Perinatal Risk Factor and Morbidity in Term Large-for-Gestational-Age Infants according to Classification by Ponderal Index

Introduction: Restricted or enhanced intrauterine growth is associated with elevated risks of early and late metabolic problems in humans. Metabolomics based on amino acid and carnitine/acylcarnitine profile may have a role in fetal and early postnatal energy metabolism. In this study, the relationship between intrauterine growth status and early metabolomics profile was evaluated.Materials and Methods: A single-center retrospective cohort study was conducted. Three hundred and sixty-one newborn infants were enrolled into the study, and they were grouped according to their birth weight percentile as small for gestational age (SGA, n = 69), appropriate for gestational age (AGA, n = 168), and large for gestational age (LGA, n = 124) infants. In all infants, amino acid and carnitine/acylcarnitine profiles with liquid chromatography-tandem mass spectrometry (LC-MS/MS) were recorded and compared between groups.Results: LGA infants had higher levels of glutamic acid and lower levels of ornithine, alanine, and glycine (p < 0.05) when compared with AGA infants. SGA infants had higher levels of alanine and glycine levels when compared with AGA and LGA infants. Total carnitine, C0, C2, C4, C5, C10:1, C18:1, C18:2, C14-OH, and C18:2-OH levels were significantly higher and C3 and C6-DC levels were lower in SGA infants (p < 0.05). LGA infants had higher C3 and C5:1 levels and lower C18:2 and C16:1-OH levels (p < 0.05). There were positive correlations between free carnitine and phenylalanine, arginine, methionine, alanine, and glycine levels (p < 0.05). Also, a positive correlation between ponderal index and C3, C5-DC, C14, and C14:1 and a negative correlation between ponderal index and ornithine, alanine, glycine, C16:1-OH, and C18:2 were shown.Conclusion: We demonstrated differences in metabolomics possibly reflecting the energy metabolism in newborn infants with intrauterine growth problems in the early postnatal period. These differences might be the footprints of metabolic disturbances in future adulthood.

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Large-for-gestational-age phenotypes and obesity risk in adulthood: a study of 195,936 women

Scientific Reports ◽

10.1038/s41598-020-58827-5 ◽

2020 ◽

Vol 10 (1) ◽

Cited By ~ 2

Author(s):

José G. B. Derraik ◽

Sarah E. Maessen ◽

John D. Gibbins ◽

Wayne S. Cutfield ◽

Maria Lundgren ◽

...

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Reference Group ◽

Ponderal Index ◽

Large For Gestational Age ◽

Adjusted Relative Risk ◽

Obesity Risk ◽

Increased Risk ◽

Appropriate For Gestational Age ◽

Using Data

AbstractWhile there is evidence that being born large-for-gestational-age (LGA) is associated with an increased risk of obesity later in life, the data are conflicting. Thus, we aimed to examine the associations between proportionality at birth and later obesity risk in adulthood. This was a retrospective study using data recorded in the Swedish Birth Register. Anthropometry in adulthood was assessed in 195,936 pregnant women at 10–12 weeks of gestation. All women were born at term (37–41 weeks of gestation). LGA was defined as birth weight and/or length ≥2.0 SDS. Women were separated into four groups: appropriate-for-gestational-age according to both weight and length (AGA – reference group; n = 183,662), LGA by weight only (n = 4,026), LGA by length only (n = 5,465), and LGA by both weight and length (n = 2,783). Women born LGA based on length, weight, or both had BMI 0.12, 1.16, and 1.08 kg/m2 greater than women born AGA, respectively. The adjusted relative risk (aRR) of obesity was 1.50 times higher for those born LGA by weight and 1.51 times for LGA by both weight and height. Length at birth was not associated with obesity risk. Similarly, women born LGA by ponderal index had BMI 1.0 kg/m2 greater and an aRR of obesity 1.39 times higher than those born AGA. Swedish women born LGA by weight or ponderal index had an increased risk of obesity in adulthood, irrespective of their birth length. Thus, increased risk of adult obesity seems to be identifiable from birth weight and ignoring proportionality.

