scholarly journals Maternal haemoglobin in pregnancy and offspring childhood weight and height trajectories: analysis of a prospective birth cohort study

2020 ◽  
Vol 5 ◽  
pp. 236
Author(s):  
Yvette V Pyne ◽  
Laura D Howe ◽  
Abigail Fraser

Background: Both anaemia and high haemoglobin in pregnancy are associated with adverse pregnancy outcomes including foetal growth restriction. The objective of this study was to investigate the associations between maternal haemoglobin in pregnancy and trajectories of length/height and weight from birth through childhood. Methods: Data from 7,597 singleton pregnancies in the Avon Longitudinal Study of Parents and Children (ALSPAC), an ongoing, prospective, UK population-based pregnancy cohort study were used. We examined associations between maternal haemoglobin (overall pregnancy and trimester specific) and offspring length and weight at birth, as well as trajectories of height and weight gain from birth to age 10 years derived from multilevel models. Results: Mean pregnancy haemoglobin was 11.61 g/dL (SD 1.12). For each 1g/dL higher mean overall pregnancy haemoglobin, offspring were on average -0.30 cm shorter (95%CI: -0.35, -0.24, p <0.001), and -97.7 g lighter (95%CI: -110.42, -84.93, p <0.001) at birth when adjusting for potential confounders. Trimester specific inverse associations with birth length and weight were strongest for third trimester haemoglobin. There was evidence of a positive association between maternal haemoglobin levels and offspring height gain up to the age of one year and no strong evidence of associations between pregnancy haemoglobin and childhood weight gain. Conclusions: In high income countries, higher maternal haemoglobin in pregnancy may be a concern, as well as anaemia. Further studies are needed to define ‘high’ haemoglobin in pregnancy and whether monitoring of women with high pregnancy haemoglobin is warranted.

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Harold D. Bright ◽  
Laura D. Howe ◽  
Jasmine N. Khouja ◽  
Andrew J. Simpkin ◽  
Matthew Suderman ◽  
...  

Abstract Background Differences between an individual’s estimated epigenetic gestational age (EGA) and their actual gestational age (GA) are defined as gestational age acceleration (GAA). GAA is associated with increased birthweight and birth length. Whether these associations persist through childhood is yet to be investigated. Methods We examined the association between GAA and trajectories of height and weight from birth to 10 years (n = 785) in a British birth cohort study, the Avon Longitudinal Study of Parents and Children (ALSPAC). EGA of participants was estimated using DNA methylation data from cord blood using a recently developed prediction model. GAA of participants, measured in weeks, was calculated as the residuals from a regression model of EGA on actual GA. Analyses were performed using linear spline multilevel models and adjusted for maternal age, maternal pre-pregnancy BMI, maternal smoking during pregnancy, and maternal education. Results In adjusted analyses, offspring with a one-week greater GAA were born on average 0.14 kg heavier (95% confidence interval (CI) 0.09, 0.19) and 0.55 cm taller (95% CI 0.33, 0.78) at birth. These differences in weight persisted up to approximately age 9 months but thereafter began to attenuate. From age 5 years onwards, the association between GAA and weight reversed such that GAA was associated with lower weight and this association strengthened with age (mean difference at age 10 years − 0.60 kg, 95% CI − 1.19, − 0.01). Differences in height persisted only up to age 9 months (mean difference at 9 months 0.15 cm, 95% CI − 0.09, 0.39). From age 9 months to age 10 years, offspring with a one-week greater GAA were of comparable height with those with no GAA (mean difference at age 10 years − 0.07 cm, 95% CI − 0.64, 0.50). Conclusions Gestational age acceleration is associated with increased birth weight and length and these differences persist to age 9 months. From age 5 years onwards, the association of GAA and weight reverses such that by age 10 years, greater GAA is associated with lower childhood weight. Further work is required to examine whether the weight effects of GAA strengthen through adolescence and into early adulthood.


2019 ◽  
Author(s):  
Harold D. Bright ◽  
Laura D. Howe ◽  
Jasmine N. Khouja ◽  
Andrew J. Simpkin ◽  
Matthew Suderman ◽  
...  

AbstractBackgroundDifferences between an individual’s estimated epigenetic gestational age (EGA) and their actual gestational age (GA) are defined as gestational age acceleration (GAA). GAA is associated with increased birthweight and birth length. Whether these associations persist through childhood is yet to be investigated.MethodsWe examined the association between GAA and trajectories of height and weight from birth to 10 years (n=785) in a British birth cohort study, the Avon Longitudinal Study of Parents and Children (ALSPAC). EGA of participants was estimated using DNA methylation data from cord blood using a recently-developed prediction model. GA of participants was gathered in ALSPAC from clinical records and was measured from last menstrual period (LMP) for most participants. GAA of participants, measured in weeks, was calculated as the residuals from a regression model of EGA on actual GA. Height and weight were obtained from several sources including birth records, research clinics, routine child health clinics, links to health visitor records and parent-reported measures from questionnaires. Analyses were performed using linear spline multilevel models and adjusted for maternal age, maternal pre-pregnancy BMI, maternal smoking during pregnancy and maternal education.ResultsIn adjusted analyses, offspring with a one-week greater GAA were born on average 0.14 kg heavier (95% Confidence Interval (CI) 0.09, 0.19) and 0.55 cm taller (95% CI 0.33, 0.78) at birth. These differences in weight persisted up to approximately age 9 months but thereafter began to attenuate and reduce in magnitude. From age 5 years onwards, the association between GAA and weight reversed such that GAA was associated with lower weight and this association strengthened with age (mean difference at age 10 years −0.60 kg (95% CI, −1.19, −0.01)). Differences in height persisted only up to age 9 months (mean difference at 9 months 0.15 cm, (95% CI −0.09, 0.39)). From age 9 months to age 10 years, offspring with a one-week greater GAA were of comparable height to those with no GAA (mean difference at age 10 years −0.07 cm, (95% CI −0.64, 0.50)).ConclusionsGestational age acceleration is associated with increased birth weight and length and these differences persist to age 9 months. From 5 years onwards, the association of GAA and weight reverses such that by age 10 years greater GAA is associated with lower childhood weight. Further work is required to examine whether the weight effects of GAA strengthen further through adolescence and into early adulthood.


BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e020182 ◽  
Author(s):  
Caroline Wright ◽  
Ruth Kipping ◽  
Matthew Hickman ◽  
Rona Campbell ◽  
Jon Heron

ObjectivesTo explore the association between adolescent multiple risk behaviours (MRBs) and educational attainment.DesignProspective population-based UK birth cohort study.SettingAvon Longitudinal Study of Parents and Children (ALSPAC), a UK birth cohort of children born in 1991–1992.ParticipantsData on some or all MRB measures were available for 5401 ALSPAC participants who attended a clinic at age 15 years and/or completed a detailed questionnaire at age 16 years. Multiple imputation was used to account for missing data.Primary outcome measuresCapped General Certificate of Secondary Education (GCSE) score and odds of attaining five or more GCSE examinations at grades A*–C. Both outcome measures come from the National Pupil Database and were linked to the ALSPAC data.ResultsEngagement in MRB was strongly associated with poorer educational attainment. Each additional risk equated to −6.31 (95% CI −7.03 to −5.58, p<0.001) in capped GCSE score, equivalent to a one grade reduction or reduced odds of attaining five or more A*–C grades of 23% (OR 0.77, 95% CI 0.74 to 0.81, p<0.001). The average cohort member engaged in 3.24 MRB and therefore have an associated reduction in GCSE score equivalent to three and a half grades in one examination, or reduced odds of attaining five or more A*–C grades of 75%.ConclusionEngagement in adolescent MRB is strongly associated with poorer educational attainment at 16 years. Preventing MRB could improve educational attainment and thereby directly and indirectly improve longer-term health.


2019 ◽  
Vol 149 (6) ◽  
pp. 1027-1036
Author(s):  
Caroline M Taylor ◽  
Rita Doerner ◽  
Kate Northstone ◽  
Katarzyna Kordas

ABSTRACT Background During pregnancy lead crosses the placenta freely and can have adverse effects on the fetus, with the potential for lifelong impact on the child. Identification of dietary patterns and food groups in relation to measures of lead status could provide a more useful alternative to nutrient-specific advice to minimize fetal lead exposure. Objectives The aim of this study was to evaluate whether dietary patterns and food groups are associated with blood lead concentration (B-Pb) in pregnancy. Design Whole blood samples were collected at a median of 11 wk gestation (IQR 9–13 wk) from women enrolled in the Avon Longitudinal Study of Parents and Children birth cohort study, and analyzed for lead. Dietary pattern scores were derived from principal components analysis of a food-frequency questionnaire (32 wk gestation). Associations of dietary pattern scores (quartiles), and of food groups (frequency of consumption), with the likelihood of B-Pb ≥5 µg/dL identified with adjusted logistic regression (n = 2167 complete cases). Results There was a negative association between the “confectionery” dietary pattern and the likelihood of B-Pb ≥5 µg/dL (OR: 0.62; 95% CI: 0.41, 0.94) in an adjusted model. There were no associations with other dietary patterns. There was a positive association between the food group “all leafy green and green vegetables” and the likelihood of B-Pb ≥5 µg/dL (OR 1.45; 95% CI: 1.04, 2.01). Conversely, the food group “cakes and biscuits” was negatively associated (OR 0.63; 95% CI: 0.43, 0.93). After multiple imputation, there was a positive association of the “healthy” diet pattern and no association of the “confectionery” pattern. Conclusions We found limited evidence of an association between women's typical diet and B-Pb during pregnancy. Our findings do not indicate need to revise dietary guidance for pregnant women, who are advised to adopt a healthy diet in pregnancy, with a variety of foods consumed in moderation.


2021 ◽  
pp. 1753495X2110125
Author(s):  
Jonathan S Zipursky ◽  
Deva Thiruchelvam ◽  
Donald A Redelmeier

Background Cardiovascular symptoms in pregnancy may be a clue to psychological distress. We examined whether electrocardiogram testing in pregnant women is associated with an increased risk of subsequent postpartum depression. Methods We conducted a population-based cohort study of pregnant women who delivered in Ontario, Canada comparing women who received a prenatal ECG to women who did not. Results In total, 3,238,218 women gave birth during the 25-year study period of whom 157,352 (5%) received an electrocardiogram during prenatal care. Receiving an electrocardiogram test was associated with a one-third relative increase in the odds of postpartum depression (odds ratio 1.34; 95% confidence interval 1.29–1.39, p < 0.001). Conclusion The association between prenatal electrocardiogram testing and postpartum depression suggests a possible link of organic disease with mental illness, and emphasizes that cardiovascular symptoms may be a clinical clue to the presence of an underlying mood disorder.


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