scholarly journals Maternal bisphenol urine concentrations, fetal growth and adverse birth outcomes: A population-based prospective cohort

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Chalana M. Sol ◽  
Charissa van Zwol - Janssens ◽  
Elise M. Philips ◽  
Alexandros G. Asimakopoulos ◽  
Maria-Pilar Martinez-Moral ◽  
...  

Abstract Background Exposure to bisphenols may affect fetal growth and development. The trimester-specific effects of bisphenols on repeated measures of fetal growth remain unknown. Our objective was to assess the associations of maternal bisphenol urine concentrations with fetal growth measures and birth outcomes and identify potential critical exposure periods. Methods In a population-based prospective cohort study among 1379 pregnant women, we measured maternal bisphenol A, S and F urine concentrations in the first, second and third trimester. Fetal head circumference, length and weight were measured in the second and third trimester by ultrasound and at birth. Results An interquartile range increase in maternal pregnancy-averaged bisphenol S concentrations was associated with larger fetal head circumference (difference 0.18 (95% confidence interval (CI) 0.01 to 0.34) standard deviation scores (SDS), p-value< 0.05) across pregnancy. When focusing on specific critical exposure periods, any detection of first trimester bisphenol S was associated with larger second and third trimester fetal head circumference (difference 0.15 (95% CI 0.05 to 0.26) and 0.12 (95% CI 0.02 to 0.23) SDS, respectively) and fetal weight (difference 0.12 (95% CI 0.02 to 0.22) and 0.16 (95% CI 0.06 to 0.26) SDS, respectively). The other bisphenols were not consistently associated with fetal growth outcomes. Any detection of bisphenol S and bisphenol F in first trimester was also associated with a lower risk of being born small size for gestational age (Odds Ratio 0.56 (95% CI 0.38 to 0.74) and 0.55 (95% CI 0.36 to 0.85), respectively). Bisphenols were not associated with risk of preterm birth. Conclusions Higher maternal bisphenol S urine concentrations, especially in the first trimester, seem to be related with larger fetal head circumference, higher weight and a lower risk of being small size for gestational age at birth.

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Sander Galjaard ◽  
Lieveke Ameye ◽  
Christoph C. Lees ◽  
Anne Pexsters ◽  
Tom Bourne ◽  
...  

Abstract Background According to the WHO Multicentre Growth Reference Study Group recommendations, boys and girls have different growth trajectories after birth. Our aim was to develop gender-specific fetal growth curves in a low-risk population and to compare immediate birth outcomes. Methods First, second, and third trimester fetal ultrasound examinations were conducted between 2002 and 2012. The data was selected using the following criteria: routine examinations in uncomplicated singleton pregnancies, Caucasian ethnicity, and confirmation of gestational age by a crown-rump length (CRL) measurement in the first trimester. Generalized Additive Model for Location, Scale and Shape (GAMLSS) was used to align the time frames of the longitudinal fetal measurements, corresponding with the methods of the postnatal growth curves of the WHO MGRS Group. Results A total of 27,680 complete scans were selected from the astraia© ultrasound database representing 12,368 pregnancies. Gender-specific fetal growth curves for biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) were derived. The HC and BPD were significantly larger in boys compared to girls from 20 weeks of gestation onwards (p < 0.001) equating to a 3-day difference at 20–24 weeks. Boys were significantly heavier, longer, and had greater head circumference than girls (p < 0.001) at birth. The Apgar score at 1 min (p = 0.01) and arterial cord pH (p < 0.001) were lower in boys. Conclusions These longitudinal fetal growth curves for the first time allow integration with neonatal and pediatric WHO gender-specific growth curves. Boys exceed head growth halfway of the pregnancy, and immediate birth outcomes are worse in boys than girls. Gender difference in intrauterine growth is sufficiently distinct to have a clinically important effect on fetal weight estimation but also on the second trimester dating. Therefore, these differences might already play a role in early fetal or immediate neonatal management.


2021 ◽  
Vol 151 ◽  
pp. 106443 ◽  
Author(s):  
Susana Santos ◽  
Chalana M. Sol ◽  
Charissa van Zwol – Janssens ◽  
Elise M. Philips ◽  
Alexandros G. Asimakopoulos ◽  
...  

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kenneth Ayuurebobi Ae-Ngibise ◽  
Blair J. Wylie ◽  
Ellen Boamah-Kaali ◽  
Darby W. Jack ◽  
Felix Boakye Oppong ◽  
...  