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Maternal obesity is the major risk factor for large-for-gestational-age infants in pregnancies complicated by gestational diabetes

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2006.10.578 ◽

2006 ◽

Vol 195 (6) ◽

pp. S159 ◽

Cited By ~ 3

Author(s):

Avi Ben Haroush ◽

Yariv Yogev ◽

Rony Chen ◽

Eran Hadar ◽

Moshe Hod

Keyword(s):

Risk Factor ◽

Gestational Diabetes ◽

Gestational Age ◽

Maternal Obesity ◽

Major Risk Factor ◽

Large For Gestational Age

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Prepregnancy body mass index is an independent risk factor for gestational hypertension, gestational diabetes, preterm labor, and small- and large-for-gestational-age infants

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.3109/14767058.2014.964675 ◽

2014 ◽

Vol 28 (14) ◽

pp. 1679-1686 ◽

Cited By ~ 76

Author(s):

Dayeon Shin ◽

Won O. Song

Keyword(s):

Body Mass Index ◽

Risk Factor ◽

Gestational Diabetes ◽

Body Mass ◽

Gestational Age ◽

Preterm Labor ◽

Independent Risk Factor ◽

Gestational Hypertension ◽

Large For Gestational Age ◽

Prepregnancy Body Mass Index

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Obstetric assistance during labour and child birth as a perinatal risk factor

Health Policy and Planning ◽

10.1093/heapol/3.3.245 ◽

1988 ◽

Vol 3 (3) ◽

pp. 245-247

Author(s):

Ana Cristina d'Andretta Tanaka

Keyword(s):

Risk Factor ◽

Perinatal Risk ◽

Child Birth ◽

Perinatal Risk Factor

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Mediation of the association between maternal pre-pregnancy overweight/obesity and childhood overweight/obesity by birth anthropometry

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174420000033 ◽

2020 ◽

pp. 1-8

Author(s):

Danielle R. Stevens ◽

Brian Neelon ◽

James R. Roberts ◽

Sarah N. Taylor ◽

Roger B. Newman ◽

...

Keyword(s):

Gestational Age ◽

Head Circumference ◽

Childhood Overweight ◽

In Utero ◽

Ponderal Index ◽

Large For Gestational Age ◽

Maternal Body Mass Index ◽

Model Framework ◽

Hospital System ◽

Maternal Overweight

Abstract The mechanism through which developmental programming of offspring overweight/obesity following in utero exposure to maternal overweight/obesity operates is unknown but may operate through biologic pathways involving offspring anthropometry at birth. Thus, we sought to examine to what extent the association between in utero exposure to maternal overweight/obesity and childhood overweight/obesity is mediated by birth anthropometry. Analyses were conducted on a retrospective cohort with data obtained from one hospital system. A natural effects model framework was used to estimate the natural direct effect and natural indirect effect of birth anthropometry (weight, length, head circumference, ponderal index, and small-for-gestational age [SGA] or large-for-gestational age [LGA]) for the association between pre-pregnancy maternal body mass index (BMI) category (overweight/obese vs normal weight) and offspring overweight/obesity in childhood. Models were adjusted for maternal and child socio-demographics. Three thousand nine hundred and fifty mother–child dyads were included in analyses (1467 [57.8%] of mothers and 913 [34.4%] of children were overweight/obese). Results suggest that a small percentage of the effect of maternal pre-pregnancy BMI overweight/obesity on offspring overweight/obesity operated through offspring anthropometry at birth (weight: 15.5%, length: 5.2%, head circumference: 8.5%, ponderal index: 2.2%, SGA: 2.9%, and LGA: 4.2%). There was a small increase in the percentage mediated when gestational diabetes or hypertensive disorders were added to the models. Our study suggests that some measures of birth anthropometry mediate the association between maternal pre-pregnancy overweight/obesity and offspring overweight/obesity in childhood and that the size of this mediated effect is small.

