PATIENTS WHO REQUIRE SUPRA-PHYSIOLOGIC ESTROGEN SUPPLEMENTATION TO ACHIEVE ADEQUATE ENDOMETRIAL THICKNESS FOR EUPLOID EMBRYO TRANSFERS ARE AT INCREASED RISK OF PRETERM DELIVERY AND LOWER BIRTH WEIGHT

BackgroundBased on existing studies, there is no conclusive evidence as to whether and why paternal age matters for birth outcomes.MethodsWe used Finnish population registers on 106 652 children born 1987–2000. We first document the unadjusted association between paternal age and the risk of low birth weight (LBW; <2500 g) and preterm birth (<37 weeks’ gestation). Second, we investigate whether the unadjusted association is attenuated on adjustment for child’s, maternal and parental socioeconomic characteristics. Third, by adopting a within-family design which involves comparing children born to the same father at different ages, we additionally adjust for unobserved parental characteristics shared between siblings.ResultsThe unadjusted results show that being born to a father aged 40+, as opposed to a father aged 30–34, is associated with an increased risk of LBW of 0.96% (95% CI 0.5% to 1.3%) and to a younger father (<25) with a 1% (95% CI 0.6% to 1.3%) increased risk. The increased risk at younger paternal ages is halved on adjustment for the child’s characteristics and fully attenuated on adjustment for child/parental characteristics. The increased risk at paternal ages 40+ is partially attenuated on adjustment for maternal characteristics (β=0.62%; 95% CI 0.13% to 1.1%). Adjustment for unobserved parental characteristics shared by siblings further attenuates the 40+ coefficient (β=0.4%; 95% CI −0.5% to −1.2%). Results for preterm delivery are similar.ConclusionsThe results underscore the importance of considering paternal age as a potential risk factor for adverse birth outcomes and of expanding research on its role and the mechanisms linking it to birth outcomes.

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Fetal growth and psychiatric and socioeconomic problems: population-based sibling comparison

The British Journal of Psychiatry ◽

10.1192/bjp.bp.113.143693 ◽

2014 ◽

Vol 205 (5) ◽

pp. 355-361 ◽

Cited By ~ 39

Author(s):

Quetzal A. Class ◽

Martin E. Rickert ◽

Henrik Larsson ◽

Paul Lichtenstein ◽

Brian M. D'Onofrio

Keyword(s):

Birth Weight ◽

Fetal Growth ◽

Population Based ◽

Autism Spectrum ◽

Swedish Population ◽

Unmeasured Confounding ◽

Lower Birth Weight ◽

Sibling Comparison ◽

Increased Risk ◽

Socioeconomic Problems

BackgroundIt is unclear whether associations between fetal growth and psychiatric and socioeconomic problems are consistent with causal mechanisms.AimsTo estimate the extent to which associations are a result of unmeasured confounding factors using a sibling-comparison approach.MethodWe predicted outcomes from continuously measured birth weight in a Swedish population cohort (n = 3 291 773), while controlling for measured and unmeasured confounding.ResultsIn the population, lower birth weight (⩽2500 g) increased the risk of all outcomes. Sibling-comparison models indicated that lower birth weight independently predicted increased risk for autism spectrum disorder (hazard ratio for low birth weight = 2.44, 95% CI 1.99–2.97) and attention-deficit hyperactivity disorder. Although attenuated, associations remained for psychotic or bipolar disorder and educational problems. Associations with suicide attempt, substance use problems and social welfare receipt, however, were fully attenuated in sibling comparisons.ConclusionsResults suggest that fetal growth, and factors that influence it, contribute to psychiatric and socioeconomic problems.

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Stroke during pregnancy: no increased risk of preterm delivery and low birth weight, a nationwide case-controlled study

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp.2009.200899 ◽

2010 ◽

Vol 81 (11) ◽

pp. 1211-1214 ◽

Cited By ~ 4

Author(s):

J.-H. Kang ◽

H.-C. Lin

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Delivery ◽

Controlled Study ◽

Increased Risk

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Warning of Immortal Time Bias When Studying Drug Safety in Pregnancy: Application to Late Use of Antibiotics and Preterm Delivery

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17186465 ◽

2020 ◽

Vol 17 (18) ◽

pp. 6465

Author(s):

Giovanni Corrao ◽

Federico Rea ◽

Matteo Franchi ◽

Benedetta Beccalli ◽

Anna Locatelli ◽

...

