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Österroos A, Lindström L, Wikman P, Wikström AK, Sundström Poromaa I, Ahlsson F. Associations between capillary glucose during pregnancy and childhood growth to the age of five: a cohort study. Sci Rep 2022; 12:1832. [PMID: 35115625 PMCID: PMC8813989 DOI: 10.1038/s41598-022-05821-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 12/23/2021] [Indexed: 02/08/2023] Open
Abstract
The objective of this study was to evaluate the relationship between random capillary glucose levels in healthy pregnant women and infant size at birth and childhood growth to the age of five years. This population-based cohort study comprised 10,937 healthy mother-child dyads. Data on highest maternal random capillary glucose level during pregnancy and sequential anthropometric data on their children during the first five years of life were gathered from the Uppsala County Mother and Child Cohort. Statistical analyses were performed with linear regression and linear mixed effect regression models. We found that higher glucose level during pregnancy was associated with higher weight z-score (β 0.10, 95% confidence interval (CI) 0.08-0.11), length z-score (β 0.05, 95% CI 0.03-0.07) and BMI z-score (β 0.09, 95% CI 0.07-0.12) at birth, adjusted for maternal BMI and country of birth, smoking during pregnancy and parity. The association did not remain at 1½, 3, 4 and 5 years of age. There was a positive relationship between higher glucose level during pregnancy and a decrease in weight z-score, height z-score and BMI z-score from birth to 5 years of age. In conclusion, higher random capillary glucose levels in pregnant healthy women were associated with greater infant size at birth, as well as decreased growth velocity in early childhood.
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Affiliation(s)
- Anna Österroos
- Department of Women's and Children's Health, Uppsala University Hospital, Uppsala University, Dag Hammarskjölds väg 14B, 1 tr, 751 85, Uppsala, Sweden.
| | - Linda Lindström
- Department of Women's and Children's Health, Uppsala University Hospital, Uppsala University, Dag Hammarskjölds väg 14B, 1 tr, 751 85, Uppsala, Sweden
| | - Per Wikman
- Department of Women's and Children's Health, Uppsala University Hospital, Uppsala University, Dag Hammarskjölds väg 14B, 1 tr, 751 85, Uppsala, Sweden
| | - Anna-Karin Wikström
- Department of Women's and Children's Health, Uppsala University Hospital, Uppsala University, Dag Hammarskjölds väg 14B, 1 tr, 751 85, Uppsala, Sweden
| | - Inger Sundström Poromaa
- Department of Women's and Children's Health, Uppsala University Hospital, Uppsala University, Dag Hammarskjölds väg 14B, 1 tr, 751 85, Uppsala, Sweden
| | - Fredrik Ahlsson
- Department of Women's and Children's Health, Uppsala University Hospital, Uppsala University, Dag Hammarskjölds väg 14B, 1 tr, 751 85, Uppsala, Sweden
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Zhong QY, Gelaye B, Fricchione GL, Avillach P, Karlson EW, Williams MA. Adverse obstetric and neonatal outcomes complicated by psychosis among pregnant women in the United States. BMC Pregnancy Childbirth 2018; 18:120. [PMID: 29720114 PMCID: PMC5930732 DOI: 10.1186/s12884-018-1750-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 04/19/2018] [Indexed: 12/30/2022] Open
Abstract
Background Adverse obstetric and neonatal outcomes among women with psychosis, particularly affective psychosis, has rarely been studied at the population level. We aimed to assess the risk of adverse obstetric and neonatal outcomes among women with psychosis (schizophrenia, affective psychosis, and other psychoses). Methods From the 2007 – 2012 National (Nationwide) Inpatient Sample, 23,507,597 delivery hospitalizations were identified. From the same hospitalization, International Classification of Diseases diagnosis codes were used to identify maternal psychosis and outcomes. