Birth weight for gestational age and the risk of infertility: a Danish cohort study

2019 ◽  
Vol 35 (1) ◽  
pp. 195-202 ◽  
Author(s):  
A Thorsted ◽  
J Lauridsen ◽  
B Høyer ◽  
L H Arendt ◽  
B Bech ◽  
...  

Abstract STUDY QUESTION Is birth weight for gestational age associated with infertility in adulthood among men and women? SUMMARY ANSWER Being born small for gestational age (SGA) was associated with infertility in adulthood among men. WHAT IS KNOWN ALREADY Fetal growth restriction may affect fertility, but results from previous studies have been inconsistent. STUDY DESIGN, SIZE, DURATION In this population-based cohort study, we used data from a Danish birth cohort, including 5594 men and 5342 women born between 1984 and 1987. Information on infertility was obtained from Danish health registers during the period from the participants’ 18th birthday and up until 31 December 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants were men and women born in two Danish municipalities, Aalborg and Odense. Information on birth weight and gestational age was obtained from birth records, and information on infertility diagnoses and fertility treatment was retrieved from the Danish National Patient Registry (NPR) and the Danish In Vitro Fertilisation (IVF) registry. Information on potential maternal confounders was obtained from questionnaires during pregnancy and was included in adjusted analyses. Logistic regression analysis was used to estimate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for infertility according to birth weight for gestational age. MAIN RESULTS AND THE ROLE OF CHANCE Men born SGA had a 55% higher risk of being diagnosed with or treated for infertility compared to men born appropriate for gestational age (AGA) (adjusted OR = 1.55, 95% CI: 1.09–2.21). The association attenuated after exclusion of men born with hypospadias or cryptorchidism (OR = 1.37, 95% CI: 0.93–2.01). No association was found between women’s birth weight for gestational age and risk of infertility (adjusted OR = 1.00, 95% CI: 0.73–1.37). LIMITATIONS, REASONS FOR CAUTION Estimation of gestational age is associated with some uncertainty and might have caused non-differential misclassification. The study design implicitly assumed similar distribution of reproductive and health-seeking behaviour across the groups that were compared. WIDER IMPLICATIONS OF THE FINDINGS Men born SGA had a higher risk of infertility. Genital malformations may account for part of the observed association, but this must be explored further. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by Health, Aarhus University. No competing interests are declared. TRIAL REGISTRATION NUMBER N/A

2021 ◽  
Author(s):  
Yinfeng Zhang ◽  
Haining Luo ◽  
Ying Han ◽  
Bolun Zhang ◽  
Junfang Ma ◽  
...  

Abstract BackgroundThe purpose of this study is to explore the influence of endometrial thickness (EMT) before embryo transfer on birth weight after in vitro fertilization–frozen-embryo transfer (IVF–FET).MethodsThis was a retrospective cohort study. We collected the medical records associated with singleton live births from Tianjin Central Obstetrics and Gynecology Hospital from June 2015 to February 2019 after IVF–frozen-embryo transfer (FET). Patients were ≤ 42 years at delivery. Outcomes related to newborns were birth weight, gestational age, delivery mode, low birth weight, and prevalence of macrosomia. Outcomes related to pregnant women were gestational hypertension, gestational diabetes mellitus, premature rupture of membranes and placenta previa.ResultsThe birth weight of singleton newborns was higher for newborns delivered by patients with EMT > 12 mm before embryo transfer than newborns delivered by patients with a thinner endometrium. Regression analysis showed that the EMT ≥ 12 mm group had a gain in mean birth weight of 85.107 g compared with that in the EMT < 8 mm group, whereas the group with EMT of 8–12 mm had an increase in mean birth weight of 25.942 g compared with that in the EMT < 8 mm group. Hypertension during pregnancy, premature rupture of membranes, placenta previa, newborn sex, gestational age, delivery mode, number of implanted embryos, follicle-stimulating hormone (FSH) level, estradiol (E2) level, and pre-pregnancy body mass index (BMI) were all independent predictors of newborn birth weight. The regression model for predicting the newborn birth weight was: Y (birth weight) = 25.942×(EMT of 8–12 mm) + 85.107×(EMT > 12 mm) + 123.483×(hypertension during pregnancy) + 148.859×(premature rupture of membranes) + 182.342×(placental position) − 126.242×(newborn sex) + 23.837×(number of days of pregnancy) + 130.487×(delivery mode) − 55.023×(number of implanted embryos) − 6.215×FSH level − 1.124×E2 level + 22.218×BMI − 4468.101.Conclusion(s)EMT before embryo transfer in patients undergoing their first freeze–thaw embryo transfer cycle is related to the weight of newborn singletons. The newborn birth weight for patients with a thinner endometrium is lower. EMT should be increased before embryo transfer to improve neonatal outcomes after fertility treatment.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Na Zeng ◽  
Erica Erwin ◽  
Wendy Wen ◽  
Daniel J. Corsi ◽  
Shi Wu Wen ◽  
...  

