-to-height ratio (WHtR) cutoffs (WHtR ≥0.48 in boys and WHtR ≥0.46 for girls). The overall rate of overweight status and obesity was 20.3% in the Chinese children and adolescents and that of central obesity was 18.9%. Subjects were stratified into eight groups according to weight at birth. J-shaped relationships were observed between birth weight and BMI for age Z-score and WHtR. After adjusting for confounders such as gender, gestational age, parental factors, and dietary factors, the risk of overweight and obese status was still higher in the children with higher birth weights than in children with birth weights of 3000-3499 g (3500-3999 g: odds ratio [OR] = 1.14, 95% confidence interval [CI] = 1.02-1.28; 4000-4499 g: OR = 1.39, 95% CI = 1.19-1.63; and 4500-4999 g: OR = 1.36, 95% CI = 1.06-1.76). Moderately high birth weight also increased the risk of central obesity. Relative to the children with normal birth weights (3000-3499 g), the adjusted OR and 95% CI were 1.33 (1.13-1.56) in children with birth weights of 4000-4499 g. Children with very low birth weight (lower than 1500 g) had the highest risk of central obesity. The adjusted OR was 2.30 (95% CI: 1.03-5.14) relative to children with birth weights of 3000-3499 g. Birth weight was associated with obesity in Chinese children and adolescents. J-shaped relationships were observed between birth weight and BMI and WHtR in childhood, and very low birth weight was associated with a mild increase in the risk of central obesity in Chinese children and adolescents. Copyright © 2015 Elsevier Inc. All rights reserved.

Does Low Birth Weight Share Common Genetic or Environmental Risk with Childhood Disruptive Disorders?

PubMed Central

Ficks, Courtney A.; Lahey, Benjamin B.; Waldman, Irwin D.

2015-01-01

Although advances in neonatal care over the past century have resulted in increased rates of survival among at-risk births, including infants with low birth weight, we have much to learn about the psychological outcomes in this population. In particular, although it appears that there is growing evidence that low birth weight may be associated with an increased risk for Attention-Deficit/Hyperactive Disorder (ADHD) symptoms in childhood, few studies have examined birth weight as a risk factor for disruptive disorders that commonly co-occur with ADHD [e.g. Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD)]. In addition, the etiology of the relation between birth weight and these disorders is unknown. The current investigation aimed to better understand the putative role of birth weight in disruptive behavior disorders in the context of potentially confounding genetic and environmental influences by examining phenotypic associations between birth weight and disruptive disorder symptoms across families (using generalized linear models with generalized estimating equations) as well as within families (using linear regression) in two independent twin samples (Sample 1: N = 1676 individuals; Sample 2: N = 4038 individuals). We found negative associations between birth weight and several childhood disruptive disorder symptom dimensions, including inattentive, hyperactive-impulsive, and broad externalizing symptoms in both samples. Nonetheless, the overall magnitude of these associations was very small, contributing to less than 1% of the variance in these symptom dimensions. Within-family associations between birth weight and disruptive disorder symptoms did not differ for monozygotic and dizygotic twin pairs, suggesting that nonshared environmental influences rather than common genetic influences are responsible for these associations. These consistent albeit weak associations between birth weight and disruptive disorder symptoms suggest that, at least in the general population, low birth weight does not represent a major risk factor in the development of these symptoms. PMID:23834065

Social stressors and strengths as predictors of infant birth weight in low-income African American women.

PubMed

Dailey, Dawn E

2009-01-01

Perinatal racial disparities remain an elusive problem in the United States. African American women experience the highest rate of low-birth-weight deliveries. Understanding the factors contributing to infant birth weight is crucial to unraveling existing perinatal racial disparities. The aim of this study was to broaden knowledge of predictors of infant birth weight in African American people by examining stress and resource factors not explored routinely in perinatal research along with other known correlates of birth weight. A total of 119 pregnant African American women participated in this prospective study. Social stressors included discrimination and trauma exposure. Personal resources included spirituality and social support. Data on socioeconomic status, health behaviors, and medical conditions were collected. On average, the infants weighed 3,194 +/- 660 g at birth. Overall, 14% were born with birth weights less than 2,500 g. Tobacco use, number of prenatal visits, and discrimination due to age and physical disability were significant predictors of infant birth weight (R2 = .25; p >or= .001). Factors such as spirituality and social support were not associated with birth weight. Other variables traditionally associated with birth weight did not contribute to the model in this sample. These findings provide further evidence that tobacco use, number of prenatal visits, and discrimination adversely affects birth outcomes. By continuing to explore the social and personal experiences of African American women, important insights can be gained on factors that contribute to the pervasive racial disparities in perinatal health and contribute to interventions to improve the quality of healthcare for all women.

Effects of transplacental exposure to environmental pollutants on birth outcomes in a multiethnic population.

PubMed Central

Perera, Frederica P; Rauh, Virginia; Tsai, Wei-Yann; Kinney, Patrick; Camann, David; Barr, Dana; Bernert, Tom; Garfinkel, Robin; Tu, Yi-Hsuan; Diaz, Diurka; Dietrich, Jessica; Whyatt, Robin M

2003-01-01

Inner-city, minority populations are high-risk groups for adverse birth outcomes and also are more likely to be exposed to environmental contaminants, including environmental tobacco smoke (ETS), polycyclic aromatic hydrocarbons (PAHs), and pesticides. In a sample of 263 nonsmoking African-American and Dominican women, we evaluated the effects on birth outcomes of prenatal exposure to airborne PAHs monitored during pregnancy by personal air sampling, along with ETS estimated by plasma cotinine, and an organophosphate pesticide (OP) estimated by plasma chlorpyrifos (CPF). Plasma CPF was used as a covariate because it was the most often detected in plasma and was highly correlated with other pesticides frequently detected in plasma. Among African Americans, high prenatal exposure to PAHs was associated with lower birth weight (p = 0.003) and smaller head circumference (p = 0.01) after adjusting for potential confounders. CPF was associated with decreased birth weight and birth length overall (p = 0.01 and p = 0.003, respectively) and with lower birth weight among African Americans (p = 0.04) and reduced birth length in Dominicans (p < 0.001), and was therefore included as a covariate in the model with PAH. After controlling for CPF, relationships between PAHs and birth outcomes were essentially unchanged. In this analysis, PAHs and CPF appear to be significant independent determinants of birth outcomes. Further analyses of pesticides will be carried out. Possible explanations of the failure to find a significant effect of PAHs in the Hispanic subsample are discussed. This study provides evidence that environmental pollutants at levels currently encountered in New York City adversely affect fetal development. PMID:12573906

Association of prenatal lipid-based nutritional supplementation with fetal growth in rural Gambia.

PubMed

Johnson, William; Darboe, Momodou K; Sosseh, Fatou; Nshe, Patrick; Prentice, Andrew M; Moore, Sophie E

2017-04-01

Prenatal supplementation with protein-energy (PE) and/or multiple-micronutrients (MMNs) may improve fetal growth, but trials of lipid-based nutritional supplements (LNSs) have reported inconsistent results. We conducted a post-hoc analysis of non-primary outcomes in a trial in Gambia, with the aim to test the associations of LNS with fetal growth and explore how efficacy varies depending on nutritional status. The sample comprised 620 pregnant women in an individually randomized, partially blinded trial with four arms: (a) iron and folic acid (FeFol) tablet (usual care, referent group), (b) MMN tablet, (c) PE LNS, and (d) PE + MMN LNS. Analysis of variance examined unadjusted differences in fetal biometry z-scores at 20 and 30 weeks and neonatal anthropometry z-scores, while regression tested for modification of intervention-outcome associations by season and maternal height, body mass index, and weight gain. Despite evidence of between-arm differences in some fetal biometry, z-scores at birth were not greater in the intervention arms than the FeFol arm (e.g., birth weight z-scores: FeFol -0.71, MMN -0.63, PE -0.64, PE + MMN -0.62; group-wise p = .796). In regression analyses, intervention associations with birth weight and head circumference were modified by maternal weight gain between booking and 30 weeks gestation (e.g., PE + MMN associations with birth weight were +0.462 z-scores (95% CI [0.097, 0.826]) in the highest quartile of weight gain but -0.099 z-scores (-0.459, 0.260) in the lowest). In conclusion, we found no strong evidence that a prenatal LNS intervention was associated with better fetal growth in the whole sample. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

Inattention and development of toddlers born in preterm and with low birth weight.

PubMed

Huang, June-Hui; Huang, Huei-Lin; Chen, Hsiu-Lin; Lin, Lung-Chang; Tseng, Hsing-I; Kao, Tsung-Jen

2012-07-01

The objective of this study was to examine the impact of low birth weight and preterm birth on a toddler's inattention and development, including cognitive, language, motor, social-emotional and adaptive behaviors. A total of 105 toddlers enrolled for the study; they were divided into four groups: 40 full-term and normal birth weight (NBW, birth weight greater than 2500 g) toddlers, 24 moderate birth weight (MLBW, birth weight between 2499 and 1500 g) toddlers, 20 very to extremely low birth weight (V-ELBW, 12 between 1000 and 1499 g and 8 lower than 1000 g) toddlers, and 21 term toddlers who were recruited from a clinic of developmental delay as the developmental delay at risk (DDR) group. The Bayley Scales of Infant and Toddler Development-Third Edition (BSID-III) and Disruptive Behavior Rating Scale-Toddler were used. The findings were as follows: (1) DDR group performed worst in BSID-III; (2) although there were no statistical differences among the NBW, MLBW, and V-ELBW groups in BSID-III, the lower the birth weight, the lower the average performance, especially in language, adaptive social behavior, and adaptive practical behavior; and (3) comparing the inattention score, the DDR group was the poorest, normal and V-ELBW groups were the best, and MLBW group was in the middle. In conclusion, low birth weight and preterm delivery affected children's inattention and development of language, adaptive social behavior, and adaptive practical behavior. Copyright © 2012. Published by Elsevier B.V.

Sports and leisure-time physical activity in pregnancy and birth weight: a population-based study.

PubMed

Hegaard, H K; Petersson, K; Hedegaard, M; Ottesen, B; Dykes, A K; Henriksen, T B; Damm, P

2010-02-01

We examined the association between sports and other leisure-time physical activities during pregnancy and birth weight of babies born after 37 completed weeks of gestation. All Danish-speaking pregnant women attending routine antenatal care at the Department of Obstetrics, Aarhus University Hospital, Denmark, from August 1989 to September 1991 were invited to participate in the study. A total of 4458 healthy women who delivered after 37 completed gestational weeks participated in this study. The associations between sports (0, 1-2, 3+ h/week) or leisure-time physical activity (sedentary, light, and moderate to heavy) and birth weight were examined by linear and logistic regression and adjusted for potential confounding factors such as smoking, parity, schooling, pre-pregnancy body mass index and gestational age. The results showed that pregnant women who practiced sports or were moderate to heavy leisure-time physical active during the early second or the early third trimester gave birth to infants with a similar birth weight as inactive women. The proportion of newborns with a low (<2500 g) or a high birth weight (>/=4500 g) was also unchanged. In conclusion, in this large population-based study, we found no association between sports and leisure-time physical activity and low-birth weight, high-birth weight, or average-birth weight.

Risk factors for low birth weight according to the multiple logistic regression model. A retrospective cohort study in José María Morelos municipality, Quintana Roo, Mexico.

PubMed

Franco Monsreal, José; Tun Cobos, Miriam Del Ruby; Hernández Gómez, José Ricardo; Serralta Peraza, Lidia Esther Del Socorro

2018-01-17

Low birth weight has been an enigma for science over time. There have been many researches on its causes and its effects. Low birth weight is an indicator that predicts the probability of a child surviving. In fact, there is an exponential relationship between weight deficit, gestational age, and perinatal mortality. Multiple logistic regression is one of the most expressive and versatile statistical instruments available for the analysis of data in both clinical and epidemiology settings, as well as in public health. To assess in a multivariate fashion the importance of 17 independent variables in low birth weight (dependent variable) of children born in the Mayan municipality of José María Morelos, Quintana Roo, Mexico. Analytical observational epidemiological cohort study with retrospective temporality. Births that met the inclusion criteria occurred in the "Hospital Integral Jose Maria Morelos" of the Ministry of Health corresponding to the Maya municipality of Jose Maria Morelos during the period from August 1, 2014 to July 31, 2015. The total number of newborns recorded was 1,147; 84 of which (7.32%) had low birth weight. To estimate the independent association between the explanatory variables (potential risk factors) and the response variable, a multiple logistic regression analysis was performed using the IBM SPSS Statistics 22 software. In ascending numerical order values of odds ratio > 1 indicated the positive contribution of explanatory variables or possible risk factors: "unmarried" marital status (1.076, 95% confidence interval: 0.550 to 2.104); age at menarche ≤ 12 years (1.08, 95% confidence interval: 0.64 to 1.84); history of abortion(s) (1.14, 95% confidence interval: 0.44 to 2.93); maternal weight < 50 kg (1.51, 95% confidence interval: 0.83 to 2.76); number of prenatal consultations ≤ 5 (1.86, 95% confidence interval: 0.94 to 3.66); maternal age ≥ 36 years (3.5, 95% confidence interval: 0.40 to 30.47); maternal age ≤ 19 years (3.59, 95% confidence interval: 0.43 to 29.87); number of deliveries = 1 (3.86, 95% confidence interval: 0.33 to 44.85); personal pathological history (4.78, 95% confidence interval: 2.16 to 10.59); pathological obstetric history (5.01, 95% confidence interval: 1.66 to 15.18); maternal height < 150 cm (5.16, 95% confidence interval: 3.08 to 8.65); number of births ≥ 5 (5.99, 95% confidence interval: 0.51 to 69.99); and smoking (15.63, 95% confidence interval: 1.07 to 227.97). Four of the independent variables (personal pathological history, obstetric pathological history, maternal stature <150 centimeters and smoking) showed a significant positive contribution, thus they can be considered as clear risk factors for low birth weight. The use of the logistic regression model in the Mayan municipality of José María Morelos, will allow estimating the probability of low birth weight for each pregnant woman in the future, which will be useful for the health authorities of the region.

Chest circumference and birth weight are good predictors of lung function in preschool children from an e-waste recycling area.

PubMed

Zeng, Xiang; Xu, Xijin; Zhang, Yuling; Li, Weiqiu; Huo, Xia

2017-10-01

The purpose of this study was to investigate the associations between birth weight, chest circumference, and lung function in preschool children from e-waste exposure area. A total of 206 preschool children from Guiyu (an e-waste recycling area) and Haojiang and Xiashan (the reference areas) in China were recruited and required to undergo physical examination, blood tests, and lung function tests during the study period. Birth outcome such as birth weight and birth height were obtained by questionnaire. Children living in the e-waste-exposed area have a lower birth weight, chest circumference, height, and lung function when compare to their peers from the reference areas (all p value <0.05). Both Spearman and partial correlation analyses showed that birth weight and chest circumference were positively correlated with lung function levels including forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV 1 ). After adjustment for the potential confounders in further linear regression analyses, birth weight, and chest circumference were positively associated with lung function levels, respectively. Taken together, birth weight and chest circumference may be good predictors for lung function levels in preschool children.

Using the effects of maternal nutritional indicators (hemoglobin and total protein) on baby's birth weight outcome to forecast a paradigm shift toward increased levels of non-communicable diseases in children.

PubMed

Ahmadu, Baba Usman; Yakubu, Nyandaiti; Yusuph, Haruna; Alfred, Marshall; Bazza, Buba; Lamurde, Abdullahi Suleiman

2013-01-01

Maternal malnutrition can lead to low birth weight in babies, which puts them at risk of developing non-communicable diseases later in life. Evidence from developed countries has shown that low birth weight is associated with a predisposition to higher rates of non-communicable diseases later in life. However, information on this is lacking in developing countries. Thus, this work studied the effects of maternal nutritional indicators (hemoglobin and total protein) on birth weight outcome of babies to forecast a paradigm shift toward increased levels of non-communicable diseases in children. Mother-baby pairs were enrolled in this study using systematic random sampling. Maternal haemogblobin and total proteins were measured using micro-hematocrit and biuret methods, and birth weights of their babies were estimated using the bassinet weighing scale. Of the 168 (100%) babies that participated in this study, 122 (72.6%) were delivered at term and 142 (84.5%) had normal birth weights. Mean comparison of baby's birth weight and maternal hemoglobin was not significant (P = 0.483), that for maternal total protein was also not significant (P = 0.411). Even though positive correlation coefficients were observed between birth weight of babies, maternal hemoglobin and total proteins, these were however not significant. Maternal nutrition did not contribute significantly to low birth weight in our babies. Therefore, association between maternal nutrition and low birth weight to predict future development of non-communicable diseases in our study group is highly unlikely. However, we recommend further work.

Are children of moderately low birth weight at increased risk for poor health? A new look at an old question.

PubMed

Stein, Ruth E K; Siegel, Michele J; Bauman, Laurie J

2006-07-01

The goal was to examine whether moderately low birth weight children were at greater risk for health problems than normal birth weight children in a nationally representative sample of US children. Data were analyzed for 7817 children, 0 to 12 years of age, from the sample child file of the 2002 National Health Interview Survey. Logistic regressions were estimated to examine whether morbidity rates were higher among moderately low birth weight children than among normal birth weight children and to control for covariates. Health was measured as having a special health care need, having a chronic condition, being hospitalized in the past year, having a learning disability, attention-deficit disorder/attention-deficit/hyperactivity disorder, or other behavioral disorders, having minor health conditions, and having acute illnesses. With control for other confounders, moderately low birth weight children were significantly more likely than normal birth weight children to be identified as having a special health care need, having a chronic condition, having a learning disability, and having attention-deficit disorder or attention-deficit/hyperactivity disorder. They were not more likely to have a hospitalization in the past year, other behavioral disorders, or minor health conditions or acute illnesses. This population-based study of rates of current morbidity shows that moderately low birth weight children born since 1990 are vulnerable to a wide range of health, learning, and behavioral problems, compared with normal birth weight children. This suggests the need for continued focus on ways to reduce morbidity rates for moderately low birth weight children.

Birth weight and non-insulin dependent diabetes: thrifty genotype, thrifty phenotype, or surviving small baby genotype?

PubMed Central

McCance, D. R.; Pettitt, D. J.; Hanson, R. L.; Jacobsson, L. T.; Knowler, W. C.; Bennett, P. H.

1994-01-01

OBJECTIVE--To determine the prevalence of diabetes in relation to birth weight in Pima Indians. DESIGN--Follow up study of infants born during 1940-72 who had undergone a glucose tolerance test at ages 20-39 years. SETTING--Gila River Indian community, Arizona. SUBJECTS--1179 American Indians. MAIN OUTCOME MEASURE--Prevalence of non-insulin dependent diabetes mellitus (plasma glucose concentration > or = 11.1 mmol/l two hours after ingestion of carbohydrate). RESULTS--The prevalence was greatest in those with the lowest and highest birth weights. The age adjusted prevalences for birth weights < 2500 g, 2500-4499 g, and > or = 4500 g were 30%, 17%, and 32%, respectively. When age, sex, body mass index, maternal diabetes during pregnancy, and birth year were controlled for, subjects with birth weights < 2500 g had a higher rate than those with weights 2500-4499 g (odds ratio 3.81; 95% confidence interval 1.70 to 8.52). The risk for subsequent diabetes among higher birthweight infants (> or = 4500 g) was associated with maternal diabetes during pregnancy. Most diabetes, however, occurred in subjects with intermediate birth weights (2500-4500 g). CONCLUSIONS--The relation of the prevalence of diabetes to birth weight in the Pima Indians is U shaped and is related to parental diabetes. Low birth weight is associated with non-insulin dependent diabetes. Given the high mortality of low birthweight infants selective survival in infancy of those genetically predisposed to insulin resistance and diabetes provides an explanation for the observed relation between low birth weight and diabetes and the high prevalence of diabetes in many populations. PMID:8173400

Nutritional status of low birth weight infants in Makkah region: Evaluation of anthropometric and biochemical parameters.

PubMed

Kensara, Osama Adnan; Azzeh, Firas Sultan

2016-04-01

To assess the nutritional status of low birth weight infants from Makkah area immediately after birth. The prospective study was conducted between October and December 2012 at Al-Noor Speciality Hospital, Makkah, Saudi Arabia, and comprised low birth weight infants who were divided into three equal groups according to their birth weight: group A (low birthweight1501-2500gm), group B (very low birthweight1001-1500gm), and group C (extremely low birth weight < 1000gm). Mothers who had delivered low birth weight infants were enrolled. Weight, length, head circumference, complete blood count, and blood tests were performed for all the infants under investigation. There were 300 infants in the study; 100(33.3%) in each of the 3 groups. Group C showed the lowest gestational age, length, and head circumferences (p< 0.05 each). No significant discrepancies were found in complete blood count results among the three groups (p>0.05). Normal serum phosphorus, potassium and magnesium levels and mild hypocalcaemia were observed in all infants. However, hypernatraemia was significantly evident (p< 0.05) for group C. All infants had hyperglycaemia and hyperbilirubinaemia. Albumin content decreased significantly (p< 0.05) as birth weight decreased. Groups B and C infants showed higher serum urea than group A infants (p< 0.05). Low newborn birth weight was related to the deteriorated nutritional status in terms of low anthropometric and abnormal biochemical measures. It was not possible to correlate the birth weight of the neonates to the parameters of the complete blood tests.

Low and High Birth Weights Are Risk Factors for Nonalcoholic Fatty Liver Disease in Children.

PubMed

Newton, Kimberly P; Feldman, Haruna S; Chambers, Christina D; Wilson, Laura; Behling, Cynthia; Clark, Jeanne M; Molleston, Jean P; Chalasani, Naga; Sanyal, Arun J; Fishbein, Mark H; Lavine, Joel E; Schwimmer, Jeffrey B

2017-08-01

To examine the distribution of birth weight in children with nonalcoholic fatty liver disease (NAFLD) compared with the general US population, and to investigate the relationship between birth weight and severity of NAFLD. A multicenter, cross-sectional study of children with biopsy-proven NAFLD enrolled in the Nonalcoholic Steatohepatitis Clinical Research Network Database. Birth weight was categorized as low birth weight (LBW), normal birth weight (NBW), or high birth weight (HBW) and compared with the birth weight distribution in the general US population. The severity of liver histology was assessed by birth weight category. Children with NAFLD (n = 538) had overrepresentation of both LBW and HBW compared with the general US population (LBW, 9.3%; NBW, 75.8%; HBW, 14.9% vs LBW, 6.1%; NBW, 83.5%; HBW 10.5%; P < .0001). Children with HBW had significantly greater odds of having more severe steatosis (OR, 1.82, 95% CI. 1.15-2.88) and nonalcoholic steatohepatitis (OR, 2.03; 95% CI, 1.21-3.40) compared with children with NBW. In addition, children with NAFLD and LBW had significantly greater odds of having advanced fibrosis (OR, 2.23; 95% CI, 1.08-4.62). Birth weight involves maternal and in utero factors that may have long-lasting consequences. Children with both LBW and HBW may be at increased risk for developing NAFLD. Among children with NAFLD, those with LBW or HBW appear to be at increased risk for more severe disease. Copyright © 2017 Elsevier Inc. All rights reserved.

Maternal arsenic exposure and birth outcomes: A comprehensive review of the epidemiologic literature focused on drinking water

PubMed Central

Bloom, Michael S.; Surdu, Simona; Neamtiu, Iulia A.; Gurzau, Eugen S.

2015-01-01

Inorganic arsenic (iAs) is a human toxicant to which populations may be exposed through consumption of geogenically contaminated groundwater. A growing body of experimental literature corroborates the reproductive toxicity of iAs; however, the results of human studies are inconsistent. Therefore, we conducted a comprehensive review of epidemiologic studies focused on drinking water iAs exposure and birth outcomes to assess the evidence for causality and to make recommendations for future study. We reviewed 18 English language papers assessing birth weight, gestational age, and birth size. Thirteen of the studies were conducted among populations with frequent exposure to high-level groundwater iAs contamination (>10 μg/L) and five studies were conducted in areas without recognized contamination. Most studies comprised small samples and used cross-sectional designs, often with ecologic exposure assessment strategies, although several large prospective investigations and studies with individual-level measurements were also reported. We conclude that: 1) the epidemiologic evidence for an increased risk of low birth weight (<2,500 grams) is insufficient, although there exists limited evidence for birth weight decreases; 2) the evidence for increased preterm delivery is insufficient; and, 3) there exists minimal evidence for decreased birth size. In further investigation of birth weight and size, we recommend incorporation of individual susceptibility measures using appropriate biomarkers, with collection timed to windows of vulnerability and speciated arsenic analysis, as well as consideration of populations exposed primarily to drinking water iAs contamination <10 μg/L. Given the large potential public health impact, additional, high quality epidemiologic studies are necessary to more definitively assess the risk. PMID:24713268

Maternal arsenic exposure and birth outcomes: a comprehensive review of the epidemiologic literature focused on drinking water.

PubMed

Bloom, Michael S; Surdu, Simona; Neamtiu, Iulia A; Gurzau, Eugen S

2014-09-01

Inorganic arsenic (iAs) is a human toxicant to which populations may be exposed through consumption of geogenically contaminated groundwater. A growing body of experimental literature corroborates the reproductive toxicity of iAs; however, the results of human studies are inconsistent. Therefore, we conducted a comprehensive review of epidemiologic studies focused on drinking water iAs exposure and birth outcomes to assess the evidence for causality and to make recommendations for future study. We reviewed 18 English language papers assessing birth weight, gestational age, and birth size. Thirteen of the studies were conducted among populations with frequent exposure to high-level groundwater iAs contamination (>10 μg/L) and five studies were conducted in areas without recognized contamination. Most studies comprised small samples and used cross-sectional designs, often with ecologic exposure assessment strategies, although several large prospective investigations and studies with individual-level measurements were also reported. We conclude that: (1) the epidemiologic evidence for an increased risk of low birth weight (<2500 g) is insufficient, although there exists limited evidence for birth weight decreases; (2) the evidence for increased preterm delivery is insufficient; and, (3) there exists minimal evidence for decreased birth size. In further investigation of birth weight and size, we recommend incorporation of individual susceptibility measures using appropriate biomarkers, with collection timed to windows of vulnerability and speciated arsenic analysis, as well as consideration of populations exposed primarily to drinking water iAs contamination <10 μg/L. Given the large potential public health impact, additional, high quality epidemiologic studies are necessary to more definitively assess the risk. Copyright © 2014 Elsevier GmbH. All rights reserved.

Ethnic differences in the relationship between birth weight and type 2 diabetes mellitus in postmenopausal women.

PubMed

Ryckman, K K; Rillamas-Sun, E; Spracklen, C N; Wallace, R B; Garcia, L; Tylavsky, F A; Howard, B V; Liu, S; Song, Y; LeBlanc, E S; White, M V; Parikh, N I; Robinson, J G

2014-11-01

The objective of this study is to examine the relationship between self-reported birth weight and the adult occurrence of type 2 diabetes mellitus in a large multi-ethnic population of women. Baseline data from the Women's Health Initiative Observational Study [n=75,993] was used to examine the association between participant birth weight category and prevalent type 2 diabetes mellitus. Models were adjusted for age, ethnicity, body mass index and other pertinent risk factors. Sub-analyses were performed stratifying by ethnicity. There was a strong inverse association between birth weight and type 2 diabetes mellitus with a birth weight of <6 pounds (lbs) (OR: 1.16, 95% CI: 1.01, 1.33) significantly associated with an increased risk of type 2 diabetes mellitus and a birth weight of ≥10 lbs (OR: 0.72, 95% CI: 0.57, 0.92) associated with a decreased risk of type 2 diabetes mellitus compared to women who reported their birth weight between 7 and 8 lbs 15 ounces (oz). Stratifying by ethnicity, the inverse association between birth weight and type 2 diabetes mellitus was only apparent in White women, but not Black, Hispanic or Asian women. Lower birth weight was associated with increased T2D risk in American White and Black post-menopausal women. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Invited commentary: Timing and types of cardiovascular risk factors in relation to offspring birth weight.

PubMed

Ness, Roberta B; Catov, Janet

2007-12-15

Birth weight is associated with later-life cardiovascular risk. A new study by Romundstad et al. (Am J Epidemiol 2007;166:1359-1364) challenges us to consider influences on birth weight with respect to timing and type. Timing of effects on birth weight, according to the "fetal origins hypothesis," is in utero. Alternatively, familial aggregation--genetics or shared environment--may explain birth weight and suggests prepregnancy influences. The Romundstad et al. findings support familial effects: maternal metabolic factors predicted birth weight for gestational age. However, because maternal physiology sets the fetal environment, these data do not necessarily counter the fetal origins hypothesis. Types of maternal metabolic influences demonstrated by Romundstad et al. include elevations in blood pressure being associated with lower birth weight for gestational age, whereas unfavorable glucose and lipid levels were associated with higher birth weight. These findings are consistent with the authors prior hypothesis that vascular dysfunction and metabolic profile (glucose and lipids) have divergent effects during pregnancy. Moreover, these new data underscore that both extremes of birth weight may be related to cardiovascular risk. Few data sets contain prepregnancy, pregnancy, and childhood information. Without all such time points, life course effects will remain only partially understood. It is hoped that studies such as the forthcoming National Children's Study will generate critical understanding of this issue.

Identifying areas at risk of low birth weight using spatial epidemiology: A small area surveillance study.

PubMed

Insaf, Tabassum Z; Talbot, Thomas

2016-07-01

To assess the geographic distribution of Low Birth Weight (LBW) in New York State among singleton births using a spatial regression approach in order to identify priority areas for public health actions. LBW was defined as birth weight less than 2500g. Geocoded data from 562,586 birth certificates in New York State (years 2008-2012) were merged with 2010 census data at the tract level. To provide stable estimates and maintain confidentiality, data were aggregated to yield 1268 areas of analysis. LBW prevalence among singleton births was related with area-level behavioral, socioeconomic and demographic characteristics using a Poisson mixed effects spatial error regression model. Observed low birth weight showed statistically significant auto-correlation in our study area (Moran's I 0.16 p value 0.0005). After over-dispersion correction and accounting for fixed effects for selected social determinants, spatial autocorrelation was fully accounted for (Moran's I-0.007 p value 0.241). The proportion of LBW was higher in areas with larger Hispanic or Black populations and high smoking prevalence. Smoothed maps with predicted prevalence were developed to identify areas at high risk of LBW. Spatial patterns of residual variation were analyzed to identify unique risk factors. Neighborhood racial composition contributes to disparities in LBW prevalence beyond differences in behavioral and socioeconomic factors. Small-area analyses of LBW can identify areas for targeted interventions and display unique local patterns that should be accounted for in prevention strategies. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Neonatal mortality in Argentina. Situation analysis from 2005 to 2014.

PubMed

Finkelstein, Juliana Z; Duhau, Mariana; Fasola, María L; Escobar, Paola

2017-08-01

Neonatal mortality (NM) refers to deaths occurring between birth and 27 days of life. This component of infant mortality has shown the least reduction over the past 50 years. The objective of this study was to analyze the course and characteristics of NM in Argentina. This was a descriptive, ecological study of NM in Argentina conducted between 2005 and 2014 to analyze its course, causes, and the relevance of prematurity and a low birth weight. Records of the Health Statistics and Information Department of the Ministry of Health of Argentina were used. The neonatal mortality rate reduced by 19.2% (2005: 8.9‰; 2014: 7.2‰); the early component (between birth and 6 days of life), by 20% (2005: 6.5‰; 2014: 5.2‰); and the late component (between 7 and 27 days of life), by 13% (2005: 2.3‰; 2014: 2‰). Disorders originating in the perinatal period and congenital malformations were the cause of more than 95% of neonatal deaths in this period. The relative significance of disorders originating in the perinatal period reduced, but that of congenital malformations increased. Preterm and low birth weight live births had the greatest risk of neonatal death. A younger gestational age and a lower birth weight resulted in a lower reduction of specific neonatal mortality rate. In the past 10 years, NM has reduced significantly. Disorders originating in the perinatal period and congenital malformations were the cause of almost all deaths in this age group. NM was associated with a low birth weight and prematurity. Sociedad Argentina de Pediatría

The Risk of Teen Mothers Having Low Birth Weight Babies: Implications of Recent Medical Research for School Health Personnel.

ERIC Educational Resources Information Center

Roth, Jeffrey; Hendrickson, Jo; Schilling, Max; Stowell, Daniel W.

1998-01-01

Reviews recent research on relationships between young maternal age and incidence of low-birth-weight infants. Different lines of research attribute low birth weight to biological and sociocultural factors. Both factors, plus lifestyle choices made by adolescents, combine to raise or lower the risk of delivering a low-birth-weight infant.…

Long-term visual outcomes in extremely low-birth-weight children (an American Ophthalmological Society thesis).

PubMed

Spencer, Rand

2006-01-01

The goal is to analyze the long-term visual outcome of extremely low-birth-weight children. This is a retrospective analysis of eyes of extremely low-birth-weight children on whom vision testing was performed. Visual outcomes were studied by analyzing acuity outcomes at >/=36 months of adjusted age, correlating early acuity testing with final visual outcome and evaluating adverse risk factors for vision. Data from 278 eyes are included. Mean birth weight was 731g, and mean gestational age at birth was 26 weeks. 248 eyes had grating acuity outcomes measured at 73 +/- 36 months, and 183 eyes had recognition acuity testing at 76 +/- 39 months. 54% had below normal grating acuities, and 66% had below normal recognition acuities. 27% of grating outcomes and 17% of recognition outcomes were /=3 years of age. A slower-than-normal rate of early visual development was predictive of abnormal grating acuity (P < .0001) and abnormal recognition acuity (P < .0001) at >/=3 years of age. Eyes diagnosed with maximal retinopathy of prematurity in zone I had lower acuity outcomes (P = .0002) than did those with maximal retinopathy of prematurity in zone II/III. Eyes of children born at 28 weeks gestational age. Eyes of children with poorer general health after premature birth had a 5.3 times greater risk of abnormal recognition acuity. Long-term visual development in extremely low-birth-weight infants is problematic and associated with a high risk of subnormal acuity. Early acuity testing is useful in identifying children at greatest risk for long-term visual abnormalities. Gestational age at birth of

Factors Associated With Changes in Magnesium Levels in Asymptomatic Neonates: A Longitudinal Analysis.

PubMed

Mehta, Yogesh; Shitole, Charudatta; Setia, Maninder Singh

2016-02-01

Neonates and infants with hypomagnesemia present with seizures and psychomotor delay. The present study evaluated the changes in magnesium (Mg) levels and factors associated with these in the first three days of life. We monitored 50 clinically asymptomatic neonates; they were not given any magnesium supplements even if they had hypomagnesemia at baseline. The variables analysed were: serum Mg; gestational age; birth weight; length; and the ponderal index. We used random effects (RE) models for longitudinal analysis of these data. The mean standard deviation (SD) gestational age was 36.3 (3.6) weeks and the mean (SD) weight was 2604.2 (754.4) grams. About 31% of the neonates had hypomagnesemia (< 1.6 mg/dL) on day one; however, all had normal magnesium levels by day three of life (P < 0.001). At birth, after adjusting for intrauterine growth retardation status (IUGR), serum Mg levels were lower by 0.0097 mg/dL (95% CI: -0.019 to -0.0003) per 100 grams increase in weight of the neonate. After adjusting for IUGR status, the mean increase in the serum Mg levels was 0.14 mg/dL (95% confidence intervals [CI]: 0.10 to 0.18) per day. The per-day increase in magnesium levels was significantly higher in low birth weight babies (0.10, 95% CI: 0.01 to 0.18) compared with normal birth weight babies. Asymptomatic neonates may have a high prevalence of hypomagnesemia; however, the levels become normal without any magnesium supplementation. Even though regular monitoring of magnesium levels is useful, no supplements are required - particularly in clinically asymptomatic neonates.

Birth weight modifies the association between central nervous system gene variation and adult body mass index.

PubMed

Ruiz-Narváez, Edward A; Haddad, Stephen A; Rosenberg, Lynn; Palmer, Julie R

2016-03-01

Genome wide association studies have identified ~100 loci associated with body mass index (BMI). Persons with low birth weight have an increased risk of metabolic disorders. We postulate that normal mechanisms of body weight regulation are disrupted in subjects with low birth weight. The present analyses included 2215 African American women from the Black Women's Health Study, and were based on genotype data on 20 BMI-associated loci and self-reported data on birth weight, weight at age 18 and adult weight. We used general linear models to assess the association of individual single-nucleotide polymorphisms (SNPs) with BMI at age 18 and later in adulthood within strata of birth weight (above and below the median, 3200 g). Three SNPs (rs1320330 near TMEM18, rs261967 near PCSK1 and rs17817964 in FTO), and a genetic score combining these three variants, showed significant interactions with birth weight in relation to BMI. Among women with birth weight <3200 g, there was an inverse association between genetic score and BMI; beta-coefficient=-0.045 (95% confidence intervals (CI) -0.104, 0.013) for BMI at age 18, and -0.055 (95% CI -0.112, 0.002) for adult BMI. Among women with birth weight ⩾3200 g, genetic score was positively associated with BMI: beta-coefficient=0.110 (95% CI 0.051, 0.169) for BMI at age 18 (P for interaction=0.0002), and 0.112 (95% CI 0.054, 0.170) for adult BMI (P for interaction<0.0001). Because TMEM18, PCSK1 and FTO are highly expressed in the central nervous system (CNS), our results suggest that low-birth weight may disrupt mechanisms of CNS body weight regulation.

Higher Pre-pregnancy BMI and Excessive Gestational Weight Gain are Risk Factors for Rapid Weight Gain in Infants.

PubMed

Subhan, Fatheema Begum; Colman, Ian; McCargar, Linda; Bell, Rhonda C

2017-06-01

Objective To describe the effects of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) on infant anthropometrics at birth and 3 months and infant growth rates between birth and 3 months. Methods Body weight prior to and during pregnancy and infant weight and length at birth and 3 months were collected from 600 mother-infant pairs. Adherence to GWG was based on IOM recommendations. Age and sex specific z-scores were calculated for infant weight and length at birth and 3 months. Rapid postnatal growth was defined as a difference of >0.67 in weight-for-age z-score between birth and 3 months. Relationships between maternal and infant characteristics were analysed using multilinear regression. Results Most women (65%) had a normal pre-pregnancy BMI and 57% gained above GWG recommendations. Infants were 39.3 ± 1.2 weeks and 3431 ± 447.9 g at birth. At 3 months postpartum 60% were exclusively breast fed while 38% received breast milk and formula. Having a pre-pregnancy BMI >25 kg/m 2 was associated with higher z-scores for birth weight and weight-for-age at 3 months. Gaining above recommendations was associated with higher z-scores for birth weight, weight-for-age and BMI. Infants who experienced rapid postnatal growth had higher odds of being born to women who gained above recommendations. Conclusion for Practice Excessive GWG is associated with higher birth weight and rapid weight gain in infants. Interventions that optimize GWG should explore effects on total and rates of early infant growth.

Neurological, psychological and educational sequelae of low birth weight.

PubMed

Dunn, H G; Crichton, J U; Grunau, R V; McBurney, A K; McCormick, A Q; Robertson, A M; Schulzer, M

1980-01-01

In a prospective study of 501 infants of low birth weight (LBW) who mostly weighed 2,041 g (4 1/2 lb) or less, and of 203 control infants of full birth weight (FBW > 2,500 g), 335 LBW and 139 FBW children were followed beyond the age of 6 years and 6 months. The incidence of neurological defects was negatively correlated with birth weight, and the mean "global" IQ of different birth weight groups retained a direct relationship. While the relationship of birth weight to IQ gradually became less marked, the effect of social class was increasingly evident from the age of 2 years and 6 months. The preterm children whose birth weight was appropriate for gestational age (AGA) attained a slightly higher mean IQ and significantly better grade placement in the third school year than the children who were unduly light for their gestational age. Details of the neurological and ophthalmological defects are given, and the predictive significance of neonatal variables is analyzed.