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were obtained using logistic regression. Results The prevalence of psychosis at delivery was 698.76 per 100,000 hospitalizations. After adjusting for sociodemographic characteristics, smoking, alcohol/substance abuse, and pregnancy-related hypertension, women with psychosis were at a heightened risk for cesarean delivery (aOR = 1.26; 95% CI: 1.23 - 1.29), induced labor (aOR = 1.05; 95% CI: 1.02 - 1.09), antepartum hemorrhage (aOR = 1.22; 95% CI: 1.14 - 1.31), placental abruption (aOR = 1.22; 95% CI: 1.13 - 1.32), postpartum hemorrhage (aOR = 1.18; 95% CI: 1.10 - 1.27), premature delivery (aOR = 1.40; 95% CI: 1.36 - 1.46), stillbirth (aOR = 1.37; 95% CI: 1.23 - 1.53), premature rupture of membranes (aOR = 1.22; 95% CI: 1.15 - 1.29), fetal abnormalities (aOR = 1.49; 95% CI: 1.38 - 1.61), poor fetal growth (aOR = 1.26; 95% CI: 1.19 - 1.34), and fetal distress (aOR = 1.14; 95% CI: 1.10 - 1.18). Maternal death during hospitalizations (aOR = 1.00; 95% CI: 0.30 - 3.31) and excessive fetal growth (aOR = 1.06; 95% CI: 0.98 - 1.14) were not statistically significantly associated with psychosis. Conclusions Pregnant women with psychosis have elevated risk of several adverse obstetric and neonatal outcomes. Efforts to identify and manage pregnancies complicated by psychosis may contribute to improved outcomes. Electronic supplementary material The online version of this article (10.1186/s12884-018-1750-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Qiu-Yue Zhong
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, 677 Huntington Avenue, Room Kresge 502A, Boston, MA, 02115, USA.
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, 677 Huntington Avenue, Room Kresge 502A, Boston, MA, 02115, USA
| | - Gregory L Fricchione
- Division of Psychiatry and Medicine, Pierce Division of Global Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Paul Avillach
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, 677 Huntington Avenue, Room Kresge 502A, Boston, MA, 02115, USA.,Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA.,Children's Hospital Informatics Program, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Elizabeth W Karlson
- Division of Rheumatology, Allergy and Immunology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Michelle A Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, 677 Huntington Avenue, Room Kresge 502A, Boston, MA, 02115, USA
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Pomeroy E, Stock JT, Cole TJ, O'Callaghan M, Wells JCK. Relationships between neonatal weight, limb lengths, skinfold thicknesses, body breadths and circumferences in an Australian cohort. PLoS One 2014; 9:e105108. [PMID: 25162658 PMCID: PMC4146506 DOI: 10.1371/journal.pone.0105108] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 07/17/2014] [Indexed: 12/11/2022] Open
Abstract
Background Low birth weight has been consistently associated with adult chronic disease risk. The thrifty phenotype hypothesis assumes that reduced fetal growth impacts some organs more than others. However, it remains unclear how birth weight relates to different body components, such as circumferences, adiposity, body segment lengths and limb proportions. We hypothesized that these components vary in their relationship to birth weight. Methods We analysed the relationship between birth weight and detailed anthropometry in 1270 singleton live-born neonates (668 male) from the Mater-University of Queensland Study of Pregnancy (Brisbane, Australia). We tested adjusted anthropometry for correlations with birth weight. We then performed stepwise multiple regression on birth weight of: body lengths, breadths and circumferences; relative limb to neck-rump proportions; or skinfold thicknesses. All analyses were adjusted for sex and gestational age, and used logged data. Results Circumferences, especially chest, were most strongly related to birth weight, while segment lengths (neck-rump, thigh, upper arm, and especially lower arm and lower leg) were relatively weakly related to birth weight, and limb lengths relative to neck-rump length showed no relationship. Skinfolds accounted for 36% of birth weight variance, but adjusting for size (neck-rump, thigh and upper arm lengths, and head circumference), this decreased to 10%. There was no evidence that heavier babies had proportionally thicker skinfolds. Conclusions Neonatal body measurements vary in their association with birth weight: head and chest circumferences showed the strongest associations while limb segment lengths did not relate strongly to birth weight. After adjusting for body size, subcutaneous fatness accounted for a smaller proportion of birth weight variance than previously reported. While heavier babies had absolutely thicker skinfolds, this was proportional to their size. Relative limb to trunk length was unrelated to birth weight, suggesting that limb proportions at birth do not index factors relevant to prenatal life.