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Preterm Delivery ◽

Apgar Score ◽

Time Varying ◽

Immortal Time Bias ◽

Increased Risk ◽

In Pregnancy

This study aimed to illustrate and account for immortal time bias in pregnancy observational investigations, using the relationship between late use of antibiotics and risk of preterm birth as an example. We conducted a population-based cohort study including 549,082 deliveries between 2007 and 2017 in Lombardy, Italy. We evaluated the risk of preterm births, low birth weight, small for gestational age, and low Apgar score associated with antibiotic dispensing during the third trimester of pregnancy. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) of the outcomes, considering the use of antibiotics as time-fixed (with biased classification of exposure person-time) and time-varying (with proper classification of exposure person-time) exposure. There were 23,638 (4.3%) premature deliveries. There was no association between time-fixed exposure to antibiotics and preterm delivery (adjusted HR 0.96; 95% CI 0.92 to 1.01) but an increased risk of preterm birth when time-varying exposure to antibiotics was considered (1.27; 1.21 to 1.34). The same trend was found for low birth weight and low Apgar score. Immortal time bias is a common and sneaky trap in observational studies involving exposure in late pregnancy. This bias could be easily avoided with suitable design and analysis.

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Maternal and fetal outcomes in pregnancy induced hypertensive patients and normotensive patients

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20195308 ◽

2019 ◽

Vol 8 (12) ◽

pp. 4721

Author(s):

Kapil Dev ◽

Rajeev Sood ◽

Anoop Sharma

Keyword(s):

Birth Weight ◽

Preterm Delivery ◽

Antihypertensive Drugs ◽

Caesarian Section ◽

Significant Rise ◽

Successful Outcome ◽

Normal Vaginal Delivery ◽

Hypertensive Disorder ◽

Increased Risk ◽

Nicu Admission

Background: Hypertensive disorder of pregnancy complicates 5 to 8% of pregnancies and is a major cause of maternal and perinatal morbidity and mortality. Hypertensive disorders of pregnancy account for nearly 18% of all maternal deaths worldwide, with an estimated 62000-77000 deaths per year.Methods: This one-year prospective case control study total 200 pregnant women attending antenatal care and admitted in Eclampsia ward fulfilling the inclusion criteria were studied. Fetal and maternal outcomes data recorded and documented. Statistical analysis of data was done by student’s t-test and p-value.Results: In PIH 68% women had normal vaginal delivery (p=0.004) 10% women had instrumental delivery. In PIH group 22% women had emergency caesarian section and in normotensive group 10% women had emergency caesarian section. In PIH group 58% delivered at term and 42% had preterm delivery. In normotensive 95% delivered at term and 5% had preterm delivery (p <0.001). PIH group 29% women developed IUGR whereas in normotensive group all women had normal growth velocity (p <0.001). In PIH group 69% mothers had newborn with birth weight <2.5 kg and 31% women had newborn with birth weight >2.5 kg (p=0.0009). While In normotensive group only 9% women had newborn with birth weight <2.5 kg. In PIH group, 24% newborn babies needed NICU admission and in normotensive group only 5% newborn needed NICU admission (p=0.001). In PIH group 76% women had normal maternal outcome (p <0.001). 11% had associated abruption (p=0.0019). In the rest 13% patient develop PRES.Conclusions: We concluded that there is a significant rise of complication in mothers having PIH and also there is an increased risk of delivering low birth weight and preterm babies. The early use of antihypertensive drugs, optimum timing of delivery and strict fluid balance, anticonvulsants in cases of eclampsia will help to achieve successful outcome.

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Pregnancy Outcomes Associated with Maternal Adherence to Mediterranean Diet During Pregnancy in an Urban, Low-Income and Multiethnic US Population

Current Developments in Nutrition ◽

10.1093/cdn/nzaa054_135 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1063-1063

Author(s):

Dong Keun Rhee ◽

Yuelong Ji ◽

Xiumei Hong ◽

Xiaobin Wang ◽

Laura Caulfield

Keyword(s):

