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Journal ArticleDOI

Effect of maternal age, height, BMI and ethnicity on birth weight: an Italian multicenter study.

TL;DR: Maternal height and early pregnancy BMI, should be considered in the evaluation of birth weight, and the effect of ethnicity suggests the appropriateness of ethnic-specific charts.
Abstract: AIM To assess the effect of maternal age, height, early pregnancy body mass index (BMI) and ethnicity on birth weight. SUBJECTS AND METHODS A cross-sectional study was conducted on more than 42,000 newborns. Ethnicity was defined by maternal country of birth or, when missing ( 90th centile) or small-(SGA) (birth weight <10th centile) for gestational age (GA) after adjustment for maternal characteristics. On the contrary, 1.6% of Italian newborns were classified as SGA or LGA according to the INeS charts and re-classified as AGA after adjustment. Maternal ethnicity had a significant impact on birth weight. Specifically, babies born to Senegalese mothers were the lightest, whilst babies born to Chinese mothers were the heaviest. CONCLUSIONS Maternal height and early pregnancy BMI, should be considered in the evaluation of birth weight. The effect of ethnicity suggests the appropriateness of ethnic-specific charts. Further studies are necessary to determine if changes in birth weight classification, may translate into improved detection of subjects at risk of adverse outcomes.
Citations
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Journal ArticleDOI
TL;DR: Understanding of how maternal obesity affects the placenta has expanded, and interventions that specifically target placental function, such as activation of placental adiponectin receptors, may prevent the transmission of metabolic disease from obese women to the next generation.
Abstract: Maternal obesity is associated with pregnancy complications and increases the risk for the infant to develop obesity, diabetes and cardiovascular disease later in life. However, the mechanisms linking the maternal obesogenic environment to adverse short- and long-term outcomes remain poorly understood. As compared with pregnant women with normal BMI, women entering pregnancy obese have more pronounced insulin resistance, higher circulating plasma insulin, leptin, IGF-1, lipids and possibly proinflammatory cytokines and lower plasma adiponectin. Importantly, the changes in maternal levels of nutrients, growth factors and hormones in maternal obesity modulate placental function. For example, high insulin, leptin, IGF-1 and low adiponectin in obese pregnant women activate mTOR signaling in the placenta, promoting protein synthesis, mitochondrial function and nutrient transport. These changes are believed to increase fetal nutrient supply and contribute to fetal overgrowth and/or adiposity in offspring, which increases the risk to develop disease later in life. However, the majority of obese women give birth to normal weight infants and these pregnancies are also associated with activation of inflammatory signaling pathways, oxidative stress, decreased oxidative phosphorylation and lipid accumulation in the placenta. Recent bioinformatics approaches have expanded our understanding of how maternal obesity affects the placenta; however, the link between changes in placental function and adverse outcomes in obese women giving birth to normal sized infants is unclear. Interventions that specifically target placental function, such as activation of placental adiponectin receptors, may prevent the transmission of metabolic disease from obese women to the next generation.