Heritable Environmental Variance Causes Nonlinear Relationships Between Traits: Application to Birth Weight and Stillbirth of Pigs

PubMed Central

Mulder, Herman A.; Hill, William G.; Knol, Egbert F.

2015-01-01

There is recent evidence from laboratory experiments and analysis of livestock populations that not only the phenotype itself, but also its environmental variance, is under genetic control. Little is known about the relationships between the environmental variance of one trait and mean levels of other traits, however. A genetic covariance between these is expected to lead to nonlinearity between them, for example between birth weight and survival of piglets, where animals of extreme weights have lower survival. The objectives were to derive this nonlinear relationship analytically using multiple regression and apply it to data on piglet birth weight and survival. This study provides a framework to study such nonlinear relationships caused by genetic covariance of environmental variance of one trait and the mean of the other. It is shown that positions of phenotypic and genetic optima may differ and that genetic relationships are likely to be more curvilinear than phenotypic relationships, dependent mainly on the environmental correlation between these traits. Genetic correlations may change if the population means change relative to the optimal phenotypes. Data of piglet birth weight and survival show that the presence of nonlinearity can be partly explained by the genetic covariance between environmental variance of birth weight and survival. The framework developed can be used to assess effects of artificial and natural selection on means and variances of traits and the statistical method presented can be used to estimate trade-offs between environmental variance of one trait and mean levels of others. PMID:25631318

Breastfeeding Is Associated with a Maternal Feeding Style Low in Control from Birth

PubMed Central

Brown, Amy; Lee, Michelle

2013-01-01

Background The influence of maternal child-feeding style upon child weight and eating style for children over the age of twelve months is well established. However there is little empirical evidence examining maternal child-feeding style during milk feeding despite evidence that mothers who breastfeed exert lower levels of control over later diet. The aim of this paper was to examine variation in maternal child-feeding style during the first six months postpartum and to explore associations with mode of milk feeding and infant weight. Methods The Child Feeding Questionnaire (CFQ) is frequently used to measure maternal child-feeding style in preschool children. 390 mothers with an infant aged 0–6 months completed an adapted version of the CFQ to measure maternal child-feeding style during milk feeding. Participants reported breastfeeding duration, infant weight and perceived size. Results Principle components analysis of questionnaire items produced six factors; encouraging feeding, feeding to a routine, limiting intake, concern for weight, monitoring and perceived responsibility. Breastfeeding was associated with lower levels of control compared to formula feeding. Infant birth weight was significantly inversely associated with concern for weight, monitoring and encouraging feeding. Discussion Formula feeding is associated with greater maternal control of child-feeding from birth whilst a lower birth weight is linked to concerns for infant weight and pressure to eat. As early maternal child-feeding relationships may impact negatively upon longer term child weight and eating style, identifying variations in maternal feeding style and understanding the factors that influence this is pertinent. PMID:23382881

Genome Wide Screening of Candidate Genes for Improving Piglet Birth Weight Using High and Low Estimated Breeding Value Populations

PubMed Central

Zhang, Lifan; Zhou, Xiang; Michal, Jennifer J.; Ding, Bo; Li, Rui; Jiang, Zhihua

2014-01-01

Birth weight is an economically important trait in pig production because it directly impacts piglet growth and survival rate. In the present study, we performed a genome wide survey of candidate genes and pathways associated with individual birth weight (IBW) using the Illumina PorcineSNP60 BeadChip on 24 high (HEBV) and 24 low estimated breeding value (LEBV) animals. These animals were selected from a reference population of 522 individuals produced by three sires and six dam lines, which were crossbreds with multiple breeds. After quality-control, 43,257 SNPs (single nucleotide polymorphisms), including 42,243 autosomal SNPs and 1,014 SNPs on chromosome X, were used in the data analysis. A total of 27 differentially selected regions (DSRs), including 1 on Sus scrofa chromosome 1 (SSC1), 1 on SSC4, 2 on SSC5, 4 on SSC6, 2 on SSC7, 5 on SSC8, 3 on SSC9, 1 on SSC14, 3 on SSC18, and 5 on SSCX, were identified to show the genome wide separations between the HEBV and LEBV groups for IBW in piglets. A DSR with the most number of significant SNPs (including 7 top 0.1% and 31 top 5% SNPs) was located on SSC6, while another DSR with the largest genetic differences in FST was found on SSC18. These regions harbor known functionally important genes involved in growth and development, such as TNFRSF9 (tumor necrosis factor receptor superfamily member 9), CA6 (carbonic anhydrase VI) and MDFIC (MyoD family inhibitor domain containing). A DSR rich in imprinting genes appeared on SSC9, which included PEG10 (paternally expressed 10), SGCE (sarcoglycan, epsilon), PPP1R9A (protein phosphatase 1, regulatory subunit 9A) and ASB4 (ankyrin repeat and SOCS box containing 4). More importantly, our present study provided evidence to support six quantitative trait loci (QTL) regions for pig birth weight, six QTL regions for average birth weight (ABW) and three QTL regions for litter birth weight (LBW) reported previously by other groups. Furthermore, gene ontology analysis with 183 genes harbored in these 27 DSRs suggested that protein, metal, ion and ATP binding, viral process and innate immune response present important pathways for deciphering their roles in fetal growth or development. Overall, our study provides useful information on candidate genes and pathways for regulating birth weight in piglets, thus improving our understanding of the genetic mechanisms involved in porcine embryonic or fetal development. PMID:24644423

Birth weight and cognitive development in adolescence: causal relationship or social selection?

PubMed

Gorman, Bridget K

2002-01-01

Using data from the National Longitudinal Survey of Adolescent Health (Add Health), I investigate the relationship between birth weight and cognitive development among adolescents aged 12-17. Initial OLS regression models reveal a significant, positive relationship between low birth weight and verbal ability. Controlling for demographic, socioeconomic, and other adolescent characteristics modifies, but does not eliminate, this relationship. Additional models that stratify the sample by parental education illustrate the greater importance of other family and adolescent characteristics for cognitive development in adolescence, and a diminished role of birth weight. In the final section of the paper, fixed effects models of non-twin full siblings indicate no significant association between birth weight and verbal ability, suggesting that traditional cross-sectional models overstate the influence of birth weight for cognitive development in adolescence.

Birth outcomes among Arab Americans in Michigan before and after the terrorist attacks of September 11, 2001.

PubMed

El-Sayed, Abdulrahman; Hadley, Craig; Galea, Sandro

2008-01-01

To assess whether the incidence of adverse birth outcomes among Arab Americans in Michigan changed after September 11, 2001. Birth data were collected on all births in Michigan from September 11, 2000, to March 11, 2001, and from September 11, 2001, to March 11, 2002. Self-reported ancestry and a name algorithm were used to determine Arab American ethnicity. Unadjusted and adjusted logistic regression analysis was used to assess the relationship between birth before/after September 11 and birth outcomes. Main outcome measures were low birth weight (LBW), very low birth weight (VLBW), and preterm birth (PTB). We observed no association between birth before/after September 11 and risk of adverse birth outcomes among Arab Americans in Michigan by using either the name algorithm or self-reported ancestry to determine Arab American ethnicity. Arab name was significantly associated with lower risk of VLBW and PTB in adjusted and unadjusted models. Arab ancestry was significantly associated with lower risk of VLBW and PTB in adjusted and unadjusted models and significantly associated with lower risk of LBW in an unadjusted model. In contrast to previous findings in California, we observed no difference in adverse birth outcomes before and after the events of September 11, 2001, among Arab Americans in Michigan. Arab American ethnicity is associated with lower risk of adverse birth outcomes compared to other racial/ethnic groups.

Prepregnancy body mass index, gestational weight gain, and birth weight in the BRISA cohort.

PubMed

Lima, Raina Jansen Cutrim Propp; Batista, Rosângela Fernandes Lucena; Ribeiro, Marizélia Rodrigues Costa; Ribeiro, Cecília Cláudia Costa; Simões, Vanda Maria Ferreira; Lima Neto, Pedro Martins; Silva, Antônio Augusto Moura da; Bettiol, Heloisa

2018-01-01

OBJECTIVE To analyze the effects of maternal pre-pregnancy body mass index and weight gain during pregnancy on the baby's birth weight. METHODS We conducted a cross-sectional study with 5,024 mothers and their newborns using a Brazilian birth cohort study. In the proposed model, estimated by structural equation modeling, we tested socioeconomic status, age, marital status, pre-pregnancy body mass index, smoking habit and alcohol consumption during pregnancy, hypertension and gestational diabetes, gestational weight gain, and type of delivery as determinants of the baby's birth weight. RESULTS For a gain of 4 kg/m2 (1 Standard Deviation [SD]) in pre-pregnancy body mass index, there was a 0.126 SD increase in birth weight, corresponding to 68 grams (p < 0.001). A 6 kg increase (1 SD) in gestational weight gain represented a 0.280 SD increase in newborn weight, correponding to 151.2 grams (p < 0.001). The positive effect of pre-pregnancy body mass index on birth weight was direct (standardized coefficient [SC] = 0.202; p < 0.001), but the negative indirect effect was small (SC = -0.076, p < 0.001) and partially mediated by the lower weight gain during pregnancy (SC = -0.070, p < 0.001). The positive effect of weight gain during pregnany on birth weight was predominantly direct (SC = 0.269, p < 0.001), with a small indirect effect of cesarean delivery (SC = 0.011; p < 0.001). Women with a higher pre-pregnancy body mass index gained less weight during pregnancy (p < 0.001). CONCLUSIONS The effect of gestational weight gain on the increase in birth weight was greater than that of pre-pregnancy body mass index.

Low Birth Weight and Cognitive Outcomes: Evidence for a Gradient Relationship in an Urban, Poor, African American Birth Cohort

ERIC Educational Resources Information Center

Dombrowski, Stefan C.; Noonan, Kelly; Martin, Roy P.

2007-01-01

This study is one of the first to investigate the relationship between low birth weight and cognitive outcomes in an urban, poor, prospectively designed African-American birth cohort. Multivariate analyses of the Pathways to Adulthood study, a subset of the Johns Hopkins Collaborative Perinatal study, compared low birth weight African-American…

Mathematics Deficiencies in Children with Very Low Birth Weight or Very Preterm Birth

ERIC Educational Resources Information Center

Taylor, H. Gerry; Espy, Kimberly Andrews; Anderson, Peter J.

2009-01-01

Children with very low birth weight (VLBW, less than 1500 g) or very preterm birth (VPTB, less than 32 weeks gestational age or GA) have more mathematics disabilities or deficiencies (MD) and higher rates of mathematics learning disabilities (MLD) than normal birth weight term-born children (NBW, greater than 2500 g and greater than 36 weeks GA).…

Anthropometric surrogates for screening of low birth weight newborns: a community-based study.

PubMed

Rustagi, Neeti; Prasuna, J G; Taneja, D K

2012-03-01

In developing countries, where about 75% of births occur at home or in the community, logistic problems prevent the weighing of every newborn child. This study compares various anthropometric surrogates for identification of low birth weight neonates. A longitudinal community based study was done in an urban resettlement colony and 283 singleton neonates within 7 days of birth were examined for the anthropometric measurements such as head, chest, mid upper arm circumference and foot length as a screening tool for low birth weight. Chest circumference measured within 7 days of birth appeared to be the most appropriate surrogate of low birth weight with highest sensitivity (75.4%), specificity (78.4%), and positive predictive value (48.9%) as compared with other anthropometric parameters. Low birth weight neonates in absence of weighing scales can be early identified by using simple anthropometric measurements for enhanced home-based care and timely referral.

Meditations on birth weight: is it better to reduce the variance or increase the mean?

PubMed

Haig, David

2003-07-01

A conceptual model is presented here in which the birth weight distribution is decomposed into a distribution of target weights and a distribution of perturbations from the target. The target weight is the adaptive goal of fetal development. In the simplest model, perinatal mortality is independent of variation in target weight and determined solely by the magnitude of the perturbation of birth weight from the target. In this model, mortality risk is concentrated in the tails of the birth weight distribution. A difference between populations in their distributions of target weights will be associated with a corresponding shift in their curves of weight-specific risk, without any difference between the populations in overall risk. In this model, risk would be reduced by decreasing the variance of the distribution of perturbations. The model is discussed in the context of the so-called "paradoxes of low birth weight."

Fetal growth in relation to gestational weight gain in women with type 2 diabetes: an observational study.

PubMed

Parellada, C B; Asbjörnsdóttir, B; Ringholm, L; Damm, P; Mathiesen, E R

2014-12-01

To evaluate fetal growth in relation to gestational weight gain in women with Type 2 diabetes. A retrospective cohort study of 142 consecutive pregnancies in 28 women of normal weight, 39 overweight women and 75 obese women with Type 2 diabetes (pre-pregnancy BMI < 25, 25-29.9, ≥ 30 kg/m2, respectively). Gestational weight gain was categorized as excessive (exceeding the US Institute of Medicine recommendations) or as non-excessive (within or below the Institute of Medicine recommendations). Excessive and non-excessive gestational weight gain were seen in 61 (43%) and 81 women (57%) with a median (range) gestational weight gain of 14.3 (9-32) vs. 7.0 (-5-16) kg (P < 0.001), respectively. Infants of women with excessive gestational weight gain were characterized by higher birth weight (3712 vs. 3258 g; P = 0.001), birth weight z-score (1.14 vs. -0.01, P = 0.001) and prevalence of large-for-gestational-age infants (48 vs. 20%; P < 0.001). In normal weight, overweight and obese women with non-excessive gestational weight gain, the median weight gain in the first half of pregnancy was 371, 114 and 81 g/week, and in the second half of pregnancy 483, 427 and 439 g/week, respectively. In multiple linear regression analysis, gestational weight gain was associated with a higher infant birth weight z-score independent of pre-pregnancy BMI, smoking, HbA1c and insulin dose at last visit, ethnicity and parity [β=0.1 (95% CI 0.06-0.14), P < 0.001]. Infant birth weight was almost 0.5 kg higher in women with Type 2 diabetes and excessive gestational weight gain than in women with Type 2 diabetes and non-excessive weight gain. © 2014 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

Fetal growth in relation to gestational weight gain in women with Type 2 diabetes: an observational study

PubMed Central

Parellada, C B; Ásbjörnsdóttir, B; Ringholm, L; Damm, P; Mathiesen, E R

2014-01-01

Aims To evaluate fetal growth in relation to gestational weight gain in women with Type 2 diabetes. Methods A retrospective cohort study of 142 consecutive pregnancies in 28 women of normal weight, 39 overweight women and 75 obese women with Type 2 diabetes (pre-pregnancy BMI  < 25, 25–29.9,  ≥ 30 kg/m2, respectively). Gestational weight gain was categorized as excessive (exceeding the US Institute of Medicine recommendations) or as non-excessive (within or below the Institute of Medicine recommendations). Results Excessive and non-excessive gestational weight gain were seen in 61 (43%) and 81 women (57%) with a median (range) gestational weight gain of 14.3 (9–32) vs 7.0 (−5–16) kg (P < 0.001), respectively. Infants of women with excessive gestational weight gain were characterized by higher birth weight (3712 vs 3258 g; P = 0.001), birth weight z-score (1.14 vs -0.01, P = 0.001) and prevalence of large-for-gestational-age infants (48 vs 20%; P < 0.001). In normal weight, overweight and obese women with non-excessive gestational weight gain, the median weight gain in the first half of pregnancy was 371, 114 and 81 g/week, and in the second half of pregnancy 483, 427 and 439 g/week, respectively. In multiple linear regression analysis, gestational weight gain was associated with a higher infant birth weight z-score independent of pre-pregnancy BMI, smoking, HbA1c and insulin dose at last visit, ethnicity and parity [β=0.1 (95% CI 0.06–0.14), P < 0.001]. Conclusions Infant birth weight was almost 0.5 kg higher in women with Type 2 diabetes and excessive gestational weight gain than in women with Type 2 diabetes and non-excessive weight gain. PMID:25081349

Cognition and behavioural development in early childhood: the role of birth weight and postnatal growth

PubMed Central

Huang, Cheng; Martorell, Reynaldo; Ren, Aiguo; Li, Zhiwen

2013-01-01

Background We evaluate the relative importance of birth weight and postnatal growth for cognition and behavioural development in 8389 Chinese children, 4–7 years of age. Method Weight was the only size measure available at birth. Weight, height, head circumference and intelligence quotient (IQ) were measured between 4 and 7 years of age. Z-scores of birth weight and postnatal conditional weight gain to 4–7 years, as well as height and head circumference at 4–7 years of age, were the exposure variables. Z-scores of weight at 4–7 years were regressed on birth weight Z-scores, and the residual was used as the measure of postnatal conditional weight gain. The outcomes were child’s IQ, measured by the Chinese Wechsler Young Children Scale of Intelligence, as well as internalizing behavioural problems, externalizing behavioural problems and other behavioural problems, evaluated by the Child Behavior Checklist 4–18. Multivariate regressions were conducted to investigate the relationship of birth weight and postnatal growth variables with the outcomes, separately for preterm children and term children. Results Both birth weight and postnatal weight gain were associated with IQ among term children; 1 unit increment in Z-score of birth weight (∼450 g) was associated with an increase of 1.60 [Confidence interval (CI): 1.18–2.02; P < 0.001] points in IQ, and 1 unit increment in conditional postnatal weight was associated with an increase of 0.46 (CI: 0.06–0.86; P = 0.02) points in IQ, after adjustment for confounders; similar patterns were observed when Z-scores of postnatal height and head circumference at age 4–7 years were used as alternative measurements of postnatal growth. Effect sizes of relationships with IQ were smaller than 0.1 of a standard deviation in all cases. Neither birth weight nor postnatal growth indicators were associated with behavioural outcomes among term children. In preterm children, neither birth weight nor postnatal growth measures were associated with IQ or behavioural outcomes. Conclusions Both birth weight and postnatal growth were associated with IQ but not behavioural outcomes for Chinese term children aged 4–7 years, but the effect sizes were small. No relation between either birth weight or postnatal growth and cognition or behavioural outcomes was observed among preterm children aged 4–7 years. PMID:23243117

Dietary patterns in pregnancy and birth weight.

PubMed

Coelho, Natália de Lima Pereira; Cunha, Diana Barbosa; Esteves, Ana Paula Pereira; Lacerda, Elisa Maria de Aquino; Theme Filha, Mariza Miranda

2015-01-01

OBJECTIVE To analyze if dietary patterns during the third gestational trimester are associated with birth weight.METHODS Longitudinal study conducted in the cities of Petropolis and Queimados, Rio de Janeiro (RJ), Southeastern Brazil, between 2007 and 2008. We analyzed data from the first and second follow-up wave of a prospective cohort. Food consumption of 1,298 pregnant women was assessed using a semi-quantitative questionnaire about food frequency. Dietary patterns were obtained by exploratory factor analysis, using the Varimax rotation method. We also applied the multivariate linear regression model to estimate the association between food consumption patterns and birth weight.RESULTS Four patterns of consumption - which explain 36.4% of the variability - were identified and divided as follows: (1) prudent pattern (milk, yogurt, cheese, fruit and fresh-fruit juice, cracker, and chicken/beef/fish/liver), which explained 14.9% of the consumption; (2) traditional pattern, consisting of beans, rice, vegetables, breads, butter/margarine and sugar, which explained 8.8% of the variation in consumption; (3) Western pattern (potato/cassava/yams, macaroni, flour/farofa/grits, pizza/hamburger/deep fried pastries, soft drinks/cool drinks and pork/sausages/egg), which accounts for 6.9% of the variance; and (4) snack pattern (sandwich cookie, salty snacks, chocolate, and chocolate drink mix), which explains 5.7% of the consumption variability. The snack dietary pattern was positively associated with birth weight (β = 56.64; p = 0.04) in pregnant adolescents.CONCLUSIONS For pregnant adolescents, the greater the adherence to snack pattern during pregnancy, the greater the baby's birth weight.

Early Pregnancy Weight Gain Exerts the Strongest Effect on Birth Weight, Posing a Critical Time to Prevent Childhood Obesity.

PubMed

Broskey, Nicholas T; Wang, Peng; Li, Nan; Leng, Junhong; Li, Weiqin; Wang, Leishen; Gilmore, L Anne; Hu, Gang; Redman, Leanne M

2017-09-01

Gestational weight gain (GWG) is associated with infant birth weight and childhood obesity; however, the patterns of GWG on infant birth weight are poorly understood. This analysis in 16,218 mother-child dyads from Tianjin, China, determined the risk of infant size at birth according to GWG occurring throughout the first and second trimester (early GWG) or during the third trimester (late GWG), according to maternal prepregnancy BMI and the 2009 Institute of Medicine recommendations. Excessive GWG in early and late pregnancy had an increased risk for large-for-gestational-age (LGA) infants (odds ratio [OR]: 2.4; 95% confidence interval [CI]: 1.5-4.0, P < 0.001). Regardless of prepregnancy BMI, excessive GWG early in pregnancy (< 24 weeks) was associated with an increased risk of LGA infants (OR: 2.5; 95% CI: 2.1-3.1, P < 0.001), and inadequate early GWG was associated with a higher risk of small-for-gestational-age (SGA) infants (OR: 1.4; 95% CI: 1.2-1.7, P < 0.001). The pattern of GWG early in pregnancy, regardless of GWG later in pregnancy, had the greatest impact on infant size at birth. Interventions initiated early in pregnancy may facilitate better adherence to the GWG guidelines and minimize the risk of LGA and SGA infants, a potential precursor for childhood obesity. © 2017 The Obesity Society.

Low midpregnancy placental volume in rural Indian women: A cause for low birth weight?

PubMed

Kinare, A S; Natekar, A S; Chinchwadkar, M C; Yajnik, C S; Coyaji, K J; Fall, C H; Howe, D T

2000-02-01

We sought to study midpregnancy placental volume in rural Indian women, its maternal determinants, and its relationship to neonatal size. We performed a prospective community-based study of maternal nutrition and fetal growth in 6 villages near the city of Pune. Measurements included midpregnancy placental volume determined by means of ultrasonography at 15 to 18 weeks' gestation, maternal anthropometric measurements before and during pregnancy, and maternal blood pressure and biochemical parameters during pregnancy. Neonatal size and placental weight were measured at birth. The mothers were short and underweight (mean height, 1.52 m; weight, 42 kg; body mass index, 18 kg/m(2)) and produced small babies (mean birth weight, 2648 g). Midpregnancy placental volume (median, 144 mL) was related to the mother's prepregnancy weight (r = 0.15; P <.001) but not to weight gain during pregnancy, blood pressure, or circulating hemoglobin, ferritin, red blood cell folate, or glucose concentrations. Midpregnancy placental volume was related to placental weight at birth (r = 0.29; P <.001) and birth weight (r = 0.25; P <.001) independent of maternal size. In Indian mothers midpregnancy placental volume is significantly associated with prepregnant maternal weight and is an independent predictor of birth weight. Our findings may provide clues to the high prevalence of low-birth-weight infants in India.

The influence of season and ambient temperature on birth outcomes: a review of the epidemiological literature.

PubMed

Strand, Linn B; Barnett, Adrian G; Tong, Shilu

2011-04-01

Seasonal patterns of birth outcomes, such as low birth weight, preterm birth and stillbirth, have been found around the world. As a result, there has been an increasing interest in evaluating short-term exposure to ambient temperature as a determinant of adverse birth outcomes. This paper reviews the epidemiological evidence on seasonality of birth outcomes and the impact of prenatal exposure to ambient temperature on birth outcomes. We identified 20 studies that investigated seasonality of birth outcomes, and reported statistically significant seasonal patterns. Most of the studies found peaks of preterm birth, stillbirth and low birth weight in winter, summer or both, which indicates the extremes of temperature may be an important determinant of poor birth outcomes. We identified 13 studies that investigated the influence of exposure to ambient temperature on birth weight and preterm birth (none examined stillbirth). The evidence for an adverse effect of high temperatures was stronger for birth weight than for preterm birth. More research is needed to clarify whether high temperatures have a causal effect on fetal health. Copyright © 2011 Elsevier Inc. All rights reserved.

Genome-wide association study of swine farrowing traits. Part II: Bayesian analysis of marker data

USDA-ARS?s Scientific Manuscript database

Reproductive efficiency has a great impact on the economic success of pork production. Number born alive (NBA) and average piglet birth weight (ABW) contribute greatly to reproductive efficiency. To better understand the underlying genetics of birth traits, a genome wide association study (GWAS) w...

The relationship between selected socioeconomic factors and thinness among Polish school-aged children and adolescents.

PubMed

Gurzkowska, Beata; Kułaga, Zbigniew; Grajda, Aneta; Góźdź, Magdalena; Wojtyło, Małgorzata; Litwin, Mieczysław

2017-06-01

The analysis was performed on a database including 17,427 records of subjects aged 7-18 years, randomly sampled from a population of Polish students. Thinness was determined using international cut-off points, defined to pass through body mass index of 18.5 kg/m 2 at the age of 18. The weighted prevalence of thinness and odds ratios with 95% confidence interval were estimated for gender, birth weight, level of schooling and school location, gross domestic product (GDP) per inhabitant, family income and maternal education. Body height was analysed according to body mass and birth weight categories. The prevalence of thinness was higher among children with low birth weight and among girls. The prevalence of thinness decreased with increasing GDP per inhabitant. In analysis by level of schooling: primary-middle-secondary, prevalence of thinness decreased among boys and increased among girls. Thin students were significantly shorter than other students, and thin girls less likely participated in physical education. Gender and socioeconomic factors are important determinants of thinness among Polish children and adolescents. Public health strategies should address family eating practices to prevent negative effects of weight deficit, especially among girls/children from low GDP regions. What is Known: • Socioeconomic factors and gender influence weight status of children and adolescents. What is New: • The first time the prevalence and determinants of thinness based on data from a nationally representative, weighted sample of Polish children aged 7-18 years were presented. • The analysis shows how gender and socioeconomics determinants influence the prevalence of thinness among children and adolescent in post-transformation country and can be used to international comparisons.

Does low birth weight predict hypertension and obesity in schoolchildren?

PubMed

Zarrati, Mitra; Shidfar, Farzad; Razmpoosh, Elham; Nezhad, Farinaz Nasir; Keivani, Hosein; Hemami, Mohsen Rezaei; Asemi, Zatollah

2013-01-01

Birth weight appears to play a role in determining high blood pressure (BP) and obesity during childhood. The purpose of this study is to investigate the association between birth weight and later obesity and hypertension among 10- to 13-year-old schoolchildren. A total of 1,184 primary school students were selected from 20 randomized schools between 2011 and 2012 in Iran. Height, weight, waist circumference and BP were measured using standard instruments. Data were analyzed using stepwise regression and logistic regression models. 13.5% of children had a history of low birth weight. First-degree family history of obesity, excessive gestational weight gain and birth weight were significantly correlated with overweight/obesity and abdominal obesity (p = 0.001), whereas only birth weight was associated with high BP (p = 0.001). An inverse correlation was found between waist circumference and systolic/diastolic BP. The duration of breastfeeding in children with low birth weight was inversely correlated with obesity/overweight, abdominal obesity and hypertension. The results suggests that birth weight is inversely associated with BP and more so with obesity and abdominal obesity. The duration of having been breastfed could have an influence on later hypertension, obesity and abdominal obesity. Further results are needed to test these correlations as well as diagnosing early life factors to prevent young adult overweight/obesity or hypertension. Copyright © 2013 S. Karger AG, Basel.

Birth outcomes among offspring of women exposed to the September 11, 2001, terrorist attacks.

PubMed

Lipkind, Heather S; Curry, Allison E; Huynh, Mary; Thorpe, Lorna E; Matte, Thomas

2010-10-01

To evaluate the effects of the September 11, 2001, World Trade Center attacks on birth outcomes. Live singleton births between September 11, 2001, and October 31, 2002, to women enrolled in a World Trade Center Health Registry (the Registry, n=446) were compared with births to women residing more than 5 miles from the World Trade Center (n=49,616). Birth weight, gestational age, low birth weight, and preterm delivery were evaluated using linear and logistic regression. Births before September 11, 2001, were analyzed to assess possible seasonal biases of associations with pregnancy trimester on September 11. Associations of birth outcomes with September 11-related psychologic stress and physical exposures were assessed among births to women within the Registry (n=499). Birth weight and gestational age distributions were similar for births to women enrolled in the Registry and comparison births. Although mean gestational age and birth weight varied with trimester on September 11, a similar association was found among births in previous years, consistent with a seasonal effect not related to exposure. Registry-linked births to mothers with probable posttraumatic stress disorder (n=61) had a higher odds of low birth weight (adjusted odds ratio [OR] 2.49, 95% confidence interval [CI] 1.02-6.08) and preterm delivery (adjusted OR 2.48, 95% CI 1.05-5.84) compared with births to women without posttraumatic stress disorder. Women who lived, worked, or were near the World Trade Center on or soon after September 11 had pregnancy outcomes similar to women residing more than 5 miles away. However, among exposed women, probable posttraumatic stress disorder was associated with low birth weight and preterm delivery. II.

Dichlorodiphenyltrichloroethane (DDT), DDT Metabolites and Pregnancy Outcomes

PubMed Central

Kezios, Katrina L.; Liu, Xinhua; Cirillo, Piera M.; Cohn, Barbara A.; Kalantzi, Olga I.; Wang, Yunzhu; Petreas, Myrto X.; Park, June-Soo; Factor-Litvak, Pam

2012-01-01

Organochlorine pesticides (OCPs) are persistent endocrine disruptors. OCPs cross the placenta; this prenatal exposure has been associated with adverse pregnancy outcomes. We investigated associations between prenatal exposure to OCPs and gestational age and birth weight in 600 infants born between 1960 and 1963. The primary OCP was 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane (p,p′-DDT), its primary metabolite, 1,1′-dichloro-2,2'-bis(p-chlorophenyl)ethylene(p,p′-DDE) and the contaminant, 1,1,1-trichloro-2-(p-chlorophenyl)-2-(o-chlorophenyl)-ethane (o,p′-DDT). Regression analysis indicated that for each natural log unit increase in p,p′-DDT, birth weight increased by 274 grams (95% CI 122, 425) when controlling for p,p′-DDE and o,p′-DDT. At a given level of p,p′-DDT exposure, o,p′-DDT and p,p′-DDE were associated with decreased birth weight. p,p′-DDE was negatively associated with length of gestation, controlling for p,p′-DDT and o,p′-DDT. These findings suggest opposing associations between exposure to p,p′-DDT and p,p′-DDE and birth weight. We did not find evidence to support mediation by maternal thyroid hormone status nor that the association differed by sex. PMID:23142753

[Comparative analysis of risk factors for preterm and small-for-gestational-age births].

PubMed

Zhong, Xin-Qi; Cui, Qi-Liang

2014-12-01

To compare the risk factors between preterm and small-for-gestational-age (SGA) births. A total of 1 270 newborns who had no obstetric risk factors or maternal diseases were enrolled in this study. Their mothers' stature, body weight, passive smoking, and history of abnormal pregnancy were investigated using the self-designed questionnaire. The infants were divided into four groups: preterm, appropriate-for-gestational-age (AGA), SGA, and term infants. Multivariate logistic regression analysis was performed to compare the risk factors between preterm and SGA births. A weight gain less than 9 kg during pregnancy increased the risks of preterm (OR=1.63, 95% CI: 1.12-2.07) and SGA (OR=1.92, 95% CI: 1.56-2.58). The histories of abortion (OR=1.46, 95% CI: 1.09-1.93) and preterm birth (OR=2.63, 95% CI: 1.81-3.92) were independent risk factors for preterm births, while low pre-pregnancy body mass index (<18.5) (OR=2.16, 95% CI: 1.53-3.16), short stature (<1.55 m) (OR=2.46, 95% CI: 1.78-3.48), and passive smoking (OR=2.24, 95% CI: 1.65-2.98) were independent risk factors for SGA births. Due to different risk factors between preterm and SGA births, specific preventive measures should be taken pertinently to reduce the incidence of the two bad pregnancy outcomes.

Serum zinc levels of cord blood: relation to birth weight and gestational period.

PubMed

Gómez, Tahiry; Bequer, Leticia; Mollineda, Angel; González, Olga; Diaz, Mireisy; Fernández, Douglas

2015-04-01

Zn-deficiency has been associated with numerous alterations during pregnancy including low birth weight; however, the research relating neonatal zinc status and birth weight has not produced reliable results. To compare the serum Zn-levels of cord blood in healthy newborns and low birth weight newborns, and to assess a possible relationship between zinc concentration and neonatal birth weight and gestational age. 123 newborns divided in "study group" (n=50) with <2500g birth weight neonates and "control group" (n=73) with ≥2500g birth weight neonates were enrolled. Study group was subdivided according to gestational age in preterm (<37 weeks) and full-term (≥37 weeks). Serum cord blood samples were collected and the Zn-levels were analyzed using flame Atomic Absorption Spectrophotometry method and the result was expressed in μmol/L. The Zn-levels were compared between the groups (Mann-Whitney-U test) and the Zn-levels were correlated with the birth weight and gestational age (Spearman's rank correlations). Statistically significant low positive correlation between Zn-levels and birth weight (ρ=0.283; p=0.005) was found. No statistically significant difference between Zn-levels of study and control groups [17.00±0.43 vs. 18.16±0.32 (p=0.053)] was found. Statistically significant low positive correlation between Zn-levels and gestational age (ρ=0.351; p=0.001) was found. No statistically significant difference between Zn-levels of preterm as compare to full-term newborns [16.33±0.42 vs. 18.43±0.93 (p=0.079)] was found. Zn-level of preterm subgroup was significantly lower compared to control group (p=0.001). Despite low birth weight preterm neonates had significantly lower serum zinc levels of cord blood than healthy term neonates, the correlation between cord blood zinc levels and birth weight and gestational age was lower. The results are not enough to relate the change in cord blood zinc concentration to the birth weight values or gestational period. In relation to complicated pregnancies, further studies regarding zinc levels in blood in our population are required. Copyright © 2015 Elsevier GmbH. All rights reserved.

Association between oocyte number retrieved with live birth rate and birth weight: an analysis of 231,815 cycles of in vitro fertilization

PubMed Central

Baker, Valerie L.; Brown, Morton B.; Luke, Barbara; Conrad, Kirk P.

2015-01-01

Objective To determine if number of oocytes correlates with live birth rate and incidence of low birthweight (LBW). Design Retrospective cohort. Setting N/A. Patients Women undergoing fresh embryo transfer utilizing either autologous (n=194,627) or donor (n=37,188) oocytes whose cycles were reported to the Society for Assisted Reproductive Technology 2004–2010. Main outcome measures Live birth rate, birthweight, birth weight z-score, LBW. Interventions None. Results For both autologous and donor oocyte cycles, increasing number of oocytes retrieved paralleled live birth rate and embryos available for cryopreservation in most analyses performed with all models adjusted for age and prior births. For cycles achieving singleton pregnancy using autologous oocytes via transfer of 2 embryos, a higher number of oocytes retrieved was associated with lower mean birth weight, lower birthweight z-score, and greater incidence of LBW. In contrast, for cycles using donor oocytes, there was no association of oocyte number retrieved with measures of birthweight. Conclusions A higher number of oocytes retrieved was associated with an increased incidence of LBW in autologous singleton pregnancies resulting from transfer of 2 embryos but not in donor oocyte cycles. Although the effect of high oocyte number on the incidence of LBW in autologous cycles was of modest magnitude, further study is warranted to determine if a subgroup of women may be particularly vulnerable. PMID:25638421

[Retinopathy of prematurity in multiple births: risk analysis for plus disease].

PubMed

García-Serrano, J L; Ramírez-García, M C; Piñar-Molina, R

2009-04-01

To analyze the risk factors associated with plus disease in retinopathy of prematurity (ROP). Over a period of 8.5 years we carried out a prospective study of ROP in twins and triplets. Fifty-four multiple-birth infants with low birth weight (< or =1500 g) and low gestational age (32< or = weeks) were admitted to the University Hospital of Granada. Logistic regression analyses showed the following variables to be associated with an increased risk of plus disease: severe ROP, large area of avascular retina, low gestational age, low birth weight, a patent ductus arteriosus, length of mechanical ventilation, adverse events increase, low 5 min Apgar scores and poor postnatal weight gain (in the first 4 to 6 weeks of life). Using multiple logistic regression, only the grade of ROP (OR: 5.5; p < 0.009) and poor postnatal weight gain (OR: 0.58; p < 0.04) were predictive factors of development of plus disease. Infants with disease gained an average 3.9 +/- 3.1 g/day in the first 6 weeks of life, compared to a mean of 11.84 +/- 8.3 g/day for those without plus disease (p < 0.0001). Advanced ROP stages and poor weight gain were the most significant factors associated with plus disease. Twins who gained weight at more than 7 g/day in the first 4-6 weeks of life had a significantly reduced risk of plus disease. A good weight gain is an effective strategy against avoidable blindness due to ROP.

Nutritional status and birth outcomes of adolescent pregnant girls in Morogoro, Coast, and Dar es Salaam regions, Tanzania.

PubMed

Shirima, Candida P; Kinabo, Joyce L

2005-01-01

Studies that link adolescence pregnancies, nutritional status, and birth outcomes in Tanzania are scarce. We examined the nutritional status and birth outcomes of pregnant adolescent girls from rural and urban areas of three regions in Tanzania. The study was carried out in the regions of Dar es Salaam (Chamazi and Gezaulole dispensaries and Round Table Maternity Home), Coast (Tumbi Regional Hospital and Mlandizi Health Center), and Morogoro (Regional Hospital, Uhuru Clinic, and Mlali Health Center). One hundred eighty pregnant adolescent girls ages 15 to 19 y were recruited and interviewed, and their nutritional status measurements were taken at the seven health facilities. Information concerning date of birth, marital status, educational status, sex education, and income status was collected with a structured questionnaire. Height, weight, and mid-upper arm circumference were measured according to standard techniques. Hemoglobin concentration was measured with a hemoglobinometer and the HemoCue technique. Nutritional status was assessed by body mass index, and hemoglobin concentration was determined by cutoff points of the World Health Organization. Suitable statistical analysis was done with SPSS 9.0. Weekly weight gain during pregnancy was measured in 123 subjects who kept their appointments and reported back after 2 wk. Fifty-seven subjects did not keep their appointments and were lost to follow-up. Records of infants' birth weights and mode of delivery were obtained from 50 subjects who delivered at the study sites. The height of about 54% of the subjects was shorter than 151 cm, suggestive of short maternal height. Severe wasting was observed in 27% of subjects. Mean weekly weight gain during pregnancy was 317 +/-110 g (-500 to 500 g). No significant differences were observed between rural and urban settings. Mean infant birth weight was 2600 +/- 480 g. About 48% of infants had low birth weight (<2500 g) and only 14% of infants had birth weight greater than 3000 g. About 14% of infants were born by cesarean section. Nearly 86% of the pregnant adolescent girls were anemic. A hemoglobin concentration below 7 g/dL was observed in 5% of subjects. Most subjects (55%) had hemoglobin concentrations from 7 to lower than 10 g/dL. There was a weak correlation between infant birth weight and weekly weight gain of the girls during pregnancy (r = 0.36, P < or = 0.01). However, a strong correlation was observed between birth weight and hemoglobin level of adolescent girls during pregnancy (r = 0.67, P = 0.01). Short stature was observed to contribute toward cesarean delivery (P = 0.05) because more cesarean deliveries were performed in short girls (<151 cm tall). The nutritional status of pregnant adolescent girls in the study areas was poor and resulted in poor pregnancy outcome. Girls should be educated about reproductive health at the primary level of education.

