Birth weight for gestational age and the risk of asthma in childhood and adolescence: a retrospective cohort study

2018 ◽  
Vol 104 (2) ◽  
pp. 179-183 ◽  
Author(s):  
Jillian H Carter ◽  
Christy G Woolcott ◽  
Lihui Liu ◽  
Stefan Kuhle

ObjectiveTo examine the association between birth weight for gestational age and asthma in childhood and adolescence while controlling for potential confounders and considering smoking as an effect modifier.MethodsA retrospective cohort of all singleton term births in Nova Scotia, Canada, between 1989 and 1993 was identified in the provincial perinatal database and followed through 2014 by linking with administrative health data. The outcome, asthma, was defined as having one hospitalisation or two physician visits with an International Classification of Diseases code for asthma in a 2-year period. Birth weight was categorised as small (SGA), large (LGA) or appropriate (AGA) for gestational age. Multivariable-adjusted Cox proportional hazards models were used to examine the association between the birth weight for gestational age and asthma and to test for effect modification by maternal smoking in pregnancy.ResultsOf the 40 724 cohort children, 10.5% and 11.7% were born SGA and LGA, respectively, and the risk of developing asthma to age 18 years was 30.2%. The adjusted HRs for SGA and LGA (relative to AGA) and asthma were 1.07 (95% CI 1.02 to 1.14) and 0.96 (95% CI 0.91 to 1.02), respectively. Relative to AGA children born to non-smoking mothers, SGA children were not at increased risk of asthma (HR 1.02), whereas both AGA and SGA children born to smoking mothers were at significantly increased risk (HR 1.14 and 1.29, respectively).ConclusionsOur findings suggest that SGA in term infants is not associated with asthma in childhood in the absence of smoking in pregnancy.

2017 ◽  
Vol 102 (5) ◽  
pp. 1606-1613 ◽  
Author(s):  
Kyoung Eun Joung ◽  
Sule Umit Cataltepe ◽  
Zoe Michael ◽  
Helen Christou ◽  
Christos S. Mantzoros

AbstractContext:Infants born small for gestational age (SGA) have increased risk for obesity and metabolic syndrome, but the underlying mechanisms are not fully elucidated. Adipocyte fatty acid–binding protein (AFABP) is an adipokine that has been implicated in modulation of insulin sensitivity and lipid metabolism. Higher plasma AFABP levels are associated with increased risk of metabolic syndrome and cardiovascular morbidity in adults. Alterations in AFABP levels during fetal growth have not been characterized.Objective:To examine AFABP levels in neonatal cord blood in relation to gestational age and birth weight.Design:A cross-sectional study of 361 neonates born at a tertiary academic center.Outcome Measures:Plasma AFABP levels were measured by enzyme-linked immunosorbent assay. For comparison, venous samples from 26 adults were analyzed.Results:AFABP levels were higher in neonates compared with adults (P < 0.01). Preterm infants had higher AFABP levels [48.2 (31.2 to 73.3) ng/mL] compared with full-term infants [35.8 (25.1 to 51.5)] ng/mL, P < 0.01). There was a negative correlation between AFABP and gestational age (r = 0.28, P = 0.02). Among full-term infants, AFABP levels in SGA infants were lower [28.6 (24.2 to 37.3) ng/mL], compared with appropriate for gestational age [36.1 (25.5 to 50.4) ng/mL] and large for gestational age infants [45.0 (24.6 to 62.4) ng/mL, P < 0.05].Conclusions:These associations may reflect the higher metabolic activity during fetal development. AFABP may also be involved in fetal growth and the association between SGA status and obesity and metabolic syndrome in later life.