Abstract Background Racial disparities in adverse perinatal outcomes have been studied in other countries, but little has been done for the Canadian population. In this study, we sought to examine the disparities in adverse perinatal outcomes between Asians and Caucasians in Ontario, Canada. Methods We conducted a population-based retrospective cohort study that included all Asian and Caucasian women who attended a prenatal screening and resulted in a singleton birth in an Ontario hospital (April 1st, 2015-March 31st, 2017). Generalized estimating equation models were used to estimate the independent adjusted relative risks and adjusted risk difference of adverse perinatal outcomes for Asians compared with Caucasians. Results Among 237,293 eligible women, 31% were Asian and 69% were Caucasian. Asians were at an increased risk of gestational diabetes mellitus, placental previa, early preterm birth (< 32 weeks), preterm birth, emergency cesarean section, 3rd and 4th degree perineal tears, low birth weight (< 2500 g, < 1500 g), small-for-gestational-age (<10th percentile, <3rd percentile), neonatal intensive care unit admission, and hyperbilirubinemia requiring treatment, but had lower risks of preeclampsia, macrosomia (birth weight > 4000 g), large-for-gestational-age neonates, 5-min Apgar score < 7, and arterial cord pH ≤7.1, as compared with Caucasians. No difference in risk of elective cesarean section was observed between Asians and Caucasians. Conclusion There are significant differences in several adverse perinatal outcomes between Asians and Caucasians. These differences should be taken into consideration for clinical practices due to the large Asian population in Canada.


PEDIATRICS ◽  
1992 ◽  
Vol 90 (3) ◽  
pp. 424-429
Author(s):  
Joseph M. Brandes ◽  
Joseph Itzkovits ◽  
Anat Scher ◽  
Miriam Sarid ◽  
Israel Thaler ◽  
...  

To assess the physical and mental development of infants born after in vitro fertilization (IVF), we performed a general physical and developmental examination (Bayley and Stanford-Binet scales) on a cohort of 116 IVF children, conceived and born at our institution between February 1985 and March 1989, and on 116 non-IVF matched controls. Study and control groups were each composed of 66 singletons, 19 pairs of twins and 4 sets of triplets, whose age at examination ranged from 12 to 45 months. The developmental indices of IVF infants were within the normal range and did not differ from those of their matched controls. The indices were positively correlated to gestational age, birth weight, head circumference at birth and at examination, and mother's education. Mean birth weight, gestational age, and birth weight percentile of IVF infants were lower than the mean of the healthy population. Mean percentiles of weight and length at examination (mean age 22.4 months) were equally low but did not differ from those of the matched controls. However, mean percentiles of head circumference at birth and at examination compare well with the normal mean, both in IVF and control groups. Twins and triplets (IVF and controls) had significantly lower physical and mental indices as compared to singletons.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M L Groendahl ◽  
M. Buhl Borgstrøm ◽  
U. Schiøler Kesmodel

