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Soria-Contreras DC, Liu J, Lawn RB, Wang S, Purdue-Smithe A, Grodstein F, Oken E, Chavarro JE. Lifetime History of Low Birth Weight Delivery and Cognitive Function in Middle-Aged Parous Women. Neurology 2024; 103:e209504. [PMID: 38865681 DOI: 10.1212/wnl.0000000000209504] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Pregnancy outcomes such as low birth weight (LBW) delivery may reflect vascular or metabolic dysfunction in mothers and presage future cognitive impairment and dementia. However, the evidence is currently limited. Our objective was to examine the extent to which a lifetime history of LBW delivery was associated with cognitive function in parous middle-aged women. METHODS We studied participants from the Nurses' Health Study II, an ongoing longitudinal cohort of female nurses enrolled in 1989. In 2009, participants completed a reproductive history questionnaire. Participants who completed at least one of 2 post-traumatic stress disorder questionnaires were invited to participate in a cognition substudy with 2 waves of baseline data collection (2014 or 2018). We restricted the analysis to participants with one valid cognitive assessment who reported ≥1 birth at 18 years and older. We defined LBW delivery history as having delivered offspring with a birth weight <2,500 g (<5.5 lbs) in any pregnancy. The outcome was a single assessment of cognitive function evaluated with the self-administered Cogstate Brief Battery. The battery comprises 4 tasks, which we used to create 2 composite z-scores measuring psychomotor speed/attention and learning/working memory (higher z-scores = better cognitive function). We used multivariable linear regression models. RESULTS The analysis included 15,323 participants with a mean age of 62 (standard deviation: 4.9 years) at cognitive assessment. Among them, 1,224 (8%) had a history of LBW delivery. After adjusting for age at cognitive assessment, race, and ethnicity, participants' education, wave of baseline cognitive assessment, socioeconomic status, and prepregnancy characteristics, women with a history of LBW delivery had lower z-scores in the psychomotor speed/attention (β, -0.06; 95% CI -0.12 to -0.01) and learning/working memory (β, -0.05; 95% CI -0.09 to -0.01) composites than parous women without a history of LBW delivery. We observed a gradient of lower z-scores with an increasing number of LBW deliveries. DISCUSSION History of LBW delivery may be marker of future poorer cognition. If confirmed, our findings support future investigations into the value of early preventive efforts targeting women with a history of LBW delivery to reduce the burden of cognitive impairment in women.
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Affiliation(s)
- Diana C Soria-Contreras
- From the Departments of Nutrition (D.C.S.-C., S.W., E.O., J.E.C.) and Epidemiology (J.L., R.B.L., J.E.C.), Harvard T.H. Chan School of Public Health, Boston; Division of Women's Health (A.P.-S.) and Channing Division of Network Medicine, Department of Medicine (J.E.C.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Rush Alzheimer's Disease Center (F.G.), Rush University Medical Center, Chicago, IL; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine (E.O.), Harvard Medical School, Boston; and Harvard Pilgrim Health Care Institute (E.O.), Boston, MA
| | - Jiaxuan Liu
- From the Departments of Nutrition (D.C.S.-C., S.W., E.O., J.E.C.) and Epidemiology (J.L., R.B.L., J.E.C.), Harvard T.H. Chan School of Public Health, Boston; Division of Women's Health (A.P.-S.) and Channing Division of Network Medicine, Department of Medicine (J.E.C.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Rush Alzheimer's Disease Center (F.G.), Rush University Medical Center, Chicago, IL; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine (E.O.), Harvard Medical School, Boston; and Harvard Pilgrim Health Care Institute (E.O.), Boston, MA
| | - Rebecca B Lawn
- From the Departments of Nutrition (D.C.S.-C., S.W., E.O., J.E.C.) and Epidemiology (J.L., R.B.L., J.E.C.), Harvard T.H. Chan School of Public Health, Boston; Division of Women's Health (A.P.-S.) and Channing Division of Network Medicine, Department of Medicine (J.E.C.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Rush Alzheimer's Disease Center (F.G.), Rush University Medical Center, Chicago, IL; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine (E.O.), Harvard Medical School, Boston; and Harvard Pilgrim Health Care Institute (E.O.), Boston, MA