57 citations

Journal ArticleDOI
TL;DR: For women of childbearing age (20–40 years old), the threshold of maternal age on low birth weight was 36 years old, and the risk of macrosomia increased with the increase of maternalAge.
Abstract: Most studies have shown that maternal age is associated with birth weight. However, the specific relationship between each additional year of maternal age and birth weight remains unclear. The study aimed to analyze the specific association between maternal age and birth weight. Raw data for all live births from 2015 to 2018 were obtained from the Medical Birth Registry of Xi’an, China. A total of 490,143 mother-child pairs with full-term singleton live births and the maternal age ranging from 20 to 40 years old were included in our study. Birth weight, gestational age, neonatal birth date, maternal birth date, residence and ethnicity were collected. Generalized additive model and two-piece wise linear regression model were used to analyze the specific relationships between maternal age and birth weight, risk of low birth weight, and risk of macrosomia. The relationships between maternal age and birth weight, risk of low birth weight, and risk of macrosomia were nonlinear. Birth weight increased 16.204 g per year when maternal age was less than 24 years old (95%CI: 14.323, 18.086), and increased 12.051 g per year when maternal age ranged from 24 to 34 years old (95%CI: 11.609, 12.493), then decreased 0.824 g per year (95% CI: -3.112, 1.464). The risk of low birth weight decreased with the increase of maternal age until 36 years old (OR = 0.917, 95%CI: 0.903, 0.932 when maternal age was younger than 27 years old; OR = 0.965, 95%CI: 0.955, 0.976 when maternal age ranged from 27 to 36 years old), then increased when maternal age was older than 36 years old (OR = 1.133, 95%CI: 1.026, 1.250). The risk of macrosomia increased with the increase of maternal age (OR = 1.102, 95%CI: 1.075, 1.129 when maternal age was younger than 24 years old; OR = 1.065, 95%CI: 1.060, 1.071 when maternal age ranged from 24 to 33 years old; OR = 1.029, 95%CI: 1.012, 1.046 when maternal age was older than 33 years old). For women of childbearing age (20–40 years old), the threshold of maternal age on low birth weight was 36 years old, and the risk of macrosomia increased with the increase of maternal age.

24 citations

Journal ArticleDOI
TL;DR: Preliminary evidence shows that women with PCOS and the highest maternal testosterone levels in early second trimester had the highest risk of developing preeclampsia, but this finding is driven by a limited number of cases and should be interpreted with caution.
Abstract: Research question Do women with polycystic ovary syndrome (PCOS) have higher testosterone levels during pregnancy and what role does high testosterone play in the development of obstetric complications? Design Retrospective cohort study from Uppsala University Hospital, Sweden. The study population consisted of women with PCOS (n = 159) and a comparison group of women without PCOS matched for body mass index (n = 320). Plasma testosterone levels were measured in the early second trimester by liquid chromatography with tandem mass spectrometry, and women with PCOS were grouped into tertiles according to their testosterone levels. Possible associations with obstetric complications, maternal metabolic factors and offspring birth weight were explored by multivariable logistic and linear regression models. Results Compared with women who do not have PCOS, women with PCOS had higher total testosterone (median 1.94, interquartile range [IQR] 1.21–2.64 versus 1.41, IQR 0.89–1.97; P Conclusions Women with PCOS have higher levels of total testosterone and free androgen index during pregnancy than women without PCOS matched for body mass index. Preliminary evidence shows that women with PCOS and the highest maternal testosterone levels in early second trimester had the highest risk of developing preeclampsia. This finding, however, is driven by a limited number of cases and should be interpreted with caution.

16 citations

Journal ArticleDOI
TL;DR: Some preliminary evidence is provided for the relationships between lower serum Se levels in early pregnancy and a higher risk of large-for-gestational age birth weight and appropriate Se intake in the periconceptual period may be important for optimal fetal growth.
Abstract: Excessive birth weight has serious perinatal consequences, and it "programs" long-term health. Mother's nutritional status can be an important element in fetal "programming"; microelements such as selenium (Se), zinc (Zn), copper (Cu), and iron (Fe) are involved in many metabolic processes. However, there are no studies assessing the relationship of the microelements in the peri-conceptual period with the risk of excessive birth weight. We performed a nested case control study of serum microelements' levels in the 10-14th week of pregnancy and assessed the risk of large-for-gestational age (LGA) newborns using the data from a prospective cohort of pregnant women recruited in 2015-2016 in Poznan, Poland. Mothers delivering LGA newborns (n = 66) were examined with matched mothers delivering appropriate-for-gestational age (AGA) newborns (n = 264). Microelements' levels were quantified using mass spectrometry. The odds ratios of LGA (and 95% confidence intervals) were calculated by multivariate logistic regression. In the whole group, women with the lowest quartile of Se had a 3 times higher LGA risk compared with women in the highest Se quartile (AOR = 3.00; p = 0.013). Importantly, the result was sustained in the subgroup of women with the normal pre-pregnancy BMI (AOR = 4.79; p = 0.033) and in women with a male fetus (AOR = 6.28; p = 0.004), but it was not sustained in women with a female fetus. There were no statistical associations between Zn, Cu, and Fe levels and LGA. Our study provides some preliminary evidence for the relationships between lower serum Se levels in early pregnancy and a higher risk of large-for-gestational age birth weight. Appropriate Se intake in the periconceptual period may be important for optimal fetal growth.