The Effect of Adequate Gestational Weight Gain among Adolescents Relative to Adults of Equivalent Body Mass Index and the Risk of Preterm Birth, Cesarean Delivery, and Low Birth Weight.

PubMed

Houde, Michele; Dahdouh, Elias M; Mongrain, Vanessa; Dubuc, Elise; Francoeur, Diane; Balayla, Jacques

2015-12-01

To determine whether similar odds of cesarean delivery (C/S), preterm birth (PTB), and low birth weight (LBW) are observed among adolescents compared with body mass index (BMI)-equivalent adults in cases of adequate gestational weight gain. We conducted a retrospective, population-based, cohort study using the Center for Disease Control and Prevention's birth data files from the United States for 2012. We selected from the cohort all singleton, cephalic pregnancies and stratified them according to maternal age, prepregnancy BMI, and gestational weight gain following the 2009 Institute of Medicine (IOM) recommendations. The effect of adequate gestational weight gain among adolescents relative to adults of equivalent BMI on the risk of C/S, PTB, and LBW was estimated using logistic regression analysis, adjusting for relevant confounders. We analyzed a total of 3,960,796 births, of which 1,036,646 (26.1%) met the inclusion criteria. In adolescents and adults, likelihood of achieving ideal gestational weight gain decreased with greater prepregnancy BMI. Relative to adults, the overall odds of C/S in all adolescents were (adjusted odds ratio [95% confidence interval]) 0.61 (0.58 to 0.63). When comparing equivalent BMI categories, these odds were unchanged (P < .0001). The overall adjusted odds ratio of LBW was 1.15 (1.13 to 1.16). These odds were significantly higher when BMI stratification took place, decreasing with advancing BMI categories, from 1.23 (1.14 to 1.33) among the underweight, to nonsignificant differences in the obese classes (P < .05). Finally, when including only those achieving ideal weight gain, the overall odds of premature delivery (1.17 [1.14 to 1.20]) were higher among nonobese adolescents, while they were not found among the obese. When ideal gestational weight gain is attained, only nonobese adolescents exhibit a greater risk of LBW and preterm birth relative to adults of similar BMI, whereas the risk of C/S remains lower for all adolescents, independent of BMI. This information may be useful in the counseling of adolescent pregnancies. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Association between maternal nutritional status of pre pregnancy, gestational weight gain and preterm birth.

PubMed

Xinxo, Sonela; Bimbashi, Astrit; Z Kakarriqi, Eduard; Zaimi, Edmond

2013-01-01

Maternal nutritional status of pre pregnancy and gestational weight gain affects the preterm birth. The association between maternal nutritional status of pre pregnancy and preterm birth appears to be complex and varied by studies from different countries, thus this association between the gestational weight gain and preterm birth is more consolidated. The study aims to determine any association between the pre pregnancy maternal nutritional status, gestational weight gain and the preterm birth rate in the Albanian context. In case control study, we analyzed women who have delivered in obstetric institutions in Tirana during the year 2012. Body mass index and gestational weight gain of 150 women who had a preterm delivery were compared with those of 150 matched control women who had a normal delivery regarding the gestation age. The self-reported pre pregnancy weight, height, gestational weight gain, age, education and parity are collected through a structured questioner. The body mass index and gestational weight gain are categorized based on the Institute of Medicine recommendation. The multiple logistic regression is used to measure the association between the nutritional status of pre pregnancy and gestational weight gain and the preterm birth rate. The women which have a underweight status or obese of pre pregnancy are more likely to have a preterm birth compared to the women of a normal pre-pregnancy nutritional status (respectively OR =2.7 and 4.3 p<0.05). Women who do not reach the recommended gestational weight gain are more likely to have a preterm birth compared to the women which reach this weight (OR=1.8 p< 0.05). Maternal nutritional status and gestational weight gain affects the risk for preterm birth. Pre-pregnancy and gestation nutritional assessments should be part of routine prenatal visits.

Arterial stiffness and fetal growth in normotensive pregnancy.

PubMed

Elvan-Taspinar, Ayten; Franx, Arie; Bots, Michiel L; Koomans, Hein A; Bruinse, Hein W

2005-03-01

Normal pregnancy is characterized by a decrease in peripheral resistance and generalized vasodilation resulting in plasma volume expansion, which is associated with intrauterine growth. Stiffness of the arterial system may be a measure of the degree of plasma volume expansion. Pulse wave velocity (PWV), measured by applanation tonometry, is a validated approach to determine arterial stiffness. Pulse pressure (PP) is considered a surrogate measure for arterial stiffness. The aim of this study was to evaluate the association between arterial stiffness and fetal growth. In 50 normotensive pregnancies, carotid-femoral PWV was measured in the third trimester in 30 degrees lateral position. Blood pressure measurements were performed with conventional auscultatory sphygmomanometry. Birth weight centiles and weight centiles at the age of 6 months were recorded. Linear regression models were used for statistical analyses. There was a significant relationship in PWV with both birth weight centiles and catch-up growth after birth, independent of mean arterial pressure (MAP). An increase of 1 m/sec in PWV was associated with a decrease in birth weight centiles by 17.6% and a catch-up of 22.3% in weight centiles after birth. A stronger association was found for pulse pressure and birth weight centiles. An increase of 1 mm Hg was associated with a decrease in birth weight centiles by 1.8%. There was no association between MAP and birth weight centiles. In normotensive pregnancy arterial stiffness is associated with birth weight centile and catch-up growth after birth, independently from MAP. This suggests that arterial stiffness reflects maternal vascular adaptation to pregnancy better than blood pressure.

Birth weight and risk factors for cardiovascular disease and type 2 diabetes in US children and adolescents: 10 year results from NHANES.

PubMed

Zhang, Zhiying; Kris-Etherton, Penny M; Hartman, Terryl J

2014-08-01

Previous studies have shown that birth weight and other birth characteristics may be associated with risk for type 2 diabetes and cardiovascular disease (CVD) later in life; however, results using large US national survey data are limited. Our goal was to determine the aforementioned associations using nationally representative data. We studied children and adolescents 6-15 years using data from the National Health and Nutrition Examination Survey cycles 2001-2010. Survey and examination data included demographic and early childhood characteristics, current health status, physical activity information, anthropometric measurements, dietary data (total energy, saturated fat, sodium, and sugar intakes), biomarkers related to selected risk factors of CVD [systolic blood pressure (SBP), plasma C-reactive protein (CRP) and lipid profiles], and type 2 diabetes [fasting glucose, insulin, and homeostasis model assessment (HOMA)]. Birth weight (proxy-reported) was inversely associated with SBP among girls; SBP levels increased 1.4 mmHg for each 1,000 g decrease in birth weight (p = 0.003) after controlling for potential confounders. Birth weight was not associated with levels of CRP or lipid profiles across the three racial groups. In addition, birth weight was inversely related to levels of fasting insulin and HOMA among non-Hispanic Whites; for each 1,000 g decrease in birth weight, fasting insulin levels increased 9.1% (p = 0.007) and HOMA scores increased 9.8% (p = 0.007). Birth weight was inversely associated with the levels of SBP, fasting insulin, and HOMA. These results support a role for birth weight, independent of the strong effects of current body weight status, in increasing risk for CVD and type 2 diabetes.

Results of screening for retinopathy of prematurity in a large nursery in Kuwait: Incidence and risk factors.

PubMed

Wani, Vivek B; Kumar, Niranjan; Sabti, Khalid; Raizada, Seemant; Rashwan, Nabeel; Shukkur, Mumtaz M; Harbi, Mohammed

2010-01-01

The aim of the study was to report the incidence of retinopathy of prematurity (ROP) and severe ROP and identify the risk factors for their development in a large nursery in Kuwait. This was a retrospective, interventional, non-comparative, hospital-based study. Retrospective review of ROP records of premature babies having either birth weight of less than 1501 g or gestational age at birth of 34 weeks or less and born between January 2001 and August 2003. By univariate and multivariate logistic regression analysis. Out of the 599 babies studied, 38.9% developed ROP and 7.8% needed treatment for severe ROP. Multivariate analysis showed low birth weight (OR 13.753, 95% CI 3.66-51.54; ( P < 0.001), gestational age (OR 13.75, 95% CI 3.66-51.54; P < 0.001), surfactant (OR 1.72, 95% CI 1.04-2.83; P = 0.032) and stay in the intensive care unit for longer than 15 days (OR 2.25, 95% CI 1.05-4.85; P = 0.033) to be significant for the development of any ROP. Low birth weight (OR 22.86, 95% CI 3.86-134.82; P = 0.001), bacterial sepsis (OR 3.27, 95% CI 1.51-7.05; P = 0.002) and need for surfactant (OR 4.41, 95% CI 0.94 -20.56; P = 0.059) were found to be the risk factors for severe ROP needing laser treatment. The incidence of both any ROP and ROP needing treatment are comparable to other studies. Low birth weight is the most important risk factor for both any ROP and severe ROP.

Screening for retinopathy of prematurity and treatment outcome in a tertiary hospital in Hong Kong.

PubMed

Iu, L Pl; Lai, C Hy; Fan, M Cy; Wong, I Yh; Lai, J Sm

2017-02-01

Studies on the prevalence and severity of retinopathy of prematurity in the local population are scarce. This study aimed to evaluate the prevalence, screening, and treatment outcome of retinopathy of prematurity in a tertiary hospital in Hong Kong. This cross-sectional study with internal comparison was conducted at Queen Mary Hospital, Hong Kong. The study evaluated 89 premature infants who were born at the hospital and were screened for retinopathy of prematurity, in accordance with the 2008 British Guidelines, between January 2013 and December 2013. The prevalences of retinopathy of prematurity and severe retinopathy requiring treatment were studied. The mean (± standard deviation) gestational age at birth was 30 +2 weeks ± 16.5 days (range, 24 +1 to 35 +5 weeks). The mean birth weight was 1285 g ± 328 g (range, 580 g to 2030 g). A total of 15 (16.9%) infants developed retinopathy of prematurity and three (3.4%) required treatment. In a subgroup analysis of extremely-low-birth-weight infants of <1000 g, 70.6% developed retinopathy of prematurity and 17.6% required treatment. Multivariate logistic regression analysis suggested low birth weight and patent ductus arteriosus were significantly associated with development of retinopathy of prematurity (P<0.001 and P=0.035, respectively). Among the three infants who received treatment for severe retinopathy of prematurity, all regressed successfully after one laser treatment. Retinopathy of prematurity is a significant problem among premature infants in Hong Kong, especially those with extremely low birth weight. Our screening service for retinopathy of prematurity was satisfactory and treatment results were good. Strict adherence to international screening guidelines and vigilance in infants at risk are key to successful management of retinopathy of prematurity.

Effects of prophylactic indomethacin in extremely low-birth-weight infants with and without adequate exposure to antenatal corticosteroids.

PubMed

Schmidt, Barbara; Seshia, Mary; Shankaran, Seetha; Mildenhall, Lindsay; Tyson, Jon; Lui, Kei; Fok, Tai; Roberts, Robin

2011-07-01

To examine whether treatment with antenatal corticosteroids modifies the immediate and long-term effects of prophylactic indomethacin sodium trihydrate in extremely low-birth-weight infants. Post hoc subgroup analysis of data from the Trial of Indomethacin Prophylaxis in Preterms. Thirty-two neonatal intensive care units in Canada, the United States, Australia, New Zealand, and Hong Kong. A total of 1195 infants with birth weights of 500 to 999 g and known exposure to antenatal corticosteroids. We defined as adequate any exposure to antenatal corticosteroids that occurred at least 24 hours before delivery. Indomethacin or placebo intravenously once daily for the first 3 days. Death or survival to 18 months with cerebral palsy, cognitive delay, severe hearing loss, or bilateral blindness; severe periventricular and intraventricular hemorrhage; patent ductus arteriosus; and surgical closure of a patent ductus arteriosus. Of the 1195 infants in this analysis cohort, 670 had adequate and 525 had inadequate exposure to antenatal corticosteroids. There was little statistical evidence of heterogeneity in the effects of prophylactic indomethacin between the subgroups for any of the outcomes. The adjusted P values for interaction were as low as .15 for the outcome of death or impairment at 18 months and as high as .80 for the outcome of surgical duct closure. We find little evidence that the effects of prophylactic indomethacin vary in extremely low-birth-weight infants with and without adequate exposure to antenatal corticosteroids. Trial Registration clinicaltrials.gov Identifier: NCT00009646.

The effect of environmental tobacco smoke during pregnancy on birth weight.

PubMed

Hegaard, Hanne K; Kjaergaard, Hanne; Møller, Lars F; Wachmann, Henrik; Ottesen, Bent

2006-01-01

This study explores whether pregnant nonsmokers' exposure to environmental tobacco smoke (ETS) affects the average birth weight at term. The population studied consists of pregnant nonsmokers participating in a study called Smoke-free Newborn Study. The participants (n = 1612) answered a questionnaire during 12th to 16th gestational week about their exposure to ETS at home and outside the home. Pregnant nonsmokers exposed to ETS both at home and outside the home gave birth to children with a birth weight of 78.9 g (95% CI -143.7 to -14.1) (P=0.02) lower than the weight of children born to women unexposed to ETS. There was no significant reduction in birth weight among women exposed to ETS at home only or outside the home only. A nonsignificant dose-response association was seen between increasing daily exposure to ETS and reduction in birth weight. Nonsmoking pregnant women who were exposed to ETS at home as well as outside the home gave birth to children with a 79 g reduction in birth weight compared to children of unexposed women. The fact that exposure to ETS has an effect on the birth weight is regarded as essential. The authors recommend that pregnant women should not be exposed to passive smoking, and that it should be considered whether workplace legislation should be instituted in order to protect pregnant women against the adverse effects of passive smoking.

Genetic Evidence for Causal Relationships Between Maternal Obesity-Related Traits and Birth Weight.

PubMed

Tyrrell, Jessica; Richmond, Rebecca C; Palmer, Tom M; Feenstra, Bjarke; Rangarajan, Janani; Metrustry, Sarah; Cavadino, Alana; Paternoster, Lavinia; Armstrong, Loren L; De Silva, N Maneka G; Wood, Andrew R; Horikoshi, Momoko; Geller, Frank; Myhre, Ronny; Bradfield, Jonathan P; Kreiner-Møller, Eskil; Huikari, Ville; Painter, Jodie N; Hottenga, Jouke-Jan; Allard, Catherine; Berry, Diane J; Bouchard, Luigi; Das, Shikta; Evans, David M; Hakonarson, Hakon; Hayes, M Geoffrey; Heikkinen, Jani; Hofman, Albert; Knight, Bridget; Lind, Penelope A; McCarthy, Mark I; McMahon, George; Medland, Sarah E; Melbye, Mads; Morris, Andrew P; Nodzenski, Michael; Reichetzeder, Christoph; Ring, Susan M; Sebert, Sylvain; Sengpiel, Verena; Sørensen, Thorkild I A; Willemsen, Gonneke; de Geus, Eco J C; Martin, Nicholas G; Spector, Tim D; Power, Christine; Järvelin, Marjo-Riitta; Bisgaard, Hans; Grant, Struan F A; Nohr, Ellen A; Jaddoe, Vincent W; Jacobsson, Bo; Murray, Jeffrey C; Hocher, Berthold; Hattersley, Andrew T; Scholtens, Denise M; Davey Smith, George; Hivert, Marie-France; Felix, Janine F; Hyppönen, Elina; Lowe, William L; Frayling, Timothy M; Lawlor, Debbie A; Freathy, Rachel M

2016-03-15

Neonates born to overweight or obese women are larger and at higher risk of birth complications. Many maternal obesity-related traits are observationally associated with birth weight, but the causal nature of these associations is uncertain. To test for genetic evidence of causal associations of maternal body mass index (BMI) and related traits with birth weight. Mendelian randomization to test whether maternal BMI and obesity-related traits are potentially causally related to offspring birth weight. Data from 30,487 women in 18 studies were analyzed. Participants were of European ancestry from population- or community-based studies in Europe, North America, or Australia and were part of the Early Growth Genetics Consortium. Live, term, singleton offspring born between 1929 and 2013 were included. Genetic scores for BMI, fasting glucose level, type 2 diabetes, systolic blood pressure (SBP), triglyceride level, high-density lipoprotein cholesterol (HDL-C) level, vitamin D status, and adiponectin level. Offspring birth weight from 18 studies. Among the 30,487 newborns the mean birth weight in the various cohorts ranged from 3325 g to 3679 g. The maternal genetic score for BMI was associated with a 2-g (95% CI, 0 to 3 g) higher offspring birth weight per maternal BMI-raising allele (P = .008). The maternal genetic scores for fasting glucose and SBP were also associated with birth weight with effect sizes of 8 g (95% CI, 6 to 10 g) per glucose-raising allele (P = 7 × 10(-14)) and -4 g (95% CI, -6 to -2 g) per SBP-raising allele (P = 1×10(-5)), respectively. A 1-SD ( ≈ 4 points) genetically higher maternal BMI was associated with a 55-g higher offspring birth weight (95% CI, 17 to 93 g). A 1-SD ( ≈ 7.2 mg/dL) genetically higher maternal fasting glucose concentration was associated with 114-g higher offspring birth weight (95% CI, 80 to 147 g). However, a 1-SD ( ≈ 10 mm Hg) genetically higher maternal SBP was associated with a 208-g lower offspring birth weight (95% CI, -394 to -21 g). For BMI and fasting glucose, genetic associations were consistent with the observational associations, but for systolic blood pressure, the genetic and observational associations were in opposite directions. In this mendelian randomization study, genetically elevated maternal BMI and blood glucose levels were potentially causally associated with higher offspring birth weight, whereas genetically elevated maternal SBP was potentially causally related to lower birth weight. If replicated, these findings may have implications for counseling and managing pregnancies to avoid adverse weight-related birth outcomes.

Relationship of low lean body mass with body weight increase until one year of age and current lifestyles in Japanese young women.

PubMed

Miyamoto, Shoji; Murotani, Kenta; Yanagawa, Takashi; Kato, Atsushi; Matsunaga, Satoshi

2010-06-01

To investigate factors affecting the low lean body mass (LBM) of young women, we focused on the increase in body weight until one year of age and current lifestyles. In 442 young women, the increase in body weight from birth until one year of age, breast-feeding method in infancy, current physique index and body composition, and physique and lifestyles were investigated using a questionnaire. Subjects with an LBM percentile of less than 33.3 (less than 36.8 kg) were classified as having a low LBM (n = 150), and those with a 33.3 or higher LBM percentile as the control (n = 293). Based on body weight changes from birth to days 3 and 7, the subjects were divided into a rapid weight gain group and two non-rapid weight gain groups (groups 1-3). To analyze factors involved in a low LBM, multivariate analysis using a logistic model was employed. The prevalence of a low LBM in the rapid weight gain group was 0.41 times higher than in the others. The prevalence of a low LBM with a low birth weight was 0.58 times higher, indicating that a low birth weight is likely to result in a low LBM. Regarding the lifestyles, the prevalence of a low LBM in subjects with a current breakfasting habit was 0.60 times higher than in those without one. These findings suggest that the thinness of young women characterized by a low LBM is associated with the increase in body weight until one year of age and current lifestyles.

Pre-pregnancy body mass index and gestational weight gain in Thai pregnant women as risks for low birth weight and macrosomia.

PubMed

Pongcharoen, Tippawan; Gowachirapant, Sueppong; Wecharak, Purisa; Sangket, Natnaree; Winichagoon, Pattanee

2016-12-01

Maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) have been reported to be associated with pregnancy outcomes. Due to the nutrition transition in Thailand, the double burden of malnutrition is increasing and this may have negative consequences on birth outcomes. This study aimed to investigate the relationship between pre-pregnancy BMI and GWG with the risks of low birth weight and macrosomia. We performed a secondary analysis of data obtained from an iodine supplementation trial in mildly iodine-deficient Thai pregnant women. Pre-pregnancy BMI was classified using the WHO classification. GWG was categorized using the IOM recommendation. Binary and multinomial logistic regressions were performed. Among 378 pregnant women, the prevalence of pre-pregnancy underweight (BMI<18.5 kg/m2) and overweight (BMI>=25 kg/m2) were 17.2% and 14.3%, respectively. Normal weight women had the highest median GWG [15.0 (12.0, 19.0) kg] when compared to overweight women [13.2 (9.0, 16.3) kg]. Forty-one percent of women had excessive GWG, while 23% of women gained weight inadequately. Women with a high pre-pregnancy BMI had a 7-fold higher risk of having a macrosomic infant. Women who had excessive GWG were 8 times more likely to deliver a newborn with macrosomia. Both high pre-pregnancy maternal weight and excessive weight gain during pregnancy increase risk of infant macrosomia. Therefore, maintaining normal body weight before and throughout pregnancy should be recommended in order to reduce the risk of excessive infant birth weight and its associated complications.

The significance of placental ratios in pregnancies complicated by small for gestational age, preeclampsia, and gestational diabetes mellitus.

PubMed

Kim, Hee Sun; Cho, Soo Hyun; Kwon, Han Sung; Sohn, In Sook; Hwang, Han Sung

2014-09-01

This study aimed to evaluate the placental weight, volume, and density, and investigate the significance of placental ratios in pregnancies complicated by small for gestational age (SGA), preeclampsia (PE), and gestational diabetes mellitus (GDM). Two hundred and fifty-four pregnant women were enrolled from August 2005 through July 2013. Participants were divided into four groups: control (n=82), SGA (n=37), PE (n=102), and GDM (n=33). The PE group was classified as PE without intrauterine growth restriction (n=65) and PE with intrauterine growth restriction (n=37). Birth weight, placental weight, placental volume, placental density, and placental ratios including birth weight/placental weight ratio (BPW) and birth weight/placental volume ratio (BPV) were compared between groups. Birth weight, placental weight, and placental volume were lower in the SGA group than in the control group. However, the BPW and BPV did not differ between the two groups. Birth weight, placental weight, placental volume, BPW, and BPV were all significantly lower in the PE group than in the control group. Compared with the control group, birth weight, BPW, and BPV were higher in the GDM group, whereas placental weight and volume did not differ in the two groups. Placental density was not significantly different among the four groups. Placental ratios based on placental weight, placental volume, placental density, and birth weight are helpful in understanding the pathophysiology of complicated pregnancies. Moreover, they can be used as predictors of pregnancy complications.

Dental neglect and adverse birth outcomes: a validation and observational study.

PubMed

Acharya, S; Pentapati, K C; Bhat, P V

2013-05-01

The objectives of this study were to validate the Indian translation of the Dental Neglect Scale (DNS) among a sample of parturient Indian women and to investigate dental neglect as a possible risk indicator in adverse birth outcomes. Three hundred and sixteen parturient women were administered the DNS and the Modified Dental Beliefs Scale (MDBS) and were also clinically examined for oral health status. Information regarding socio-economic status, weeks of gestation and birth weight was also collected. A gestation period of less than 37 weeks was considered as preterm and a birth weight of less than 2500 gm as 'low birth weight'. The Indian version of the DNS was found to be reliable (Cronbach's Alpha = 0.72) and valid for assessing dental neglect among the women. Factor analysis of the DNS revealed a two-factor structure accounting for 56% variance. Dental neglect was higher among those with poorer oral health status, lower socio-economic and educational status. Multinomial logistic regression showed high dental neglect and negative dental beliefs and not poor oral health, as significant risk indicators for occurrence of adverse birth outcomes. The finding of an association of adverse birth outcomes with dental neglect and beliefs, but not with poor oral health could be due to the influence of other more important general factors which had a direct bearing on birth outcomes. There is a need for further research to assess the role of behavioural factors like dental neglect as risk indicators for adverse birth outcomes. © 2012 John Wiley & Sons A/S.

Effect of prematurity and low birth weight in visual abilities and school performance.

PubMed

Perez-Roche, T; Altemir, I; Giménez, G; Prieto, E; González, I; Peña-Segura, J L; Castillo, O; Pueyo, V

2016-12-01

Prematurity and low birth weight are known risk factors for cognitive and developmental impairments, and school failure. Visual perceptual and visual motor skills seem to be among the most affected cognitive domains in these children. To assess the influence of prematurity and low birth weight in visual cognitive skills and school performance. We performed a prospective cohort study, which included 80 boys and girls in an age range from 5 to 13. Subjects were grouped by gestational age at birth (preterm, <37 weeks; term, 37-42 weeks) and birth weight (small for gestational age (SGA), <10th centile; appropriate weight for gestational age (AGA), ≥10th centile). Each child underwent full ophthalmologic assessment and standardized testing of visual cognitive abilities (Test of Visual Perceptual Skills and Test of Visual Analysis Skills). Parents completed a questionnaire on school performance in children. Figure-ground skill and visual motor integration were significantly decreased in the preterm birth group, compared with term control subjects (figure-ground: 45.7 vs 66.5, p=0.012; visual motor integration, TVAS: (9.9 vs 11.8, p=0.018), while outcomes of visual memory (29.0 vs 47.7, p=0.012), form constancy (33.3 vs 52.8, p=0.019), figure-ground (37.4 vs 65.6, p=0.001), and visual closure (43.7 vs 62.6 p=0.016) testing were lower in the SGA (vs AGA) group. Visual cognitive difficulties corresponded with worse performance in mathematics (r=0.414, p=0.004) and reading (r=0.343, p=0.018). Specific patterns of visual perceptual and visual motor deficits are displayed by children born preterm or SGA, which hinder mathematics and reading performance. Copyright © 2016 Elsevier Ltd. All rights reserved.

Maternal Dietary Patterns and Practices and Birth Weight in Northern Ghana

PubMed Central

Jahn, Albrecht

2016-01-01

Background Adequate maternal nutrition is a key factor for achieving good pregnancy outcomes. Moreover, inadequate dietary intake during pregnancy is considered an important contributor to maternal malnutrition in developing countries. Although some studies have examined the effect of the entire diet on birth outcome, most studies have been very narrow because they considered the effect of single nutrient. The single nutrient approach is a major setback because usually several nutrient deficiencies are more likely to occur than single deficiencies especially in low-income settings. Objectives The main aim of this study was to investigate the association between maternal dietary patterns, and practices and birth weight in Northern Ghana. Participant Settings A facility-based cross-sectional survey was performed in two districts in the Northern Region of Ghana. The selected districts were the Tamale Metropolis and Savelugu-Nanton District. These districts were purposively sampled to represent a mix of urban, peri-urban and rural populations, therefore ensuring that the distribution in social groups of the study population was similar to the entire population of the region. In all, 578 mothers who were drawing antenatal and postnatal care services were interviewed using a questionnaire, which asked the mothers about their frequency of consumption of individual foods per week since they became pregnant or when they were pregnant. Statistical Analysis We determined dietary patterns by applying a factor analysis with a varimax rotation using STATA. Multivariate analysis was used to establish association between maternal factors and dietary patterns. Logistic regression was used to assess the association between dietary practices and patterns and birth weight. Results Women who ate outside the home twice a week (OR = 1.6 & 95% CI; 1.1–2.45, P; 0.017) and those who practiced ‘pica’ (OR = 1.7 & 95% CI; 1.16–2.75, P; 0.008) had increased odds for low birth. Two dietary patterns were identified—namely ‘health conscious’ and ‘non-health conscious’. Health conscious diet (OR = 0.23 95% CI 0.12–0.45 per standard deviation change in scores, P; <0.0001) and dietary diversity score (OR = 0.10 95% CI 0.04–0.13 per standard deviation change in scores, P; <0.0001) showed a protective effect for low birth weight respectively after adjusting for gestational age. Conclusion Mothers who practiced good nutrition such as consuming foods across and within the various food groups were less likely to have low birth weight babies. Our findings buttress the importance of optimal nutrition during pregnancy. PMID:27611597

The low birth-weight infants of Saudi adolescents: maternal implications.

PubMed

al-Sibai, M H; Khwaja, S S; al-Suleiman, S A; Magbool, G

1987-11-01

Maternal factors and perinatal outcome of low birth-weight (less than or equal to 2,500 g) infants of 46 adolescent mothers was studied and compared with 160 adolescents who delivered infants weighing greater than 2,500 g. The significant factors found in the low birth-weight group were anaemia, small maternal physique and preterm delivery. Expectedly, the perinatal mortality rate was significantly increased in low birth-weight infants.

Developmental origins of polycystic ovary syndrome (PCOS), a case control study comparing birth weight in women with PCOS and control group.

PubMed

Sadrzadeh, Sheda; Painter, Rebecca C; Lambalk, Cornelis B

2016-10-01

Evidence from various epidemiological studies and experimental animal studies has linked adverse intrauterine circumstances with health problems in adult life. This field of investigation is known as Developmental Origins of Health and Disease (DOHaD). Studies investigating the relation between developing polycystic ovary syndrome (PCOS) in adulthood and birth weight have yielded inconsistent results: PCOS is described more often in women with low birth weight and high birth weight, while other studies have failed to establish any relation. In this retrospective case-control study, we evaluated whether women diagnosed with PCOS had lower birth weight compared to women with a regular menstrual cycle (controls). Binary logistic regression models were used to analyze the data and correct for known confounders. About 65 women with PCOS and 96 controls were recruited for this purpose. The average birth weight of PCOS women (3357 g) did not differ from the average birth weight of controls (3409 g). Mean age at menarche differed significantly between groups, 13.7  years and 12.8  years (p = 0.006), respectively, for PCOS women and controls. In conclusion, we could not confirm the effect of adverse intrauterine conditions, reflected in birth weight, on developing PCOS.

Impact of nulliparous women's body mass index or excessive weight gain in pregnancy on genital tract trauma at birth.

PubMed

Gallagher, Kelly; Migliaccio, Laura; Rogers, Rebecca G; Leeman, Lawrence; Hervey, Elizabeth; Qualls, Clifford

2014-01-01

The purpose of this study was to explore the impact of body mass index (BMI) or pregnancy weight gain on the presence, site, and severity of genital tract trauma at childbirth in nulliparous women. The present study is a subanalysis of a prospective cohort of healthy nulliparous women recruited during pregnancy and followed through birth. Weight gain during pregnancy and prepregnancy BMI were recorded. At birth, women underwent detailed mapping of genital tract trauma. For analyses, women were dichotomized into obese (BMI ≥ 30) versus nonobese (BMI < 30) at baseline as well as into those who gained weight as recommended by the Institute of Medicine (IOM) and those who gained more than the recommended amount to determine the impact of obesity or excessive weight gain on rates of genital tract trauma. Data from 445 women were available for analysis. Presence and severity of genital tract trauma did not vary between obese and nonobese women (51% vs 53%, P = .64). Likewise, women who had more than the IOM-recommended weight gain did not have a higher incidence of perineal lacerations (52% versus 53% with perineal lacerations, P = .69). Obese women were more likely to gain in excess of the IOM guidelines during pregnancy (75% vs 50% excessive weight gain in obese vs nonobese women, respectively; P < .001). A woman's BMI or excessive weight gain in pregnancy did not influence her risk of genital tract trauma at birth. © 2014 by the American College of Nurse-Midwives.

Low Birth Weight and School Readiness

ERIC Educational Resources Information Center

Reichman, Nancy E.

2005-01-01

In the United States black women have for decades been twice as likely as white women to give birth to babies of low birth weight who are at elevated risk for developmental disabilities. Does the black-white disparity in low birth weight contribute to the racial disparity in readiness? The author summarizes the cognitive and behavioral problems…

Physical activity during pregnancy and infant's birth weight: results from the 3D Birth Cohort.

PubMed

Bisson, Michèle; Croteau, Jordie; Guinhouya, Benjamin C; Bujold, Emmanuel; Audibert, François; Fraser, William D; Marc, Isabelle

2017-01-01

To evaluate the association between maternal physical activity and infant's birth weight or risk of inappropriate weight for gestational age (GA), and whether this association differs by infant's sex, maternal body mass index (BMI) or pregnancy complications in a prospective cohort study. 1913 pregnant women from the 3D Birth Cohort (Québec, Canada) completed the Pregnancy Physical Activity Questionnaire at each trimester. Energy expenditure (metabolic equivalent of task (MET)*hours/week) for total activity, sports and exercise and vigorous intensity activities was calculated. The associations with birth weight and risk of inappropriate weight for GA were evaluated by regression modelling. Interactions were tested with infant's sex, maternal prepregnancy BMI, gestational diabetes, hypertensive disorders and prematurity. Each 1 MET/hours/week increase in sports and exercise in the first trimester was associated with a 2.5 g reduction in infant's birth weight (95% CI -4.8 to -0.3) but was not associated with the risk of small weight for GA. In contrast, although not significant, a 17% reduction in the risk of large weight for GA was observed with increasing sports and exercise. Furthermore, in women with subsequent pre-eclampsia (but not normotensive or hypertensive women), each 1 MET/hours/week increment spent in any vigorous exercise in the first trimester reduced the infant's birth weight by 19.8 g (95% CI -35.2 to -4.3). Pregnant women with higher sports and exercise levels in the first trimester delivered infants with a lower birth weight. The risk of reducing infant's birth weight with vigorous exercise in women who develop pre-eclampsia later in pregnancy requires evaluation.

Prediction of birth weight discordance from fetal weight estimations at 21-24 weeks' scans in monochorionic and dichorionic twins.

PubMed

Queirós, Alexandra; Blickstein, Isaac; Valdoleiros, Sandra; Felix, Nisa; Cohen, Alvaro; Simões, Teresinha

2017-08-01

To evaluate if inter-twin estimated fetal weight (EFW) differences at 21-24 weeks' scans predict birth weight discordance in monochorionic and dichorionic twins born at three gestational age periods. We counted the number of pairs with discordant EFWs (EFWs greater than the mean + 1SD; i.e. a difference above 12% in dichorionic and 21% in monochorionic twins) derived during a 21-24 weeks' scan as compared to actual discordant birth weight (>25%) in monochorionic and dichorionic pairs born at ≤32, 33-36 and >36 weeks. We studied 416 dichorionic and 244 monochorionic twins. The frequency of EFWs discordance at 21-24 weeks was the same for dichorionic and monochorionic twins but the total number of birth weight discordant pairs was significantly smaller among dichorionic twins (OR 0.2, 95% CI 0.1, 0.6). Generally, the positive predictive values for birth weight discordance by using the EFWs difference were quite poor, but always better in monochorionic than in dichorionic twins. Whereas the negative predictive value and hence the sensitivity for monochorionic twins was 100% irrespective of gestational age at birth, it was much lower in the dichorionic pairs. Concordant EFWs at 21-24 weeks exclude discordant birth weight in monochorionic twins whereas discordant EFWs are poor predictors of birth weight discordance especially in dichorionic twins irrespective when the twins were born.

A prominent large high-density lipoprotein at birth enriched in apolipoprotein C-I identifies a new group of infancts of lower birth weight and younger gestational age

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kwiterovich Jr., Peter O.; Cockrill, Steven L.; Virgil, Donna G.

2003-10-01

Because low birth weight is associated with adverse cardiovascular risk and death in adults, lipoprotein heterogeneity at birth was studied. A prominent, large high-density lipoprotein (HDL) subclass enriched in apolipoprotein C-I (apoC-I) was found in 19 percent of infants, who had significantly lower birth weights and younger gestational ages and distinctly different lipoprotein profiles than infants with undetectable, possible or probable amounts of apoC-I-enriched HDL. An elevated amount of an apoC-I-enriched HDL identifies a new group of low birth weight infants.

The effect of supervised prenatal exercise on fetal growth: a meta-analysis.

PubMed

Wiebe, Henry W; Boulé, Normand G; Chari, Radha; Davenport, Margie H

2015-05-01

To estimate the influence of structured prenatal exercise on newborn birth weight, macrosomia, and growth restriction. A structured search of MEDLINE, EMBASE, CINAHL, Sport Discus, Ovid's All EBM Reviews, and ClinicalTrials.gov databases up to January 13, 2015. The search combined keywords and MeSH-like terms including, but not limited, to "physical activity," "exercise," "pregnancy," "gestation," "neonatal," and "randomized controlled trial." Articles reporting randomized controlled trials comparing standard care with standard care plus supervised prenatal exercise for which birth size was available were included. Supervision was defined as at least one exercise session performed with study personnel every 2 weeks throughout the program. Interventions consisting solely of pelvic floor exercises, stretching, or relaxation were excluded. Our search yielded 1,036 publications of which 79 were assessed for eligibility. Twenty-eight studies reporting on 5,322 pregnancies were subsequently included in the analysis. Our meta-analysis demonstrated that prenatal exercise reduced the odds of having a large newborn (birth weight greater than 4,000 g or greater than the 90th percentile for gestational age and sex) by 31% (odds ratio [OR] 0.69, 95% confidence interval [CI] 0.55-0.86; I 25%) without altering the risk of having a small newborn (birth weight less than 2,500 g or less than the 10th percentile for gestational age and sex) (OR 1.02, 95% CI 0.72-1.46; I 0%) or gestational age at delivery (weighted mean difference -0.00 weeks, 95% CI -0.09 to 0.09; I 0%). Newborns of mothers assigned to exercise were lighter than those of nonexercising controls (weighted mean difference -31 g, 95% CI -57 to -4; I 0%). Maternal gestational weight gain (weighted mean difference -1.1 kg, 95% CI -1.5 to -0.6; I 53%) and odds of cesarean delivery (OR 0.80, 95% CI 0.69-0.94; I 0%) were also reduced. These data demonstrate that structured prenatal exercise reduces the risk of having a large newborn without a change in the risk of having a small newborn.

Estimates of burden and consequences of infants born small for gestational age in low and middle income countries with INTERGROWTH-21st standard: analysis of CHERG datasets.