| | - Siwen Wang
- From the Departments of Nutrition (D.C.S.-C., S.W., E.O., J.E.C.) and Epidemiology (J.L., R.B.L., J.E.C.), Harvard T.H. Chan School of Public Health, Boston; Division of Women's Health (A.P.-S.) and Channing Division of Network Medicine, Department of Medicine (J.E.C.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Rush Alzheimer's Disease Center (F.G.), Rush University Medical Center, Chicago, IL; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine (E.O.), Harvard Medical School, Boston; and Harvard Pilgrim Health Care Institute (E.O.), Boston, MA
| | - Alexandra Purdue-Smithe
- From the Departments of Nutrition (D.C.S.-C., S.W., E.O., J.E.C.) and Epidemiology (J.L., R.B.L., J.E.C.), Harvard T.H. Chan School of Public Health, Boston; Division of Women's Health (A.P.-S.) and Channing Division of Network Medicine, Department of Medicine (J.E.C.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Rush Alzheimer's Disease Center (F.G.), Rush University Medical Center, Chicago, IL; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine (E.O.), Harvard Medical School, Boston; and Harvard Pilgrim Health Care Institute (E.O.), Boston, MA
| | - Francine Grodstein
- From the Departments of Nutrition (D.C.S.-C., S.W., E.O., J.E.C.) and Epidemiology (J.L., R.B.L., J.E.C.), Harvard T.H. Chan School of Public Health, Boston; Division of Women's Health (A.P.-S.) and Channing Division of Network Medicine, Department of Medicine (J.E.C.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Rush Alzheimer's Disease Center (F.G.), Rush University Medical Center, Chicago, IL; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine (E.O.), Harvard Medical School, Boston; and Harvard Pilgrim Health Care Institute (E.O.), Boston, MA
| | - Emily Oken
- From the Departments of Nutrition (D.C.S.-C., S.W., E.O., J.E.C.) and Epidemiology (J.L., R.B.L., J.E.C.), Harvard T.H. Chan School of Public Health, Boston; Division of Women's Health (A.P.-S.) and Channing Division of Network Medicine, Department of Medicine (J.E.C.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Rush Alzheimer's Disease Center (F.G.), Rush University Medical Center, Chicago, IL; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine (E.O.), Harvard Medical School, Boston; and Harvard Pilgrim Health Care Institute (E.O.), Boston, MA
| | - Jorge E Chavarro
- From the Departments of Nutrition (D.C.S.-C., S.W., E.O., J.E.C.) and Epidemiology (J.L., R.B.L., J.E.C.), Harvard T.H. Chan School of Public Health, Boston; Division of Women's Health (A.P.-S.) and Channing Division of Network Medicine, Department of Medicine (J.E.C.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Rush Alzheimer's Disease Center (F.G.), Rush University Medical Center, Chicago, IL; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine (E.O.), Harvard Medical School, Boston; and Harvard Pilgrim Health Care Institute (E.O.), Boston, MA
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Kudo R, Iwama N, Hamada H, Tomita H, Tagami K, Kumagai N, Sato N, Izumi S, Sakurai K, Watanabe Z, Ishikuro M, Obara T, Tatsuta N, Hoshiai T, Metoki H, Saito M, Sugawara J, Kuriyama S, Arima T, Yaegashi N. Maternal birth weight is an indicator of preterm delivery: the Japan environment and children's study. J Dev Orig Health Dis 2024; 15:e11. [PMID: 38773803 DOI: 10.1017/s2040174424000126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Abstract
This study aimed to investigate the association between maternal birth weight (MBW) with preterm delivery (PTD) in the Japanese population. To this end, a total of 78,972 Japanese pregnant women were included in a prospective birth cohort study. Multiple logistic regression and multinominal logistic regression models were applied to investigate the associations of MBW with PTD (delivery from 22 to < 37 weeks of gestation), early PTD (delivery from 22 to < 34 weeks), and late PTD (delivery from 34 to < 37 weeks). The results showed that MBW was inversely associated with PTD, early PTD, and late PTD (p-for-trend < 0.0001, 0.0014, and < 0.0001, respectively). The adjusted odds ratios per each 500 g of MBW decrease were 1.167 (95% confidence interval [CI]: 1.118-1.218) for PTD, 1.174 (95% CI: 1.070-1.287) for early PTD and 1.151 (95% CI: 1.098-1.206) for late PTD. The effect size of the association of MBW with early PTD was similar to that with late PTD. This study demonstrated for the first time an association of a low MBW with PTD, early PTD, and late PTD in a Japanese nationwide cohort.