10 citations


Cites background or methods from "Effect of maternal age, height, BMI..."

  • ...Risk factors for birth weight/LGA [35] and related to the concentrations of microelements [28,34] have been identified based on the literature....

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  • ...In the current study, the recognized factors increasing the risk of LGA [35] and potential factors affecting microelements’ levels [28,34] were matched or statistically insignificantly differ between the LGA and control (AGA) group or were used to correct the risk as confounders....

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Journal ArticleDOI
TL;DR: Wang et al. as mentioned in this paper assessed the association between couple's preconception BMI and the risk of small for gestational age (SGA)/large for gestatorial age (LGA) infants, among over 4·7 million couples in a retrospective cohort study based on the National Free Pre-pregnancy Checkups Project between 1 December 2013 and 30 November 2016 in China.
Abstract: Abstract Evidence of couples’ BMI and its influence on birth weight is limited and contradictory. Therefore, this study aims to assess the association between couple’s preconception BMI and the risk of small for gestational age (SGA)/large for gestational age (LGA) infant, among over 4·7 million couples in a retrospective cohort study based on the National Free Pre-pregnancy Checkups Project between 1 December 2013 and 30 November 2016 in China. Among the live births, 256 718 (5·44 %) SGA events and 506 495 (10·73 %) LGA events were documented, respectively. After adjusting for confounders, underweight men had significantly higher risk (OR 1·17 (95 % CI 1·15, 1·19)) of SGA infants compared with men with normal BMI, while a significant and increased risk of LGA infants was obtained for overweight and obese men (OR 1·08 (95 % CI 1·06, 1·09); OR 1·19 (95 % CI 1·17, 1·20)), respectively. The restricted cubic spline result revealed a non-linear decreasing dose–response relationship of paternal BMI (less than 22·64) with SGA. Meanwhile, a non-linear increasing dose–response relationship of paternal BMI (more than 22·92) with LGA infants was observed. Moreover, similar results about the association between maternal preconception BMI and SGA/LGA infants were obtained. Abnormal preconception BMI in either women or men were associated with increased risk of SGA/LGA infants, respectively. Overall, couple’s abnormal weight before pregnancy may be an important preventable risk factor for SGA/LGA infants.

8 citations

References
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Journal ArticleDOI
TL;DR: The findings indicate that the prevalence of fetal growth restriction (FGR) will vary markedly, depending on the fetal growth curve used, and many previously published fetal growth curves no longer provide an up-to-date reference for describing the distribution of birth weight by gestational age.

2,183 citations


"Effect of maternal age, height, BMI..." refers background in this paper

  • ...Furthermore, current reference charts do not differentiate between abnormally grown versus constitutionally large, or small, but otherwise healthy fetuses [4, 5]....

    [...]

Journal ArticleDOI
TL;DR: Mortality and morbidity are increased among infants born at term whose birth weights are at or below the 3rd percentile for their gestational age, and these differences persisted after adjustment for the mother's race and parity and the infant's sex.
Abstract: Background At any given gestational age, infants with low birth weight have relatively high morbidity and mortality. It is not known, however, whether there is a threshold weight below which morbidity and mortality are significantly greater, or whether that threshold varies with gestational age. Methods We analyzed the neonatal outcomes of death, five-minute Apgar score, umbilical-artery blood pH, and morbidity due to prematurity for all singleton infants delivered at Parkland Hospital, Dallas, between January 1, 1988, and August 31, 1996. A distribution of birth weights according to week of gestation at birth was created. Infants in the 26th through 75th percentiles for weight served as the reference group. Data on preterm infants (those born at 24 to 36 weeks of gestation) were analyzed separately from data on infants delivered at term (37 or more weeks of gestation). Results A total of 122,754 women and adolescents delivered singleton live infants without malformations between 24 and 43 weeks of gestat...