PubMed

Lee, Anne Cc; Kozuki, Naoko; Cousens, Simon; Stevens, Gretchen A; Blencowe, Hannah; Silveira, Mariangela F; Sania, Ayesha; Rosen, Heather E; Schmiegelow, Christentze; Adair, Linda S; Baqui, Abdullah H; Barros, Fernando C; Bhutta, Zulfiqar A; Caulfield, Laura E; Christian, Parul; Clarke, Siân E; Fawzi, Wafaie; Gonzalez, Rogelio; Humphrey, Jean; Huybregts, Lieven; Kariuki, Simon; Kolsteren, Patrick; Lusingu, John; Manandhar, Dharma; Mongkolchati, Aroonsri; Mullany, Luke C; Ndyomugyenyi, Richard; Nien, Jyh Kae; Roberfroid, Dominique; Saville, Naomi; Terlouw, Dianne J; Tielsch, James M; Victora, Cesar G; Velaphi, Sithembiso C; Watson-Jones, Deborah; Willey, Barbara A; Ezzati, Majid; Lawn, Joy E; Black, Robert E; Katz, Joanne

2017-08-17

Objectives  To estimate small for gestational age birth prevalence and attributable neonatal mortality in low and middle income countries with the INTERGROWTH-21 st birth weight standard. Design  Secondary analysis of data from the Child Health Epidemiology Reference Group (CHERG), including 14 birth cohorts with gestational age, birth weight, and neonatal follow-up. Small for gestational age was defined as infants weighing less than the 10th centile birth weight for gestational age and sex with the multiethnic, INTERGROWTH-21 st birth weight standard. Prevalence of small for gestational age and neonatal mortality risk ratios were calculated and pooled among these datasets at the regional level. With available national level data, prevalence of small for gestational age and population attributable fractions of neonatal mortality attributable to small for gestational age were estimated. Setting  CHERG birth cohorts from 14 population based sites in low and middle income countries. Main outcome measures  In low and middle income countries in the year 2012, the number and proportion of infants born small for gestational age; number and proportion of neonatal deaths attributable to small for gestational age; the number and proportion of neonatal deaths that could be prevented by reducing the prevalence of small for gestational age to 10%. Results  In 2012, an estimated 23.3 million infants (uncertainty range 17.6 to 31.9; 19.3% of live births) were born small for gestational age in low and middle income countries. Among these, 11.2 million (0.8 to 15.8) were term and not low birth weight (≥2500 g), 10.7 million (7.6 to 15.0) were term and low birth weight (<2500 g) and 1.5 million (0.9 to 2.6) were preterm. In low and middle income countries, an estimated 606 500 (495 000 to 773 000) neonatal deaths were attributable to infants born small for gestational age, 21.9% of all neonatal deaths. The largest burden was in South Asia, where the prevalence was the highest (34%); about 26% of neonatal deaths were attributable to infants born small for gestational age. Reduction of the prevalence of small for gestational age from 19.3% to 10.0% in these countries could reduce neonatal deaths by 9.2% (254 600 neonatal deaths; 164 800 to 449 700). Conclusions  In low and middle income countries, about one in five infants are born small for gestational age, and one in four neonatal deaths are among such infants. Increased efforts are required to improve the quality of care for and survival of these high risk infants in low and middle income countries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Estimates of burden and consequences of infants born small for gestational age in low and middle income countries with INTERGROWTH-21st standard: analysis of CHERG datasets

PubMed Central

Kozuki, Naoko; Cousens, Simon; Stevens, Gretchen A; Blencowe, Hannah; Silveira, Mariangela F; Sania, Ayesha; Rosen, Heather E; Schmiegelow, Christentze; Adair, Linda S; Baqui, Abdullah H; Barros, Fernando C; Bhutta, Zulfiqar A; Caulfield, Laura E; Christian, Parul; Clarke, Siân E; Fawzi, Wafaie; Gonzalez, Rogelio; Humphrey, Jean; Huybregts, Lieven; Kariuki, Simon; Kolsteren, Patrick; Lusingu, John; Manandhar, Dharma; Mongkolchati, Aroonsri; Mullany, Luke C; Ndyomugyenyi, Richard; Nien, Jyh Kae; Roberfroid, Dominique; Saville, Naomi; Terlouw, Dianne J; Tielsch, James M; Victora, Cesar G; Velaphi, Sithembiso C; Watson-Jones, Deborah; Willey, Barbara A; Ezzati, Majid; Lawn, Joy E; Black, Robert E; Katz, Joanne

2017-01-01

Objectives To estimate small for gestational age birth prevalence and attributable neonatal mortality in low and middle income countries with the INTERGROWTH-21st birth weight standard. Design Secondary analysis of data from the Child Health Epidemiology Reference Group (CHERG), including 14 birth cohorts with gestational age, birth weight, and neonatal follow-up. Small for gestational age was defined as infants weighing less than the 10th centile birth weight for gestational age and sex with the multiethnic, INTERGROWTH-21st birth weight standard. Prevalence of small for gestational age and neonatal mortality risk ratios were calculated and pooled among these datasets at the regional level. With available national level data, prevalence of small for gestational age and population attributable fractions of neonatal mortality attributable to small for gestational age were estimated. Setting CHERG birth cohorts from 14 population based sites in low and middle income countries. Main outcome measures In low and middle income countries in the year 2012, the number and proportion of infants born small for gestational age; number and proportion of neonatal deaths attributable to small for gestational age; the number and proportion of neonatal deaths that could be prevented by reducing the prevalence of small for gestational age to 10%. Results In 2012, an estimated 23.3 million infants (uncertainty range 17.6 to 31.9; 19.3% of live births) were born small for gestational age in low and middle income countries. Among these, 11.2 million (0.8 to 15.8) were term and not low birth weight (≥2500 g), 10.7 million (7.6 to 15.0) were term and low birth weight (<2500 g) and 1.5 million (0.9 to 2.6) were preterm. In low and middle income countries, an estimated 606 500 (495 000 to 773 000) neonatal deaths were attributable to infants born small for gestational age, 21.9% of all neonatal deaths. The largest burden was in South Asia, where the prevalence was the highest (34%); about 26% of neonatal deaths were attributable to infants born small for gestational age. Reduction of the prevalence of small for gestational age from 19.3% to 10.0% in these countries could reduce neonatal deaths by 9.2% (254 600 neonatal deaths; 164 800 to 449 700). Conclusions In low and middle income countries, about one in five infants are born small for gestational age, and one in four neonatal deaths are among such infants. Increased efforts are required to improve the quality of care for and survival of these high risk infants in low and middle income countries PMID:28819030

Preterm birth and adolescent bone mineral content.

PubMed

Erlandson, Marta C; Sherar, Lauren B; Baxter-Jones, Adam D G; Jackowski, Stefan A; Ludwig-Auser, Heidi; Arnold, Chris; Sankaran, Koravangattu

2011-02-01

The purpose of this study was to determine the influence of preterm low birth weight on bone mineral content in adolescence. In 2007 to 2008, data on adolescents were obtained for study, including 16 females and 25 males who were born preterm (≤37 weeks' gestation) between October 1, 1989, and December 31, 1995, with a birth weight of less than 1850 g. Preterm low-birth-weight individuals were age- and sex-matched to full-term (>37 weeks) normal-birth-weight (>2500 g) controls. Total body, hip, and spine bone mineral content (BMC) was assessed using dual energy X-ray absorptiometry. Male preterm individuals had less BMC at the proximal femur in adolescence compared with controls ( p < 0.05). However, once adjusted for age, maturity, height, weight, physical activity, and diet, there were no differences between groups ( p < 0.05) in any bone parameters. These findings suggest that preterm birth and low birth weight did not influence bone accrual in these individuals at adolescence. © Thieme Medical Publishers.

Improving the accuracy of birth notification data: lessons from the Birth to Ten study

PubMed Central

Ellison, GTH; Richter, LM; de Wet, T; Harris, HE; Griesel, RD; McIntyre, JA

2007-01-01

The aim of the present study was to evaluate the accuracy of birth notification data collected during Birth to Ten, a longitudinal birth cohort study based in the Soweto-Johannesburg Metropole. Photocopies of birth notification forms were obtained from three local health authorities (Soweto, Diepmeadow and Johannesburg) for 5 448 of the 5 460 singleton births that occurred during seven weeks between April and June 1990, to women resident in Soweto-Johannesburg. By comparing the data recorded on the three different types of notification forms used by delivery centres within the Metropole, it was possible to assess the consistency of data collected during birth notification. For 539 of the 2 120 births that occurred at Baragwanath Hospital in Soweto, it was possible to locate the original records of maternal age, gravidity, infant sex, date of birth, birth weight and gestational age at birth, contained in obstetric and neonatal hospital files. By comparing these records with information contained in the birth notification forms it was possible to assess the accuracy of birth notification data submitted for deliveries at Baragwanath Hospital. Each of the different notification forms contained a different selection of variables and failed to specify the precision with which continuous variables should be recorded. For 12 selected variables, the proportion of missing records ranged from 0.0% to 40.9%, and was highest for those variables (such as APGAR scores and parity) that were not required on all four forms. The percentage agreement between information recorded on these forms and the original hospital records was highest for the categorical variable infant sex (99.1%), while the accuracy of notification data for continuous variables ranged from 95.2% (maternal age) to 29.7% (gestational age at birth). The upper 95% confidence intervals for the mean absolute errors in gestational age at birth and birth weight were two to three times the units of measurement, at 2.4 weeks and 165 g, respectively. When these extremes of error were applied to data for all 539 children, the proportion classified as premature or post-term varied by up to 25.7%, while those classified as macrosomic, low or very low birth weight varied by 10.5%. This analysis illustrates the potential consequences of imprecise birth notification data on the apparent prevalence of premature and low birth weight babies, both of which are key indicators in maternal and child health. Improving the process of birth notification and standardising the format of birth notification forms would increase the consistency of birth notification data. Selecting variables that are established indicators of health status, and can be reliably measured, would help improve the utility and accuracy of birth notification data. PMID:19330041

Famine, third-trimester pregnancy weight gain, and intrauterine growth: the Dutch Famine Birth Cohort Study.

PubMed

Stein, A D; Ravelli, A C; Lumey, L H

1995-02-01

Data from the Dutch Famine Birth Cohort Study were analyzed to assess the influence of acute famine on the relation of maternal weight gain to birth weight, length, and ponderal index. Records were examined for 734 women receiving at least one month of prenatal care and delivering live-born singleton females at the University of Amsterdam Teaching Hospital between August 1944 and April 1946. This period preceded, encompassed, and followed the Hunger Winter, a severe famine. After adjusting for covariates, weight loss or low to moderate (< or = 0.5 kg/week) weight gain was strongly associated with (p < 0.001 for each model) with offspring birth weight, length, and ponderal index and with trimester of famine exposure. At weight gains greater than 0.5 kg/week further weight gain was not associated with birth size. Among women losing weight or gaining < or = 0.5 kg/week the association between third-trimester weight change and birth weight among mother-daughter pairs exposed to famine in early or mid-pregnancy was stronger than the association observed among the unexposed cohort or among those exposed only late in pregnancy. Our results suggest that acute maternal nutritional deprivation affects fetal growth only below a threshold and that, conversely, even after a famine period offspring birth size does not respond in a linear fashion to ad libitum maternal feeding.

Identification of extremely premature infants at high risk of rehospitalization.

PubMed

Ambalavanan, Namasivayam; Carlo, Waldemar A; McDonald, Scott A; Yao, Qing; Das, Abhik; Higgins, Rosemary D

2011-11-01

Extremely low birth weight infants often require rehospitalization during infancy. Our objective was to identify at the time of discharge which extremely low birth weight infants are at higher risk for rehospitalization. Data from extremely low birth weight infants in Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network centers from 2002-2005 were analyzed. The primary outcome was rehospitalization by the 18- to 22-month follow-up, and secondary outcome was rehospitalization for respiratory causes in the first year. Using variables and odds ratios identified by stepwise logistic regression, scoring systems were developed with scores proportional to odds ratios. Classification and regression-tree analysis was performed by recursive partitioning and automatic selection of optimal cutoff points of variables. A total of 3787 infants were evaluated (mean ± SD birth weight: 787 ± 136 g; gestational age: 26 ± 2 weeks; 48% male, 42% black). Forty-five percent of the infants were rehospitalized by 18 to 22 months; 14.7% were rehospitalized for respiratory causes in the first year. Both regression models (area under the curve: 0.63) and classification and regression-tree models (mean misclassification rate: 40%-42%) were moderately accurate. Predictors for the primary outcome by regression were shunt surgery for hydrocephalus, hospital stay of >120 days for pulmonary reasons, necrotizing enterocolitis stage II or higher or spontaneous gastrointestinal perforation, higher fraction of inspired oxygen at 36 weeks, and male gender. By classification and regression-tree analysis, infants with hospital stays of >120 days for pulmonary reasons had a 66% rehospitalization rate compared with 42% without such a stay. The scoring systems and classification and regression-tree analysis models identified infants at higher risk of rehospitalization and might assist planning for care after discharge.

Identification of Extremely Premature Infants at High Risk of Rehospitalization

PubMed Central

Carlo, Waldemar A.; McDonald, Scott A.; Yao, Qing; Das, Abhik; Higgins, Rosemary D.

2011-01-01

OBJECTIVE: Extremely low birth weight infants often require rehospitalization during infancy. Our objective was to identify at the time of discharge which extremely low birth weight infants are at higher risk for rehospitalization. METHODS: Data from extremely low birth weight infants in Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network centers from 2002–2005 were analyzed. The primary outcome was rehospitalization by the 18- to 22-month follow-up, and secondary outcome was rehospitalization for respiratory causes in the first year. Using variables and odds ratios identified by stepwise logistic regression, scoring systems were developed with scores proportional to odds ratios. Classification and regression-tree analysis was performed by recursive partitioning and automatic selection of optimal cutoff points of variables. RESULTS: A total of 3787 infants were evaluated (mean ± SD birth weight: 787 ± 136 g; gestational age: 26 ± 2 weeks; 48% male, 42% black). Forty-five percent of the infants were rehospitalized by 18 to 22 months; 14.7% were rehospitalized for respiratory causes in the first year. Both regression models (area under the curve: 0.63) and classification and regression-tree models (mean misclassification rate: 40%–42%) were moderately accurate. Predictors for the primary outcome by regression were shunt surgery for hydrocephalus, hospital stay of >120 days for pulmonary reasons, necrotizing enterocolitis stage II or higher or spontaneous gastrointestinal perforation, higher fraction of inspired oxygen at 36 weeks, and male gender. By classification and regression-tree analysis, infants with hospital stays of >120 days for pulmonary reasons had a 66% rehospitalization rate compared with 42% without such a stay. CONCLUSIONS: The scoring systems and classification and regression-tree analysis models identified infants at higher risk of rehospitalization and might assist planning for care after discharge. PMID:22007016

Reference curves of birth weight, length, and head circumference for gestational ages in Yogyakarta, Indonesia.

PubMed

Haksari, Ekawaty L; Lafeber, Harrie N; Hakimi, Mohammad; Pawirohartono, Endy P; Nyström, Lennarth

2016-11-21

The birth weight reference curve to estimate the newborns at risk in need of assessment and monitoring has been established. The previous reference curves from Indonesia, approximately 8 years ago, were based on the data collected from teaching hospitals only with limited gestational ages. The aims of the study were to update the reference curves for birth weight, supine length and head circumference for Indonesia, and to compare birth weight curves of boys and girls, first child and later children, and the ones in the previous studies. Data were extracted from the Maternal-Perinatal database between 1998-2007. Only live singletons with recorded gestational ages of 26 to 42 weeks and the exact time of admission to the neonatal facilities delivered or referred within 24 h of age to Sardjito Hospital, five district hospitals and five health centers in Yogyakarta Special Territory were included. Newborns with severely ill conditions, congenital anomaly and chromosomal abnormality were excluded. Smoothening of the curves was accomplished using a third-order polynomial equation. Our study included 54,599 singleton live births. Growth curves were constructed for boys (53.3%) and girls (46.7%) for birth weight, supine length, and head circumference. At term, mean birth weight for each gestational age of boys was significantly higher than that of girls. While mean birth weight for each gestational age of first-born-children, on the other hand was significantly lower than that of later-born-children. The mean birth weight was lower than that of Lubchenco's study. Compared with the previous Indonesian study by Alisyahbana, no differences were observed for the aterm infants, but lower mean birth weight was observed in preterm infants. Updated neonatal reference curves for birth weight, supine length and head circumference are important to classify high risk newborns in specific area and to identify newborns requiring attention.

Effects of pre-pregnancy body mass index and gestational weight gain on neonatal birth weight.

PubMed

Du, Meng-Kai; Ge, Li-Ya; Zhou, Meng-Lin; Ying, Jun; Qu, Fan; Dong, Min-Yue; Chen, Dan-Qing

To evaluate the effects of maternal pre-pregnancy body mass index (pre-BMI) and gestational weight gain (GWG) on neonatal birth weight (NBW) in the population of Chinese healthy pregnant women, attempting to guide weight control in pregnancy. A retrospective cohort study of 3772 Chinese women was conducted. The population was stratified by maternal pre-BMI categories as underweight (<18.5 kg/m 2 ), normal weight (18.5-23.9 kg/m 2 ), overweight (24.0-27.9 kg/m 2 ), and obesity (≥28.0 kg/m 2 ). The NBW differences were tested among the four groups, and then deeper associations among maternal pre-BMI, GWG, and NBW were investigated by multivariate analysis. NBW increased significantly with the increase of maternal pre-BMI level (P<0.05), except overweight to obesity (P>0.05). The multivariate analysis showed that both pre-BMI and GWG were positively correlated with NBW (P<0.05). Compared with normal pre-BMI, underweight predicted an increased odds ratio of small-for-gestational-age (SGA) and decreased odds ratio for macrosomia and large-for-gestational-age (LGA), and the results were opposite for overweight. With the increase of GWG, the risk of SGA decreased and the risks of macrosomia and LGA increased. In addition, in different pre-BMI categories, the effects of weight gain in the first trimester on NBW were different (P<0.05). NBW is positively affected by both maternal pre-BMI and GWG, extreme pre-BMI and GWG are both associated with increased risks of abnormal birth weight, and maternal pre-BMI may modify the effect of weight gain in each trimester on NBW. A valid GWG guideline for Chinese women is an urgent requirement, whereas existing recommendations seem to be not very suitable for the Chinese.

Birth weight and mortality: causality or confounding?

PubMed

Basso, Olga; Wilcox, Allen J; Weinberg, Clarice R

2006-08-15

The association between birth weight and mortality is among the strongest seen in epidemiology. While preterm delivery causes both small babies and high mortality, it does not explain this association. Fetal growth restriction has also been proposed, although its features are unclear because it lacks a definition independent of weight. If, as some postulate, birth weight is not itself on the causal path to mortality, its relation with mortality would have to be explained by confounding factors that decrease birth weight and increase mortality. In this paper, the authors explore the characteristics such confounders would require in order to achieve the observed association between birth weight and mortality. Through a simple simulation, they found that the observed steep gradient of risk for small babies at term can be produced by a rare condition or conditions (with a total prevalence of 0.5%) having profound effects on both fetal growth (-1.7 standard deviations) and mortality (relative risk = 160). Candidate conditions might include malformations, fetal or placental aneuploidy, infections, or imprinting disorders. If such rare factors underlie the association of birth weight with mortality, it would have broad implications for the study of fetal growth restriction and birth weight, and for the prevention of infant mortality.

The influence of birth weight and length on bone mineral density and content in adolescence: The Tromsø Study, Fit Futures.

PubMed

Christoffersen, Tore; Ahmed, Luai A; Daltveit, Anne Kjersti; Dennison, Elaine M; Evensen, Elin K; Furberg, Anne-Sofie; Gracia-Marco, Luis; Grimnes, Guri; Nilsen, Ole-Andreas; Schei, Berit; Tell, Grethe S; Vlachopoulos, Dimitris; Winther, Anne; Emaus, Nina

2017-12-01

The influence of birth weight and length on bone mineral parameters in adolescence is unclear. We found a positive association between birth size and bone mineral content, attenuated by lifestyle factors. This highlights the impact of environmental stimuli and lifestyle during growth. The influence of birth weight and length on bone mineral density and content later in life is unclear, especially in adolescence. This study evaluated the impact of birth weight and length on bone mineral density and content among adolescents. We included 961 participants from the population-based Fit Futures study (2010-2011). Dual-energy X-ray absorptiometry (DXA) was used to measure bone mineral density (BMD) and bone mineral content (BMC) at femoral neck (FN), total hip (TH) and total body (TB). BMD and BMC measures were linked with birth weight and length ascertained from the Medical Birth Registry of Norway. Linear regression models were used to investigate the influence of birth parameters on BMD and BMC. Birth weight was positively associated with BMD-TB and BMC at all sites among girls; standardized β coefficients [95% CI] were 0.11 [0.01, 0.20] for BMD-TB and 0.15 [0.06, 0.24], 0.18 [0.09, 0.28] and 0.29 [0.20, 0.38] for BMC-FN, TH and TB, respectively. In boys, birth weight was positively associated with BMC at all sites with estimates of 0.10 [0.01, 0.19], 0.12 [0.03, 0.21] and 0.15 [0.07, 0.24] for FN, TH and TB, respectively. Corresponding analyses using birth length as exposure gave significantly positive associations with BMC at all sites in both sexes. The significant positive association between birth weight and BMC-TB in girls, and birth length and BMC-TB in boys remained after multivariable adjustment. We found a positive association between birth size and BMC in adolescence. However, this association was attenuated after adjustment for weight, height and physical activity during adolescence.

Effects of early pregnancy BMI, mid-gestational weight gain, glucose and lipid levels in pregnancy on offspring's birth weight and subcutaneous fat: a population-based cohort study.

PubMed

Sommer, Christine; Sletner, Line; Mørkrid, Kjersti; Jenum, Anne Karen; Birkeland, Kåre Inge

2015-04-03

Maternal glucose and lipid levels are associated with neonatal anthropometry of the offspring, also independently of maternal body mass index (BMI). Gestational weight gain, however, is often not accounted for. The objective was to explore whether the effects of maternal glucose and lipid levels on offspring's birth weight and subcutaneous fat were independent of early pregnancy BMI and mid-gestational weight gain. In a population-based, multi-ethnic, prospective cohort of 699 women and their offspring, maternal anthropometrics were collected in gestational week 15 and 28. Maternal fasting plasma lipids, fasting and 2-hour glucose post 75 g glucose load, were collected in gestational week 28. Maternal risk factors were standardized using z-scores. Outcomes were neonatal birth weight and sum of skinfolds in four different regions. Mean (standard deviation) birth weight was 3491 ± 498 g and mean sum of skinfolds was 18.2 ± 3.9 mm. Maternal fasting glucose and HDL-cholesterol were predictors of birth weight, and fasting and 2-hour glucose were predictors of neonatal sum of skinfolds, independently of weight gain as well as early pregnancy BMI, gestational week at inclusion, maternal age, parity, smoking status, ethnic origin, gestational age and offspring's sex. However, weight gain was the strongest independent predictor of both birth weight and neonatal sum of skinfolds, with a 0.21 kg/week increased weight gain giving a 110.7 (95% confidence interval 76.6-144.9) g heavier neonate, and with 0.72 (0.38-1.06) mm larger sum of skinfolds. The effect size of mother's early pregnancy BMI on birth weight was higher in non-Europeans than in Europeans. Maternal fasting glucose and HDL-cholesterol were predictors of offspring's birth weight, and fasting and 2-hour glucose were predictors of neonatal sum of skinfolds, independently of weight gain. Mid-gestational weight gain was a stronger predictor of both birth weight and neonatal sum of skinfolds than early pregnancy BMI, maternal glucose and lipid levels.

The Effect of an Increased Minimum Wage on Infant Mortality and Birth Weight

PubMed Central

Livingston, Melvin D.; Markowitz, Sara; Wagenaar, Alexander C.

2016-01-01

Objectives. To investigate the effects of state minimum wage laws on low birth weight and infant mortality in the United States. Methods. We estimated the effects of state-level minimum wage laws using a difference-in-differences approach on rates of low birth weight (< 2500 g) and postneonatal mortality (28–364 days) by state and month from 1980 through 2011. All models included state and year fixed effects as well as state-specific covariates. Results. Across all models, a dollar increase in the minimum wage above the federal level was associated with a 1% to 2% decrease in low birth weight births and a 4% decrease in postneonatal mortality. Conclusions. If all states in 2014 had increased their minimum wages by 1 dollar, there would likely have been 2790 fewer low birth weight births and 518 fewer postneonatal deaths for the year. PMID:27310355

The Effect of an Increased Minimum Wage on Infant Mortality and Birth Weight.

PubMed

Komro, Kelli A; Livingston, Melvin D; Markowitz, Sara; Wagenaar, Alexander C

2016-08-01

To investigate the effects of state minimum wage laws on low birth weight and infant mortality in the United States. We estimated the effects of state-level minimum wage laws using a difference-in-differences approach on rates of low birth weight (< 2500 g) and postneonatal mortality (28-364 days) by state and month from 1980 through 2011. All models included state and year fixed effects as well as state-specific covariates. Across all models, a dollar increase in the minimum wage above the federal level was associated with a 1% to 2% decrease in low birth weight births and a 4% decrease in postneonatal mortality. If all states in 2014 had increased their minimum wages by 1 dollar, there would likely have been 2790 fewer low birth weight births and 518 fewer postneonatal deaths for the year.

Birth weight and gestational age characteristics of children with autism, including a comparison with other developmental disabilities.

PubMed

Schendel, Diana; Bhasin, Tanya Karapurkar

2008-06-01

The objectives of this study were to compare the birth weight and gestational age distributions and prevalence rates of autism with those of other developmental disabilities and to estimate the birth weight-and gestational age-specific risks for autism. For the first objective, a retrospective cohort of children born in Atlanta, Georgia, in 1981-1993 who survived to 3 years of age was identified through vital records. Children in the cohort who had developmental disabilities (autism, mental retardation, cerebral palsy, hearing loss, or vision impairment) and were still residing in metropolitan Atlanta at 3 to 10 years of age were identified through the Metropolitan Atlanta Developmental Disabilities Surveillance Program. A nested case-control sample from the cohort was used for the second objective; all cohort children identified with autism were case participants, and control participants were cohort children who were not identified as having developmental disabilities or receiving special education services. The prevalence of autism in low birth weight or preterm children was markedly lower than those of other developmental disabilities. In multivariate analyses, birth weight of <2500 g and preterm birth at <33 weeks' gestation were associated with an approximately twofold increased risk for autism, although the magnitude of risk from these factors varied according to gender (higher in girls) and autism subgroup (higher for autism accompanied by other developmental disabilities). For example, a significant fourfold increased risk was observed in low birth weight girls for autism accompanied by mental retardation, whereas there was no significantly increased risk observed in low birth weight boys for autism alone. Gender and autism subgroup differences in birth weight and gestational age, resulting in lower gender ratios with declining birth weight or gestational age across all autism subgroups, might be markers for etiologic heterogeneity in autism.

Child nutritional status and child growth in Kenya: socioeconomic determinants.

PubMed

Deolalikar, A B

1996-01-01

The determinants of weight and height are explored using nationally representative data for Kenya. The author also uses recall data on child birth weights to estimate conditional reduced-form demand relations for weight gain among 7907 children aged 0-5 years. Maternal education was found to be a significant determinant of weight, height, and weight gain, with secondary schooling having larger, but not significantly different effects than primary schooling. Per capita household expenditure is highly significant but with only small numerical effects. Birth weight has a large, negative effect upon subsequent weight gain, indicating almost complete catch-up growth by age one. The effect becomes more negative when birth weight is treated as an endogenous variable. There is no evidence of any catch-up growth beyond age three. The study results indicate that small deficits in birth weight are not likely to be permanent, with infants making up for birth weight deficits completely within the first year of life through biological catch-up growth.

Perinatal outcome of singleton siblings born after assisted reproductive technology and spontaneous conception: Danish national sibling-cohort study.

PubMed

Henningsen, Anna-Karina Aaris; Pinborg, Anja; Lidegaard, Øjvind; Vestergaard, Christina; Forman, Julie Lyng; Andersen, Anders Nyboe

2011-03-01

To compare the perinatal outcome of singleton siblings conceived differently. National population-based registry study. Denmark, from 1994 to 2008. Pairs of siblings (13,692 pairs; n = 27,384 children) conceived after IVF, intracytoplasmatic sperm injection (ICSI), frozen embryo replacement (FER), or spontaneous conception subcategorized into five groups according to succession: [1] IVF-ICSI vs. spontaneous conception (n = 7,758), [2] IVF-ICSI vs. FER (n = 716), [3] FER vs. FER (n = 34), [4] IVF-ICSI vs. IVF-ICSI (n = 2,876), and [5] spontaneous conception vs. spontaneous conception (n = 16,000). Observations were obtained from national registries. Birth weight, gestational age, low birth weight (<2,500 g), preterm birth (<37 weeks' gestation) and perinatal deaths. Mean birth weight was 65 g (95% confidence interval [CI], 41-89] lower in all assisted reproductive technology children compared with their spontaneously conceived siblings. FER children were 167 g (95% CI, 90-244] heavier than siblings born after replacement of fresh embryos. The difference in birth weight between firstborn and second born sibling depended on order of conception method. Higher risk of low birth weight with (odds ratio [OR], 1.4; 95%CI, 1.1-1.7] and preterm birth (OR, 1.3; 95% CI, 1.1-1.6] was observed in IVF/ICSI compared with spontaneous conception. When differentiating between order and mode of conception, it seems that assisted reproductive technology plays a role in mean birth weight and risk of low birth weight and preterm birth. Birth weight was higher in siblings born after FER compared with fresh embryos replacement. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Birth weight, intrauterine growth restriction and nutritional status in childhood in relation to grip strength in adults: from the 1982 Pelotas (Brazil) birth cohort.

PubMed

Bielemann, Renata Moraes; Gigante, Denise Petrucci; Horta, Bernardo Lessa

2016-02-01

The aim of this study was to evaluate the association among birth weight, intrauterine growth, and nutritional status in childhood with grip strength in young adults from the 1982 Pelotas (Brazil) birth cohort. In 1982, the hospital live births of Pelotas were followed. In 2012, grip strength was evaluated using a hand dynamometer and the best of the six measurements was used. Birth weight was analyzed as z-score for gestational age according to Williams (1982) curve. Weight-for-age, weight-for-length/height, and length/height-for-age at 2 and 4 y were analyzed in z-scores according to 2006 World Health Organization Child Growth Standards. Lean mass at 30 y was included as possible mediator using the g-computation formula. In 2012, 3701 (68.1%) individuals were interviewed and 3470 were included in the present analyses. An increase of 1 z-score in birth weight was associated with an increase of 1.5 kg in grip strength in males (95% confidence interval, 1.1-1.9). Positive effect of birth weight on grip strength was found in females. Grip strength was greater in individuals who were born with appropriate size for gestational age and positively associated with weight- and length/height-for-age z-score at 2 and 4 y of age. A positive association between birth weight and grip strength was only partially mediated by adult lean mass (50% and 33% of total effect in males and females), whereas direct effect of weight at 2 y was found only in males. It is suggested that good nutrition in prenatal and early postnatal life has a positive influence on adult muscle strength. The results from birth weight were suggestive of fetal programming on grip strength measurement. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Relationships among intrapartum maternal fluid intake, birth type, neonatal output, and neonatal weight loss during the first 48 hours after birth.

PubMed

Lamp, Jane M; Macke, Judi K

2010-01-01

To examine predictive relationships among intrapartum maternal fluid intake, birth type, neonatal output, and neonatal weight loss during the first 48 hours after birth. Prospective descriptive design. Women's center of a 900-bed regional acute care facility with 6,700 births per year. A convenience sample of 200 mother/neonate dyads. The Optimality Index of Murphy and Fullerton guided the inclusion and exclusion criteria to ensure healthy dyads. Data collection began in the intrapartum period and concluded with maternal/neonatal discharge. Measures included maternal intrapartum fluid intake from admission to birth, daily neonatal weight, output, and feedings. Data were analyzed via descriptive statistics, tests of significance and multiple regression. Neonatal weight loss was not significantly related to intrapartum maternal fluid intake. Strong predictors of neonatal weight loss and significant weight loss within the first 48 hours were type of feeding (p=.000) and average number of wet diapers (p=.003). Variables predictive of neonatal weight loss can facilitate identification of at-risk neonates to prevent significant weight loss. Close monitoring of the number of wet diapers in the first 48 hours and accurate daily weights at birth time can lead to early detection and preventive interventions.

Race, Age, and Neighborhood Socioeconomic Status in Low Birth Weight Disparities Among Adolescent Mothers: An Intersectional Inquiry.

PubMed

Coley, Sheryl L; Nichols, Tracy R

2016-01-01

Few studies examined socioeconomic contributors to racial disparities in low birth weight outcomes between African-American and Caucasian adolescent mothers. This cross-sectional study examined the intersections of maternal racial status, age, and neighborhood socioeconomic status in explaining these disparities in low birth weight outcomes across a statewide sample of adolescent mothers. Using data from the North Carolina State Center of Health Statistics for 2010-2011, birth cases for 16,472 adolescents were geocoded by street address and linked to census-tract information from the 2010 United States Census. Multilevel models with interaction terms were used to identify significant associations between maternal racial status, age, and neighborhood socioeconomic status (as defined by census-tract median household income) and low birth weight outcomes across census tracts. Significant racial differences were identified in which African-American adolescents had greater odds of low birth weight outcomes than Caucasian adolescents (OR=1.88, 95% CI 1.64, 2.15). Although racial disparities in low birth weight outcomes remained significant in context of maternal age and neighborhood socioeconomic status, the greatest disparities were found between African-American and Caucasian adolescents that lived in areas of higher socioeconomic status (p<.001). Maternal age was not significantly associated with racial differences in low birth weight outcomes. These findings indicate that racial disparities in low birth weight outcomes among adolescent mothers can vary by neighborhood socioeconomic status. Further investigations using intersectional frameworks are needed for examining the relationships between neighborhood socioeconomic status and birth outcome disparities among infants born to adolescent mothers.

Does Maternal Body Mass Index Have an Effect on the Accuracy of Ultrasound-Derived Estimated Birth Weight?: A Retrospective Study.

PubMed

Gonzalez, Maritza G; Reed, Kathryn L; Center, Katherine E; Hill, Meghan G

2017-05-01

The purpose of this study was to investigate the relationship between the maternal body mass index (BMI) and the accuracy of ultrasound-derived birth weight. A retrospective chart review was performed on women who had an ultrasound examination between 36 and 43 weeks' gestation and had complete delivery data available through electronic medical records. The ultrasound-derived fetal weight was adjusted by 30 g per day of gestation that elapsed between the ultrasound examination and delivery to arrive at the predicted birth weight. A total of 403 pregnant women met inclusion criteria. Age ranged from 13-44 years (mean ± SD, 28.38 ± 5.97 years). The mean BMI was 32.62 ± 8.59 kg/m 2 . Most of the women did not have diabetes (n = 300 [74.0%]). The sample was primarily white (n = 165 [40.9%]) and Hispanic (n = 147 [36.5%]). The predicted weight of neonates at delivery (3677.07 ± 540.51 g) was higher than the actual birth weight (3335.92 ± 585.46 g). Based on regression analyses, as the BMI increased, so did the predicted weight (P < .01) and weight at delivery (P < .01). The accuracy of the estimated ultrasound-derived birth weight was not predicted by the maternal BMI (P = .22). Maternal race and diabetes status were not associated with the accuracy of ultrasound in predicting birth weight. Both predicted and actual birth weight increased as the BMI increased. However, the BMI did not affect the accuracy of the estimated ultrasound-derived birth weight. Maternal race and diabetes status did not influence the accuracy of the ultrasound-derived predicted birth weight. © 2017 by the American Institute of Ultrasound in Medicine.

Admission temperature of low birth weight infants: predictors and associated morbidities.

PubMed

Laptook, Abbot R; Salhab, Walid; Bhaskar, Brinda

2007-03-01

There is a paucity of information on the maintenance of body temperature at birth for low birth weight infants. We examined the distribution of temperatures in low birth weight infants on admission to the NICUs in the Neonatal Research Network centers and determined whether admission temperature was associated with antepartum and birth variables and selected morbidities and mortality. Infants without major congenital anomalies born during 2002 and 2003 with birth weights of 401 to 1499 g who were admitted directly from the delivery room to the NICU were included. Bivariate associations between antepartum/birth variables and admission temperature and selected morbidities/mortality and admission temperature were examined, followed by multivariable linear or logistic regressions to detect independent associations. There were 5277 study infants and the mean (+/-SD) birth weight and gestational age were 1036 +/- 286 g and 28 +/- 3 weeks, respectively. The distribution of admission temperatures was 14.3% at < 35 degrees C, 32.6% between 35 and 35.9 degrees C, 42.3% between 36 and 36.9 degrees C, and 10.8% at > or = 37 degrees C. The estimate of birth weight on admission temperature with and without intubation was +0.13 degrees C and +0.04 degrees C per 100-g increase in birth weight, respectively. The mean admission temperature for each center varied from 1.5 degrees C below to 0.3 degrees C above a reference center. On adjusted analyses, admission temperature was inversely related to mortality (28% increase per 1 degrees C decrease) and late-onset sepsis (11% increase per 1 degrees C decrease) but not to intraventricular hemorrhage, necrotizing enterocolitis, or duration of conventional ventilation. Preventing decreases in temperature at birth among low birth weight infants remains a challenge. Associations with intubation and center of birth suggest that assessment of temperature control for infants intubated in the delivery room may be beneficial. Whether the admission temperature is part of the casual path or a marker of mortality needs additional study.

Gestational age and newborn size according to parental social mobility: an intergenerational cohort study.

PubMed

Gigante, Denise P; Horta, Bernardo L; Matijasevich, Alicia; Mola, Christian Loret de; Barros, Aluisio J D; Santos, Ina S; Barros, Fernando C; Victora, Cesar G

2015-10-01

We examined the associations between socioeconomic trajectories from birth to adulthood and gestational age and birth size in the next generation, using linked data from two population-based birth cohorts carried out in a Brazilian city. By comparing socioeconomic trajectories of mothers and fathers, we attempted to identify-specific effects of maternal and paternal socioeconomic trajectory on offspring birth weight, birth length, head circumference and gestational age at birth. 2 population-based birth cohort studies were carried out in 1982 and 2004 in Pelotas (Brazil); 156 mothers and 110 fathers from the earlier cohort had children in 2004. Gestational age and birth length, weight and head circumference were measured. Analyses were carried out separately for mothers and fathers. Mediation analyses assessed the role of birth weight and adult body mass index (BMI). Among mothers, but not for fathers, childhood poverty was strongly associated with smaller size in the next generation (about 400 g in weight and 1.5 cm in height) and shorter gestations (about 2 weeks). Adult poverty did not play a role. For mothers, the associations with gestational age, birth length and weight-but not with head circumference-persisted after adjusting for maternal birth weight and for the height and weight of the grandmother. Maternal birth weight did not mediate the observed associations, but high maternal BMI in adulthood was partly responsible for the association with gestational age. Strong effects of early poverty on gestational age and birth size in the next generation were observed among mothers, but not among fathers. These findings suggest a specific maternal effect of socioeconomic trajectory, and in particular of early poverty on offspring size and duration of pregnancy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Nationwide singleton birth weight percentiles by gestational age in Taiwan, 1998-2002.

PubMed

Hsieh, Wu-Shiun; Wu, Hui-Chen; Jeng, Suh-Fang; Liao, Hua-Fang; Su, Yi-Ning; Lin, Shio-Jean; Hsieh, Chia-Jung; Chen, Pau-Chung

2006-01-01

There are limited nationwide population-based data about birth weight percentiles by gestational age in Taiwan. The purpose of this study was to develop updated intrauterine growth charts that are population based and contain the information of birth weight percentiles by gestational age for singleton newborns in Taiwan. We abstracted and analyzed the birth registration database from the Ministry of the Interior in Taiwan during the period of 1998-2002 that consisted of over one million singleton births. Percentiles of birth weight for each increment of gestational week from 21 to 44 weeks were estimated using smoothed means and standard deviations. The analyses revealed that birth weight rose with advancing gestational age, with greater slopes during the third trimester and then leveled off beyond 40 weeks of gestational age. The male to female ratio ranged from 1.088 to 1.096. The mean birth weights during the period of 1998-2002 were higher than those previously reported for the period of 1945-1967; while the birth weight distribution and percentile during the period of 1998-2002 were similar to those reported for the period of 1979-1989. The 10th, 50th, and 90th percentiles of birth weigh at 40th gestational age among the male newborns were 2914, 3374, and 3890 g respectively; and for the female newborns 2816, 3250, and 3747 g. At the gestational age of 37 weeks, the 10th, 50th, and 90th percentiles of birth weigh among the male newborns were 2499, 2941, and 3433 g respectively; and for the female newborns 2391, 2832, and 3334 g. From 1998 to 2002, there was a gradual increase in the prevalence of low birth weight and preterm birth together with the percentage of infants born to foreign-born mothers. This study provides the first nationwide singleton intrauterine growth charts in Taiwan that are population-based and gender-specific. The normative data are particularly useful for the investigation of predictors and outcomes of altered fetal growth.

Social aspects of low birth weight.