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Affiliation(s)
- Emma Pomeroy
- Newnham College, University of Cambridge, Cambridge, United Kingdom
- Division of Biological Anthropology, Department of Archaeology and Anthropology, University of Cambridge, Cambridge, United Kingdom
- * E-mail:
| | - Jay T. Stock
- Division of Biological Anthropology, Department of Archaeology and Anthropology, University of Cambridge, Cambridge, United Kingdom
| | - Tim J. Cole
- Population Policy and Practice, UCL Institute of Child Health, London, United Kingdom
| | - Michael O'Callaghan
- School of Medicine, Mater Clinical School, University of Queensland, Brisbane, Queensland, Australia
| | - Jonathan C. K. Wells
- Division of Biological Anthropology, Department of Archaeology and Anthropology, University of Cambridge, Cambridge, United Kingdom
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom
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Byström M, Liu A, Quinton AE, Champion BL, Mann K, Peek M, Nanan RKH. Gestational Diabetes Independently Increases Birth Length and Augments the Effects of Maternal BMI on Birth Weight: A Retrospective Cohort Study. Front Pediatr 2014; 2:112. [PMID: 25368857 PMCID: PMC4201105 DOI: 10.3389/fped.2014.00112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 10/01/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To investigate the effect of the interaction between gestational diabetes mellitus (GDM) and maternal body mass index (BMI) on the individual neonatal growth parameters. DESIGN Retrospective cohort study. SETTING A tertiary maternity service in Sydney, Australia, between 2005 and 2009. POPULATION A cohort of 8859 women. METHODS Generalized linear models. MAIN OUTCOME MEASURES Neonatal growth parameters, represented by z-scores for infant birth weight (BW), birth length (BL), and head circumference (HC) in GDM and non-GDM groups. RESULTS Only GDM alone had an independent and positive effect on BL (p = 0.02) but not on BW or HC. In addition, in pregnancies complicated with GDM, the association between maternal weight and BW was significantly stronger (p < 0.001). In combination, GDM and maternal BMI significantly affected z-score differences between BW and BL (p < 0.001), in that underweight mothers had babies that were lighter relative to their length and inversely obese mothers had babies that were heavier relative to their length. CONCLUSION GDM independently influences BL and increases the association between maternal BMI and BW. In accordance with the hypothesis of the fetal origins of health and disease, the pronounced effects of GDM on fetal growth patterns demonstrated in this study are likely to influence long-term health outcomes in children.