1,177 citations

Journal ArticleDOI
TL;DR: An in utero fetal weight model from a population of 392 predominantly middle-class white patients with certain menstrual histories is developed, with a gradual increase in fetal weight from 35 g at 10 weeks to 3,619 g at 40 weeks, with uniform variance throughout gestation.
Abstract: Regression analysis was used to develop an in utero fetal weight model from a population of 392 predominantly middle-class white patients with certain menstrual histories. There was a gradual increase in fetal weight from 35 g at 10 weeks to 3,619 g at 40 weeks, with uniform variance of +/- 12.7% (1 standard deviation) throughout gestation. When tested against the estimated weights of 1,771 chromosomally normal fetuses between 14 and 21 weeks, the mean percent difference was 0.8% and the average absolute percent error was 3.3%. When compared with actual delivery data for 163 fetuses in the group, the mean percent difference was 0.8% and the average absolute percent error was 1.1%. These data are compared with other prenatal weight curves obtained at ultrasound and with data from several large postnatal weight studies.

1,034 citations


"Effect of maternal age, height, BMI..." refers background in this paper

  • ...Furthermore, current reference charts do not differentiate between abnormally grown versus constitutionally large, or small, but otherwise healthy fetuses [4, 5]....

    [...]

Journal ArticleDOI
TL;DR: Large differences in BMI growth pattern emerged between the SIEDP-2006, 2000 CDC and UK90 references: in Italy, BMI is higher and its distribution is more skewed during childhood and adolescence, and thus should be suitable for adequately monitoring the growth of patients.
Abstract: Objective To trace growth charts for height, weight and body mass index (BMI) that apply to the whole Italian population. Different charts were drawn for central-north and south Italy since children in central-north regions are known to be taller and leaner. Design: Cross-sectional study. Setting: A sample of schoolchildren covering 16 of the 20 Italian regions, with data collected between 1994 and 2000. Subjects: A total of 27 421 girls and 27 374 boys, aged 6–20 y. Methods: Height and weight were measured using portable Harpenden stadiometers and properly calibrated scales, respectively. SIEDP references are presented both as centiles and as LMS curves for the calculation of standard deviation scores. According to International Obesity Task Force, SIEDP charts for BMI include the limits for overweight and obesity, ie the centiles having, at 18 y of age, the value of 25 and 30 kg/m2, respectively. Results: The comparison between SIEDP and Tanner et al's charts for height, still in use among most Italian paediatricians, shows that before puberty Italian children are 2–4 cm taller than their English peers. Because of these differences, Tanner's charts fail to detect, when applied to Italian children, 50–90% of short children aged 6–11 y, ie with stature below the 3rd centile of their reference population. Rolland-Cachera et al's centiles for BMI are lower than those of SIEDP standards, mainly during adolescence (up to 6.6 kg/m2 for the 97th centile), and apply poorly to Italian children. The prevalence of overweight is 27 (boys) and 19% (girls) in south Italy vs 17 (boys) and 10% (girls) in central-north Italy. Conclusions: These references intend to supply Italian paediatricians with a tool that avoids the use of outdated or inadequate charts, and thus should be suitable for monitoring their patients' growth. Sponsorship: Italian Society for Pediatric Endocrinology and Diabetes (SIEDP).

851 citations


"Effect of maternal age, height, BMI..." refers methods in this paper

  • ...Maternal height, early pregnancy weight and BMI were expressed as standard deviation score (SDS) according to the Italian Society for Pediatric Endocrinology and Diabetes (ISPED)2006 growth charts [18]....

    [...]

Journal ArticleDOI
TL;DR: A computer-generated antenatal chart can be easily "customised" for each individual pregnancy, taking the mother's characteristics and birthweights from previous pregnancies into consideration, to make assessment of fetal growth more precise and reduce unnecessary investigations, interventions, and parental anxiety.

786 citations