Abstract Study question Do stage and morphology of the competent blastocyst associate with initial hCG rise, gestational age, preterm birth, child birth weight, length, and child sex? Summary answer Higher stage, TE- and ICM-scores associated with higher hCG-rise; ICM- and TE-scores associated with length at birth, and higher stage and TE-score associated with boys. What is known already Many studies have focused on the developmental stage and morphology of the blastocysts in order to find biomarkers of competence to improve the efficacy of assisted reproduction technology treatment. In contrast, the associations between blastocyst assessment score parameters (individually or by combined score) and perinatal outcome have only been reported in few and smaller single center studies, and conflicting results have been presented. In the present study, we focused on the in vitro cultured blastocyst leading to a live birth and how the stage and morphology of these competent blastocysts relate to implantation and birth outcomes. Study design, size, duration Multicenter historical cohort study based on exposure (blastocyst stage (1-6) and morphology (trophectoderm (TE) and inner cell mass (ICM): A,B,C)) and outcome data (serum human chorionic gonadotrophin (hCG), gestational age, preterm birth, child weight, length, and sex) from women undergoing single blastocyst transfer resulting in singleton pregnancy and birth. Data from 16 private and university-based facilities for clinical services and research from 2014 to 2018 was included. Participants/materials, setting, methods 7246 women, who underwent ovarian stimulation or Frozen-thawed-Embryo-Transfer with single blastocyst transfer resulting in singleton pregnancy were identified. Linking to the Danish Medical Birth Registry resulted in a total of 4842 women with live birth being included. Initial serum hCG value (IU/L) (11 days after transfer), gestational age (days), preterm birth (%) child weight (grams), length (cm) and sex. The analyses were adjusted for female age, BMI, smoking, center, diagnosis, parity, gestational age and sex. Main results and the role of chance Higher mean initial hCG was consistently positively associated with higher developmental stage (p &lt; 0.001), TE (p &lt; 0.001) and ICM score (p = 0.02); for stage 6, TE (A) and ICM (A): 508.4, 436.5 and 428.5 IU/L, respectively. No differences between blastocyst morphology (stage, TE, ICM), gestational age (mean 276.6 days), preterm birth (8.3%) and birth weight (mean 3461.7 gram) were statistically significant. While stage showed no association with length at birth (mean 51.6 cm), length at birth between blastocysts with a TE score C and a TE score A were statistically significant (mean difference 0.5 cm (0.07;0.83)) as was the length at birth between blastocysts with an ICM score B and C compared to score A, mean differences respectively 0.2 cm (0.02;0.31) and 0.5 cm (0.03;0.87). Stage and TE, but not ICM were associated with the sex of the child. Blastocysts transferred with stage score 5 compared to blastocysts transferred with score 3 had a 33% increased probability of being a boy (OR 1.33 (1.08;1.64)). Further, TE score B blastocysts compared to TE score A blastocysts had a 28% reduced probability of being a boy (OR 0.72 (0.62;0.82)). Limitations, reasons for caution The assessment scores of the blastocystś stage and morphology were based on subjective evaluation, and information bias may have influenced the results. By adjusting for center, we took the potential variation in scoring between clinics into considerations. Wider implications of the findings Stage and morphology of the competent blastocyst was associated with initial hCG rise suggesting an effect on implantation, which may be used in routine, everyday information to women and couples on the day of blastocyst transfer. Trial registration number j.nr.: VD-2018-282


PEDIATRICS ◽  
1981 ◽  
Vol 67 (3) ◽  
pp. 407-411
Author(s):  
R. K. Chandra

Groups of healthy, small-for-gestational age (SGA) and preterm appropriate-for-gestational age (AGA) infants were studied at birth, 1 month, 3 months, and 12 months of age. Serum thymic hormone (TH) activity was assayed, the number of T lymphocytes in the peripheral blood was counted, and in vitro lymphocyte stimulation responses to phytohemagglutinin (PHA) were evaluated. TH activity was decreased in 1-month-old SGA infants. T cells were reduced in all low birth weight infants; the number reverted to normal by 3 months of age in preterm AGA infants, whereas it remained low for at least 12 months in the SGA group. Lymphocyte stimulation response was decreased in low birth weight infants; the extent of depression paralleled reduction in T lymphocyte number. These observations indicate that cell-mediated immunity is impaired in low birth weight newborns and reduced TH activity may be one of the pathogenetic factors involved. Persistent depression of immunocompetence may underlie the increased susceptibility of SGA infants to infection-related morbidity and mortality.


2020 ◽  
Vol 35 (2) ◽  
pp. 484-484
Author(s):  
A Thorsted ◽  
J Lauridsen ◽  
B Høyer ◽  
L H Arendt ◽  
B Bech ◽  
...  

2020 ◽  
Vol 27 (01) ◽  
pp. 84-88
Author(s):  
Muhammad Ejaz Mazari ◽  
Fazal ur Rehman ◽  
Muhammad Ashfaq Zafar

Objectives: Hypoglycemia is a matter of great concern especially in newborns. Its prevalence varies globally as different protocols and feeding policies exist. We aimed this study to find out the incidence of hypoglycemia in newborns with risk factors of hypoglycemia. Study Design: Observational study Setting: Pediatric Medicine Unit-2, Mayo Hospital, Lahore. Period: From 1st January 2018 to 31st December 2018. Material & Methods: A total of 342 babies born with risk factors for hypoglycemia fulfilling the inclusion and exclusion criteria were considered for this study. Screening for hypoglycemia was performed prior to feeding at 2, 6, 12, 24 and 48 hours of life. Results: Out of a total of 342 newborns with risk factors, 109 (31.9%) were found to have hypoglycemia. Amongst these newborns, 99 (28.9%) and 10 (2.9%) newborns had asymptomatic and symptomatic hypoglycemia respectively. Among these 109 newborns, majority were male 56 (51.4%), 70 (64.2%) with gestational age more than 37 weeks, 66 (60.6%) with birth weight more than 2500 grams and 62 (56.9%) small for gestational age (SGA). Amongst newborns who developed at least 1 hypoglycemia episode, 52 (47.7%) were at 2 hours of life, 31 (28.4%) at 6 hours whereas no hypoglycemia episode recorded beyond 24 hours of life. Conclusions: Screening for hypoglycemia should always be performed in babies who had risk factors of hypoglycemia especially within 24 hours of life. As per our study blood glucose screening should be mandatory in all newborns who are SGA.


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