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Affiliation(s)
- Magdalena Byström
- Sydney Medical School - Nepean, The University of Sydney , Penrith, NSW , Australia
| | - Anthony Liu
- Sydney Medical School - Nepean, The University of Sydney , Penrith, NSW , Australia ; Charles Perkins Centre - Nepean, The University of Sydney , Penrith, NSW , Australia
| | - Ann Elizabeth Quinton
- Sydney Medical School - Nepean, The University of Sydney , Penrith, NSW , Australia ; Charles Perkins Centre - Nepean, The University of Sydney , Penrith, NSW , Australia
| | - Bernard Linton Champion
- Sydney Medical School - Nepean, The University of Sydney , Penrith, NSW , Australia ; Charles Perkins Centre - Nepean, The University of Sydney , Penrith, NSW , Australia
| | - Kristy Mann
- Sydney Medical School - Nepean, The University of Sydney , Penrith, NSW , Australia
| | - Michael Peek
- Sydney Medical School - Nepean, The University of Sydney , Penrith, NSW , Australia ; Charles Perkins Centre - Nepean, The University of Sydney , Penrith, NSW , Australia
| | - Ralph Kay Heinrich Nanan
- Sydney Medical School - Nepean, The University of Sydney , Penrith, NSW , Australia ; Charles Perkins Centre - Nepean, The University of Sydney , Penrith, NSW , Australia
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Persson M, Fadl H, Hanson U, Pasupathy D. Disproportionate body composition and neonatal outcome in offspring of mothers with and without gestational diabetes mellitus. Diabetes Care 2013; 36:3543-8. [PMID: 24159180 PMCID: PMC3816875 DOI: 10.2337/dc13-0899] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 05/21/2013] [Indexed: 02/03/2023]
Abstract
OBJECTIVE High birth weight is a risk factor for neonatal complications. It is not known if the risk differs with body proportionality. The primary aim of this study was to determine the risk of adverse pregnancy outcome in relation to body proportionality in large-for-gestational-age (LGA) infants stratified by maternal gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS Population-based study of all LGA (birth weight [BW] >90th percentile) infants born to women with GDM (n = 1,547) in 1998-2007. The reference group comprised LGA infants (n = 83,493) born to mothers without diabetes. Data were obtained from the Swedish Birth Registry. Infants were categorized as proportionate (P-LGA) if ponderal index (PI) (BW in grams/length in cm(3)) was ≤90th percentile and as disproportionate (D-LGA) if PI >90th percentile. The primary outcome was a composite morbidity: Apgar score 0-3 at 5 min, birth trauma, respiratory disorders, hypoglycemia, or hyperbilirubinemia. Logistic regression analysis was used to obtain odds ratios (ORs) for adverse outcomes. RESULTS The risk of composite neonatal morbidity was increased in GDM pregnancies versus control subjects but comparable between P- and D-LGA in both groups. D-LGA infants born to mothers without diabetes had significantly increased risk of birth trauma (OR 1.19 [95% CI 1.09-1.30]) and hypoglycemia (1.23 [1.11-1.37]). D-LGA infants in both groups had significantly increased odds of Cesarean section. CONCLUSIONS The risk of composite neonatal morbidity is significantly increased in GDM offspring. In pregnancies both with and without GDM, the risk of composite neonatal morbidity is comparable between P- and D-LGA.
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Au CP, Raynes-Greenow CH, Turner RM, Carberry AE, Jeffery HE. Body composition is normal in term infants born to mothers with well-controlled gestational diabetes mellitus. Diabetes Care 2013; 36:562-4. [PMID: 23223404 PMCID: PMC3579380 DOI: 10.2337/dc12-1557] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study aims to describe body composition in term infants of mothers with gestational diabetes mellitus (GDM) compared with infants of mothers with normal glucose tolerance (NGT). RESEARCH DESIGN AND METHODS This cross-sectional study included 599 term babies born at Royal Prince Alfred Hospital, Sydney, Australia. Neonatal body fat percentage (BF%) was measured within 48 h of birth using air-displacement plethysmography. Glycemic control data were based on third-trimester HbA(1c) levels and self-monitoring blood glucose levels. Associations between GDM status and BF% were investigated using linear regression adjusted for relevant maternal and neonatal variables. RESULTS Of 599 babies, 67 (11%) were born to mothers with GDM. Mean ± SD neonatal BF% was 7.9 ± 4.5% in infants with GDM and 9.3 ± 4.3% in infants with NGT, and this difference was not statistically significant after adjustment. Good glycemic control was achieved in 90% of mothers with GDM. CONCLUSIONS In this study, neonatal BF% did not differ by maternal GDM status, and this may be attributed to good maternal glycemic control.
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Affiliation(s)
- Cheryl P Au
- Sydney Medical School, University of Sydney, Sydney, Australia.
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Siervo M, Jebb S. Body Composition Assessment: Theory into Practice: Introduction of Multicompartment Models. ACTA ACUST UNITED AC 2010; 29:48-59. [DOI: 10.1109/memb.2009.935471] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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