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279: Large for gestational age - a risk factor for long-term pediatric neoplastic morbidity of the offspring

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2017.10.208 ◽

2018 ◽

Vol 218 (1) ◽

pp. S177-S178

Author(s):

Naama Steiner ◽

Asnat Walfisch ◽

Tamar Wainstock ◽

Idit Sesgal ◽

Daniella Landau ◽

...

Keyword(s):

Risk Factor ◽

Gestational Age ◽

Large For Gestational Age

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Elevated Anti-Müllerian Hormone Is an Independent Risk Factor for Preterm Birth Among Patients With Overweight Polycystic Ovary Syndrome

Frontiers in Endocrinology ◽

10.3389/fendo.2021.788000 ◽

2021 ◽

Vol 12 ◽

Author(s):

Mingze Du ◽

Junwei Zhang ◽

Xiaona Yu ◽

Yichun Guan

Keyword(s):

Risk Factor ◽

Preterm Birth ◽

Gestational Age ◽

Independent Risk Factor ◽

Reference Group ◽

Polycystic Ovary ◽

Multiple Logistic Regression Analysis ◽

Large For Gestational Age ◽

Significant Difference ◽

Potential Evaluation

ObjectiveTo explore whether elevated anti-Müllerian hormone (AMH) levels affect the rate of preterm birth (PTB) among PCOS patients with different BMIs.MethodsIn this retrospective cohort study, patients with PCOS who had undergone IVF/ICSI from January 2017 to December 2019 were included for potential evaluation. A total of 2368 singleton live births from PCOS patients were included. According to the BMI, all the PCOS patients were divided into two groups: BMI<24 kg/m2 and BMI≥24 kg/m2. In total, 1339 PCOS patients with a BMI<24 kg/m2 were grouped according to their serum AMH levels: ① <2.71 ng/ml (n=333), ② 2.71-4.08 ng/ml (n=330), ③ 4.09-6.45 ng/ml (n=351), and ④ >6.45 ng/ml (n=325). Additionally, 1029 cycles of patients with a BMI≥24 kg/m2 were grouped according to the serum AMH level: ① <2.71 ng/ml (n=255), ② 2.71-4.08 ng/ml (n=267), ③ 4.09-6.45 ng/ml (n=239), and ④ >6.45 ng/ml (n=268), with <2.71 ng/ml being considered the reference group. The grouping was based mainly on the interquartile range of serum AMH levels. The primary outcome of the study was PTB. The secondary outcomes were low birth weight (LBW), small for gestational age (SGA), macrosomia and large for gestational age (LGA).ResultsRegarding PCOS patients with a BMI<24 kg/m2, compared with the PTB rate of the AMH <2.71 ng/ml group, the PTB rates of the different groups were not significantly different (AMH 2.71-4.08, AOR (95% CI)=1.01 (0.52-2.00), P=0.99; AMH 4.09-6.45, AOR (95% CI)=0.93 (0.45-1.91), P=0.85; AMH>6.45, AOR (95% CI)=0.78 (0.35-1.73), P=0.54). Regarding PCOS patients with a BMI ≥24 kg/m2, compared with the PTB rate of the AMH <2.71 ng/ml group, the PTB rate of the AMH>6.45 ng/ml group was significantly higher (OR=2.47; 95% CI=1.34-4.55). After multiple logistic regression analysis, the risk of PTB in the AMH>6.45 ng/ml group was 2.1 times that in the AMH<2.71 ng/ml group (AOR=2.1, 95% CI=1.01-4.37, P=0.04). However, no statistically significant difference was found in the rate of SGA, LBW, macrosomia or LGA among patients in the different serum AMH groups.ConclusionFor PCOS patients, a BMI≥24 kg/m2 plus serum AMH>6.45 ng/ml (75th percentile) is an independent risk factor for PTB.

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