Logistic Regression ◽

Birth Weight ◽

Low Birth Weight ◽

Preterm Delivery ◽

Low Income ◽

Pregnancy Outcomes ◽

Multinomial Logistic Regression ◽

Medical Center ◽

Food Groups ◽

Lower Birth Weight

Abstract Objectives To evaluate associations between maternal adherence to Mediterranean-style diet during pregnancy and pregnancy outcomes. Methods The data originate from the Boston Birth Cohort (BMC), an urban, low-income, multiethnic cohort study which enrolled mother-infant dyads upon delivery at Boston Medical Center (Boston, MA) beginning in 1998. Demographic information and health history of mothers were obtained via interviewer-administered questionnaires, which also captured the maternal food and beverage intake during pregnancy using a food frequency questionnaire (FFQ). Pregnancy outcomes and other health information were extracted from medical records. A Mediterranean-style diet score (MSDS) was formulated based on the reported intake history, wherein each respondent was scored depending on their consumption of select food groups listed in the FFQ. MSDS was transformed into quintiles for analyses. Linear regression, logistic regression and multinomial logistic regression were performed to assess associations between MSDS quintiles and pregnancy outcomes, both overall and stratified by race. Results Among 7068 mother-infant dyads, 46.2% were black, 27.4% had preterm birth and 26.3% had low birth weight. Adjusting for eleven maternal sociodemographic and clinical factors, lowest MSDS quintile was associated with shorter gestation (−0.21 wk; 95% CI, −0.38– −0.04 wk) and lower birth weight (−63.4 g; 95% CI, −102.8– −24.0 g), compared to the other quintiles combined. This translated to higher relative risk (RR) of preterm delivery (1.18; 95% CI: 1.04–1.34) and of low birth weight (RR, 1.22; 95% CI, 1.07–1.39). When the analyses were limited to black mother-infant dyads, the associations were similar: lowest MSDS quintile was associated with shorter gestation (−0.28 wk; 95% CI, −0.54– −0.02 wk) and lower birth weight (−82.2 g; 95% CI, −141.1– −23.2 g), and greater risk of preterm delivery (RR, 1.19; 95% 0.99–1.44) and low birth weight (RR, 1.31; 95% CI, 1.08–1.58). Conclusions In this urban, low-income and multi-ethnic sample, lower adherence to Mediterranean-style diet was statistically significantly associated with adverse birth outcomes including preterm delivery and low birth weight. Funding Sources BMC (the parent study) is supported by the National Institutes of Health (NIH) grants (R01HD086013, 2R01HD041702 and R01HD098232).

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RE: “DELAYED CHILDBEARING: NO EVIDENCE FOR INCREASED RISK OF LOW BIRTH WEIGHT AND PRETERM DELIVERY”

American Journal of Epidemiology ◽

10.1093/oxfordjournals.aje.a114874 ◽

1988 ◽

Vol 127 (4) ◽

pp. 881-882

Author(s):

Michele R. Forman ◽

Heinz W. Berendes

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Delivery ◽

Delayed Childbearing ◽

Increased Risk

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Delayed Childbearing and Its Impact on Population Rate Changes in Lower Birth Weight, Multiple Birth, and Preterm Delivery

PEDIATRICS ◽

10.1542/peds.109.3.399 ◽

2002 ◽

Vol 109 (3) ◽

pp. 399-403 ◽

Cited By ~ 125

Author(s):

S. C. Tough ◽

C. Newburn-Cook ◽

D. W. Johnston ◽

L. W. Svenson ◽

S. Rose ◽

...

Keyword(s):

Birth Weight ◽

Preterm Delivery ◽

Multiple Birth ◽

Delayed Childbearing ◽

Lower Birth Weight ◽

Population Rate

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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

BMJ Open ◽

10.1136/bmjopen-2017-017753 ◽

2017 ◽

Vol 7 (11) ◽

pp. e017753 ◽

Cited By ~ 14

Author(s):

Michael A Zulyniak ◽

Russell J de Souza ◽

Mateen Shaikh ◽

Dipika Desai ◽

Diana L Lefebvre ◽

...

Keyword(s):

Birth Weight ◽

Ethnic Groups ◽

Gestational Age ◽

Dietary Pattern ◽

South Asians ◽

Lower Birth Weight ◽

Increased Risk ◽

Unit Increase ◽

Maternal Consumption ◽

The Impact

ObjectiveBirth 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.SettingFour multiethnic birth cohorts based in Canada (the NutriGen Alliance).Participants3997 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.ResultsNo 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.ConclusionsMaternal 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.

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