PubMed

Dunn, H G

1984-05-01

The categories of low birth weigth infants, social vs. racial factors, factors increasing the risk of low birth weight, prevention of low birth weight, social factors in the development of low birth weight children, the influence of social factors vs. other variables, and implications for management are reviewed. In 1948 the World Health Assembly designated children who were born weighing 2500 g or less as "immature" and further stated that a liveborn infant with a period of gestation of less than 37 weeks or specified as "premature" may be considered as the equivalent of an immature event. In 1961 it was recommended that babies weighing 2500 g or less should no longer be referred to as being "premature" and that the concept of "prematurity" in the definition should give way to that of "low birth weight." Intrauterine growth curves for liveborn males and females were devised from data on birth weight and gestational age. Infants born prior to 37 completed weeks of gestation whose weight lies between the 10th and 90th percentiles on such curves may be called preterm with a weight appropriate for gestational age (AGA), whereas infants born after any length of gestation whose birth weight is at or below the 10th percentile may be named hypotrophic or small for gestational age (SGA). On a worldwide scale it has been estimated that about 22 million low birth weight babies, representing roughly 1/6 of all births, are born alive each day. Only about 1 million of them (mostly preterm) are born in developed countries; of the 21 million born in developing areas, roughly 16 million are SGA full-term and not preterm babies. Socioeconomic status appears as 1 of the most important dterminants of the ultimate level of brain function in children of low birth weight, and this is true with respect to neurologic, psychologic, and educational outcome. Social class also has an indirect effect through birth weight, frequency of perinatal brain injury, and other biological variables as well as maternal habits, the quality of nutrition and health care for mother and child, and other "culture factors." The following seem important facets of the management of low birth weight children: optimal obstetric and perinatal care; "bonding" by parents visiting the intensive care nursery and handling the infant; anticipatory guidance; regular pediatric follow-up for at-risk infants; infant stimulation; early correction of refractive errors, strabismus, other visual defects, hearing defects and orthopedic deformities; and developmental assessments and school readiness tests.

Early life risk factors for testicular cancer: a case-cohort study based on the Copenhagen School Health Records Register.

PubMed

Piltoft, Johanne Spanggaard; Larsen, Signe Benzon; Dalton, Susanne Oksbjerg; Johansen, Christoffer; Baker, Jennifer L; Cederkvist, Luise; Andersen, Ingelise

2017-02-01

One established risk factors for testicular cancer is cryptorchidism. However, it remains unclear whether cryptorchidism is a risk factor in itself or whether the two conditions share common causes in early life (estrogen hypothesis), such as birth weight and birth order. The objective of this study is to utilize data from the Copenhagen School Health Records Register (CSHRR) to evaluate cryptorchidism, birth weight and birth order as risk factors for testicular cancer. The study population consisted of 408 cases of testicular cancer identified by a government issued identification number linkage of the entire CSHRR with the Danish Cancer Registry and a random subsample of 4819 males from the CSHRR. The study design was case-cohort and the period of follow-up between 2 April 1968 and 31 December 2003. Cryptorchidism was significantly associated with testicular cancer in crude analyses [hazard ratio (HR) = 3.60, 95% CI 2.79-4.65]. Birth weight was inversely associated with testicular cancer and no clear association with birth order was observed. The positive association between cryptorchidism and testicular cancer was only slightly attenuated controlling for birth weight and birth order and stratified on birth cohort (HR = 3.46, 95% CI 2.67-4.48). This study confirmed the robustness of the association between cryptorchidism and testicular cancer even after adjustment for birth weight and birth order. Furthermore, the study showed an inverse association between birth weight and testicular cancer.

Analysis of low birth weight and its co-variants in Bangladesh based on a sub-sample from nationally representative survey.

PubMed

Khan, Jahidur Rahman; Islam, Md Mazharul; Awan, Nabil; Muurlink, Olav

2018-03-06

Low birth weight (LBW) remains a leading global cause of childhood morbidity and mortality. This study leverages a large national survey to determine current prevalence and socioeconomic, demographic and heath related factors associated with LBW in Bangladesh. Data from the Multiple Indicator Cluster Survey (MICS) 2012-13 of Bangladesh were analyzed. A total of 2319 women for whom contemporaneous birth weight data was available and who had a live birth in the two years preceding the survey were sampled for this study. However, this analysis only was able to take advantage of 29% of the total sample with 71% missing birth weight for newborns. The indicator, LBW (< 2500 g) of infants, was examined as the outcome variable in association with different socioeconomic, demographic and health-related covariates. Mixed-effects logistic regression was performed to identify possible factors related to LBW. In the selected sub-sample, about 20% of infants were born with LBW, with lowest rates observed in Rajshahi (11%) and highest rates in Rangpur (28%). Education of mothers (adjusted odds ratio [AOR] 0.52, 95% confidence interval [CI] 0.39-0.68 for secondary or higher educated mother) and poor antenatal care (ANC) (AOR 1.40, 95% CI 1.04-1.90) were associated with LBW after adjusting for mother's age, parity and cluster effects. Mothers from wealthier families were less likely to give birth to an LBW infant. Further indicators that wealth continues to play a role in LBW were that place of delivery, ANC and delivery assistance by quality health workers were significantly associated with LBW. However there has been a notable fall in LBW prevalence in Bangladesh since the last comparable survey (prevalence 36%), and an evidence of possible elimination of rural/urban disparities. Low birth weight remains associated with key indicators not just of maternal poverty (notably adequate maternal education) but also markers of structural poverty in health care (notably quality ANC). Results based on this sub-sample indicate LBW is still a public health concern in Bangladesh and an integrated effort from all stakeholders should be continued and interventions based on the study findings should be devised to further reduce the risk of LBW.

Overweight and obesity in mothers and risk of preterm birth and low birth weight infants: systematic review and meta-analyses.

PubMed

McDonald, Sarah D; Han, Zhen; Mulla, Sohail; Beyene, Joseph

2010-07-20

To determine the relation between overweight and obesity in mothers and preterm birth and low birth weight in singleton pregnancies in developed and developing countries. Systematic review and meta-analyses. Medline and Embase from their inceptions, and reference lists of identified articles. Studies including a reference group of women with normal body mass index that assessed the effect of overweight and obesity on two primary outcomes: preterm birth (before 37 weeks) and low birth weight (<2500 g). Two assessors independently reviewed titles, abstracts, and full articles, extracted data using a piloted data collection form, and assessed quality. 84 studies (64 cohort and 20 case-control) were included, totalling 1 095 834 women. Although the overall risk of preterm birth was similar in overweight and obese women and women of normal weight, the risk of induced preterm birth was increased in overweight and obese women (relative risk 1.30, 95% confidence interval 1.23 to 1.37). Although overall the risk of having an infant of low birth weight was decreased in overweight and obese women (0.84, 0.75 to 0.95), the decrease was greater in developing countries than in developed countries (0.58, 0.47 to 0.71 v 0.90, 0.79 to 1.01). After accounting for publication bias, the apparent protective effect of overweight and obesity on low birth weight disappeared with the addition of imputed "missing" studies (0.95, 0.85 to 1.07), whereas the risk of preterm birth appeared significantly higher in overweight and obese women (1.24, 1.13 to 1.37). Overweight and obese women have increased risks of preterm birth and induced preterm birth and, after accounting for publication bias, appeared to have increased risks of preterm birth overall. The beneficial effects of maternal overweight and obesity on low birth weight were greater in developing countries and disappeared after accounting for publication bias.

Prenatal mercury exposure and infant birth weight in the Norwegian Mother and Child Cohort Study.

PubMed

Vejrup, Kristine; Brantsæter, Anne Lise; Knutsen, Helle K; Magnus, Per; Alexander, Jan; Kvalem, Helen E; Meltzer, Helle M; Haugen, Margaretha

2014-09-01

To examine the association between calculated maternal dietary exposure to Hg in pregnancy and infant birth weight in the Norwegian Mother and Child Cohort Study (MoBa). Exposure was calculated with use of a constructed database of Hg in food items and reported dietary intake during pregnancy. Multivariable regression models were used to explore the association between maternal Hg exposure and infant birth weight, and to model associations with small-for-gestational-age offspring. The study is based on data from MoBa. The study sample consisted of 62 941 women who answered a validated FFQ which covered the habitual diet during the first five months of pregnancy. Median exposure to Hg was 0·15 μg/kg body weight per week and the contribution from seafood intake was 88 % of total Hg exposure. Women in the highest quintile compared with the lowest quintile of Hg exposure delivered offspring with 34 g lower birth weight (95 % CI -46 g, -22 g) and had an increased risk of giving birth to small-for-gestational-age offspring, adjusted OR = 1·19 (95 % CI 1·08, 1·30). Although seafood intake was positively associated with increased birth weight, stratified analyses showed negative associations between Hg exposure and birth weight within strata of seafood intake. Although seafood intake in pregnancy is positively associated with birth weight, Hg exposure is negatively associated with birth weight. Seafood consumption during pregnancy should not be avoided, but clarification is needed to identify at what level of Hg exposure this risk might exceed the benefits of seafood.

IMPACT OF BARBECUED MEAT CONSUMED IN PREGNANCY ON BIRTH OUTCOMES ACCOUNTING FOR PERSONAL PRENATAL EXPOSURE TO AIRBORNE POLYCYCLIC AROMATIC HYDROCARBONS. BIRTH COHORT STUDY IN POLAND

PubMed Central

Jedrychowski, Wieslaw; Perera, Frederica P.; Tang, Deliang; Stigter, Laura; Mroz, Elzbieta; Flak, Elzbieta; Spengler, John; Budzyn-Mrozek, Dorota; Kaim, Irena; Jacek, Ryszard

2011-01-01

We previously reported an association between prenatal exposure to airborne PAH and lower birth weight, birth length and head circumference. The main goal of the present analysis was to assess the possible impact of co-exposure to PAH-containing of barbecued meat consumed during pregnancy on birth outcomes. The birth cohort consisted of 432 pregnant women who gave birth at term (>36 weeks of gestation). Only non-smoking women with singleton pregnancies, 18-35 years of age, and who were free from chronic diseases such as diabetes and hypertension were included in the study. Detailed information on diet over pregnancy was collected through interviews and the measurement of exposure to airborne PAHs was carried out by personal air monitoring during the second trimester of pregnancy. The effect of barbecued meat consumption on birth outcomes (birthweight, length and head circumference at birth) was adjusted in multiple linear regression models for potential confounding factors such as prenatal exposure to airborne PAHs, child’s sex, gestational age, parity, size of mother (maternal prepregnancy weight, weight gain in pregnancy) and prenatal environmental tobacco smoke (ETS). The multivariable regression model showed a significant deficit in birthweight associated with barbecued meat consumption in pregnancy (coeff = −106.0 g; 95%CI: −293.3, −35.8); The effect of exposure to airborne PAHs was about the same magnitude order (coeff. = −164.6 g; 95%CI: −172.3, − 34.7). Combined effect of both sources of exposure amounted to birth weight deficit of 214.3 g (95%CI: −419.0, − 9.6). Regression models performed for birth length and head circumference showed similar trends but the estimated effects were of borderline significance level. As the intake of barbecued meat did not affect the duration of pregnancy, the reduced birthweight could not have been mediated by shortened gestation period. In conclusion, the study results provided epidemiologic evidence that prenatal PAH exposure from diet including grilled meat might be hazardous for fetal development. PMID:22079395

Ambient air pollution exposure and full-term birth weight in California.

PubMed

Morello-Frosch, Rachel; Jesdale, Bill M; Sadd, James L; Pastor, Manuel

2010-07-28

Studies have identified relationships between air pollution and birth weight, but have been inconsistent in identifying individual pollutants inversely associated with birth weight or elucidating susceptibility of the fetus by trimester of exposure. We examined effects of prenatal ambient pollution exposure on average birth weight and risk of low birth weight in full-term births. We estimated average ambient air pollutant concentrations throughout pregnancy in the neighborhoods of women who delivered term singleton live births between 1996 and 2006 in California. We adjusted effect estimates of air pollutants on birth weight for infant characteristics, maternal characteristics, neighborhood socioeconomic factors, and year and season of birth. 3,545,177 singleton births had monitoring for at least one air pollutant within a 10 km radius of the tract or ZIP Code of the mother's residence. In multivariate models, pollutants were associated with decreased birth weight; -5.4 grams (95% confidence interval -6.8 g, -4.1 g) per ppm carbon monoxide, -9.0 g (-9.6 g, -8.4 g) per pphm nitrogen dioxide, -5.7 g (-6.6 g, -4.9 g) per pphm ozone, -7.7 g (-7.9 g, -6.6 g) per 10 microg/m3 particulate matter under 10 microm, -12.8 g (-14.3 g, -11.3 g) per 10 microg/m3 particulate matter under 2.5 microm, and -9.3 g (-10.7 g, -7.9 g) per 10 microg/m3 of coarse particulate matter. With the exception of carbon monoxide, estimates were largely unchanged after controlling for co-pollutants. Effect estimates for the third trimester largely reflect the results seen from full pregnancy exposure estimates; greater variation in results is seen in effect estimates specific to the first and second trimesters. This study indicates that maternal exposure to ambient air pollution results in modestly lower infant birth weight. A small decline in birth weight is unlikely to have clinical relevance for individual infants, and there is debate about whether a small shift in the population distribution of birth weight has broader health implications. However, the ubiquity of air pollution exposures, the responsiveness of pollutant levels to regulation, and the fact that the highest pollution levels in California are lower than those regularly experienced in other countries suggest that precautionary efforts to reduce pollutants may be beneficial for infant health from a population perspective.

Effects of lead exposure before pregnancy and dietary calcium during pregnancy on fetal development and lead accumulation.

PubMed Central

Han, S; Pfizenmaier, D H; Garcia, E; Eguez, M L; Ling, M; Kemp, F W; Bogden, J D

2000-01-01

Millions of women of child-bearing age have substantial bone lead stores due to lead exposure as children. Dietary calcium ingested simultaneously with lead exposure can reduce lead absorption and accumulation. However, the effects of dietary calcium on previously accumulated maternal lead stores and transfer to the fetus have not been investigated. We studied the effects of lead exposure of female rats at an early age on fetal development during a subsequent pregnancy. We gave 5-week-old female Sprague-Dawley rats lead as the acetate in their drinking water for 5 weeks; controls received equimolar sodium acetate. This was followed by a 1-month period without lead exposure before mating. We randomly assigned pregnant rats (n = 39) to diets with a deficient (0.1%) or normal (0.5%) calcium content during pregnancy. A total of 345 pups were delivered alive. Lead-exposed dams and their pups had significantly higher blood lead concentrations than controls, but the concentrations were in the range of those found in many pregnant women. Pups born to dams fed the calcium-deficient diet during pregnancy had higher blood and organ lead concentrations than pups born to dams fed the 0. 5% calcium diet. Pups born to lead-exposed dams had significantly (p<0.0001) lower mean birth weights and birth lengths than controls. There were significant inverse univariate associations between dam or pup organ lead concentrations and birth weight or length. The 0.5% calcium diet did not increase in utero growth. Stepwise regression analysis demonstrated that greater litter size and female sex were significantly associated with reduced pup birth weight and length. However, lead exposure that ended well before pregnancy was significantly (p<0.0001) associated with reduced birth weight and length, even after litter size, pup sex, and dam weight gain during pregnancy were included in the regression analysis. The data demonstrate that an increase in dietary calcium during pregnancy can reduce fetal lead accumulation but cannot prevent lead-induced decreases in birth weight and length. The results provide evidence that dietary nutrients can influence the transfer of toxins to the fetus during pregnancy. If these results are applicable to women, an increase in diet calcium during pregnancy could reduce the transfer of lead from prepregnancy maternal exposures to the fetus. Images Figure 3 Figure 4 Figure 1 Figure 2 PMID:10856026

Co-occurrence of IBS and symptoms of anxiety or depression, among Norwegian twins, is influenced by both heredity and intrauterine growth.

PubMed

Bengtson, May-Bente; Aamodt, Geir; Vatn, Morten H; Harris, Jennifer R

2015-02-05

Environmental and genetic factors contribute to variation in irritable bowel syndrome (IBS), anxiety and depression. Comorbidity between these disorders is high. A previous investigation of our population-based twin cohort revealed that low birth weight increased the risk for development of IBS, with environmental influences in utero as the most relevant contributing factor. We hypothesise that both intrauterine and genetic factors influence the co-occurrence of IBS and symptoms of anxiety and depression. A postal questionnaire sent to 12700 Norwegian twins born between 1967 and 1979 comprised a checklist of 31 illnesses and symptoms, including IBS and symptoms of anxiety and depression. The influence of genetic factors and intrauterine growth on comorbidity between these disorders were analysed in the full sample and compared to those based on only monozygotic (MZ) twin pairs discordant for IBS (95 pairs) in birth weight group < 2500 g and ≥ 2500 g. In the co-twin analyses restricted growth (birth weight < 2500 g) was significantly associated with anxiety and depression (average birth weight difference of 181.0 g (p <0.0001) and 249.9 g (p < 0.0001), respectively). The analysis of the full sample revealed that IBS was significantly associated with symptoms of anxiety (adjusted OR = 2.5, 95% CI: 1.9, 3.3) and depression (adjusted OR = 2.3. 95% CI: 1.8, 3.0). Analyses of MZ pairs discordant for IBS indicated significant associations between IBS and symptoms of anxiety (OR = 3.7, 95% CI: 1.3, 10.5) and between IBS and symptoms of depression (OR = 4.2, 95% CI: 1.7, 9.9) only in the birth weight group below 2500 g. Our findings suggest that genetic factors partly explain the association between IBS and symptoms of anxiety and depression. In the low range of birth weight (<2500 g), restricted fetal growth seems to be a common contributing factor to the co-occurrence between these disorders.

The changing trends in live birth statistics in Korea, 1970 to 2010.

PubMed

Lim, Jae Woo

2011-11-01

Although Korean population has been growing steadily during the past four decades, the nation is rapidly becoming an aging society because of its declining birth rate combined with an increasing life expectancy. In addition, Korea has one of the lowest fertility rates in the world due to fewer married couples, advanced maternal age, and falling birth rate. The prevalence of low birth weight infants and multiple births has been increased compared with the decrease in the birth rate. Moreover, the number of congenital anomalies is expected to increase due to the advanced maternal age. In addition, the number of interracial children is expected to increase due to the rise in the number of international marriages. However, the maternal education level is high, single-mother birth rate is low, and the gender imbalance has lessened. The number of overweight babies has been decreased, as more pregnant women are receiving adequate prenatal care. Compared to the Asian average birth weight, the average birth weight is the highest in Asia. Moreover, the rate of low birth weight infants is low, and infant mortality is similarly low across Asia. Using birth data from Statistics Korea and studies of birth outcomes in Korea and abroad, this study aimed to assess the changes in maternal and infant characteristics associated with birth outcomes during the past four decades and identify necessary information infrastructures to study countermeasures the decrease in birth rate and increase in low birth weight infants in Korea.

Contribution of birth weight and adult waist circumference to cardiovascular disease risk in a longitudinal study.

PubMed

Tian, Jingyan; Qiu, Miaoyan; Li, Yanyun; Zhang, Xuan'e; Wang, Haiyan; Sun, Siming; Sharp, Nora Sebeca; Tong, Wenxin; Zeng, Hailuan; Zheng, Sheng; Song, Xiaomin; Wang, Weiqing; Ning, Guang

2017-08-29

To determine the association of birth weight (BW) and waist circumference (WC) on cardiovascular disease (CVD). The longitudinal cohort study consisted of 745 participants who were able to provide their birth weight information and were followed from 2002 to 2014. During the follow-up, 83 events of CVD were confirmed. After adjusting for confounding factors, subjects with birth weight <2500 g were at a significantly increased CVD risk when compared to subjects with birth weight between 2500-3999 g (OR 2·47, 95%CI, 1·07-5·71). When high waist circumference (HWC), a measurement of adult obesity, was incorporated into stratifying factors according to presence or absence of low birth weight (LBW, birth weight <2500 g), adjusted CVD risk was significantly elevated in -LBW/+ HWC group (OR 1·94, 95%CI, 1·10-3·43) and marginally significantly increased in +LBW/-HWC group (OR 2·94, 95%CI, 1·00-8·64). CVD risk was highest in subjects with LBW and HWC (+LBW/+HWC), OR 4·74 (95%CI, 1·48-15·21). Higher waist circumference in adulthood is an especially strong risk factor for cardiovascular disease among those small at birth. In this cohort, birth size and adiposity in adulthood interact to predict events of cardiovascular disease.

EFFECTS ON BIRTH WEIGHT AND ADULT HEALTH IN RATS PRENATALLY EXPOSED TO TOXICANTS OR UNDERNUTRITION

EPA Science Inventory

Low fetal weight is a sensitive indicator of developmental toxicity in animal studies. While low birth weight may be permanent or transitory, the long-term effects of low birth weight on adult health have not been elucidated. Previous research has shown in humans an inverse rela...

The relation of birth weight and gestational age to biological, occupational and socioeconomic factors.

PubMed

Velonakis, E G; Maghiorakos, P; Tzonou, A; Barrat, J; Proteau, J; Ladopoulos, I

1997-01-01

The data of the 2,040 single births, born during 1987 at the "Saint Antoine" Hospital in Paris, were analysed in order to identify the impact of various biological, occupational, and socioeconomic factors on gestational age and birth weight. Birth weight is associated with the height of the mother and the weight gained during pregnancy. It is lower for mothers with preeclampsia during the current or previous pregnancies or with urogenital infections during the current pregnancy and for mothers with one or more induced abortions. Girls weigh less than boys. Parity has a positive relation to the baby's weight, while manual work seems to have a negative one. APGAR score and duration of the pregnancy are associated with the birth weight. Placenta previa, preeclampsia and urinary infections affect the gestational age. A short pause period in work is related to a shorter gestational age. Weight gain is associated with a prolonged duration of the pregnancy. Gestational age and birth weight are associated with the nationality of the mother, especially in some ethnic groups, and with marital status.

Associations of neonatal high birth weight with maternal pre-pregnancy body mass index and gestational weight gain: a case–control study in women from Chongqing, China

PubMed Central

Peng, Rong; Han, Lingli; Zhou, Xiaoli; Xiong, Zhengai; Zhang, Yuan; Li, Junnan; Yao, Ruoxue; Li, Tingyu; Zhao, Yong

2016-01-01

Objectives To examine the associations of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with neonatal high birth weight (HBW) in a sample of Chinese women living in southwest China. Methods A hospital-based case–control study was conducted in Chongqing, China. A total of 221 mothers who delivered HBW babies (>4.0 kg) were recruited as cases and 221 age-matched (2-year interval) mothers with normal birth weight babies (2.5–4.0 kg) were identified as controls. ORs were estimated using conditional logistic regression analysis. For the analysis, pre-pregnancy BMI was categorised as underweight/normal weight/overweight and obesity and GWG was categorised as inadequate/appropriate/excessive. Results Among the cases, mean pre-pregnancy BMI was 21.8±2.8 kg/m2, mean GWG was 19.7±5.1 kg and mean neonatal birth weight was 4.2±0.2 kg. In the controls, the corresponding values were 21.1±3.1 kg/m2, 16.4±5.0 kg and 3.3±0.4 kg, respectively. More cases than controls gained excessive weight during pregnancy (80.1% vs 48.4%, p<0.001). No significant association was found between pre-pregnancy BMI and HBW babies (OR=1.04, 95% CI 0.97 to 1.11; p>0.05). GWG was positively related to HBW after adjustment for gravidity, gestational age, newborns' gender and family income (OR=1.18, 95% CI 1.12 to 1.25; p<0.001). The adjusted OR of delivering HBW babies was 5.39 (95% CI 2.94 to 9.89; p<0.001) for excessive GWG versus appropriate GWG. This OR was strengthened among pre-pregnancy normal weight women (OR=10.27, 95% CI 3.20 to 32.95; p<0.001). Conclusions Overall, the findings suggest a significantly positive association between GWG and HBW. However, pre-pregnancy BMI shows no independent relationship with HBW. PMID:27531723

Pathways from Birth Weight to ADHD Symptoms through Fluid Reasoning in Youth with or without Intellectual Disability.

PubMed

Morgan, Julia E; Lee, Steve S; Loo, Sandra K; Yuhan, Joshua W; Baker, Bruce L

2018-05-01

Although individual differences in fluid reasoning reliably mediate predictions of attention-deficit/hyperactivity disorder (ADHD) symptoms from birth weight in youth with typical cognitive development (TD), it is unknown if this indirect effect operates similarly in the development of ADHD symptoms secondary to intellectual disability (ID). Thus, we evaluated mediation by fluid reasoning in a longitudinal sample of 163 youth (45% female) with (n = 52) or without (n = 111) ID who were followed prospectively from age 5 to age 13. At age 9, youth completed the Arithmetic subtest of the Wechsler Intelligence Scale for Children, a measure of fluid reasoning. At ages 9 and 13, mothers and teachers separately rated youth ADHD symptoms and mothers completed a diagnostic interview. Mediation was tested via path analysis with bootstrapped confidence intervals, and moderated mediation estimated whether indirect effects differed between ID and TD youth or based on youth IQ. Controlling for demographic factors and age 9 ADHD symptoms, age 9 Arithmetic mediated birth weight and multi-method/informant age 13 ADHD symptoms, such that birth weight positively predicted Arithmetic, which negatively predicted ADHD symptoms. Neither ID status nor IQ moderated the observed indirect effect through Arithmetic, suggesting that it was similar for ID and TD youth as well as across the range of youth IQs. These findings support previous evidence that fluid reasoning, as measured by Arithmetic, may causally mediate birth weight and ADHD symptoms, and suggest that this pathway operates similarly with respect to the development of ADHD symptoms in youth with ID.

Dietary patterns in pregnancy and birth weight

PubMed Central

Coelho, Natália de Lima Pereira; Cunha, Diana Barbosa; Esteves, Ana Paula Pereira; Lacerda, Elisa Maria de Aquino; Filha, Mariza Miranda Theme

2015-01-01

OBJECTIVE To analyze if dietary patterns during the third gestational trimester are associated with birth weight. METHODS Longitudinal study conducted in the cities of Petropolis and Queimados, Rio de Janeiro (RJ), Southeastern Brazil, between 2007 and 2008. We analyzed data from the first and second follow-up wave of a prospective cohort. Food consumption of 1,298 pregnant women was assessed using a semi-quantitative questionnaire about food frequency. Dietary patterns were obtained by exploratory factor analysis, using the Varimax rotation method. We also applied the multivariate linear regression model to estimate the association between food consumption patterns and birth weight. RESULTS Four patterns of consumption – which explain 36.4% of the variability – were identified and divided as follows: (1) prudent pattern (milk, yogurt, cheese, fruit and fresh-fruit juice, cracker, and chicken/beef/fish/liver), which explained 14.9% of the consumption; (2) traditional pattern, consisting of beans, rice, vegetables, breads, butter/margarine and sugar, which explained 8.8% of the variation in consumption; (3) Western pattern (potato/cassava/yams, macaroni, flour/farofa/grits, pizza/hamburger/deep fried pastries, soft drinks/cool drinks and pork/sausages/egg), which accounts for 6.9% of the variance; and (4) snack pattern (sandwich cookie, salty snacks, chocolate, and chocolate drink mix), which explains 5.7% of the consumption variability. The snack dietary pattern was positively associated with birth weight (β = 56.64; p = 0.04) in pregnant adolescents. CONCLUSIONS For pregnant adolescents, the greater the adherence to snack pattern during pregnancy, the greater the baby’s birth weight. PMID:26398873

Birth Weight, Physical Morbidity, and Mortality: A Population-based Sibling-Comparison Study

PubMed Central

Class, Quetzal A.; Rickert, Martin E.; Lichtenstein, Paul; D'Onofrio, Brian M.

2014-01-01

Associations between low birth weight (≤2,500 g) and increased risk of mortality and morbidity provided the foundation for the “developmental origins of health and disease” hypothesis. Previous between-family studies could not control for unmeasured confounders. Therefore, we compared differentially exposed siblings to estimate the extent to which the associations were due to uncontrolled factors. Our population cohort included 3,291,773 persons born in Sweden from 1973 to 2008. Analyses controlled for gestational age, among other covariates, and considered birth weight as both an ordinal and a continuous variable. Outcomes included mortality after 1 year, cardiac-related death, hypertension, ischemic heart disease, pulmonary circulation problems, stroke, and type 2 diabetes mellitus. We fitted fixed-effects models to compare siblings and conducted sensitivity analyses to test alternative explanations. Across the population, the lower the birth weight, the greater the risk of mortality (e.g., cardiac-related death (low birth weight hazard ratio = 2.69, 95% confidence interval: 2.05, 3.53)) and morbidity (e.g., type 2 diabetes mellitus (low birth weight hazard ratio = 1.79, 95% confidence interval: 1.50, 2.14)) outcomes in comparison with normal birth weight. All associations were independent of shared familial confounders and measured covariates. Results emphasize the importance of birth weight as a risk factor for subsequent mortality and morbidity. PMID:24355331

Influence of exercise intervention on gestational diabetes mellitus: a systematic review and meta-analysis.

PubMed

Zheng, J; Wang, H; Ren, M

2017-10-01

Exercise intervention might be a promising approach to prevent gestational diabetes mellitus. However, the results remained controversial. We conducted a systematic review and meta-analysis to explore the effect of exercise intervention on gestational diabetes mellitus. PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of exercise intervention on gestational diabetes mellitus were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome was the incidence of gestational diabetes mellitus, preterm birth, and gestational age at birth. Meta-analysis was performed using random-effect model. Five RCTs involving 1872 patients were included in the meta-analysis. Overall, compared with control intervention, exercise intervention was found to significantly reduce the risk of gestational diabetes mellitus (std. mean difference 0.62; 95% CI 0.43-0.89; P = 0.01), but demonstrated no influence on preterm birth (OR 0.93; 95% CI 0.44-1.99; P = 0.86), gestational age at birth (std. mean difference -0.03; 95% CI -0.12 to 0.07; P = 0.60), glucose 2-h post-OGTT (std. mean difference -1.02; 95% CI -2.75 to 0.71; P = 0.25), birth weight (std. mean difference -0.10; 95% CI -0.25 to 0.04; P = 0.16), Apgar score less than 7 (OR 0.78; 95% CI 0.21-2.91; P = 0.71), and preeclampsia (OR 1.05; 95% CI 0.53-2.07; P = 0.88). Compared to control intervention, exercise intervention was found to significantly reduce the incidence of gestational diabetes mellitus, but had no significant influence on preterm birth, gestational age at birth, glucose 2-h post-OGTT, birth weight, Apgar score less than 7, and preeclampsia.

Influence of cryopreservation on perinatal outcome after blastocyst- vs cleavage-stage embryo transfer: systematic review and meta-analysis.

PubMed

Alviggi, C; Conforti, A; Carbone, I F; Borrelli, R; de Placido, G; Guerriero, S

2018-01-01

To compare the perinatal outcomes of singleton pregnancies resulting from blastocyst- vs cleavage-stage embryo transfer and to assess whether they differ between fresh and frozen embryo transfer cycles. A systematic review of the literature was carried out using the Scopus, MEDLINE and ISI Web of Science databases with no time restriction. We included only peer-reviewed articles involving humans, in which perinatal outcomes of singleton pregnancies after blastocyst-stage embryo transfer were compared with those after cleavage-stage embryo transfer. Primary outcomes were preterm birth before 37 weeks and low birth weight (< 2500 g). Secondary outcomes were very preterm birth before 32 weeks, very low birth weight (< 1500 g), small-for-gestational-age (SGA), large-for-gestational-age (LGA), perinatal mortality and congenital anomaly. A meta-analysis was performed using a random-effects model. Three subgroups were evaluated: fresh only, frozen only and fresh plus frozen embryo transfer cycles. From a total of 3928 articles identified, 14 were selected for qualitative/quantitative analysis. Significantly higher incidences of preterm birth < 37 weeks (11 studies, n = 106 629 participants; risk ratio (RR), 1.15 (95% CI, 1.05 - 1.25); P = 0.002) and very preterm birth < 32 weeks (seven studies, n = 103 742; RR, 1.16 (95% CI, 1.02-1.31); P = 0.03) were observed after blastocyst- than after cleavage-stage embryo transfer in fresh cycles. However, the risk of preterm and very preterm birth was similar after blastocyst- and cleavage-stage transfers in frozen and fresh plus frozen cycles. Overall effect size analysis revealed fewer SGA deliveries after blastocyst- compared with cleavage-stage transfer in fresh cycles but a similar number in frozen cycles. Conversely, more LGA deliveries were observed after blastocyst- compared with cleavage-stage transfer in frozen cycles (two studies, n = 39 044; RR, 1.18 (95% CI, 1.09-1.27); P < 0.0001) and no differences between the two groups in fresh cycles (four studies, n = 42 982; RR, 1.14 (95% CI, 0.97-1.35); P = 0.11). There were no differences with respect to low birth weight, very low birth weight or congenital anomalies between blastocyst- and cleavage-stage transfers irrespective of the cryopreservation method employed. Only one study reported a higher incidence of perinatal mortality after blastocyst- vs cleavage-stage embryo transfer in frozen cycles, while no differences were found in fresh cycles. Our results suggest that cryopreservation of embryos can influence outcome of pregnancy conceived following blastocyst- vs cleavage-stage embryo transfer in terms of preterm birth, very preterm birth, LGA, SGA and perinatal mortality. Caution should be exercised in interpreting these findings given the low level of evidence and wide heterogeneity of the studies. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

Early life determinants of frailty in old age: the Helsinki Birth Cohort Study.

PubMed

Haapanen, M J; Perälä, M M; Salonen, M K; Kajantie, E; Simonen, M; Pohjolainen, P; Eriksson, J G; von Bonsdorff, M B

2018-04-12

there is evidence suggesting that several chronic diseases have their origins in utero and that development taking place during sensitive periods may affect the aging process. We investigated whether early life determinants would be associated with frailty in old age. at a mean age of 71 years, 1,078 participants belonging to the Helsinki Birth Cohort Study were assessed for frailty according to the Fried frailty criteria. Early life measurements (birth weight, length, mother body mass index [BMI] and parity) were obtained from birth, child welfare and school health records. Multinomial regression analysis was used to assess the association between early life determinants and frailty in old age. weight, length and BMI at birth were all inversely associated with frailty in old age. A 1 kg increase in birth weight was associated with a lower relative risk ratio (RRR) of frailty (age and sex-adjusted RRR = 0.40, 95% CI: 0.19, 0.82) compared to non-frailty. Associations persisted after adjusting for several confounding factors. Compared to cohort members in the upper middle class, those who as adults worked as manual workers or belonged to the lower middle class, were at an increased risk of frailty. those who were small at birth were at an increased risk of developing frailty in old age, suggesting that frailty is at least partly programmed in early life. A less privileged socioeconomic status in adulthood was associated with an increased risk of frailty in old age.

Are there differences in birth weight between neighbourhoods in a Nordic welfare state?

PubMed

Sellström, Eva; Arnoldsson, Göran; Bremberg, Sven; Hjern, Anders

2007-09-26

The objective of this cohort study was to examine the effect on birth weight of living in a disadvantaged neighbourhood in a Nordic welfare state. Birth weight is a health indicator known to be sensitive to political and welfare state conditions. No former studies on urban neighbourhood differences regarding mean birth weight have been carried out in a Nordic country. A register based on individual data on children's birth weight and maternal risk factors was used. A neighbourhood characteristic, i.e. an aggregated measure on income was also included. Connections between individual- and neighbourhood-level determinants and the outcome were analysed using multi-level regression technique. The study covered six hundred and ninety-six neighbourhoods in the three major cities of Sweden, Stockholm, Göteborg and Malmö, during 1992-2001. The majority of neighbourhoods had a population of 4 000-10 000 inhabitants. An average of 500 births per neighbourhood were analysed in this study. Differences in mean birth weight in Swedish urban neighbourhoods were minor. However, gestational length, parity and maternal smoking acted as modifiers of the neighbourhood effects. Most of the observed variation in mean birth weight was explained by individual risk factors. Welfare institutions and benefits in Sweden might buffer against negative infant outcomes due to adverse structural organisation of urban neighbourhoods.

PedsQL relates to function and behavior in very low and normal birth weight 2- and 3-year-olds from a regional cohort.

PubMed

Palta, Mari; Sadek-Badawi, Mona

2008-06-01

To compare PedsQL scores in young children who were very low (< or =1,500 g) or normal birth weight (>2,500 g) and to examine the relationship of the PedsQL score to behavioral and functional scores. The PedsQL, Achenbach Child Behavior Checklist and the PEDI functional scales were telephone administered to parents of a regional cohort of 672 very low birth weight and 455 normal birth weight children, 2- and 3-years old. PedsQL scales were regressed on behavior, function and health conditions. Mean (SD) overall PedsQL score was 91 (8.4) for normal birth weight and 87 (12) for very low birth weight children, and changed little when standardized to the race/ethnicity and maternal education of corresponding Wisconsin births. Mobility function and the CBCL explained 58% of the variance in PedsQL, but the relationship was curvilinear. The PedsQL is sensitive to health problems of very low birth weight in young children. The PedsQL is quite strongly related to mobility and behavior problems, but scales these differently than do standard instruments. Parents either do not think of subtle issues with child function and behavior without specific prompting or do not perceive them as problems affecting quality of life.

Breastfeeding Trends Among Very Low Birth Weight, Low Birth Weight, and Normal Birth Weight Infants.

PubMed

Campbell, Angela G; Miranda, Patricia Y

2018-05-18

To examine the change in breastfeeding behaviors over time, among low birth weight (LBW), very low birth weight (VLBW), and normal birth weight (NBW) infants using nationally representative US data. Univariate statistics and bivariate logistic models were examined using the Early Child Longitudinal Study-Birth Cohort (2001) and National Study of Children's Health (2007 and 2011/2012). Breastfeeding behaviors improved for infants of all birth weights from 2007 to 2011/2012. In 2011/2012, a higher percentage of VLBW infants were ever breastfed compared with LBW and NBW infants. In 2011/2012, LBW infants had a 28% lower odds (95% CI, 0.57-0.92) of ever breastfeeding and a 52% lower odds (95% CI, 0.38-0.61) of breastfeeding for ≥6 months compared with NBW infants. Among black infants, a larger percentage of VLBW infants were breastfed for ≥6 months (26.2%) compared with LBW infants (14.9%). Breastfeeding rates for VLBW and NBW infants have improved over time. Both VLBW and NBW infants are close to meeting the Healthy People 2020 ever breastfeeding goal of 81.9%. LBW infants are farther from this goal than VLBW infants. The results suggest a need for policies that encourage breastfeeding specifically among LBW infants. Copyright © 2018 Elsevier Inc. All rights reserved.

The relative influence of maternal nutritional status before and during pregnancy on birth outcomes in Vietnam.