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Affiliation(s)
- Rie Kudo
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriyuki Iwama
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
- Division of Molecular Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Hirotaka Hamada
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hasumi Tomita
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kazuma Tagami
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Natsumi Kumagai
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Naoto Sato
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Seiya Izumi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kasumi Sakurai
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Zen Watanabe
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mami Ishikuro
- Division of Molecular Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taku Obara
- Division of Molecular Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nozomi Tatsuta
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tetsuro Hoshiai
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical Pharmaceutical University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
| | - Masatoshi Saito
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Maternal and Fetal Therapeutics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Junichi Sugawara
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
| | - Shinichi Kuriyama
- Division of Molecular Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Takahiro Arima
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
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Kasuga Y, Tanaka K, Akita K, Tamai J, Hamuro A, Fukuma Y, Hasegawa K, Ikenoue S, Tanaka M. Factors associated with low birthweight among late preterm singletons in Japan using pregnancy birth registry data. J Dev Orig Health Dis 2023; 14:584-590. [PMID: 37699750 DOI: 10.1017/s2040174423000235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
Late preterm (LP, born between 34 0/7 and 36 6/7 weeks of gestation) infants may experience several adverse outcomes, similar to those experienced by low birthweight (LBW, birthweight <2500 g) infants. However, while LP infants are often born with LBW, the association between LP and LBW remains unknown. This study aimed to investigate LBW rate and independent risk factors for LBW in LP singleton neonates. We retrospectively analyzed data of LP singleton neonates, born between 2013 and 2017, from the Japan Society of Obstetrics and Gynecology Successive Pregnancy Birth Registry System. The exclusion criteria included stillbirths and infants with missing data. Logistic regression analyses were performed to investigate maternal and perinatal factors associated with LBW in LP singletons. LBW was observed in 62.5% (n = 35,113) of 56,160 LP singleton births. In the multiple logistic regression analysis, LBW in LP neonates was independently associated with modifiable maternal factors, including pre-pregnancy underweight, inadequate gestational weight gain, and smoking during pregnancy, as well as non-modifiable factors, including younger maternal age, nulliparity, hypertensive disorder of pregnancy, preeclampsia, cesarean section delivery, and female offspring. According to the Japanese pregnancy birth registry data, more than half of LP neonates were LBW. We previously discussed the issue of LBW regarding infants with different backgrounds, as there are many different causes of LBW. Several risk factors should be subdivided and considered for the risk of LP and LBW.
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Affiliation(s)
- Yoshifumi Kasuga
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Kunio Tanaka
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Keisuke Akita
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Junko Tamai
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Asuka Hamuro
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Yuka Fukuma
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Keita Hasegawa
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Satoru Ikenoue
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Mamoru Tanaka
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
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Kasuga Y, Iida M, Tanaka Y, Tamagawa M, Hasegawa K, Ikenoue S, Sato Y, Tanaka M, Ochiai D. The Associated Factors of Low Birthweight Among Term Singletons in Japan: A Pregnancy Birth Registry Analysis. J Epidemiol 2023; 33:450-455. [PMID: 35370228 PMCID: PMC10409524 DOI: 10.2188/jea.je20210483] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/19/2022] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Progress in reducing the global low birthweight (LBW) has been insufficient. Although the focus has been on preventing preterm birth, evidence regarding LBW in term births is limited. Despite its low preterm birth prevalence, Japan has a higher LBW proportion than other developed countries. This study aimed to examine the prevalence of LBW in term singleton births and its associated factors using a national database. METHODS We retrospectively analyzed the data of neonates registered in the Japan Society of Obstetrics and Gynecology Successive Pregnancy Birth Registry System who were born 2013-2017. Exclusion criteria included stillbirths, delivery after 42 gestational weeks, and missing data. Logistic regression analyses were performed to investigate the maternal and perinatal factors associated with LBW in term singletons using the data of 715,414 singleton neonates. RESULTS The overall prevalence of LBW was 18.3%, and 35.7% of LBWs originated from singleton term pregnancies. Multiple logistic regression analyses indicated that both modifiable and non-modifiable factors were independently associated with LBW in term neonates. The modifiable maternal factors included pre-pregnancy underweight, inadequate gestational weight gain, and smoking during pregnancy, while the non-modifiable factors included younger maternal age, nulliparity, hypertensive disorders of pregnancy, cesarean section delivery, female offspring, and congenital anomalies. CONCLUSION Using the Japanese pregnancy birth registry data, more than one-third of LBWs were found to originate from singleton term pregnancies. Both modifiable and non-modifiable factors were independently associated with LBW in term neonates. Prevention strategies on modifiable risk factor control will be effective in reducing LBW worldwide.
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Affiliation(s)
- Yoshifumi Kasuga
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Miho Iida
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Yuya Tanaka
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Masumi Tamagawa
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Keita Hasegawa
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Satoru Ikenoue
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Mamoru Tanaka
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Daigo Ochiai
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
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