Abstract Background In developed countries, prenatal maternal stress has been associated with poor fetal growth, however this has not been evaluated in rural sub-Saharan Africa. We evaluated the effect of prenatal maternal stress on fetal growth and birth outcomes in rural Ghana. Methods Leveraging a prospective, rural Ghanaian birth cohort, we ascertained prenatal maternal negative life events, categorized scores as 0-2 (low stress; referent), 3-5 (moderate), and > 5 (high) among 353 pregnant women in the Kintampo North Municipality and Kintampo South District located within the middle belt of Ghana. We employed linear regression to determine associations between prenatal maternal stress and infant birth weight, head circumference, and length. We additionally examined associations between prenatal maternal stress and adverse birth outcome, including low birth weight, small for gestational age, or stillbirth. Effect modification by infant sex was examined. Results In all children, high prenatal maternal stress was associated with reduced birth length (β = − 0.91, p = 0.04; p-value for trend = 0.04). Among girls, moderate and high prenatal maternal stress was associated with reduced birth weight (β = − 0.16, p = 0.02; β = − 0.18, p = 0.04 respectively; p-value for trend = 0.04) and head circumference (β = − 0.66, p = 0.05; β = − 1.02, p = 0.01 respectively; p-value for trend = 0.01). In girls, high prenatal stress increased odds of any adverse birth outcome (OR 2.41, 95% CI 1.01-5.75; p for interaction = 0.04). Sex-specific analyses did not demonstrate significant effects in boys. Conclusions All infants, but especially girls, were vulnerable to effects of prenatal maternal stress on birth outcomes. Understanding risk factors for impaired fetal growth may help develop preventative public health strategies. Trial registration NCT01335490 (prospective registration). Date of Registration: April 14, 2011. Status of Registration: Completed.


2020 ◽  
Vol 9 (11) ◽  
pp. 3504
Author(s):  
Małgorzata Lewandowska ◽  
Barbara Więckowska ◽  
Lidia Sztorc ◽  
Stefan Sajdak

Many studies have shown that neonates of smoking mothers have a lower birth weight, but several issues remain poorly studied, e.g., the effects of giving up smoking or the combined effects of smoking and maternal obesity. Therefore, we evaluated a prospective cohort of 912 mothers in a single pregnancy, recruited in Poland, in 2015−2016. In the cohort, we recorded 72 (7.9%) newborns with birth weight <10th percentile, 21 (2.3%) fetal growth restriction (FGR) cases, and 60 (6.6%) low birth weight (LBW, <2500 g) newborns. In the cohort, 168 (18.4%) women smoked before pregnancy; the mean number of cigarettes/day was 10.8 (1–30), and the mean number of years of cigarette smoking was 8.5 (1–25). Among smokers, 57 (6.3%) women smoked in the first trimester. Adjusted odds ratio (AOR) of newborn outcomes (with 95% confidence intervals, CI) was calculated in multi-dimensional logistic regressions. Compared to participants who had never smoked, smoking before pregnancy was associated with a higher odds ratio of birth weight <10th percentile (AOR = 1.93, CI: 1.08–3.44, p = 0.027), but the result for LBW (AOR = 2.76, CI: 1.05–7.26, p = 0.039) and FGR (AOR = 1.13, CI: 0.38–3.36, p = 0.822) had the wider confidence interval or was insignificant. Effects of smoking cessation before pregnancy were statistically insignificant for the studied outcomes. Smoking in the first trimester was associated with a higher risk of birth weight <10th percentile (AOR = 4.68, CI: 2.28–9.62, p < 0.001), LBW (AOR = 6.42, CI: 1.84–22.36, p = 0.004), and FGR (AOR = 3.60, CI: 0.96–13.49, p = 0.057). Smoking cessation in the second/third trimester was associated with a higher odds ratio of birth weight <10th percentile (AOR = 4.54, CI: 1.58–13.02, p = 0.005), FGR (AOR = 3.36, CI: 0.6–18.74, p = 0.167), and LBW (AOR = 2.14, CI: 0.62–7.36), p = 0.229), to a similar degree to smoking in the first trimester. The odds ratios were higher in the subgroup of pre-pregnancy body mass index ≥25 kg/m2 for the risk of birth weight <10th percentile (AOR = 6.39, CI: 2.01–20.34, p = 0.002) and FGR (AOR = 6.25, CI: 0.86–45.59, p = 0.071). The length of cigarette smoking time was also the risk factor for studied outcomes. Conclusions: Smoking in the first trimester increased the studied risks, and the coexistence of excessive maternal weight increased the effects. Smoking cessation during the second/third trimester did not have a protective effect.