PubMed

Young, Melissa F; Nguyen, Phuong Hong; Addo, O Yaw; Hao, Wei; Nguyen, Hieu; Pham, Hoa; Martorell, Reynaldo; Ramakrishnan, Usha

2015-11-01

This study aimed to: (1) examine the role of multiple measures of prepregnancy nutritional status (weight, height, body composition) on birth outcomes (low birth weight (LBW), small for gestational age (SGA), preterm, birth weight, birth length, infant head circumference and mid-upper arm circumference (MUAC)); (2) assess relative influence of maternal nutritional status before and during (gestational weight gain) pregnancy on birth outcomes. We used prospective data on maternal body size and composition collected from women who participated in a randomized controlled trial evaluating the impact of preconceptional micronutrient supplements (PRECONCEPT) on birth outcomes in Thai Nguyen province, Vietnam (n=1436). Anthropometric measurements were obtained before conception through delivery by trained health workers. The relationship between prepregnancy nutritional status indicators, gestational weight gain (GWG) and birth outcomes were examined using generalized linear models, adjusting for potential confounding factors. Maternal prepregnancy weight (PPW) was the strongest anthropometric indicator predicting infant birth size. A 1 standard deviation (SD) increase in PPW (5.4kg) was associated with a 283g (95%CI: 279-286) increase in birthweight. A similar and independent association was observed with birthweight for an increase of 1 SD in gestational weight gain (4kg) (250g; 95% CI: 245-255). Women with a PPW <43kg or who gained <8kg during their pregnancy were more likely to give birth to a SGA (OR 2.9: 95%CI 1.9-4.5, OR 3.3: 95%CI 2.2-5.1) or LBW infant (OR 3.1: 95%CI 1.5-6.2, OR 3.4: 95%CI 1.6-7.2), respectively. These findings indicate that clinical care and programs aimed at improving birth outcomes will have the greatest impact if they address maternal nutrition both before and during pregnancy. Women with a PPW <43kg or a GWG <8kg are at greatest risk for poor birth outcomes in this setting. Preconception counseling and clinical care to obtain a healthy weight prior to pregnancy along with routine obstetric care on gestational weight gain is critical to improve birth outcomes. NCT01665378 (https://clinicaltrials.gov/show/NCT01665378). Copyright © 2015. Published by Elsevier Ireland Ltd.

[Risk factors for iron deficiency anemia in infants aged 6 to 12 months and its effects on neuropsychological development].

PubMed

Xu, Kang; Zhang, Cui-Mei; Huang, Lian-Hong; Fu, Si-Mao; Liu, Yu-Ling; Chen, Ang; Ou, Jun-Bin

2015-08-01

To study the risk factors for moderate and severe iron deficiency anemia (IDA) in infants aged 6-12 months, and to preliminarily investigate the effects of IDA on the neuromotor development and temperament characteristics of infants. A total of 326 infants aged 6-12 months with IDA were classified into three groups: mild IDA (n=176), moderate IDA (n=111), and severe IDA (n=39) according to the severity of anemia. The risk factors for moderate or severe IDA were investigated by multivariate logistic regression analysis. Three hundred and forty-six infants without IDA who showed matched age, sex, and other backgrounds were selected as the control group. The Gesell Development Diagnosis Scale was used to evaluate children's mental development. The Temperament Scale for infants was used for evaluating children's temperament. The univariate analysis showed that the severity of IDA was associated with sex, birth weight, gestational age, multiple birth, maternal anemia during pregnancy, and mother's lack of knowledge about IDA (P<0.05). Setting the mild IDA group as control, the multivariate logistic regression analysis showed that multiple birth, premature birth, low birth weight (<2500 g), maternal anemia during pregnancy, breast feeding, and mother's lack of knowledge about IDA were the risk factors for severe IDA (OR>1; P<0.05); premature birth, breast feeding, and mixed feeding were the risk factors for moderate IDA (OR>1; P<0.05). The IDA group had significantly lower scores in Gesell general development quotient, gross motor, adaptive behavior, and fine motor than the control group (P<0.05). The IDA group had higher percentages of children with difficulty and intermediate difficulty temperaments than the control group (P<0.05). The IDA group had significantly higher scores in activity level, rhythmicity, adaptability, and perseverance than the control group (P<0.05). The severity of IDA is associated with premature birth, multiple birth, low birth weight, feeding pattern, maternal anemia during pregnancy and mother's lack of knowledge about IDA in infants aged 6-12 months. Infants with IDA have delayed neuromotor development and most of them have negative temperaments. More attention should be paid to mental and behavior problems for the infants. It is necessary to provide guidance for their parents in feeding and education.

Maternal anthropometrics are associated with fetal size in different periods of pregnancy and at birth. The Generation R Study.

PubMed

Ay, L; Kruithof, C J; Bakker, R; Steegers, E A P; Witteman, J C M; Moll, H A; Hofman, A; Mackenbach, J P; Hokken-Koelega, A C S; Jaddoe, V W V

2009-06-01

We aimed to examine the associations of maternal anthropometrics with fetal weight measured in different periods of pregnancy and with birth outcomes. Population-based birth cohort study. Data of pregnant women and their children in Rotterdam, the Netherlands. In 8541 mothers, height, prepregnancy body mass index (BMI) and gestational weight gain were available. Fetal growth was measured by ultrasound in mid- and late pregnancy. Regression analyses were used to assess the impact of maternal anthropometrics on fetal weight and birth outcomes. Fetal weight and birth outcomes: weight (grams) and the risks of small (<5th percentile) and large (>95th percentile) size for gestational age at birth. Maternal BMI in pregnancy was positively associated with estimated fetal weight during pregnancy. The effect estimates increased with advancing gestational age. All maternal anthropometrics were positively associated with fetal size (P-values for trend <0.01). Mothers with both their prepregnancy BMI and gestational weight gain quartile in the lowest and highest quartiles showed the highest risks of having a small and large size for gestational age child at birth, respectively. The effect of prepregnancy BMI was strongly modified by gestational weight gain. Fetal growth is positively affected by maternal BMI during pregnancy. Maternal height, prepregnancy BMI and gestational weight gain are all associated with increased risks of small and large size for gestational age at birth in the offspring, with an increased effect when combined.

IGF-I and relation to growth in infancy and early childhood in very-low-birth-weight infants and term born infants.

PubMed

de Jong, Miranda; Cranendonk, Anneke; Twisk, Jos W R; van Weissenbruch, Mirjam M

2017-01-01

In very-low-birth-weight infants IGF-I plays an important role in postnatal growth restriction and is probably also involved in growth restriction in childhood. We compared IGF-I and its relation to growth in early childhood in very-low-birth-weight infants and term appropriate for gestational age born infants. We included 41 very-low-birth-weight and 64 term infants. Anthropometry was performed at all visits to the outpatient clinic. IGF-I and insulin were measured in blood samples taken at 6 months and 2 years corrected age (very-low-birth-weight children) and at 3 months, 1 and 2 years (term children). Over the first 2 years of life growth parameters are lower in very-low-birth-weight children compared to term children, but the difference in length decreases significantly. During the first 2 years of life IGF-I is higher in very-low-birth-weight children compared to term children. In both groups there is a significant relationship between IGF-I and (change in) length and weight over the first 2 years of life and between insulin and change in total body fat. Considering the relation of IGF-I to growth and the decrease in difference in length, higher IGF-I levels in very-low-birth-weight infants in early childhood probably have an important role in catch-up growth in length.

IGF-I and relation to growth in infancy and early childhood in very-low-birth-weight infants and term born infants

PubMed Central

de Jong, Miranda; Cranendonk, Anneke; Twisk, Jos W. R.; van Weissenbruch, Mirjam M.

2017-01-01

Background In very-low-birth-weight infants IGF-I plays an important role in postnatal growth restriction and is probably also involved in growth restriction in childhood. We compared IGF-I and its relation to growth in early childhood in very-low-birth-weight infants and term appropriate for gestational age born infants. Methods We included 41 very-low-birth-weight and 64 term infants. Anthropometry was performed at all visits to the outpatient clinic. IGF-I and insulin were measured in blood samples taken at 6 months and 2 years corrected age (very-low-birth-weight children) and at 3 months, 1 and 2 years (term children). Results Over the first 2 years of life growth parameters are lower in very-low-birth-weight children compared to term children, but the difference in length decreases significantly. During the first 2 years of life IGF-I is higher in very-low-birth-weight children compared to term children. In both groups there is a significant relationship between IGF-I and (change in) length and weight over the first 2 years of life and between insulin and change in total body fat. Conclusions Considering the relation of IGF-I to growth and the decrease in difference in length, higher IGF-I levels in very-low-birth-weight infants in early childhood probably have an important role in catch-up growth in length. PMID:28182752

Trends of preterm birth and low birth weight in Japan: a one hospital-based study.

PubMed

Yorifuji, Takashi; Naruse, Hiroo; Kashima, Saori; Murakoshi, Takeshi; Kato, Tsuguhiko; Inoue, Sachiko; Doi, Hiroyuki; Kawachi, Ichiro

2012-12-26

The proportions of preterm birth (PTB, ie., delivered before 37 gestational weeks) and low birth weight (LBW, ie., birth weight less than 2500 g at delivery) have been rising in developed countries. We sought to examine the factors contributing to the rise in Japan, with particular focus on the effects of obstetric interventions. We used a database maintained by one large regional hospital in Shizuoka, Japan. We restricted the analysis to mothers who delivered live singleton births from 1997 to 2010 (n = 19,221). We assessed the temporal trends in PTB and LBW, then divided the study period into four intervals and compared the proportions of PTB and LBW. We also compared the newborns' outcomes between the intervals. PTB, in particular medically indicated PTB, increased considerably. The increase was largely explained by changes in caesarean sections. The neonatal outcomes did not worsen, and instead the Apgar scores and proportions requiring neonatal intensive care unit (NICU) admission improved. In particular, the risks of NICU admission in the interval from 2007 to 2010 were decreased among all births [odds ratio (OR): 0.84; 95% confidence interval (CI): 0.75, 0.95] and medically indicated births (OR: 0.44; 95% CI: 0.29, 0.68) compared with the interval from 1997 to 2000. Despite the increases in PTB as well as LBW, the present study suggests benefits of obstetric interventions. Rather than simple categorization of PTB or LBW, indicators such as perinatal mortality or other outcomes may be more appropriate for evaluation of perinatal health in developed countries.

Inadequate gestational weight gain and adverse pregnancy outcomes among normal weight women in China

PubMed Central

Wen, Tingyuan; Lv, Yanwei

2015-01-01

Objective: The objective of the paper is to find the association between inadequate gestational weight gain and pregnancy outcomes in normal weight women in China. Method: A retrospective study was conducted among 13,776 normal weight pregnant women who received antenatal care and delivered singleton infants at the participating hospital during August, 2009 to July, 2013. Adverse pregnancy outcomes like low birth weight (LBW), preterm birth, birth asphyxia, neonatal intensive care unit (NICU) admission and length of hospital stay were compared and analyzed between two groups with inadequate and adequate gestational weight gain. Results: According to the IOM recommendations, inadequate gestational weight gain was found to be 14.7% in this study. Women with inadequate gestational weight gain (GWG) were found to be at a higher risk for LBW (aOR = 2.13, 95% CI: 1.75, 2.86) and preterm birth (aOR = 1.44, 95% CI: 1.21, 1.67) than those in the adequate gestational weight gain group, after adjusting for monthly family income, maternal education, occupation, and whether they received any advice regarding benefits of gestational weight gain and residential area. However, inadequate GWG was not associated with longer hospital stay (aOR = 1.13, 95% CI: 0.91-1.43) in adjusted model. In addition, the rate of birth asphyxia and NICU admission were similar in both groups (P > 0.05). Conclusions: Normal weight pregnant women with GWG below the recommended AIOM 2009 guidelines were found to be at an increased risk of low birth weight and preterm birth. PMID:25932249

Inadequate gestational weight gain and adverse pregnancy outcomes among normal weight women in China.

PubMed

Wen, Tingyuan; Lv, Yanwei

2015-01-01

The objective of the paper is to find the association between inadequate gestational weight gain and pregnancy outcomes in normal weight women in China. A retrospective study was conducted among 13,776 normal weight pregnant women who received antenatal care and delivered singleton infants at the participating hospital during August, 2009 to July, 2013. Adverse pregnancy outcomes like low birth weight (LBW), preterm birth, birth asphyxia, neonatal intensive care unit (NICU) admission and length of hospital stay were compared and analyzed between two groups with inadequate and adequate gestational weight gain. According to the IOM recommendations, inadequate gestational weight gain was found to be 14.7% in this study. Women with inadequate gestational weight gain (GWG) were found to be at a higher risk for LBW (aOR = 2.13, 95% CI: 1.75, 2.86) and preterm birth (aOR = 1.44, 95% CI: 1.21, 1.67) than those in the adequate gestational weight gain group, after adjusting for monthly family income, maternal education, occupation, and whether they received any advice regarding benefits of gestational weight gain and residential area. However, inadequate GWG was not associated with longer hospital stay (aOR = 1.13, 95% CI: 0.91-1.43) in adjusted model. In addition, the rate of birth asphyxia and NICU admission were similar in both groups (P > 0.05). Normal weight pregnant women with GWG below the recommended AIOM 2009 guidelines were found to be at an increased risk of low birth weight and preterm birth.

An evaluation of the impact of maternity care coordination on Medicaid birth outcomes in North Carolina.

PubMed Central

Buescher, P A; Roth, M S; Williams, D; Goforth, C M

1991-01-01

BACKGROUND. Care coordination is an important component of the enhanced prenatal care services provided under the recent expansions of the Medicaid program. The effect of maternity care coordination services on birth outcomes in North Carolina was assessed by comparing women on Medicaid who did and did not receive these services. METHODS. Health program data files, including Medicaid claims paid for maternity care coordination, were linked to 1988 and 1989 live birth certificates. Simple comparisons of percentages and rates were supplemented by a logistic regression analysis. RESULTS. Among women on Medicaid who did not receive maternity care coordination services, the low birth weight rate was 21% higher, the very low birth weight rate was 62% higher, and the infant mortality rate was 23% higher than among women on Medicaid who did receive such services. It was estimated that, for each $1.00 spent on maternity care coordination, Medicaid saved $2.02 in medical costs for newborns up to 60 days of age. Among the women who did receive maternity care coordination, those receiving it for 3 or more months had better outcomes than those receiving it for less than 3 months. CONCLUSIONS: These results suggest that maternity care coordination can be effective in reducing low birth weight, infant mortality, and newborn medical care costs among babies born to women in poverty. PMID:1746659

An evaluation of the impact of maternity care coordination on Medicaid birth outcomes in North Carolina.

PubMed

Buescher, P A; Roth, M S; Williams, D; Goforth, C M

1991-12-01

Care coordination is an important component of the enhanced prenatal care services provided under the recent expansions of the Medicaid program. The effect of maternity care coordination services on birth outcomes in North Carolina was assessed by comparing women on Medicaid who did and did not receive these services. Health program data files, including Medicaid claims paid for maternity care coordination, were linked to 1988 and 1989 live birth certificates. Simple comparisons of percentages and rates were supplemented by a logistic regression analysis. Among women on Medicaid who did not receive maternity care coordination services, the low birth weight rate was 21% higher, the very low birth weight rate was 62% higher, and the infant mortality rate was 23% higher than among women on Medicaid who did receive such services. It was estimated that, for each $1.00 spent on maternity care coordination, Medicaid saved $2.02 in medical costs for newborns up to 60 days of age. Among the women who did receive maternity care coordination, those receiving it for 3 or more months had better outcomes than those receiving it for less than 3 months. These results suggest that maternity care coordination can be effective in reducing low birth weight, infant mortality, and newborn medical care costs among babies born to women in poverty.

Birth Weight, Intrauterine Growth Retardation and Fetal Susceptibility to Porcine Reproductive and Respiratory Syndrome Virus

PubMed Central

Ladinig, Andrea; Foxcroft, George; Ashley, Carolyn; Lunney, Joan K.; Plastow, Graham; Harding, John C. S.

2014-01-01

The severity of porcine reproductive and respiratory syndrome was compared in pregnant gilts originating from high and low birth weight litters. One-hundred and eleven pregnant gilts experimentally infected with porcine reproductive and respiratory syndrome virus on gestation day 85 (±1) were necropsied along with their fetuses 21 days later. Ovulation rates and litter size did not differ between groups, but fetuses from low birth weight gilts were shorter, lighter and demonstrated evidence of asymmetric growth with large brain:organ weight ratios (i.e. brain sparing). The number of intrauterine growth retarded fetuses, defined by brain:organ weight ratios greater than 1 standard deviation from the mean, was significantly greater in low, compared to high, birth weight gilts. Although γδ T cells significantly decreased over time in high compared to low birth weight gilts, viral load in serum and tissues, gilt serum cytokine levels, and litter outcome, including the percent dead fetuses per litter, did not differ by birth weight group. Thus, this study provided no substantive evidence that the severity of porcine reproductive and respiratory syndrome is affected by dam birth weight. However, intrauterine growth retarded fetuses had lower viral loads in both fetal thymus and in endometrium adjacent to the umbilical stump. Crown rump length did not significantly differ between fetuses that survived and those that died at least one week prior to termination. Taken together, this study clearly demonstrates that birth weight is a transgenerational trait in pigs, and provides evidence that larger fetuses are more susceptible to transplacental PRRSv infection. PMID:25275491

Estimating the relative contributions of maternal genetic, paternal genetic and intrauterine factors to offspring birth weight and head circumference.

PubMed

Rice, Frances; Thapar, Anita

2010-07-01

Genetic factors and the prenatal environment contribute to birth weight. However, very few types of study design can disentangle their relative contribution. To examine maternal genetic and intrauterine contributions to offspring birth weight and head circumference. To compare the contribution of maternal and paternal genetic effects. Mothers and fathers were either genetically related or unrelated to their offspring who had been conceived by in vitro fertilization. 423 singleton full term offspring, of whom 262 were conceived via homologous IVF (both parents related), 66 via sperm donation (mother only related) and 95 via egg donation (father only related). Maternal weight at antenatal booking, current weight and maternal height. Paternal current weight and height were all predictors. Infant birth weight and head circumference were outcomes. Genetic relatedness was the main contributing factor between measures of parental weight and offspring birth weight as correlations were only significant when the parent was related to the child. However, there was a contribution of the intrauterine environment to the association between maternal height and both infant birth weight and infant head circumference as these were significant even when mothers were unrelated to their child. Both maternal and paternal genes made contributions to infant birth weight. Maternal height appeared to index a contribution of the intrauterine environment to infant growth and gestational age. Results suggested a possible biological interaction between the intrauterine environment and maternal inherited characteristics which suppresses the influence of paternal genes. 2010 Elsevier Ltd. All rights reserved.

Longitudinal Predictors of Psychiatric Disorders in Very Low Birth Weight Adults

ERIC Educational Resources Information Center

Westrupp, E. M.; Northam, E.; Doyle, L. W.; Callanan, C.; Anderson, P. J.

2012-01-01

The purpose of this study was to determine risk and protective factors for adult psychiatric disorders in very low birth weight (VLBW, birth weight less than 1,501 g) survivors. 79 of 154 (51%) VLBW subjects recruited at birth were assessed in early adulthood (24-27 years). Participants were screened for a psychiatric disorder; those elevated were…

Variants in ADCY5 and near CCNL1 are associated with fetal growth and birth weight

PubMed Central

Freathy, Rachel M; Mook-Kanamori, Dennis O; Sovio, Ulla; Prokopenko, Inga; Timpson, Nicholas J; Berry, Diane J; Warrington, Nicole M; Widen, Elisabeth; Hottenga, Jouke Jan; Kaakinen, Marika; Lange, Leslie A; Bradfield, Jonathan P; Kerkhof, Marjan; Marsh, Julie A; Mägi, Reedik; Chen, Chih-Mei; Lyon, Helen N; Kirin, Mirna; Adair, Linda S; Aulchenko, Yurii S; Bennett, Amanda J; Borja, Judith B; Bouatia-Naji, Nabila; Charoen, Pimphen; Coin, Lachlan J M; Cousminer, Diana L; de Geus, Eco J. C.; Deloukas, Panos; Elliott, Paul; Evans, David M; Froguel, Philippe; Glaser, Beate; Groves, Christopher J; Hartikainen, Anna-Liisa; Hassanali, Neelam; Hirschhorn, Joel N; Hofman, Albert; Holly, Jeff M P; Hyppönen, Elina; Kanoni, Stavroula; Knight, Bridget A; Laitinen, Jaana; Lindgren, Cecilia M; McArdle, Wendy L; O'Reilly, Paul F; Pennell, Craig E; Postma, Dirkje S; Pouta, Anneli; Ramasamy, Adaikalavan; Rayner, Nigel W; Ring, Susan M; Rivadeneira, Fernando; Shields, Beverley M; Strachan, David P; Surakka, Ida; Taanila, Anja; Tiesler, Carla; Uitterlinden, Andre G; van Duijn, Cornelia M; Wijga, Alet H; Willemsen, Gonneke; Zhang, Haitao; Zhao, Jianhua; Wilson, James F; Steegers, Eric A P; Hattersley, Andrew T; Eriksson, Johan G; Peltonen, Leena; Mohlke, Karen L; Grant, Struan F A; Hakonarson, Hakon; Koppelman, Gerard H; Dedoussis, George V; Heinrich, Joachim; Gillman, Matthew W; Palmer, Lyle J; Frayling, Timothy M; Boomsma, Dorret I; Smith, George Davey; Power, Chris; Jaddoe, Vincent W V; Jarvelin, Marjo-Riitta; McCarthy, Mark I

2010-01-01

INTRODUCTORY PARAGRAPH To identify genetic variants associated with birth weight, we meta-analyzed six genome-wide association (GWA) studies (N=10,623 Europeans from pregnancy/birth cohorts) and followed up two lead signals in thirteen replication studies (N=27,591). Rs900400 near LEKR1 and CCNL1 (P=2×10−35), and rs9883204 in ADCY5 (P=7×10−15) were robustly associated with birth weight. Correlated SNPs in ADCY5 were recently implicated in regulation of glucose levels and type 2 diabetes susceptibility,1 providing evidence that the well described association between lower birth weight and subsequent type 2 diabetes2,3 has a genetic component, distinct from the proposed role of programming by maternal nutrition. Using data from both SNPs, the 9% of Europeans with 4 birth weight-lowering alleles were, on average, 113g (95%CI 89-137g) lighter at birth than the 24% with 0 or 1 allele (Ptrend=7×10−30). The impact on birth weight is similar to that of a mother smoking 4-5 cigarettes per day in the third trimester of pregnancy.4 PMID:20372150

The association between height and birth order: evidence from 652,518 Swedish men.

PubMed

Myrskylä, Mikko; Silventoinen, Karri; Jelenkovic, Aline; Tynelius, Per; Rasmussen, Finn

2013-07-01

Birth order is associated with outcomes such as birth weight and adult socioeconomic position (SEP), but little is known about the association with adult height. This potential birth order-height association is important because height predicts health, and because the association may help explain population-level height trends. We studied the birth order-height association and whether it varies by family characteristics or birth cohort. We used the Swedish Military Conscription Register to analyse adult height among 652,518 men born in 1951-1983 using fixed effects regression models that compare brothers and account for genetic and social factors shared by brothers. We stratified the analysis by family size, parental SEP and birth cohort. We compared models with and without birth weight and birth length controls. Unadjusted analyses showed no differences between the first two birth orders but in the fixed effects regression, birth orders 2, 3 and 4 were associated with 0.4, 0.7 and 0.8 cm (p<0.001 for each) shorter height than birth order 1, respectively. The associations were similar in large and small and high-SEP and low-SEP families, but were attenuated in recent cohorts. Birth characteristics did not explain these associations. Birth order is an important determinant of height. The height difference between birth orders 3 and 1 is larger than the population-level height increase achieved over 10 years. The attenuation of the effect over cohorts may reflect improvements in living standards. Decreases in family size may explain some of the secular-height increases in countries with decreasing fertility.

Trends in birth weight and the prevalence of low birth weight and small-for-gestational-age in Surinamese South Asian babies since 1974: cross-sectional study of three birth cohorts.

PubMed

de Wilde, Jeroen A; van Buuren, Stef; Middelkoop, Barend J C

2013-10-07

South Asian babies born in developed countries are generally lighter than babies from other ethnic groups born in the same country. While the mean birth weight of Caucasian babies in the Netherlands has increased the past decades, it is unknown if the mean birth weight of South Asian babies born in the Netherlands has increased or if the prevalence of low birth weight (LBW) or small-for-gestational-age (SGA) has decreased.The aims of this study are: 1. to investigate secular changes in mean birth weight and the prevalence of LBW and SGA in Surinamese South Asian babies, and 2. to assess differences between Surinamese South Asian and Dutch Caucasian neonates born 2006-2009. A population based study for which neonatal characteristics of 2014 Surinamese South Asian babies, born between 1974 and 2009 in the Netherlands, and 3104 Dutch Caucasian babies born 2006-2009 were obtained from well-baby clinic records. LBW was defined as a birth weight <2500 g. SGA was based on a universal population standard (the Netherlands) and three ethnic specific standards (the Netherlands, UK, Canada). In Surinamese South Asian babies from 1974 to 2009 no secular trend in mean birth weight and prevalence of LBW was found, whereas SGA prevalence decreased significantly.Surinamese South Asian babies born in 2006-2009 (2993 g; 95% CI 2959-3029 g) were 450 g lighter than Dutch Caucasian babies (3448 g; 95% CI 3429-3468 g), while LBW and SGA prevalences, based on universal standards, were three times higher. Application of ethnic specific standards from the Netherlands and the UK yielded SGA rates in Surinamese South Asian babies that were similar to Dutch. There were considerable differences between the standards used. Since 1974, although the mean birth weight of Surinamese South Asian babies remained unchanged, they gained a healthier weight for their gestational age.

Continuous Positive Airway Pressure versus Mechanical Ventilation on the Fist Day of Life in Very Low-Birth-Weight Infants

PubMed Central

Flannery, Dustin D.; O’Donnell, Elizabeth; Kornhauser, Mike; Dysart, Kevin; Greenspan, Jay; Aghai, Zubair H.

2017-01-01

Objective The objective of this study was to determine differences in the incidence of bronchopulmonary dysplasia (BPD) or death in very low-birth-weight (VLBW) infants managed successfully on continuous positive airway pressure (CPAP) versus mechanical ventilation on the first day of life (DOL). Study Design This is a retrospective analysis of the Alere neonatal database for infants born between January 2009 and December 2014, weighing ≤ 1,500 g. Baseline demographics, clinical characteristics, and outcomes were compared between the two groups. Multivariate regression analysis was performed to control the variables that differ in bivariate analysis. Results In this study, 4,629 infants (birth weight 1,034 ± 290 g, gestational age 28.1 ± 2.5 weeks) met the inclusion criteria. The successful use of early CPAP was associated with a significant reduction in BPD or death (p < 0.001), as well as days to room air, decreased oxygen use at discharge, lower risk for severe intraventricular hemorrhage, and patent ductus arteriosus requiring surgical ligation (p < 0.001 for all outcomes). Conclusion Successful use of early CPAP on the first DOL in VLBW infants is associated with a reduced risk of BPD or death. PMID:27057767

Importance of early postnatal weight gain for normal retinal angiogenesis in very preterm infants: a multicenter study analyzing weight velocity deviations for the prediction of retinopathy of prematurity.

PubMed

Wu, Carolyn; Löfqvist, Chatarina; Smith, Lois E H; VanderVeen, Deborah K; Hellström, Ann

2012-08-01

To assess WINROP (https://winrop.com), an algorithm using postnatal weight measurements, as a tool for the prediction of retinopathy of prematurity (ROP) in a large geographically and racially diverse study population. WINROP analysis was performed retrospectively on conventionally at-risk infants from 10 neonatal intensive careunits.Weight measurements were entered into WINROP, which signals an alarm for an abnormal weight gain rate. Infants were classified into categories of no alarm (unlikely to develop type 1ROP)and alarm (at risk for developing type 1ROP).Use of WINROP requires that an infant has (1) gestational age less than 32 weeks at birth, (2) weekly weight measurements,(3) physiologic weight gain,and(4)absence of other pathologic retinal vascular disease. A total of 1706 infants with a median gestational age of 28 weeks (range, 22-31 weeks) and median birth weight of 1016 g (range, 378-2240 g) were included in the study analysis. An alarm occurred in 1101 infants (64.5%), with a median time from birth to alarm of 3 weeks (range, 0-12 weeks) and from alarm to treatment of 8 weeks (range, 1 day to 22 weeks). The sensitivity of WINROP was 98.6% and the negative predictive value was 99.7%. Two infants with type 1 ROP requiring treatment after 40 weeks' postmenstrual age did not receive an alarm. The WINROP system is a useful adjunct for ROP screening that identifies high-risk infants early to optimize care and potentially reduce the overall number of diagnostic ROP examinations.

Effect of Exposure to Air Pollution on Placental Weight in Isfahan-Iran.

PubMed

Ghasemi-Tehrani, Hatav; Fallah, Setare; Mozafarian, Nafiseh; Miranzadeh, Sareh; Sadeghi, Shokooh; Azidhak, Azam

2017-06-01

Objective: To determine the effect of Air Quality Index (AQI) in the first trimester of pregnancy on birth weight, placental weight, and the ratio of placental weight to the birth weight (pw-bw) in Isfahan. Materials and methods: This cross-sectional study was done on 312 consecutive pregnant women in Beheshti Hospital in Isfahan city in 2013. Information on air pollution was received from the Environmental department of Isfahan. Average exposure to air pollution in the first trimester of pregnancy was calculated for eachpregnant woman. In order to compare quantitative and qualitative variables, analysis of variance (ANOVA), and chi-square were applied. After that, the multiple linear regression analysis was used to assess the association the Air Quality Index (AQI) on birth weight, placental weight and the ratio of pw-bw. Potential confounders including age, baby gender, smoking of husband, maternal BMI, maternal occupation, and education and mother's residential area were considered. A statistical significant association were considered for P-value less than 0.05. Results: The findings showed that there is inverse relationship between exposure to air pollution and placental weight in the first trimester of pregnancy after controlling potential confounders (β = -2.57, p-value = 0.008). The inverse relationship between air pollution and the ratio of pw-bw was found. (β = -0.001, p-value = 0.002). Conclusion: The results of this study suggest that air pollution is associated with newborns' health which in turn is a warning alarm for considering some actions in both sides of reducing the air pollution and teaching the pregnant women about the adverse effects of air pollution on the pregnancy outcomes.

Trends in gestational age and birth weight in Chile, 1991–2008. A descriptive epidemiological study

PubMed Central

2012-01-01

Background Gestational age and birth weight are the principal determinants of newborn’s health status. Chile, a middle income country traditionally has public policies that promote maternal and child health. The availability of an exhaustive database of live births has allows us to monitor over time indicators of newborns health. Methods This descriptive epidemiological study included all live births in Chile, both singleton and multiple, from 1991 through 2008. Trends in gestational age affected the rate of prevalence (%) of preterm births (<37 weeks, including the categories < 32 and 32–36 weeks), term births (37–41) and postterm births (42 weeks or more). Trends in birth weight affected the prevalence of births < 1500 g, 1500–2499 g, 2500–3999 g, and 4000 g or more. Results Data from an exhaustive register of live births showed that the number of term and postterm births decreased and the number of multiple births increased significantly. Birth weights exceeding 4000 g did not vary. Total preterm births rose from 5.0% to 6.6%, with increases of 28% for the singletons and 31% for multiple births (p for trend < 0.0001). Some categories increased even more: specifically preterm birth < 32 weeks increased 32.3% for singletons and 50.6% for multiple births (p for trend 0.0001). The overall rate of low birth weight infants (<2500 g) increased from 4.6% to 5.3%. This variation was not statistically significant for singletons (p for trend = 0.06), but specific analyses exhibited an important increase in the category weighing <1500 g (42%) similar to that observed in multiple births (43%). Conclusions The gestational age and birth weight of live born child have significantly changed over the past two decades in Chile. Monitoring only overall rates of preterm births and low-birth-weight could provide restricted information of this important problem to public health. Monitoring them by specific categories provides a solid basis for planning interventions to reduce adverse perinatal outcomes. This epidemiological information also showed the need to assess several factors that could contribute to explain these trends, as the demographics changes, medical interventions and the increasing probability of survival of extremely and very preterm child. PMID:23116061

Paternal factors associated with neonatal deaths and births with low weight: evidence from Pakistan Demographic and Health Survey 2006-2007.

PubMed

Zakar, Rubeena; Zakar, Muhammad Zakria; Aqil, Nauman; Nasrullah, Muazzam

2015-07-01

We aimed to discern paternal factors associated with neonatal deaths and births with low weight, independent of maternal and other socio-demographic factors. We analyzed the nationally representative sample of 5,724 ever-married women of reproductive age (15-49 years) who delivered their last child during the past 5 years preceding the Pakistan Demographic and Health Survey 2006-2007. We assessed adverse birth outcomes using two variables i.e. neonatal deaths (<28 days) and small size births (as a proxy for birth weight). Associations between paternal factors and adverse birth outcomes were assessed by calculating unadjusted and adjusted odds ratios using logistic regression models after controlling for maternal and socio-demographic factors. The analysis was performed by using the statistical package for social sciences (SPSS) version 17. About 4.5 % mothers reported neonatal deaths and 34 % had small size births (SSB). We found that fathers involved in manual occupation were more likely to have neonatal deaths than fathers involved in managerial/professional jobs (adjusted odds ratio (aOR): 1.64; 95 % Confidence Interval (CI) 1.01, 3.55). Similarly, fathers who belonged to poorer wealth index had higher risk of SSB (aOR: 1.62; 95 % CI 1.18, 2.22). Additionally, consanguinity was a major risk factor which was associated with neonatal deaths (aOR: 1.73; 95 % CI 1.09, 2.74) and SSB (aOR: 1.25; 95 % CI 1.03, 1.55). Fathers' occupation including unemployment and consanguinity were associated with increased risk of adverse birth outcomes. Further studies are warranted to discern other paternal risk factors related to adverse birth outcomes.

Growth changes in infants born of adolescent mothers: Results of a national cohort study in Taiwan

PubMed Central

Chen, Yu-Ju; Li, Chi-Rong; Lee, Shu-Hsin; Hsu, Bu-Qing; Wu, Wei-Ya; Kuo, Ching-Pyng; Hwang, Shiow-Li; Lee, Ming-Chih

2014-01-01

Background: Adolescent pregnancy and childbirth are associated with increased risk and challenges for both mothers and birth outcomes. Objective: To investigate the associations of growth change over time with parenting factors and to compare the differences between children born to adolescent and adult mothers in Taiwan. Materials and Methods: The dataset retrieved from Taiwan birth cohort study (TBCS) was collected by interviews using structured questionnaires, birth certificate and Passport of Well-baby Care of each child. Changes in body weight, body height and head circumference from birth to 18 months, as well as other variables were assessed by statistical analysis. Results: There were 4.13% births born to adolescent mothers in 2005. Higher ratios of breastfeeding and working were found among adult mothers (p<0.001). Significantly higher percentage of adolescent mothers caregave their infants up to 18 months (p<0.001). Children born to adolescent mothers were associated with statistically significant lower body weight (p<0.001), body height (p<0.001) and head circumference (p<0.001) in spite of velocity and slop of growth patterns were similar over time. Breastfeeding did not significantly affected growth rate during the first 6 months. Generalized estimated equation models showed that gender and preterm birth were predictive factors for birth outcomes (both p<0.001) and correlated to changes over time. Conclusion: Adolescent childbearing was associated with preterm birth and lower body weight, body height and head circumference from birth to 18 months. The changes in growth and development among children born to adolescent mothers remain to be followed and evaluated with the TBCS. PMID:25709629

Effect of maternal multiple micronutrient vs iron-folic acid supplementation on infant mortality and adverse birth outcomes in rural Bangladesh: the JiVitA-3 randomized trial.

PubMed

West, Keith P; Shamim, Abu Ahmed; Mehra, Sucheta; Labrique, Alain B; Ali, Hasmot; Shaikh, Saijuddin; Klemm, Rolf D W; Wu, Lee S-F; Mitra, Maithilee; Haque, Rezwanul; Hanif, Abu A M; Massie, Allan B; Merrill, Rebecca Day; Schulze, Kerry J; Christian, Parul

Maternal micronutrient deficiencies may adversely affect fetal and infant health, yet there is insufficient evidence of effects on these outcomes to guide antenatal micronutrient supplementation in South Asia. To assess effects of antenatal multiple micronutrient vs iron-folic acid supplementation on 6-month infant mortality and adverse birth outcomes. Cluster randomized, double-masked trial in Bangladesh, with pregnancy surveillance starting December 4, 2007, and recruitment on January 11, 2008. Six-month infant follow-up ended August 30, 2012. Surveillance included 127,282 women; 44,567 became pregnant and were included in the analysis and delivered 28,516 live-born infants. Median gestation at enrollment was 9 weeks (interquartile range, 7-12). Women were provided supplements containing 15 micronutrients or iron-folic acid alone, taken daily from early pregnancy to 12 weeks postpartum. The primary outcome was all-cause infant mortality through 6 months (180 days). Prespecified secondary outcomes in this analysis included stillbirth, preterm birth (<37 weeks), and low birth weight (<2500 g). To maintain overall significance of α = .05, a Bonferroni-corrected α = .01 was calculated to evaluate statistical significance of primary and 4 secondary risk outcomes (.05/5). Among the 22,405 pregnancies in the multiple micronutrient group and the 22,162 pregnancies in the iron-folic acid group, there were 14,374 and 14,142 live-born infants, respectively, included in the analysis. At 6 months, multiple micronutrients did not significantly reduce infant mortality; there were 764 deaths (54.0 per 1000 live births) in the iron-folic acid group and 741 deaths (51.6 per 1000 live births) in the multiple micronutrient group (relative risk [RR], 0.95; 95% CI, 0.86-1.06). Multiple micronutrient supplementation resulted in a non-statistically significant reduction in stillbirths (43.1 vs 48.2 per 1000 births; RR, 0.89; 95% CI, 0.81-0.99; P = .02) and significant reductions in preterm births (18.6 vs 21.8 per 100 live births; RR, 0.85; 95% CI, 0.80-0.91; P < .001) and low birth weight (40.2 vs 45.7 per 100 live births; RR, 0.88; 95% CI, 0.85-0.91; P < .001). In Bangladesh, antenatal multiple micronutrient compared with iron-folic acid supplementation did not reduce all-cause infant mortality to age 6 months but resulted in a non-statistically significant reduction in stillbirths and significant reductions in preterm births and low birth weight. clinicaltrials.gov Identifier: NCT00860470.

Impacts of green space and tree cover on birth outcomes in Durham-Chapel Hill, NC

EPA Science Inventory

Ecosystem services affect human health through a variety of mechanisms. We investigated associations between green space and tree cover, and birth weight (BWT), pre-term birth (PTB), and low birth weight (LBW). Births in and around Durham-Chapel Hill, NC, between 1 January 2004 ...

Connecting Green Space, Tree Cover, and Birth Outcomes in Durham-Chapel Hill, NC

EPA Science Inventory

Green space provides many ecosystem services relevant to human health. We investigated associations between green space, tree cover, and near-road tree cover with birth weight (BWT), pre-term birth (PTB), and low birth weight (LBW). Births occurring around Durham-Chapel Hill, NC,...

Quantitative, high-resolution epigenetic profiling of CpG loci identifies associations with cord blood plasma homocysteine and birth weight in humans

PubMed Central

Ismail, Khaled MK; Haworth, Kim E; Mein, Charles; Carroll, William D

2011-01-01

Supplementation with folic acid during pregnancy is known to reduce the risk of neural tube defects and low birth weight. It is thought that folate and other one-carbon intermediates might secure these clinical effects via DNA methylation. We examined the effects of folate on the human methylome using quantitative interrogation of 27,578 CpG loci associated with 14,496 genes at single-nucleotide resolution across 12 fetal cord blood samples. Consistent with previous studies, the majority of CpG dinucleotides located within CpG islands exhibited hypomethylation while those outside CpG islands showed mid-high methylation. However, for the first time in human samples, unbiased analysis of methylation across samples revealed a significant correlation of methylation patterns with plasma homocysteine, LINE-1 methylation and birth weight centile. Additionally, CpG methylation significantly correlated with either birth weight or LINE-1 methylation were predominantly located in CpG islands. These data indicate that levels of folate-associated intermediates in cord blood reflect their influence and consequences for the fetal epigenome and potentially on pregnancy outcome. In these cases, their influence might be exerted during late gestation or reflect those present during the peri-conceptual period. PMID:20864804

Effect of prenatal smoking cessation interventions on birth weight: meta-analysis.