2004 ◽  
Vol 84 (2) ◽  
pp. 159-172 ◽  
Author(s):  
Suh-Fang Jeng ◽  
Li-Chiou Chen ◽  
Kuo-Inn Tsou ◽  
Wei J Chen ◽  
Hong-Ji Luo

Abstract Background and Purposes. Although early kicking differences have been reported for preterm infants without overt cranial sonographic abnormalities, their functional importance remains unclear because no outcomes have been measured. Therefore, the first purpose of this prospective study was to examine the age of walking attainment in preterm infants who had very low birth weight (VLBW) but no overt neurosonographic abnormalities and full-term infants without known impairments or pathology. The second purpose was to examine the relationship between spontaneous kicking and age of walking attainment in these infants. Subjects and Methods. Twenty-two preterm infants and 22 full-term infants were examined for kicking movements at 2 and 4 months corrected age and were followed up for age of walking attainment until 18 months corrected age. Results. Survival analysis showed that infants with VLBW attained walking ability at older ages than full-term infants after correction for prematurity. Cox proportional-hazards regression analyses for all infants revealed that a high hip-knee correlation at 2 months corrected age, a high kick frequency at 4 months corrected age, and a short intra-kick pause together with a low variability in interlimb coordination at 2 and 4 months corrected age were all associated with a decreased rate of walking attainment. Discussion and Conclusion. The results indicated that preterm infants who had VLBW but no overt neurosonographic abnormalities had an increased risk of delayed walking attainment compared with full-term infants. Alterations of spontaneous kicking may predict a decreased rate of walking attainment in both preterm and full-term infants.


2013 ◽  
Vol 17 (9) ◽  
pp. 2071-2080 ◽  
Author(s):  
Kristine Vejrup ◽  
Anne Lise Brantsæter ◽  
Helle K Knutsen ◽  
Per Magnus ◽  
Jan Alexander ◽  
...  

AbstractObjectiveTo 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).DesignExposure 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.SettingThe study is based on data from MoBa.SubjectsThe study sample consisted of 62 941 women who answered a validated FFQ which covered the habitual diet during the first five months of pregnancy.ResultsMedian 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.ConclusionsAlthough 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.


2021 ◽  
Vol 12 ◽  
Author(s):  
Yiting Mao ◽  
Chen Zhang ◽  
Yinyu Wang ◽  
Yicong Meng ◽  
Lei Chen ◽  
...  

PurposeWhile it is well documented that maternal adverse exposures contribute to a series defects on offspring health according to the Developmental Origins of Health and Disease (DOHaD) theory, paternal evidence is still insufficient. Advanced paternal age is associated with multiple metabolism and psychiatric disorders. Birth weight is the most direct marker to evaluate fetal growth. Therefore, we designed this study to explore the association between paternal age and birth weight among infants born at term and preterm (<37 weeks gestation).MethodsA large retrospective study was conducted using population-based hospital data from January 2015 to December 2019 that included 69,964 cases of singleton infant births with complete paternal age data. The primary outcome was infant birth weight stratified by sex and gestational age including small for gestational age (SGA, 10th percentile) and large for gestational age (LGA, 90th percentile). Birth weight percentiles by gestational age were based on those published in the INTERGROWTH-21st neonatal weight-for gestational-age standard. Logistic regression analysis and linear regression model were used to estimate the association between paternal age and infant birth weight.ResultsAdvanced paternal age was associated with a higher risk for a preterm birth [35–44 years: adjusted odds ratio (OR) = 1.13, 95%CI (1.03 to 1.24); >44 years: OR = 1.36, 95%CI (1.09 to 1.70)]. Paternal age exerted an opposite effect on birth weight with an increased risk of SGA among preterm infants (35–44years: OR = 1.85, 95%CI (1.18 to 2.89) and a decreased risk among term infant (35–44years: OR = 0.81, 95%CI (0.68 to 0.98); >44 years: OR = 0.50, 95%CI (0.26 to 0.94). U-shaped associations were found in that LGA risk among term infants was higher in both younger (<25 years) (OR = 1.32; 95%CI, 1.07 to 1.62) and older (35–44 years) (OR = 1.07; 95% CI, 1.01 to 1.14) fathers in comparison to those who were 25 to 34 years old at the time of delivery.ConclusionsOur study found advanced paternal age increased the risk of SGA among preterm infants and for LGA among term infants. These findings likely reflect a pathophysiology etiology and have important preconception care implications and suggest the need for antenatal monitoring.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hui He ◽  
Huazhang Miao ◽  
Zhijiang Liang ◽  
Ye Zhang ◽  
Wei Jiang ◽  
...  