BMJ ◽  
2014 ◽  
Vol 348 (jan23 1) ◽  
pp. g14-g14 ◽  
Author(s):  
V. W. V. Jaddoe ◽  
L. L. de Jonge ◽  
A. Hofman ◽  
O. H. Franco ◽  
E. A. P. Steegers ◽  
...  

2016 ◽  
Vol 175 (5) ◽  
pp. 387-393 ◽  
Author(s):  
S L Andersen ◽  
A Carlé ◽  
J Olsen ◽  
P Laurberg

Objective Immunological changes in and after a pregnancy may influence the onset of autoimmune diseases. An increased incidence of hyperthyroidism has been observed both in early pregnancy and postpartum, but it remains to be studied if the incidence of hypothyroidism varies in a similar way. Design Population-based cohort study using Danish nationwide registers. Method All women who gave birth to a singleton live-born child in Denmark from 1999 to 2008 (n = 403 958) were identified, and data on hospital diagnosis of hypothyroidism and redeemed prescriptions of thyroid hormone were extracted. The overall incidence rate (IR) of hypothyroidism during 1997–2010 and the IR in three-month intervals before, during and after the woman’s first pregnancy in the study period were calculated and compared with the IR of hyperthyroidism. Results Altogether 5220 women were identified with onset of hypothyroidism from 1997 to 2010 (overall IR 92.3/100 000/year) and 1572 women developed hypothyroidism in the period from 2 years before to 2 years after birth of the first child in the study period. The incidence of hypothyroidism decreased during the pregnancy (incidence rate ratio (IRR) vs overall IR in the rest of the study period: first trimester: 0.89 (95% CI: 0.66–1.19), second trimester: 0.71 (0.52–0.97), third trimester: 0.29 (0.19–0.45)) and increased after birth with the highest level at 4–6 months postpartum (IRR 3.62 (2.85–4.60)). Conclusion These are the first population-based data on the incidence of hypothyroidism in and around pregnancy. The incidence declined during pregnancy followed by a sharp increase postpartum. Notably, hypothyroidism as opposed to hyperthyroidism showed no early pregnancy increase.


2020 ◽  
Author(s):  
Tonderayi Mathew Matsungo ◽  
Shingai Mudzuri ◽  
Prosper Chopera

Abstract Background : The World Health Organization (WHO) recommends early registration, regular and consistent attendance of antenatal care (ANC) sessions for all pregnant women. Specifically, if ANC services promote evidence-based practices this improves pregnancy outcomes and reduce maternal mortality. Yet there are worrying gaps in knowledge of antenatal care services in Zimbabwe. Objectives: To determine the relationship between early registration and frequency of ANC visits on birth weight, birth length, head circumference, Apgar score, birth complications, delivery mode, preterm birth and duration of labour among women aged 15-49 from Hatcliffe Polyclinic, Harare. Methods: This was a health facility based analytical cross-sectional study. An interviewer administered questionnaire was used to collect data. Data was entered and analysed using SPSS version 20. Descriptive statistics, and associations between dependent and independent variables were determined using Pearson’s Chi-square and Fisher’s exact test. Ethical approval was granted from the Medical Research Council of Zimbabwe (MRCZ/B/1438). Results: A total of 75 mother child pairs were interviewed. Most (77.3%) had more than four ANC visits. Only 36% registered early (during first trimester). Most of the children had normal birth weight ≥2500g (80.3%), birth length ≥47cm, (76%), head circumference ≥33cm (80%), and Apgar score ≥7 (96%). A positive association was observed between number of ANC visits and birth weight [Odds ratio (OR) 7.6; 95% Confidence Interval (CI) 1.6, 36.4 (p=0.013)], birth length [OR 6.1; 95%CI 1.8, 20.1 (p=0.010)], and head circumference [OR 4.3; 95% CI 1.3, 14.8 (p=0.013)]. Positive associations were also observed between timing of registration and birth weight [OR 1.2; 95% 1.05, 1.36 (p=0.045)], birth length [OR 0.16; 95% CI 0.03, 0.76 (p=0.012)]. Conclusions: In this study increased frequency and early registration for ANC visits had a positive relationship with birth weight, birth length and head circumference. These findings show the need for improving the uptake of ANC services, early registration for ANC in the first trimester and adoption of community wide strategies to ensure that pregnant women attend all recommended visits for improved birth outcomes in this and related settings.


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