PubMed

Veisani, Yousef; Jenabi, Ensiyeh; Delpisheh, Ali; Khazaei, Salman

2017-09-19

Smoking is preventable factor for pregnancy outcomes such as low birth weight (LBW). In this study, we assessed the effects of smoking cessation in pregnancy period on the birth weight in Randomized Controlled Trial studies (RCTs). International databases of Pub Med, Scopus, and Web of Science, by the MeSH heading and/or additional terms, were searched to assess relevant studies in systematic possess. I 2 statistics was used to assess of heterogeneity. Pooled effects size was obtained by random effects model. Meta-regression was used to explore of heterogeneity using Stata software version 12 (Stata Corp, College Station, TX). A total 16 RCTs, 6192 women were enrolled to assess of smoking cessation in pregnancy period on the birth weight. Relative risk (RR) of not smoking at the end of pregnancy in intervention group was 2.47 (95% CI: 1.73-3.20). The odds ratio (OR) for effect of smoking cessation on LBW was 0.65 (95% CI: 0.42-0.88) and standardized mean difference (SMD) was significantly increased in the intervention group, 0.28 (95% CI: 0.05-0.50). Results of this study approve results of previous RCTs that smoking cessation in pregnancy is a good practical action to prevention of LBW in infants.

Personalized weight change prediction in the first week of life.

PubMed

Wilbaux, Mélanie; Kasser, Severin; Gromann, Julia; Mancino, Isabella; Coscia, Tania; Lapaire, Olav; van den Anker, Johannes N; Pfister, Marc; Wellmann, Sven

2018-04-11

Almost all neonates show physiological weight loss and consecutive weight gain after birth. The resulting weight change profiles are highly variable as they depend on multiple neonatal and maternal factors. This limits the value of weight nomograms for the early identification of neonates at risk for excessive weight loss and related morbidities. The objective of this study was to characterize weight changes and the effect of supplemental feeding in late preterm and term neonates during the first week of life, to identify and quantify neonatal and maternal influencing factors, and to provide an educational online prediction tool. Longitudinal weight data from 3638 healthy term and late preterm neonates were prospectively recorded up to 7 days of life. Two-thirds (n = 2425) were randomized to develop a semi-mechanistic model characterizing weight change as a balance between time-dependent rates of weight gain and weight loss. The dose-dependent effect of supplemental feeding on weight gain was characterized. A population analysis applying nonlinear mixed-effects modeling was performed using NONMEM 7.3. The model was evaluated on the remaining third of neonates (n = 1213). Key population characteristics (median [range]) of the whole sample were gestational age 39.9 [34.4-42.4] weeks, birth weight 3400 [1980-5580] g, maternal age 32 [15-51] years, cesarean section 26%, and girls 50%. The model demonstrated good predictive performance (bias 0.01%, precision 0.56%), and is able to accurately predict individual weight change (bias 0.15%, precision 1.43%) and the dose-dependent effects of supplemental feeding up to 1 week after birth based on weight measurements during the first 3 days of life, including birth weight, and the following characteristics: gestational age, gender, delivery mode, type of feeding, maternal age, and parity. We present the first mathematical model not only to describe weight change in term and late preterm neonates but also to provide an educational online tool for personalized weight prediction in the first week of life. Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Male scarcity is associated with higher prevalence of premature gestation and low birth weight births across the United States.

PubMed

Kruger, Daniel J; Clark, Jillian; Vanas, Sarah

2013-01-01

Modern adverse birth outcomes may partially result from mechanisms evolved to evaluate environmental conditions and regulate maternal investment trade-offs. Male scarcity in a population is associated with a cluster of characteristics related to higher mating effort and lower paternal investment. We predicted that modern populations with male scarcity would have shorter gestational times and lower birth weights on average. We compared US Centers for Disease Control and Prevention county-aggregated year 2000 birth records with US Decennial Census data. We combined these data in a path model with the degree of male scarcity and known socio-economic predictors of birth outcomes as exogenous predictors of prematurity and low birth weight, with single mother households as a proportion of families with children as a mediator (N = 450). Male scarcity was directly associated with higher rates of low birth weight. Male scarcity made significant indirect predictions of rates of prematurity and low birth weight, as mediated by the proportion of families headed by single mothers. Aggregate socio-economic status also indirectly predicted birth outcomes, as mediated by the proportion of families headed by single mothers, whereas the proportion African American retained both direct and indirect predictions of adverse birth outcomes. Male scarcity influences life history tradeoffs, with consequences for important social and public health issues such as adverse birth outcomes. Copyright © 2013 Wiley Periodicals, Inc.

Rate of gestational weight gain and preterm birth in relation to prepregnancy body mass indices and trimester: a follow-up study in China.

PubMed

Huang, Aiqun; Ji, Zhenpeng; Zhao, Wei; Hu, Huanqing; Yang, Qi; Chen, Dafang

2016-08-12

To evaluate the association between rate of gestational weight gain and preterm birth varying prepregnancy body mass indices and trimester. Data from Maternal and Newborn's Health Monitoring System on 17475 pregnant women who delivered live singletons at ≥ 28 weeks of gestation between October 2013 and September 2014 from 12 districts/counties of 6 provinces in China and started prenatal care at ≤ 12 weeks of gestation was analyzed. Gestational weight gain was categorized by rate of weight gain during the 2(nd) and 3(rd) trimester, based on the 2009 Institute of Medicine guidelines. Multivariable binary logistic regression models were conducted to investigate the association between rate of gestational weight gain and preterm birth stratified by prepregnancy body mass indices and trimester. Excessive weight gain occurred in 57.9 % pregnant women, and insufficient weight gain 12.5 %. Average rate of gestational weight gain in 2(nd) and 3(rd) trimester was independently associated with preterm birth (U-shaped), and the association varied by prepregnancy body mass indices and trimesters. In underweight women, excessive gestational weight gain was positively associated with preterm birth (OR 1.93, 95 % confidence interval (CI): 1.29- 2.88) when compared with women who gained adequately. While in overweight/obese women, insufficient gestational weight gain was positively associated with preterm birth (OR 3.92, 95 % CI: 1.13-13.67). When stratifying by trimester, we found that excessive weight gain in 3(rd) trimester had a significantly positive effect on preterm birth (OR 1.27, 95 % CI: 1.02-1.58). Excessive gestational weight gain among underweight pregnant women, insufficient gestational weight gain among overweight/obese women and excessive gestational weight gain in 3(rd) trimester were important predictors of preterm birth.

Race/Ethnic Differences in Birth Size, Infant Growth, and Body Mass Index at Age Five Years in Children in Hawaii.

PubMed

Oshiro, Caryn E S; Novotny, Rachel; Grove, John S; Hurwitz, Eric L

2015-12-01

Factors at birth and infancy may increase risk of being overweight in childhood. The aim of this study was to examine the relationship of birth size and infant growth (2-24 months) with BMI at age 5 years in a multiethnic population. This was a retrospective study (using electronic medical records of a health maintenance organization in Hawaii) of singleton children born in 2004-2005, with linked maternal and birth information, infant weights (n = 597) and lengths (n = 473) in the first 2 years, and BMI measures at age 5 years (n = 894). Multiple regression models were used to estimate the association of BMI at age 5 years with birth size and infant growth. Birth weight was positively associated with BMI at age 5 years, adjusting for gestational age, sex, race/ethnicity, and maternal prepregnancy weight, age, education, and smoking. A greater change in infant weight was associated with a higher BMI at age 5 years, though the effect of birth weight on BMI was neither mediated nor modified by infant growth rate. Birth weight, change in infant weight, and BMI at age 5 years varied by race/ethnicity. Change in infant BMI in the first 2 years was higher in other Pacific Islanders and whites (Δ = 0.966; confidence interval [CI] = 0.249-1.684; p = 0.02) than in Asian, other, and part Native Hawaiian race/ethnic groups. Early biological measures of birth weight and infant weight gain varied by race/ethnicity and positively predicted BMI at age 5 years.

Association between Blood Pressure and Birth Weight among Rural South African Children: Ellisras Longitudinal Study.

PubMed

Monyeki, Kotsedi; Kemper, Han; Mogale, Alfred; Hay, Leon; Sekgala, Machoene; Mashiane, Tshephang; Monyeki, Suzan; Sebati, Betty

2017-08-29

The aim of this cross-sectional study was to investigate the association between birth weight, underweight, and blood pressure (BP) among Ellisras rural children aged between 5 and 15 years. Data were collected from 528 respondents who participated in the Ellisras Longitudinal Study (ELS) and had their birth weight recorded on their health clinic card. Standard procedure was used to measure the anthropometric measurements and BP. Linear regression was used to assess BP, underweight variables, and birth weight. Logistic regression was used to assess the association of hypertension risks, low birth weight, and underweight. The association between birth weight and BP was not statistically significant. There was a significant ( p < 0.05) association between mean BP and the sum of four skinfolds (β = 0.26, 95% CI 0.15-0.23) even after adjusting for age (β = 0.18, 95% CI 0.01-0.22). Hypertension was significantly associated with weight for age z-scores (OR = 5.13, 95% CI 1.89-13.92) even after adjusting for age and sex (OR = 5.26, 95% CI 1.93-14.34). BP was significantly associated with the sum of four skinfolds, but not birth weight. Hypertension was significantly associated with underweight. Longitudinal studies should confirm whether the changes in body weight we found can influence the risk of cardiovascular diseases.

LONG-TERM VISUAL OUTCOMES IN EXTREMELY LOW-BIRTH-WEIGHT CHILDREN (AN AMERICAN OPHTHALMOLOGICAL SOCIETY THESIS)

PubMed Central

Spencer, Rand

2006-01-01

Purpose The goal is to analyze the long-term visual outcome of extremely low-birth-weight children. Methods This is a retrospective analysis of eyes of extremely low-birth-weight children on whom vision testing was performed. Visual outcomes were studied by analyzing acuity outcomes at ≥36 months of adjusted age, correlating early acuity testing with final visual outcome and evaluating adverse risk factors for vision. Results Data from 278 eyes are included. Mean birth weight was 731g, and mean gestational age at birth was 26 weeks. 248 eyes had grating acuity outcomes measured at 73 ± 36 months, and 183 eyes had recognition acuity testing at 76 ± 39 months. 54% had below normal grating acuities, and 66% had below normal recognition acuities. 27% of grating outcomes and 17% of recognition outcomes were ≤20/200. Abnormal early grating acuity testing was predictive of abnormal grating (P < .0001) and recognition (P = .0001) acuity testing at ≥3 years of age. A slower-than-normal rate of early visual development was predictive of abnormal grating acuity (P < .0001) and abnormal recognition acuity (P < .0001) at ≥3 years of age. Eyes diagnosed with maximal retinopathy of prematurity in zone I had lower acuity outcomes (P = .0002) than did those with maximal retinopathy of prematurity in zone II/III. Eyes of children born at ≤28 weeks gestational age had 4.1 times greater risk for abnormal recognition acuity than did those of children born at >28 weeks gestational age. Eyes of children with poorer general health after premature birth had a 5.3 times greater risk of abnormal recognition acuity. Conclusions Long-term visual development in extremely low-birth-weight infants is problematic and associated with a high risk of subnormal acuity. Early acuity testing is useful in identifying children at greatest risk for long-term visual abnormalities. Gestational age at birth of ≤ 28 weeks was associated with a higher risk of an abnormal long-term outcome. PMID:17471358

Pregnancy outcomes in female childhood and adolescent cancer survivors: a linked cancer-birth registry analysis.

PubMed

Mueller, Beth A; Chow, Eric J; Kamineni, Aruna; Daling, Janet R; Fraser, Alison; Wiggins, Charles L; Mineau, Geraldine P; Hamre, Merlin R; Severson, Richard K; Drews-Botsch, Carolyn

2009-10-01

To compare birth outcomes among female survivors of childhood and adolescent cancer who subsequently bear children, relative to those of women without a history of cancer. Retrospective cohort study. Four US regions. Cancer registries identified girls younger than 20 years who were diagnosed as having cancer from 1973 through 2000. Linked birth records identified the first live births after diagnosis (n = 1898). Comparison subjects were selected from birth records (n = 14 278). Survivors of genital tract carcinomas underwent separate analysis. Cancer diagnosis at younger than 20 years. Infant low birth weight, preterm delivery, sex ratio, malformations, mortality, and delivery method, and maternal diabetes, anemia, and preeclampsia. Infants born to childhood cancer survivors were more likely to be preterm (relative risk [RR], 1.54; 95% confidence interval [CI], 1.30-1.83) and to weigh less than 2500 g (1.31; 1.10-1.57). For the offspring of genital tract carcinoma survivors, RRs were 1.33 (95% CI, 1.13-1.56) and 1.29 (1.10-1.53), respectively. There were no increased risks of malformations, infant death, or altered sex ratio, suggesting no increased germ cell mutagenicity. In exploratory analysis, bone cancer survivors had an increased risk of diabetes (RR, 4.92; 95% CI, 1.60-15.13), and anemia was more common among brain tumor survivors (3.05; 1.16-7.98) and childhood cancer survivors whose initial treatment was chemotherapy only (2.45; 1.16-5.17). Infants born to female survivors of childhood and adolescent cancer were not at increased risk of malformations or death. Increased occurrence of preterm delivery and low birth weight suggest that close monitoring is warranted. Increased diabetes and anemia among subgroups have not been reported, suggesting areas for study.

Can we predict shoulder dystocia?

PubMed

Revicky, Vladimir; Mukhopadhyay, Sambit; Morris, Edward P; Nieto, Jose J

2012-02-01

To analyse the significance of risk factors and the possibility of prediction of shoulder dystocia. This was a retrospective cohort study. There were 9,767 vaginal deliveries at 37 and more weeks of gestation analysed during 2005-2007. Studied population included 234 deliveries complicated by shoulder dystocia. Shoulder dystocia was defined as a delivery that required additional obstetric manoeuvres to release the shoulders after gentle downward traction has failed. First, a univariate analysis was done to identify the factors that had a significant association with shoulder dystocia. Parity, age, gestation, induction of labour, epidural analgesia, birth weight, duration of second stage of labour and mode of delivery were studied factors. All factors were then combined in a multivariate logistic regression analysis. Adjusted odds ratios (Adj. OR) with 95% confidence intervals (CI) were calculated. The incidence of shoulder dystocia was 2.4% (234/9,767). Only mode of delivery and birth weight were independent risk factors for shoulder dystocia. Parity, age, gestation, induction of labour, epidural analgesia and duration of second stage of labour were not independent risk factors. Ventouse delivery increases the risk of shoulder dystocia almost 3 times, forceps delivery comparing to the ventouse delivery increases risk almost 3.4 times. Risk of shoulder dystocia is minimal with the birth weight of 3,000 g or less. It is difficult to foretell the exact birth weight and the mode of delivery, therefore occurrence of shoulder dystocia is highly unpredictable. Regular drills for shoulder dystocia and awareness of increased incidence with instrumental deliveries are important to reduce fetal and maternal morbidity and mortality.

A cumulative risk factor model for early identification of academic difficulties in premature and low birth weight infants.

PubMed

Roberts, G; Bellinger, D; McCormick, M C

2007-03-01

Premature and low birth weight children have a high prevalence of academic difficulties. This study examines a model comprised of cumulative risk factors that allows early identification of these difficulties. This is a secondary analysis of data from a large cohort of premature (<37 weeks gestation) and LBW (<2500 g) children. The study subjects were 8 years of age and 494 had data available for reading achievement and 469 for mathematics. Potential predictor variables were categorized into 4 domains: sociodemographic, neonatal, maternal mental health and early childhood (ages 3 and 5). Regression analysis was used to create a model to predict reading and mathematics scores. Variables from all domains were significant in the model, predicting low achievement scores in reading (R (2) of 0.49, model p-value < .0001) and mathematics (R (2) of 0.44, model p-value < .0001). Significant risk factors for lower reading scores, were: lower maternal education and income, and Black or Hispanic race (sociodemographic); lower birth weight and male gender (neonatal); lower maternal responsivity (maternal mental health); lower intelligence, visual-motor skill and higher behavioral disturbance scores (early childhood). Lower mathematics scores were predicted by lower maternal education, income and age and Black or Hispanic race (sociodemographic); lower birth weight and higher head circumference (neonatal); lower maternal responsivity (maternal mental health); lower intelligence, visual-motor skill and higher behavioral disturbance scores (early childhood). Sequential early childhood risk factors in premature and LBW children lead to a cumulative risk for academic difficulties and can be used for early identification.

Perinatal outcomes in a South Asian setting with high rates of low birth weight.

PubMed

George, Kuryan; Prasad, Jasmin; Singh, Daisy; Minz, Shanthidani; Albert, David S; Muliyil, Jayaprakash; Joseph, K S; Jayaraman, Jyothi; Kramer, Michael S

2009-02-09

It is unclear whether the high rates of low birth weight in South Asia are due to poor fetal growth or short pregnancy duration. Also, it is not known whether the traditional focus on preventing low birth weight has been successful. We addressed these and related issues by studying births in Kaniyambadi, South India, with births from Nova Scotia, Canada serving as a reference. Population-based data for 1986 to 2005 were obtained from the birth database of the Community Health and Development program in Kaniyambadi and from the Nova Scotia Atlee Perinatal Database. Menstrual dates were used to obtain comparable information on gestational age. Small-for-gestational age (SGA) live births were identified using both a recent Canadian and an older Indian fetal growth standard. The low birth weight and preterm birth rates were 17.0% versus 5.5% and 12.3% versus 6.9% in Kaniyambadi and Nova Scotia, respectively. SGA rates were 46.9% in Kaniyambadi and 7.5% in Nova Scotia when the Canadian fetal growth standard was used to define SGA and 6.7% in Kaniyambadi and < 1% in Nova Scotia when the Indian standard was used. In Kaniyambadi, low birth weight, preterm birth and perinatal mortality rates did not decrease between 1990 and 2005. SGA rates in Kaniyambadi declined significantly when SGA was based on the Indian standard but not when it was based on the Canadian standard. Maternal mortality rates fell by 85% (95% confidence interval 57% to 95%) in Kaniyambadi between 1986-90 and 2001-05. Perinatal mortality rates were 11.7 and 2.6 per 1,000 total births and cesarean delivery rates were 6.0% and 20.9% among live births >or= 2,500 g in Kaniyambadi and Nova Scotia, respectively. High rates of fetal growth restriction and relatively high rates of preterm birth are responsible for the high rates of low birth weight in South Asia. Increased emphasis is required on health services that address the morbidity and mortality in all birth weight categories.

Financial strain and birth weight: the mediating role of psychological distress.

PubMed

Mitchell, Amanda M; Christian, Lisa M

2017-02-01

The effects of financial strain during pregnancy have received limited attention. In addition, data examining the pathways by which SES indicators contribute to birth weight are lacking. The objective of the current study was to examine the potential pathway of psychological distress in the relationship between financial strain and birth weight. Participants consisted of 138 pregnant women who completed measures assessing financial strain, depressive symptoms, pregnancy-specific distress, perceived stress, and general anxiety during pregnancy (mean gestational age = 18.5, SD = 7.2). Birth outcome data were obtained via medical record review. Simple and parallel mediation models were conducted using PROCESS. Simple mediation models showed that depressive symptoms (95% CI -24.65, -0.90) and pregnancy-specific distress (95% CI -37.31, -5.91), but not perceived stress (95% CI -31.17, 4.69) or anxiety (95% CI -25.84, 5.57), served as mediators in the relationship between financial strain and birth weight. When depressive symptoms and pregnancy-specific distress were included in the same mediation model, only pregnancy-specific distress remained significant. Financial strain was positively associated with all facets of psychological distress and negatively associated with birth weight during pregnancy. The current study demonstrated the mechanistic role of pregnancy-specific distress in the link between financial strain and birth weight in a racially diverse sample. Interventions targeting pregnancy-specific distress may mitigate the effects of financial strain on birth weight. Studies examining whether pregnancy-specific distress accounts for the relationship between other types of stressor exposures and birth weight would be informative.

Maternal OGTT Glucose Levels at 26–30 Gestational Weeks with Offspring Growth and Development in Early Infancy

PubMed Central

Liu, Gongshu; Li, Nan; Sun, Shurong; Wen, Jing; Lyu, Fengjun; Gao, Wen; Li, Lili; Chen, Fang; Baccarelli, Andrea A.; Hou, Lifang

2014-01-01

Aims. We aim to evaluate the association of maternal gestational oral glucose tolerance test (OGTT) glucose concentrations with anthropometry in the offspring from birth to 12 months in Tianjin, China. Methods. A total of 27,157 pregnant women underwent OGTT during 26–30 weeks gestation, and their children had body weight/length measured from birth to 12 months old. Results. Maternal OGTT glucose concentrations at 26–30 gestational weeks were positively associated with Z-scores for birth length-for-gestational age and birth weight-for-length. Compared with infants born to mothers with normal glucose tolerance, infants born to mothers with gestational diabetes mellitus (impaired glucose tolerance/new diabetes) had higher mean values of Z-scores for birth length-for-gestational age (0.07/0.23; normal group −0.08) and birth weight-for-length (0.27/0.57; normal group −0.001), smaller changes in mean values of Z-scores for length-for-age (0.75/0.62; normal group 0.94) and weight-for-length (0.18/−0.17; normal group 0.37) from birth to month 3, and bigger changes in mean values in Z-scores for weight-for-length (0.07/0.12; normal group 0.02) from month 9 to 12. Conclusions. Abnormal maternal glucose tolerance during pregnancy was associated with higher birth weight and birth length, less weight and length gain in the first 3 months of life, and more weight gain in the months 9–12 of life. PMID:24689042

Effect of exercise during pregnancy to prevent gestational diabetes mellitus: a systematic review and meta-analysis.

PubMed

Yu, Ying; Xie, Rongrong; Shen, Cainuo; Shu, Lianting

2018-06-01

Exercise showed some potential in preventing gestational diabetes mellitus. However, the results remained controversial. We conducted a systematic review and meta-analysis to evaluate the impact of exercise during pregnancy on gestational diabetes mellitus. PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the influence of exercise during pregnancy on gestational diabetes mellitus were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome was the incidence of gestational diabetes mellitus. Meta-analysis was performed using random-effect model. Six RCTs involving 2164 patients were included in the meta-analysis. Compared with control intervention, exercise intervention was associated with significantly decreased incidence of gestational diabetes mellitus (Std. mean difference = 0.59; 95%CI = 0.39-.88; p = .01), but had no effect on gestational age at birth (Std. mean difference = -0.03; 95%CI = -0.12 to 0.07; p = .60), the number of preterm birth (OR = 0.85; 95%CI = 0.43-1.66; p = .63), glucose 2-h post-OGTT (Std. mean difference = -1.02; 95%CI = -2.75 to 0.71; p = .25), birth weight (Std. mean difference = -0.13; 95%CI = -0.26 to 0.01; p = .06), and Apgar score less than 7 (OR = .78; 95%CI = 0.21-2.91; p = .71). Compared to control intervention, exercise intervention could significantly decrease the risk of gestational diabetes mellitus, but showed no impact on gestational age at birth, preterm birth, glucose 2-h post-OGTT, birth weight, and Apgar score less than 7.

[Prevalence and associated factors of macrosomia in Peru, 2013].

PubMed

Cunha, Antonio José Ledo Alves da; Toro, Manuel Sobrino; Gutiérrez, César; Alarcón-Villaverde, Jorge

2017-01-01

To determine the prevalence of macrosomia and factors associated with it in Peru and to describe the occurrence of complications peri- and postpartum. Birth weights of children under the age of 5 years were analyzed using data from the 2013 Demographic and Family Health Survey (ENDES) carried out by the Instituto Nacional de Estadística e Informática. Children with a birth weight higher than 4000 g were considered macrosomic. A logistic regression analysis was used to establish the independent association of sociodemographic factors with macrosomia. The sample comprised 6121 children. The prevalence of macrosomia was 5.3% (95% interval confidence: 4.8-5.9%). Being male, a higher birth order, maternal obesity, and greater maternal height were independently linked with macrosomia. Caesarean births were more common in macrosomic children than unaffected ones (43.9% vs 26.9%). Complications during birth and postpartum were common but not statistically linked with macrosomia. The prevalence of macrosomia in Peru is relatively low compared to other low-to-middle income countries. The factors associated with macrosomia were mainly unmodifiable, with the exception of maternal obesity. Macrosomic children were more frequently born by caesarean. Weight reduction and the prevention of obesity in women of childbearing age in Peru could potentially reduce macrosomia and caesarean rates.

Size at birth and blood pressure: cross sectional study in 8-11 year old children.

PubMed Central

Taylor, S. J.; Whincup, P. H.; Cook, D. G.; Papacosta, O.; Walker, M.

1997-01-01

OBJECTIVE: To identify which patterns of fetal growth, represented by different measurements of size at birth, are associated with increased blood pressure in children aged 8-11 years. DESIGN AND SETTING: School based, cross sectional survey conducted in 10 towns in England and Wales in 1994. SUBJECTS: 3010 singleton children (response rate 75%) with physical measurements and information on birth weight from parental questionnaires. Hospital birth records were examined for 1573. MAIN OUTCOME MEASURES: Systolic and diastolic blood pressure at age 8-11 years. RESULTS: In the whole group birth weight was inversely related to systolic pressure (regression coefficient -1.48 mm Hg/kg; 95% confidence interval -2.20 to -0.76) after adjustment for current body size. There was no significant association between birth weight and diastolic pressure. The association with systolic pressure was much stronger in girls (-2.54 mm Hg/kg; -3.60 to -1.48) than in boys (-0.64 mm Hg/kg; -1.58 to 0.30), with a significant difference between the sexes (P = 0.006). Among the other neonatal measures, head circumference and placental weight were inversely associated with subsequent blood pressure in girls, and placental ratio (placental weight:birth weight) was positively associated with blood pressure in boys. Neither ponderal index at birth nor length:head circumference ratio was related to blood pressure in either sex. CONCLUSIONS: In these contemporary children the association between birth weight and blood pressure was apparent only in girls. There was no evidence that measures of size at birth, which may be related to nutrition at critical periods of pregnancy (thinness at birth or shortness in relation to head circumference), are related to blood pressure in the offspring. PMID:9056797

Genetic evidence for causal relationships between maternal obesity-related traits and birth weight

PubMed Central

Tyrrell, Jessica; Richmond, Rebecca C.; Palmer, Tom M.; Feenstra, Bjarke; Rangarajan, Janani; Metrustry, Sarah; Cavadino, Alana; Paternoster, Lavinia; Armstrong, Loren L.; De Silva, N. Maneka G.; Wood, Andrew R.; Horikoshi, Momoko; Geller, Frank; Myhre, Ronny; Bradfield, Jonathan P.; Kreiner-Møller, Eskil; Huikari, Ville; Painter, Jodie N.; Hottenga, Jouke-Jan; Allard, Catherine; Berry, Diane J.; Bouchard, Luigi; Das, Shikta; Evans, David M.; Hakonarson, Hakon; Hayes, M. Geoffrey; Heikkinen, Jani; Hofman, Albert; Knight, Bridget; Lind, Penelope A.; McCarthy, Mark I.; McMahon, George; Medland, Sarah E.; Melbye, Mads; Morris, Andrew P.; Nodzenski, Michael; Reichetzeder, Christoph; Ring, Susan M.; Sebert, Sylvain; Sengpiel, Verena; Sørensen, Thorkild I.A.; Willemsen, Gonneke; de Geus, Eco J. C.; Martin, Nicholas G.; Spector, Tim D.; Power, Christine; Järvelin, Marjo-Riitta; Bisgaard, Hans; Grant, Struan F.A.; Nohr, Ellen A.; Jaddoe, Vincent W.; Jacobsson, Bo; Murray, Jeffrey C.; Hocher, Berthold; Hattersley, Andrew T.; Scholtens, Denise M.; Smith, George Davey; Hivert, Marie-France; Felix, Janine F.; Hyppönen, Elina; Lowe, William L.; Frayling, Timothy M.; Lawlor, Debbie A.; Freathy, Rachel M.

2016-01-01

Structured abstract Importance Neonates born to overweight/obese women are larger and at higher risk of birth complications. Many maternal obesity-related traits are observationally associated with birth weight, but the causal nature of these associations is uncertain. Objective To test for genetic evidence of causal associations of maternal body mass index (BMI) and related traits with birth weight. Design, Setting and Participants We used Mendelian randomization to test whether maternal BMI and obesity-related traits are causally related to offspring birth weight. Mendelian randomization makes use of the fact that genotypes are randomly determined at conception and are thus not confounded by non-genetic factors. Data were analysed on 30,487 women from 18 studies. Participants were of European ancestry from population- or community-based studies located in Europe, North America or Australia and participating in the Early Growth Genetics (EGG) Consortium. Live, term, singleton offspring born between 1929 and 2013 were included. We tested associations between a genetic score of 30 BMI-associated single nucleotide polymorphisms (SNPs) and (i) maternal BMI and (ii) birth weight, to estimate the causal relationship between BMI and birth weight. Analyses were repeated for other obesity-related traits. Exposures Genetic scores for BMI, fasting glucose level, type 2 diabetes, systolic blood pressure (SBP), triglyceride level, HDL-cholesterol level, vitamin D status and adiponectin level. Main Outcome(s) and Measure(s) Offspring birth weight measured by trained study personnel (n=2 studies), from medical records (n= 10 studies) or from maternal report (n=6 studies). Results Among the 30,487 newborns the mean birth weight in the various cohorts ranged from 3325 g to 3679 g. The genetic score for BMI was associated with a 2g (95%CI: 0, 3g) higher offspring birth weight per maternal BMI-raising allele (P=0.008). The maternal genetic scores for fasting glucose and SBP were also associated with birth weight with effect sizes of 8g (95%CI: 6, 10g) per glucose-raising allele (P=7×10−14) and −4g (95%CI: −6, −2g) per SBP-raising allele (P=1×10−5), respectively. A 1 standard deviation (1 SD ≈ 4kg/m2) genetically higher maternal BMI was associated with a 55g (95% CI: 17, 93g) higher birth weight. A 1-SD genetically higher maternal fasting glucose (≈ 0.4mmol/L) or SBP (10mmHg) were associated with a 114g (95%CI: 80, 147g) higher or −208g (95% CI: −394, −21g) lower birth weight, respectively. For BMI and fasting glucose these genetic associations were consistent with the observational associations, but for SBP, the genetic and observational associations were in opposite directions. Conclusions and Relevance In this Mendelian randomization study of more than 30,000 women with singleton offspring from 18 studies, genetically elevated maternal BMI and blood glucose levels were potentially causally associated with higher offspring birth weight, whereas genetically elevated maternal systolic blood pressure was shown to be potentially causally related to lower birth weight. If replicated, these findings may have implications for counseling and managing pregnancies to avoid adverse weight-related birth outcomes. PMID:26978208

Birth weight and two possible types of maternal effects on male sexual orientation: a clinical study of children and adolescents referred to a Gender Identity Service.

PubMed

VanderLaan, Doug P; Blanchard, Ray; Wood, Hayley; Garzon, Luisa C; Zucker, Kenneth J

2015-01-01

This study tested predictions regarding two hypothesized maternal immune responses influencing sexual orientation: one affecting homosexual males with high fraternal birth order and another affecting firstborn homosexual individuals whose mothers experience repeated miscarriage after the birth of the first child. Low birth weight was treated as a marker of possible exposure to a maternal immune response during gestation. Birth weight was examined relative to sibship characteristics in a clinical sample of youth (N = 1,722) classified as heterosexual or homosexual based on self-reported or probable sexual orientation. No female sexual orientation differences in birth weight were found. Homosexual, compared to heterosexual, males showed lower birth weight if they had one or more older brothers--and especially two or more older brothers--or if they were an only-child. These findings support the existence of two maternal immune responses influencing male sexual orientation and possibly also cross-gender behavior and identity. © 2014 Wiley Periodicals, Inc.

Effects of depression, anxiety, self-esteem, and health behaviour on neonatal outcomes in a population-based Hungarian sample.

PubMed

Bödecs, Tamás; Horváth, Boldizsár; Szilágyi, Eniko; Gonda, Xénia; Rihmer, Zoltán; Sándor, János

2011-01-01

To investigate possible associations of maternal antenatal depression, anxiety and self-esteem with negative neonatal outcomes controlling for the effects of demographic covariates and health behaviour in a Hungarian sample. A population-based monitoring system was established in 10 districts of health visitors in Szombathely, Hungary, covering every woman registered as pregnant between February 1, 2008 and February 1 2009. Three hundred and seven expectant women in the early stage of their pregnancy were surveyed using the Short Form of Beck Depression Inventory for the measurement of depression and the Spielberger Trait-Anxiety Inventory for the measurement of anxiety. Self-esteem was evaluated by the Rosenberg's Self-Esteem Scale. At the end of the follow-up period, data on 261 mothers and their singleton neonates were available. The relationship between the explanatory and outcome variables (birth weight, length, chest circumference, gestational age, and 1- and 5-min Apgar score) was tested in girls and boys separately by multiple linear regression analysis (Forward method). Categorical variables were used as "dummy variables". Maternal depression, anxiety and health behaviour did not show any association with neonatal outcomes. Higher level of maternal self-esteem was associated with higher birth weight and birth length in boys and higher birth length in girls. Maternal education positively correlated with birth length, gestational age and chest circumference in boys, and with birth length in girls. In girls, maternal socioeconomic status showed a positive association with birth weight and gestational age, while common law marriage had a negative effect on birth weight and chest circumference. Lower level of maternal self-esteem possibly leads to a higher level of maternal stress which may reduce fetal growth via physiologic changes. Gender differences in associations between demographic factors and neonatal outcome measures indicate differences in fetal development between boys and girls. Copyright © 2010. Published by Elsevier Ireland Ltd.

Applicability of a high-throughput shotgun plasma protein screening approach in understanding maternal biological pathways relevant to infant birth weight outcome.

PubMed

Kumarathasan, P; Vincent, R; Das, D; Mohottalage, S; Blais, E; Blank, K; Karthikeyan, S; Vuong, N Q; Arbuckle, T E; Fraser, W D

2014-04-04

There are reports linking maternal nutritional status, smoking and environmental chemical exposures to adverse pregnancy outcomes. However, biological bases for association between some of these factors and birth outcomes are yet to be established. The objective of this preliminary work is to test the capability of a new high-throughput shotgun plasma proteomic screening in identifying maternal changes relevant to pregnancy outcome. A subset of third trimester plasma samples (N=12) associated with normal and low-birth weight infants were fractionated, tryptic-digested and analyzed for global proteomic changes using a MALDI-TOF-TOF-MS methodology. Mass spectral data were mined for candidate biomarkers using bioinformatic and statistical tools. Maternal plasma profiles of cytokines (e.g. IL8, TNF-α), chemokines (e.g. MCP-1) and cardiovascular endpoints (e.g. ET-1, MMP-9) were analyzed by a targeted approach using multiplex protein array and HPLC-Fluorescence methods. Target and global plasma proteomic markers were used to identify protein interaction networks and maternal biological pathways relevant to low infant birth weight. Our results exhibited the potential to discriminate specific maternal physiologies relevant to risk of adverse birth outcomes. This proteomic approach can be valuable in understanding the impacts of maternal factors such as environmental contaminant exposures and nutrition on birth outcomes in future work. We demonstrate here the fitness of mass spectrometry-based shot-gun proteomics for surveillance of biological changes in mothers, and for adverse pathway analysis in combination with target biomarker information. This approach has potential for enabling early detection of mothers at risk for low infant birth weight and preterm birth, and thus early intervention for mitigation and prevention of adverse pregnancy outcomes. This article is part of a Special Issue entitled: Can Proteomics Fill the Gap Between Genomics and Phenotypes? Copyright © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

Trends in the delivery route of twin pregnancies in the United States, 2006-2013.

PubMed

Bateni, Zhoobin H; Clark, Steven L; Sangi-Haghpeykar, Haleh; Aagaard, Kjersti M; Blumenfeld, Yair J; Ramin, Susan M; Lee, Henry C; Fox, Karin A; Moaddab, Amirhossein; Shamshirsaz, Amir A; Salmanian, Bahram; Hosseinzadeh, Pardis; Racusin, Diana A; Erfani, Hadi; Espinoza, Jimmy; Dildy, Gary A; Belfort, Michael A; Shamshirsaz, Alireza A

2016-10-01

To determine the trends of cesarean delivery rate among twin pregnancies from 2006 to 2013. This is a population-based, cross-sectional analysis of twin live births from United State birth data files of the National Center for Health Statistics for calendar years 2006 through 2013. We stratified the population based on the gestational age groups, maternal race/ethnicity, advanced maternal age (AMA) which was defined by age more than 35 years and within the standard birth weight groups (group 1: birth weight 500-1499g, group 2: birth weight 1500-2499g and group 3: birth weight >2500g). We also analyzed the effect of different risk factors for cesarean delivery in twins. There were 1,079,102 infants born of twin gestations in the U.S. from 2006 to 2013, representing a small but significant increase in the proportion of twin births among all births (3.2% in 2006 versus 3.4% in 2013). The rate of cesarean delivery in twin live births peaked at 75.3% in 2009, and was significantly lower (74.8%) in 2013. The rate of the twin live birth with the breech presentation increased steadily from 26.3% in 2006 to 29.1% in 2013. For the fetus of the twin pregnancy presented as breech, the cesarean delivery rate peaked at 92.2% in 2010, falling slightly but significantly in the ensuing 3 years. The results demonstrated that the decrease in cesarean delivery rate was due to fewer cesareans in non-Hispanic white patients; all other ethnic subgroups showed increasing rates of cesarean delivery throughout the study. Gestational diabetes, gestational hypertension, previous cesarean delivery and breech presentation were all significant risk factors for cesarean delivery during the entire study period. Induction of labor and premature rupture of the membranes were associated with lower rates of cesarean delivery in twins. The recent decrease in the cesarean delivery rate in twin gestation appears to be largely attributable to a decline in cesarean among pregnancies complicated by breech presentation in non-Hispanic white women, and may reflect a health care disparity that deserves further research. Published by Elsevier Ireland Ltd.

No association between antenatal common mental disorders in low-obstetric risk women and adverse birth outcomes in their offspring: results from the CDS study in Ghana and Côte D'Ivoire.

PubMed

Bindt, Carola; Guo, Nan; Bonle, Marguerite Te; Appiah-Poku, John; Hinz, Rebecca; Barthel, Dana; Schoppen, Stefanie; Feldt, Torsten; Barkmann, Claus; Koffi, Mathurin; Loag, Wibke; Nguah, Samuel Blay; Eberhardt, Kirsten A; Tagbor, Harry; N'goran, Eliezer; Ehrhardt, Stephan

2013-01-01

Evidence linking common mental disorders (CMD) in pregnant women to adverse birth outcomes is inconsistent, and studies often failed to control for pregnancy complications. This study aimed to explore the association between antenatal depression and anxiety symptoms and birth outcomes in a low-obstetric risk sample of mother/child dyads in Ghana and Côte d'Ivoire. In 2010-2011, a prospective cohort of 1030 women in their third trimester in Ghana and Côte d'Ivoire was enrolled. Depression and anxiety were assessed in the third trimester using the Patient Health Questionnaire depression module and the 7-item Generalized Anxiety Disorder scale. 719 mother/child dyads were included in the analysis. We constructed multivariate regression models to estimate the association between CMD and low birth weight (LBW), and preterm birth (PTB) to control for potential confounders. The prevalence of depression and anxiety symptoms were 28.9% and 14.2% respectively. The mean birth weight was 3172.1g (SD 440.6) and the prevalence of LBW was 1.7%. The mean gestational age was 39.6 weeks and the proportion of PTB was 4%. Multivariate linear regression revealed no significant association between maternal depression (B=52.2, 95% CI -18.2 122.6, p=0.15) or anxiety (B=17.1, 95% CI -74.6 108.7, p=0.72) and birth weight. Yet, low socio-economic status, female sex of the child, and younger maternal age were associated with lower birth weight. Multivariate logistic regression suggested no significant association between maternal depression (OR: 2.1, 95% CI 0.8 5.6, p=0.15) or anxiety (OR: 1.8, 95% CI 0.6 5.5, p=0.29) with PTB. Our data suggests that depression and/or anxiety in the 3(rd) trimester of pregnancy are not independent predictors of adverse birth outcomes in low obstetric risk women. The role of pregnancy complications as confounders or effect modifiers in studies of maternal CMD and their impact on birth outcomes should be investigated.