AbstractInfants who are small for gestational age (SGA) are at increased risk of neonatal and infant death, non-communicable diseases and growth retardation. However, the epidemiological characteristics of SGA remain unclear. We aim to explore the prevalence of SGA and to examine its socioeconomic associations by using data from 21 cities. 10,515,494 single live birth records between 2014 and 2019 from the Guangdong Women and Children Health Information System were included in the study. Descriptive statistical methods were used to analyze the prevalence trend of SGA and its distribution. We also analyze the associations between the prevalence of SGA and per-capita GDP. The prevalence of SGA in Guangdong Province from the years 2014–2019 was 13.17%, 12.96%, 11.96%, 12.72%, 11.45%, 11.30% respectively, and the overall prevalence was 12.28%. The prevalence of term SGA infants in Guangdong Province was 12.50%, which was much higher than that of preterm SGA (7.71%). There was a significant negative correlation between the SGA prevalence and per-capita GDP in 21 cities of Guangdong Province. The level of economic development may affect the prevalence of SGA. The prevalence of SGA in full term infants is significantly higher than in premature infants, suggesting that most SGA infants may be born at a later gestational age.


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.


2021 ◽  
Vol 10 (4) ◽  
pp. 643
Author(s):  
Veronica Giorgione ◽  
Corey Briffa ◽  
Carolina Di Fabrizio ◽  
Rohan Bhate ◽  
Asma Khalil

Twin pregnancies are commonly assessed using singleton growth and birth weight reference charts. This practice has led to a significant number of twins labelled as small for gestational age (SGA), causing unnecessary interventions and increased risk of iatrogenic preterm birth. However, the use of twin-specific charts remains controversial. This study aims to assess whether twin-specific estimated fetal weight (EFW) and birth weight (BW) charts are more predictive of adverse outcomes compared to singleton charts. Centiles of EFW and BW were calculated using previously published singleton and twin charts. Categorical data were compared using Chi-square or McNemar tests. The study included 1740 twin pregnancies, with the following perinatal adverse outcomes recorded: perinatal death, preterm birth <34 weeks, hypertensive disorders of pregnancy (HDP) and admissions to the neonatal unit (NNU). Twin-specific charts identified prenatally and postnatally a smaller proportion of infants as SGA compared to singleton charts. However, twin charts showed a higher percentage of adverse neonatal outcomes in SGA infants than singleton charts. For example, perinatal death (SGA 7.2% vs. appropriate for gestational age (AGA) 2%, p < 0.0001), preterm birth <34 weeks (SGA 42.1% vs. AGA 16.4%, p < 0.0001), HDP (SGA 21.2% vs. AGA 13.5%, p = 0.015) and NNU admissions (SGA 69% vs. AGA 24%, p < 0.0001), when compared to singleton charts (perinatal death: SGA 2% vs. AGA 1%, p = 0.029), preterm birth <34 weeks: (SGA 20.6% vs. AGA 17.4%, p = 0.020), NNU admission: (SGA 34.5% vs. AGA 23.9%, p < 0.000). There was no significant association between HDP and SGA using the singleton charts (p = 0.696). In SGA infants, according to the twin charts, the incidence of abnormal umbilical artery Doppler was significantly more common than in SGA using the singleton chart (27.0% vs. 8.1%, p < 0.001). In conclusion, singleton charts misclassify a large number of twins as at risk of fetal growth restriction. The evidence suggests that the following twin-specific charts could reduce unnecessary medical interventions prenatally and postnatally.


Author(s):  
Elizabeth Norton ◽  
Frances Shofer ◽  
Hannah Schwartz ◽  
Lorraine Dugoff

Objective To determine if women who newly met criteria for stage 1 hypertension in early pregnancy were at increased risk for adverse perinatal outcomes compared with normotensive women. Study Design We conducted a retrospective cohort study of women who had prenatal care at a single institution and subsequently delivered a live infant between December 2017 and August 2019. Women with a singleton gestation who had at least two prenatal visits prior to 20 weeks of gestation were included. We excluded women with known chronic hypertension or other major maternal illness. Two groups were identified: (1) women newly diagnosed with stage 1 hypertension before 20 weeks of gestation (blood pressure [BP] 130–139/80–89 on at least two occasions) and (2) women with no known history of hypertension and normal BP (<130/80 mm Hg) before 20 weeks of gestation. The primary outcome was any hypertensive disorder of pregnancy; secondary outcomes were indicated preterm birth and small for gestational age. Generalized linear models were used to compare risk of adverse outcomes between the groups. Results Of the 1,630 women included in the analysis, 1,443 women were normotensive prior to 20 weeks of gestation and 187 women (11.5%) identified with stage 1 hypertension. Women with stage 1 hypertension were at significantly increased risk for any hypertensive disorder of pregnancy (adjusted risk ratio [aRR]: 1.86, 95% confidence interval [CI]: 1.12–3.04) and indicated preterm birth (aRR: 1.83, 95% CI: 1.12–3.02). Black women and obese women with stage 1 hypertension were at increased for hypertensive disorder of pregnancy compared with white women and nonobese women, respectively (aRR: 1.32, 95% CI: 1.11–1.57; aRR: 1.69, 95% CI: 1.39–2.06). Conclusion These results provide insight about the prevalence of stage 1 hypertension and inform future guidelines for diagnosis and management of hypertension in pregnancy. Future research is needed to assess potential interventions to mitigate risk. Key Points


2018 ◽  
Vol 149 (4) ◽  
pp. 628-634 ◽  
Author(s):  
Rebecca Kofod Vinding ◽  
Jakob Stokholm ◽  
Astrid Sevelsted ◽  
Bo L Chawes ◽  
Klaus Bønnelykke ◽  
...  

ABSTRACT Background Randomized trials have reported that supplementation with n–3 long-chain polyunsaturated fatty acids (LCPUFAs) in pregnancy can prolong pregnancy and thereby increase birth weight. Objective We aimed to examine the relations of n–3 LCPUFA supplementation in pregnancy with duration of pregnancy, birth weight, and size for gestational age (GA). Methods This was a double-blind randomized controlled trial conducted in 736 pregnant women and their offspring, from the Copenhagen Prospective Studies on Asthma in Childhood2010cohort. They were recruited between weeks 22 and 26 in pregnancy and randomly assigned to either of 2.4 g n–3 LCPUFA or control (olive oil) daily until 1 wk after birth. Exclusion criteria were endocrine, cardiovascular, or nephrologic disorders and vitamin D supplementation intake >600 IU/d. In this study we analyzed secondary outcomes, and further excluded twin pregnancies and extrauterine death. The primary outcome for the trial was persistent wheeze or asthma. Results The random assignment ran between 2008 and 2010. Six hundred and ninety-nine mother-infant pairs were included in the analysis. n–3 LCPUFA compared with control was associated with a 2-d prolongation of pregnancy [median (IQR): 282 (275–288) d compared with 280 (273–286) d, P = 0.02], a 97-g higher birth weight (mean ± SD: 3601 ± 534 g compared with 3504 ± 528 g, P = 0.02), and an increased size for GA according to the Norwegian population-based growth curves-Skjærven (mean ± SD: 49.9 ± 28.3 percentiles compared with 44.5 ± 27.6 percentiles, P = 0.01). Conclusion Supplementing pregnant women with n–3 LCPUFAs during the third trimester is associated with prolonged gestation and increased size for GA, leading to a higher birth weight in this randomized controlled trial. This trial was registered at clinicaltrials.gov as NCT00798226.


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