Analysis of risk factors in the development of retinopathy of prematurity.

PubMed

Knezević, Sanja; Stojanović, Nadezda; Oros, Ana; Savić, Dragana; Simović, Aleksandra; Knezević, Jasmina

2011-01-01

Retinopathy of prematurity (ROP) is a multifactorial disease that occurs most frequently in very small and very sick preterm infants, and it has been identified as the major cause of childhood blindness. The aim of this study was to evaluate ROP incidence and risk factors associated with varying degrees of illness. The study was conducted at the Centre for Neonatology, Paediatric Clinic of the Clinical Centre Kragujevac, Serbia, in the period from June 2006 to December 2008. Ophthalmologic screening was performed in all children with body weight lower than 2000 g or gestational age lower than 36 weeks. We analyzed eighteen postnatal and six perinatal risk factors and the group correlations for each of the risk factors. Out of 317 children that were screened, 56 (17.7%) developed a mild form of ROP, while 68 (21.5%) developed a severe form. Univariate analysis revealed a large number of statistically significant risk factors for the development of ROP, especially the severe form. Multivariate logistical analysis further separated two independent risk factors: small birth weight (p = 0.001) and damage of central nervous system (p = 0.01). Independent risk factors for transition from mild to severe forms of ROP were identified as: small birth weight (p = 0.05) and perinatal risk factors (p = 0.02). Small birth weight and central nervous system damage were risk factors for the development of ROP, perinatal risk factors were identified as significant for transition from mild to severe form of ROP.

Prevalence of Low Birth Weight and Obesity in Central Iran

ERIC Educational Resources Information Center

Rafiei, M.; Ayatollahi, S. M. T.

2008-01-01

To estimate the prevalence of low birth weight (LBW) and to document distribution of body mass index (BMI) at birth in Arak (central Iran) neonates of the 10,241 live neonates (5241 boys, 5000 girls, sex ratio 105) born in 2004 in Arak. A birth weight of less than 2500 g was classified as LBW. BMI based on the original supine length and weight…

DENGUE DURING PREGNANCY: ASSOCIATION WITH LOW BIRTH WEIGHT AND PREMATURITY

PubMed Central

RIBEIRO, Christiane Fernandes; LOPES, Vânia Glória Silami; Brasil, Patricia; da Silva, Licinio Esmeraldo; RIBEIRO, Pedro Henrique Fernandes Josephson; UGENTI, Luca Cipriani; NOGUEIRA, Rita Maria Ribeiro

2016-01-01

The aim of this study was to evaluate the effects of dengue virus infection during pregnancy and its correlation with low birth weight, prematurity, and asphyxia. A non-concurrent cohort study reveals the association of dengue during pregnancy with prematurity and low birth weight, when birth occurred during the maternal-fetal viremia period (p = 0.016 and p < 0.0001, respectively). PMID:26910454

Meat Science and Muscle Biology Symposium: in utero nutrition related to fetal development, postnatal performance, and meat quality of pork.

PubMed

Oksbjerg, N; Nissen, P M; Therkildsen, M; Møller, H S; Larsen, L B; Andersen, M; Young, J F

2013-03-01

Intrauterine growth restriction (IUGR) occurs naturally in pigs and leads to low birth weight of piglets due to undernutrition caused by placental insufficiency. For 2 main reasons, low birth weight causes economic loss. First, low birth weight pigs have a greater mortality and increasing the litter size causes more low birth weight piglets within litters. Second, surviving low birth weight piglets have reduced performance (i.e., ADG, feed conversion rate, and percentage meat). To develop dietary strategies for preventing IUGR, knowledge of the biological basis of IUGR is required. Muscle fiber number, formed during myogenesis, is correlated positively with performance traits and has been shown in several studies to be reduced in low birth weight pigs. Postnatal muscle hypertrophy is due to satellite cell number per fiber at birth and their rate of proliferation as well as protein deposition (i.e., protein synthesis and degradation). Previous studies and some recent ones indicate that low birth weight littermates in mice are born with fewer satellite cells and studies on pigs show that the rate of satellite cell proliferation may vary within litters. Proteomics studies show that protein synthesis and degradation is downregulated in IUGR pigs and low birth weight pigs also produce meat with less tenderness. Alternative maternal feeding strategies to prevent IUGR have been examined. Increasing maternal global nutrition had no beneficial effect on performance and muscle growth traits in several studies. Feeding excess maternal dietary protein also did not influence muscle growth traits whereas moderately decreased maternal dietary protein may decrease muscle fiber number and performance. On the other hand, addition of L-carnitine to the maternal gestation or lactation diet may increase birth and weaning weights or the muscle fiber number, respectively, in low birth weight pig offspring. Finally, promising data have been obtained on reproductive traits in pigs after addition of functional AA, such as arginine and glutamine, to the gestational diet. Although much is known about the biological basis of IUGR, we still need to learn much more about the mode of action before maternal dietary strategies can be developed to prevent IUGR.

Action-oriented colour-coded foot length calliper for primary healthcare workers as a proxy for birth weight & gestational period.

PubMed

Pratinidhi, Asha K; Bagade, Abhijit C; Kakade, Satish V; Kale, Hemangi P; Kshirsagar, Vinayak Y; Babar, Rohini; Bagal, Shilpa

2017-03-01

Foot length of the newborn has a good correlation with the birth weight and is recommended to be used as a proxy measure. There can be variations in the measurement of foot length. A study was, therefore, carried out to develop a foot length calliper for accurate foot length measurement and to find cut-off values for birth weight and gestational age groups to be used by primary healthcare workers. This study was undertaken on 645 apparently healthy newborn infants with known gestational age. Nude birth weight was taken within 24 h of birth on a standard electronic weighing machine. A foot length calliper was developed. Correlation between foot length and birth weight as well as gestational age was calculated. Correctness of cut-off values was tested using another set of 133 observations on the apparently healthy newborns. Action-oriented colour coding was done to make it easy for primary healthcare workers to use it. There was a significant correlation of foot length with birth weight (r=0.75) and gestational age (r=0.63). Cut-off values for birth weight groups were 6.1, 6.8 and 7.3 cm and for gestational age of 6.1, 6.8 and 7.0 cm. Correctness of these cut-off values ranged between 77.1 and 95.7 per cent for birth weight and 60-93.3 per cent for gestational age. Considering 2.5 kg as cut-off between normal birth weight and low birth weight (LBW), cut-off values of 6.1, 6.8 and 7.3 were chosen. Action-oriented colour coding was done by superimposing the colours on the scale of the calliper, green indicating home care, yellow indicating supervised home care, orange indicating care at newborn care units at primary health centres and red indicating Neonatal Intensive Care Unit care for infants. A simple device was developed so that the primary health care workers and trained Accredited Social Health Activist workers can identify the risk of LBW in the absence of accurate weighing facilities and decide on the type of care needed by the newborn and take action accordingly.

Estimated Nephron Number of the Donor Kidney: Impact on Allograft Kidney Outcomes.

PubMed

Schachtner, T; Reinke, P

Low birth weights have been associated with a reduction in nephron number with compensatory hypertrophy of existing glomeruli. The impact of donor birth weight as an estimate of nephron number on allograft function, however, has not been examined. We collected donor birth weight, kidney weight, and volume from 91 living kidney donor-recipient pairs before nephrectomy and after 12, 36, and 60 months. Nephron number was calculated from donor birth weight and age. Donor birth weight, kidney weight/body surface area (BSA), and kidney volume showed a moderate positive correlation with allograft estimated glomerular filtration rate (eGFR) at 12 months (P < .05). Donor age showed a negative moderate correlation with allograft eGFR at 12 months (P = .015). The strongest correlation with allograft eGFR was observed for calculated donor kidney nephron number at 12, 36, and 60 months (R, 0.340, 0.305, and 0.476, respectively; P < .05). No impact was observed on allograft daily proteinuria of any investigated marker (P > .05). Recipients of donors with birth weight <2.5 kg had need of a significantly greater number of antihypertensive drugs (P < .05). Calculated nephron number from donor birth weight and age is suggested to be superior to donor kidney weight/BSA and volume regarding allograft function. Calculated nephron number could estimate expected eGFR and guide decision making in cases of impaired allograft function. Copyright © 2017 Elsevier Inc. All rights reserved.

The effect of maternal betel quid exposure during pregnancy on adverse birth outcomes among aborigines in Taiwan.

PubMed

Yang, Mei-Sang; Lee, Chien-Hung; Chang, Shun-Jen; Chung, Tieh-Chi; Tsai, Eing-Mei; Ko, Allen Min-Jen; Ko, Ying-Chin

2008-05-01

In considering documented developmental toxicity and teratogenicity found in earlier research, maternal betel quid chewing may very well be linked to a higher risk of adverse birth outcomes. The aim of this study was to investigate the significance of betel quid chewing, together with the use of cigarettes or alcohol, either independently or combined, on birth-related outcomes. A total of 1264 aboriginal women who had just given birth in 10 hospitals in Southern and Eastern Taiwan were recruited. Information on their maternal and newborn characteristics was obtained from medical charts and by performing personal interviews using a validated questionnaire. Maternal areca nut chewing during pregnancy was found to be significantly associated with both birth weight loss (-89.54 g) and birth length reduction (-0.43 cm). A significantly lower male newborn rate (aOR=0.62) was observed among aboriginal women with a habit of betel quid chewing during pregnancy. The use of this substance conveyed a 2.40- and 3.67-fold independent risk of low birth weight and full-term low birth weight, respectively. An enhanced risk (aOR=3.26-5.99) of low birth weight was observed among women concomitantly using betel quid, cigarette and alcohol during gestation. Our findings suggest that betel quid chewing during pregnancy has a substantial effect on a number of birth outcomes, including sex ratio at birth, lower birth weight and reduced birth length.

Uncertainty in the relationship between criteria pollutants and low birth weight in Chicago

NASA Astrophysics Data System (ADS)

Kumar, Naresh

2012-03-01

Using the data on all live births (˜400,000) and criteria pollutants from the Chicago Metropolitan Statistical Area (MSA) between 2000 and 2004, this paper empirically demonstrates how mismatches in the spatiotemporal scales of health and air pollution data can result in inconsistency and uncertainty in the linkages between air pollution and birth outcomes. This paper suggests that the risks of low birth weight associated with air pollution exposure changes significantly as the distance interval (around the monitoring stations) used for exposure estimation changes. For example, when the analysis was restricted within 3 miles distance of the monitoring stations the odds of LBW (births <2500 g) increased by a factor of 1.045 (±0.0285 95% CI) with a unit increase in the average daily exposure to PM10 (in μg m-3) during the gestation period; the value dropped to 1.028 when the analysis was restricted within 6 miles distance of air pollution monitoring stations. The effect of PM10 exposure on LBW became null when controlled for confounders. But PM2.5 exposure showed a significant association with low birth weight when controlled for confounders. These results must be interpreted with caution, because the distance to monitoring station does not influence the risks of adverse birth outcomes, but uncertainty in exposure increases with the increase in distance from the monitoring stations, especially for coarse particles such as PM10 that settle with gravity within short distance and time interval. The results of this paper have important implications for the research design of environmental epidemiological studies, and the way air pollution (and potentially other environmental) and health data are collocated to compute exposure. While this paper challenges the findings of pervious epidemiological studies that have relied on coarse resolution air pollution data (such as county level aggregated data), the paper also calls for time-space resolved estimate of air pollution to minimize uncertainty in exposure estimation.

Lower birth weights, shorter breastfeeding and lack of primary healthcare contributed to higher pacifier use in a birth cohort.

PubMed

Martins, R F M; Lima, A A S J; Ribeiro, C C C; Alves, C M C; da Silva, A A M; Thomaz, E B A F

2018-05-11

Pacifier use has been associated with sociodemographic factors, working mothers, girls, less breastfeeding (1-3) and a lower risk of sudden infant death syndrome (4). However, studies have not considered some important perinatal health factors, such as low birth weight, preterm birth and healthcare factors. Pacifiers have been used to stimulate oral functions in low birth weight and preterm birth infants, but the evidence has been inconclusive (5). This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Ileostomy Complications in Infants less than 1500 grams - Frequent but Manageable.

PubMed

Kargl, Simon; Wagner, Oliver; Pumberger, Wolfgang

2017-01-01

In very low birth weight infants abdominal emergency surgery may result in ileostomy formation. We observed a frequent stoma complications in these patients. This retrospective analysis put light on ileostomy-related problems and complications in very low birth weight (VLBW) infants. In a seven-year retrospective chart review (2008 - 2014) infants with ileostomy formation weighing less than 1500 grams at time of operation were identified and reviewed. Data analysis included demographic data, complications and short term outcomes. Thirty patients were included. Ileostomy was formed for spontaneous intestinal perforation (SIP) (n=17), meconium obstruction of prematurity (MOP) (n=6), midgut volvulus (MV) (n=5), necrotizing enterocolitis (NEC) (n=1) and Hirschsprung's disease (HD) (n=1). Three patients died before ileostomy reversal was considered. In seven patients planned ileostomy reversal was done. Twenty infants had stoma related complications (stoma prolapse, prestomal obstruction, stoma retraction, high output stoma, peristomal skin excoriation, and stomal ischemia). Complications did not correlate with underlying diseases. Stomal complications necessitated earlier stoma reversal (mean 62 days). Postoperative complications after stoma reversal occurred in three children (wound dehiscence, adhesion ileus, anastomotic stricture). Although ileostomy related complications are frequent in very low birth weight infants, mortality is low. Morbidity is manageable.

Rapid Infancy Weight Gain and 7- to 9-year Childhood Obesity Risk: A Prospective Cohort Study in Rural Western China.

PubMed

Zhou, Jing; Dang, Shaonong; Zeng, Lingxia; Gao, Wenlong; Wang, Duolao; Li, Qiang; Jiang, Wenhui; Pei, Leilei; Li, Chao; Yan, Hong

2016-04-01

Obesity is increasing in developing countries. This study aimed to identify the association between rapid infancy weight gain and obesity risk among early school-age children. A total of 581 singletons (349 boys, 232 girls) whose mothers participated in an antenatal multiple micronutrient supplement trial in rural western China were followed from birth to between 7 and 9 years of age. Height and weight were measured at birth, 1.5 years, and between 7 and 9 years. At the 7- to 9-year time point, body composition was determined using bioelectrical impedance analysis. Multilevel mixed analysis was used to test the associations between rapid weight gain in infancy (from birth to age 1.5 years) and body size and composition or overweight/obesity among early school-age children. Overall, 31.2% (181 of 581) of the infants showed a weight-for-age Z score gain greater than 0.67 between birth and 1.5 years, indicating rapid weight gain. Approximately 5.7% (33 of 579) of the subjects were overweight (BMI-for-age Z scores [BAZ] >1 and ≤2) or obese (BAZ >2). Rapid infancy weight gain was associated with a higher BAZ (P < 0.001), mid-upper arm circumferences (P < 0.001), percentage body fat (P < 0.001), and fat mass index (P < 0.001) at 7 to 9 years of age after adjusting for biological and social economic factors, genetic factors, and perinatal and postnatal factors. These associations appeared to be independent of gender, economic status at early school age, and maternal nutritional status at enrollment. Rapid growers may have approximately 3 times the risk of being overweight/obese during the early school-age years (odds ratio = 2.94, 95% CI: 1.17-7.43, P = 0.022). Rapid infancy weight gain is a risk factor for being overweight/obesity among early school-age children in rural western China. We propose that social and biological determinants, such as economic status, physical activity, and feeding practice, should be targeted to prevent obesity.

Which Anthropometric Measure Best Correlates with Neonatal Fat Mass at Birth?

PubMed

Dubnov-Raz, Gal; Gal, Moran; Landau-Helman, Yeela; Biderman, Lihi; Nir, Romy; Maayan-Metzger, Ayala

2016-07-01

Objective Body composition provides additional information than weight alone. There is currently no accepted anthropometric measure of adiposity in infants, yet weight and length data allow calculations of a wide array of indices. The study objective was to identify the anthropometric index which best correlates with neonatal adiposity, by examining the associations between neonatal fat mass and several anthropometric indices of newborn infants. Study Design The sum of skinfolds (SSF), birth weight, and birth length were measured in 94 healthy infants (58% males) born at term to healthy mothers. Several anthropometric indices were calculated, and their relationship with SSF was assessed using linear regression adjusting for gestational age and sex. Results SSF at birth was significantly higher in females compared with males (20.7 ± 3.3 vs. 18.8 ± 4.1 mm, p = 0.019). Birth weight, birth weight-for-gestational-age percentile, birth weight percentile, and weight/length ratio had the highest associations with SSF, yet R (2) values were very low, ranging from 16 to 18%. Body mass index (BMI), BMI percentile, ponderal index, and the symmetry index had even lower associations. Conclusion No anthropometric measure can confidently assess fat mass in infants at birth, in accordance with previous research. When body composition data are needed, they should be directly measured. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Are there differences in birth weight between neighbourhoods in a Nordic welfare state?

PubMed Central

Sellström, Eva; Arnoldsson, Göran; Bremberg, Sven; Hjern, Anders

2007-01-01

Background The objective of this cohort study was to examine the effect on birth weight of living in a disadvantaged neighbourhood in a Nordic welfare state. Birth weight is a health indicator known to be sensitive to political and welfare state conditions. No former studies on urban neighbourhood differences regarding mean birth weight have been carried out in a Nordic country. Methods A register based on individual data on children's birth weight and maternal risk factors was used. A neighbourhood characteristic, i.e. an aggregated measure on income was also included. Connections between individual- and neighbourhood-level determinants and the outcome were analysed using multi-level regression technique. The study covered six hundred and ninety-six neighbourhoods in the three major cities of Sweden, Stockholm, Göteborg and Malmö, during 1992–2001. The majority of neighbourhoods had a population of 4 000–10 000 inhabitants. An average of 500 births per neighbourhood were analysed in this study. Results Differences in mean birth weight in Swedish urban neighbourhoods were minor. However, gestational length, parity and maternal smoking acted as modifiers of the neighbourhood effects. Most of the observed variation in mean birth weight was explained by individual risk factors. Conclusion Welfare institutions and benefits in Sweden might buffer against negative infant outcomes due to adverse structural organisation of urban neighbourhoods. PMID:17897453

Risk factors for low birth weight in Botucatu city, SP state, Brazil: a study conducted in the public health system from 2004 to 2008.

PubMed

da Fonseca, Cátia Regina Branco; Strufaldi, Maria Wany Louzada; de Carvalho, Lídia Raquel; Puccini, Rosana Fiorini

2012-01-23

Low birth weight (LBW), defined as birth weight less than 2500 g, has a complex etiology and may be a result of premature interruption of pregnancy or intrauterine growth restriction. The objective of this study was to provide information on determinants of LBW and contribute to the understanding of the problem in Brazil. A case-control study was conducted in Botucatu city, SP state, Brazil. The study population consisted of 2 groups with 860 newborns in each group as follows: low weight newborns (LWNB) and a control group (weight ≥ 2500 g). Secondary data from 2004 to 2008 were collected using the Live Birth Certificate (LBC) and records from medical charts of pregnant women in Basic Health Units (BHU) and in the Public University Hospital (UH). Variables were as follows: maternal socio-demographic characteristics, pregnancy and birth conditions including quality of prenatal care according to 3 criteria. They were based on parameters established by the Ministry of Health (MH), one of them, the modified Kessner Index. The multivariable analysis by logistic regression was used to evaluate the association between variables and LBW. According to the analysis, the factors associated with LBW were as follows: prematurity (OR = 56.98, 95% CI 29.52-109.95), twin pregnancy (OR = 20.00, 95% CI 6.25-100.00), maternal smoking (OR = 2.12, 95% CI 1.33-3.45), maternal malnourishment (OR = 2.30, 95% CI 1.08-5.00), maternal obesity (OR = 2.30, 95% IC 1.18-4.48), weight gain during pregnancy less than 5 kg (OR = 2.63, 95% CI 1.35-5.00) and weight gain during pregnancy more than 15 kg (OR = 2.26, 95% CI 1.16-4.41). Adequacy of prenatal care visits adjusted to gestational age was less frequent in the LBW group than in the control group (68.7% vs. 80.5%, x2 p < 0.001). According to the modified Kessner Index, 64.4% of prenatal visits in the LWNB group were adequate. LWNB are a quite heterogeneous group of infants concerning their determinants and prevention actions against LBW and the follow-up of these infants have also been very complex. Therefore, improvement in the quality of care provided should be given priority through concrete actions for prevention of LBW.

A WHO Collaborative Study of Maternal Anthropometry and Pregnancy Outcomes.

PubMed

Kelly, A; Kevany, J; de Onis, M; Shah, P M

1996-06-01

To evaluate to what degree anthropometric measurements are useful and efficient in predicting maternal and fetal outcomes in different country settings and to develop appropriate reference curves for maternal weight gain. A meta-analysis of 25 data sets providing information on over 111,000 births worldwide. Attained weight indicators from pre-pregnancy (Pp) through 9 lunar months demonstrated high odds ratios (O.R.) for both low birth weight (LBW) and intra-uterine growth retardation (IUGR). The strongest effect size (O.R. = 4.0) was provided by attained weight at 7 lunar months for IUGR, when applied to women of below average pre-pregnancy weight. The study indicators showed only minor and inconsistent O.R. for preterm birth (PTB). The ability of study indicators to predict the three maternal outcomes was much weaker. Maternal height as a predictor of assisted delivery showed the highest positive O.R. (1.6), but did not meet the screening criteria. A single measurement of attained weight at 5 or 7 lunar months (16-20 or 24-28 weeks) is the most practical screening instrument for LBW and IUGR in most primary health care settings and provides warning of the need for intervention. The operational value of these findings should be demonstrated through their successful large-scale application in service settings.

Anthropometric Measurements: Options for Identifying Low Birth Weight Newborns in Kumasi, Ghana

PubMed Central

Otupiri, Easmon; Wobil, Priscilla; Nguah, Samuel Blay; Hindin, Michelle J.

2014-01-01

Background In Ghana, 32% of deliveries take place outside a health facility, and birth weight is not measured. Low birth weight (LBW) newborns who are at increased risk of death and disability, are not identified; 13%–14% of newborns in Ghana are LBW. We aimed at determining whether alternative anthropometrics could be used to identify LBW newborns when weighing scales are not available to measure birth weight. Methods We studied 973 mother and newborn pairs at the Komfo Anokye Teaching and the Suntreso Government hospitals between November 2011 and October 2012. We used standard techniques to record anthropometric measurements of newborns within 24 hours of birth; low birth weight was defined as birth weight <2.5kg. Pearson's correlation coefficient and the area under the curve were used to determine the best predictors of low birth weight. The sensitivity, specificity and predictive values were reported with 95% confidence intervals at generated cut-off values. Results One-fifth (21.7%) of newborns weighed less than 2.5 kg. Among LBW newborns, the following measurements had the highest correlations with birth weight: chest circumference (r = 0.69), mid-upper arm circumference (r = 0.68) and calf circumference (r = 0.66); the areas under the curves of these three measurements demonstrated the highest accuracy in determining LBW newborns. Chest, mid-upper arm and calf circumferences at cut-off values of ≤29.8 cm, ≤9.4 cm and ≤9.5 cm respectively, had the best combination of maximum sensitivity, specificity and predictive values for identifying newborns with LBW. Conclusions Anthropometric measurements, such as the chest circumference, mid-upper arm circumference and calf circumference, offer an opportunity for the identification of and subsequent support for LBW newborns in settings in Ghana, where birth weights are not measured by standardized weighing scales. PMID:25226505

Estimating the relative contributions of maternal genetic, paternal genetic and intrauterine factors to offspring birth weight and head circumference

PubMed Central

Rice, Frances; Thapar, Anita

2010-01-01

Background Genetic factors and the prenatal environment contribute to birth weight. However, very few types of study design can disentangle their relative contribution. Aims To examine maternal genetic and intrauterine contributions to offspring birth weight and head circumference. To compare the contribution of maternal and paternal genetic effects. Study design Mothers and fathers were either genetically related or unrelated to their offspring who had been conceived by in vitro fertilization. Subjects 423 singleton full term offspring, of whom 262 were conceived via homologous IVF (both parents related), 66 via sperm donation (mother only related) and 95 via egg donation (father only related). Measures Maternal weight at antenatal booking, current weight and maternal height. Paternal current weight and height were all predictors. Infant birth weight and head circumference were outcomes. Results Genetic relatedness was the main contributing factor between measures of parental weight and offspring birth weight as correlations were only significant when the parent was related to the child. However, there was a contribution of the intrauterine environment to the association between maternal height and both infant birth weight and infant head circumference as these were significant even when mothers were unrelated to their child. Conclusions Both maternal and paternal genes made contributions to infant birth weight. Maternal height appeared to index a contribution of the intrauterine environment to infant growth and gestational age. Results suggested a possible biological interaction between the intrauterine environment and maternal inherited characteristics which suppresses the influence of paternal genes. PMID:20646882

Overweight and obesity in mothers and risk of preterm birth and low birth weight infants: systematic review and meta-analyses

PubMed Central

Han, Zhen; Mulla, Sohail; Beyene, Joseph

2010-01-01

Objective To determine the relation between overweight and obesity in mothers and preterm birth and low birth weight in singleton pregnancies in developed and developing countries. Design Systematic review and meta-analyses. Data sources Medline and Embase from their inceptions, and reference lists of identified articles. Study selection Studies including a reference group of women with normal body mass index that assessed the effect of overweight and obesity on two primary outcomes: preterm birth (before 37 weeks) and low birth weight (<2500 g). Data extraction Two assessors independently reviewed titles, abstracts, and full articles, extracted data using a piloted data collection form, and assessed quality. Data synthesis 84 studies (64 cohort and 20 case-control) were included, totalling 1 095 834 women. Although the overall risk of preterm birth was similar in overweight and obese women and women of normal weight, the risk of induced preterm birth was increased in overweight and obese women (relative risk 1.30, 95% confidence interval 1.23 to 1.37). Although overall the risk of having an infant of low birth weight was decreased in overweight and obese women (0.84, 0.75 to 0.95), the decrease was greater in developing countries than in developed countries (0.58, 0.47 to 0.71 v 0.90, 0.79 to 1.01). After accounting for publication bias, the apparent protective effect of overweight and obesity on low birth weight disappeared with the addition of imputed “missing” studies (0.95, 0.85 to 1.07), whereas the risk of preterm birth appeared significantly higher in overweight and obese women (1.24, 1.13 to 1.37). Conclusions Overweight and obese women have increased risks of preterm birth and induced preterm birth and, after accounting for publication bias, appeared to have increased risks of preterm birth overall. The beneficial effects of maternal overweight and obesity on low birth weight were greater in developing countries and disappeared after accounting for publication bias. PMID:20647282

Excess gains in weight and waist circumference associated with childbearing: The Coronary Artery Risk Development in Young Adults Study (CARDIA)

PubMed Central

Gunderson, EP; Murtaugh, MA; Lewis, CE; Quesenberry, CP; West, DS; Sidney, S

2010-01-01

OBJECTIVE To examine the association of childbearing with weight and waist circumference (WC) changes, we compared women with and without pregnancies or births during follow-up. STUDY DESIGN A multicenter, longitudinal observational study over 10 years. Comparison groups defined by the number of pregnancies and births during follow-up: P0 (0 pregnancies; nongravid), P1 (1+ miscarriages or abortions; ‘short’ pregnancies), B1 (1 birth), and B2 (2+ births). Mean changes in weight and WC for P1, B1 and B2 groups vs P0 were examined separately by race (black and white), baseline parity (nulliparous and parous) and baseline weight status (normal weight; BMI <25 kg/m2 and overweight; BMI ≥25 kg/m2). SUBJECTS A population-based sample of 2070 women aged 18–30 y at baseline (1053 black subjects and 1017 white subjects) from Birmingham, Alabama, Chicago, Illinois, Minneapolis, Minnesota, and Oakland, California were examined five times between 1985–1986 and 1995–1996. MEASURMENTS Weight and WC measurements were obtained using standardized protocol at baseline and examinations at years 2, 5, 7 and 10. Sociodemographic, reproductive, and behavioral attributes were assessed at baseline and follow-up examinations. RESULTS Gains in weight and WC associated with pregnancy and childbearing varied by race (P<0.001), baseline parity (P<0.05) and overweight status (P<0.001). Among overweight nulliparas, excess gains in weight (black subjects: 3–5 kg, white subjects: 5–6 kg) and WC (black subjects: 3–4 cm, white subjects: 5–6 cm) were associated with ‘short’ pregnancies and one or more birth(s) during follow-up compared to no pregnancies (P<0.01 and 0.001). Among normal weight nulliparas, excess gains in weight (about 1 kg) and WC (2–3 cm) were associated with follow-up birth(s) (P<0.05). Among women parous at baseline, no excess weight gains were found, but excess WC gains (2–4 cm) were associated with follow-up births. CONCLUSION Substantial excess weight gain is associated with both short pregnancies and a first birth in women overweight prior to initiation of childbearing. Excess weight gain was not associated with higher order births. Increases in waist girth were cumulative with both first and higher order births among overweight as well as normal weight women. Interventions to prevent obesity should be targeted at women who are overweight prior to initiation of childbearing. The impact of excess WC gains associated with childbearing on women’s future health risk should be evaluated further. PMID:14770188

Validation of birth outcomes from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS): population-based analysis from the Massachusetts Outcome Study of Assisted Reproductive Technology (MOSART).

PubMed

Stern, Judy E; Gopal, Daksha; Liberman, Rebecca F; Anderka, Marlene; Kotelchuck, Milton; Luke, Barbara

2016-09-01

To assess the validity of outcome data reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) compared with data from vital records and the birth defects registry in Massachusetts. Longitudinal cohort. Not applicable. A total of 342,035 live births and fetal deaths from Massachusetts mothers giving birth in the state from July 1, 2004, to December 31, 2008; 9,092 births and fetal deaths were from mothers who had conceived with the use of assisted reproductive technology (ART) and whose cycle data had been reported to the SART CORS. Not applicable. Percentage agreement between maternal race and ethnicity, delivery outcome (live birth or fetal death), plurality (singleton, twin, or triplet+), delivery date, and singleton birth weight reported in the SART CORS versus vital records; sensitivity and specificity for birth defects among singletons as reported in the SART CORS versus the Massachusetts Birth Defects Monitoring Program (BDMP). There was >95% agreement between the SART CORS and vital records for fields of maternal race/ethnicity, live birth/fetal death, and plurality; birth outcome date was within 1 day with 94.9% agreement and birth weight was within 100 g with 89.6% agreement. In contrast, sensitivity for report of any birth defect was 38.6%, with a range of 18.4%-50.0%, for specific birth defect categories. Although most SART CORS outcome fields are accurately reported, birth defect variables showed poor sensitivity compared with the gold standard data from the BDMP. We suggest that reporting of birth defects be discontinued. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Relationship Between Excessive Gestational Weight Gain and Neonatal Adiposity in Women With Mild Gestational Diabetes Mellitus.

PubMed

Blackwell, Sean C; Landon, Mark B; Mele, Lisa; Reddy, Uma M; Casey, Brian M; Wapner, Ronald J; Varner, Michael W; Rouse, Dwight J; Thorp, John M; Sciscione, Anthony; Catalano, Patrick; Saade, George; Caritis, Steve N; Sorokin, Yoram; Grobman, William A

2016-12-01

To evaluate the relationships among excessive gestational weight gain, neonatal adiposity, and adverse obstetric outcomes in women with mild gestational diabetes mellitus. This is a secondary analysis of a multicenter randomized clinical trial of women with mild gestational diabetes mellitus. Based on self-reported prepregnancy body weight, gestational weight gain was categorized as excessive if it was greater than 2009 Institute of Medicine guidelines. Maternal outcomes and neonatal anthropomorphic characteristics were compared between women with excessive weight gain and those without excessive weight gain. Multiple linear and logistic regression analyses were performed to adjust for confounding factors. We studied 841 women who participated in the main trial and had prepregnancy body mass index (BMI) and delivery information available (n=431 treatment group, n=410 no treatment). After adjustment for factors including treatment and prepregnancy BMI, excessive weight gain remained associated with large for gestational age (adjusted odds ratio [OR] 2.94, 95% confidence interval [CI] 1.81-4.93), birth weight greater than 4,000 g (adjusted OR 2.56, 95% CI 1.54-4.40), preeclampsia (adjusted OR 2.96, 95% CI 1.35-7.03), and cesarean delivery for labor arrest (adjusted OR 2.37, 95% CI 1.30-4.44). In addition, excessive weight gain was independently associated with increased total neonatal fat (P<.001) and birth weight (P<.001). In women with both treated and untreated mild gestational diabetes mellitus, excessive gestational weight gain was independently associated with both greater birth weight and adiposity.

Investigating the association between birth weight and complementary air pollution metrics: a cohort study.

PubMed

Laurent, Olivier; Wu, Jun; Li, Lianfa; Chung, Judith; Bartell, Scott

2013-02-17

Exposure to air pollution is frequently associated with reductions in birth weight but results of available studies vary widely, possibly in part because of differences in air pollution metrics. Further insight is needed to identify the air pollution metrics most strongly and consistently associated with birth weight. We used a hospital-based obstetric database of more than 70,000 births to study the relationships between air pollution and the risk of low birth weight (LBW, <2,500 g), as well as birth weight as a continuous variable, in term-born infants. Complementary metrics capturing different aspects of air pollution were used (measurements from ambient monitoring stations, predictions from land use regression models and from a Gaussian dispersion model, traffic density, and proximity to roads). Associations between air pollution metrics and birth outcomes were investigated using generalized additive models, adjusting for maternal age, parity, race/ethnicity, insurance status, poverty, gestational age and sex of the infants. Increased risks of LBW were associated with ambient O(3) concentrations as measured by monitoring stations, as well as traffic density and proximity to major roadways. LBW was not significantly associated with other air pollution metrics, except that a decreased risk was associated with ambient NO(2) concentrations as measured by monitoring stations. When birth weight was analyzed as a continuous variable, small increases in mean birth weight were associated with most air pollution metrics (<40 g per inter-quartile range in air pollution metrics). No such increase was observed for traffic density or proximity to major roadways, and a significant decrease in mean birth weight was associated with ambient O3 concentrations. We found contrasting results according to the different air pollution metrics examined. Unmeasured confounders and/or measurement errors might have produced spurious positive associations between birth weight and some air pollution metrics. Despite this, ambient O(3) was associated with a decrement in mean birth weight and significant increases in the risk of LBW were associated with traffic density, proximity to roads and ambient O(3). This suggests that in our study population, these air pollution metrics are more likely related to increased risks of LBW than the other metrics we studied. Further studies are necessary to assess the consistency of such patterns across populations.

Investigating the association between birth weight and complementary air pollution metrics: a cohort study

PubMed Central

2013-01-01

Background Exposure to air pollution is frequently associated with reductions in birth weight but results of available studies vary widely, possibly in part because of differences in air pollution metrics. Further insight is needed to identify the air pollution metrics most strongly and consistently associated with birth weight. Methods We used a hospital-based obstetric database of more than 70,000 births to study the relationships between air pollution and the risk of low birth weight (LBW, <2,500 g), as well as birth weight as a continuous variable, in term-born infants. Complementary metrics capturing different aspects of air pollution were used (measurements from ambient monitoring stations, predictions from land use regression models and from a Gaussian dispersion model, traffic density, and proximity to roads). Associations between air pollution metrics and birth outcomes were investigated using generalized additive models, adjusting for maternal age, parity, race/ethnicity, insurance status, poverty, gestational age and sex of the infants. Results Increased risks of LBW were associated with ambient O3 concentrations as measured by monitoring stations, as well as traffic density and proximity to major roadways. LBW was not significantly associated with other air pollution metrics, except that a decreased risk was associated with ambient NO2 concentrations as measured by monitoring stations. When birth weight was analyzed as a continuous variable, small increases in mean birth weight were associated with most air pollution metrics (<40 g per inter-quartile range in air pollution metrics). No such increase was observed for traffic density or proximity to major roadways, and a significant decrease in mean birth weight was associated with ambient O3 concentrations. Conclusions We found contrasting results according to the different air pollution metrics examined. Unmeasured confounders and/or measurement errors might have produced spurious positive associations between birth weight and some air pollution metrics. Despite this, ambient O3 was associated with a decrement in mean birth weight and significant increases in the risk of LBW were associated with traffic density, proximity to roads and ambient O3. This suggests that in our study population, these air pollution metrics are more likely related to increased risks of LBW than the other metrics we studied. Further studies are necessary to assess the consistency of such patterns across populations. PMID:23413962

Prenatal exposure to polychlorinated biphenyls and fetal growth in British girls.

PubMed

Patel, Jill F; Hartman, Terryl J; Sjodin, Andreas; Northstone, Kate; Taylor, Ethel V

2018-04-17

Polychlorinated biphenyls (PCBs) are synthetic chemicals that bioaccumulate in the food chain. PCBs were used primarily for industrial applications due to their insulating and fire retardant properties, but were banned in the 1970s in the United States and in the 1980s in the United Kingdom, as adverse health effects following exposure were identified. Previous studies of populations with high PCB exposure have reported inverse associations with birth weight and gestational length. Birth weight is a powerful predictor of infant survival, and low birth weight can predispose infants to chronic conditions in adult life such as diabetes and cardiovascular diseases. Using data from the Avon Longitudinal Study of Parents and Children, we investigated the association between prenatal exposure to PCBs and fetal growth in a sample of 448 mother-daughter dyads. Concentrations of three common PCB analytes, PCB-118, PCB-153 and PCB-187, were measured in maternal serum collected during pregnancy, and fetal growth was measured by birth weight and birth length. Multivariable linear regression was used to examine the associations between PCB analytes and measures of fetal growth, after adjusting for parity, maternal age, pre-pregnancy BMI, educational status, tobacco use and gestational age of infant at sample collection. Birth length, ponderal index and gestational age were not associated with any of the PCB analytes. Mothers' educational status modified associations for PCB analytes with birthweight. We observed significant inverse associations with birth weight only among daughters of mothers with less education. Daughter's birth weight was -138.4 g lower (95% CI: -218.0, -58.9) for each 10 ng/g lipid increase in maternal serum PCB-118. Similarly, every 10 ng/g lipid increase in maternal serum PCB-153 was associated with a -41.9 g (95% CI: -71.6, -12.2) lower birth weight. Every 10 ng/g lipids increase in maternal serum PCB-187, was associated with a -170.4 g (95% CI: -306.1, -34.7) lower birth weight, among girls with mothers in the lowest education group. Our findings suggest that prenatal exposure to PCBs is inversely associated with daughters' birth weight and that mothers' education, which is a possible marker for socioeconomic status, significantly modified the association between maternal PCB concentrations and birth weight in female newborns. Copyright © 2018 Elsevier Ltd. All rights reserved.