Parent-reported birth information: birth weight,birth length and gestational age. Validation study in the SENDO project

ObjectiveTo test the validity of parent-reported birth information obtained through an online, self-administered questionnaire.MethodThe SENDO project is a prospective and dynamic paediatric cohort of Spanish children aged 4 to 6 years old at recruitment. Objective data from medical birth records were compared to parent-reported data getting intra-class correlation coefficients (ICC) for quantitative variables and weighted Kappa Index for qualitative ones. Percentage of responders and of total agreement was also evaluated.ResultsParental response rate was over 99% for birth weight and gestational age and 76% for birth length. ICC for birth weight was 0.95 (95% confidence interval [95%CI]: 0.94-0.96) and 0.78 (95%CI: 0.73-0.83) for birth length, both showing very high correlations. The total agreement percentage for gestational age was 97%, and Kappa weighted index was 0.90 (95%CI: 0.89-0.90), showing a very high agreement as well.ConclusionsWe found high correlations and excellent agreement in parent-reported birth data 4 to 6 years after delivery. Our results show parent-reported birth data, especially birth weight, are valid for use in epidemiological research.     

Ambient air pollution exposure, residential mobility and term birth weight in Oslo, Norway

Environmental exposure during pregnancy may have lifelong health consequences for the offspring and some studies have association between maternal exposure to air pollution during pregnancy and offspring’s birth weight. However, many of these studies do not take into account small-scale variations in exposure, residential mobility, and work addresses during pregnancy.We used information from the National Birth Registry of Norway to examine associations between ambient environmental exposure such as air pollution and temperature, and offspring’s birth weight taking advantage of information on migration history and work address in a large population-based cohort. A dispersion model was used to estimate ambient air pollution levels at all residential addresses and work addresses for a total of 25,229 pregnancies between 1999 and 2002 in Oslo, Norway.Ambient exposure to traffic pollution for the entire pregnancy was associated with a reduction in term birth weight in crude analyzes when comparing children of the highest and lowest exposed mothers. No evidence for an association between exposure to traffic pollution at home and work addresses and term birth weight after adjustment for covariates known to influence birth weight during pregnancy. After stratification, small statistically non-significant reductions were present but only for multiparious mothers. This group also had less residential mobility and less employment during pregnancy.The overall findings suggest no clear association between term birth weight and traffic pollution exposure during pregnancy. However, mobility patterns could introduce possible confounding when examining small-scale variations in exposure by using addresses. This could be of importance in future studies.     

Work in pregnancy and birth weight for gestational age

In a recent report on prematurity and work in pregnancy based on the Montreal survey noteworthy increases in both preterm births (less than 37 weeks) and infants of low birth weight (less than or equal to 2500 g) were found in women in certain specific occupations or whose work entailed heavy lifting, shift work, long hours, or great fatigue. Because of the large overlap between preterm births and low birth weight, the latter was further analysed with allowance for gestational age in order better to separate factors retarding fetal growth from those shortening gestation. The association of low birth weight with specific occupations, long working hours, and fatigue largely disappeared, suggesting that the effect of these factors was to shorten gestation. By contrast, the association with lifting heavy weights and with shift work persisted, suggesting that these factors retarded fetal growth as well as increasing the risk of preterm birth.     

Graphic model of birth weight and gestational age in Monastir,Tunisia

BackgroundBirth weight for gestational age curves provide to clinicians available references to assess fetal growth in individual infants and in populations. In Tunisia, until now, only North American based references were used. The objective of this study was to create national reference curves for birth weight and to compare these to those actually used in our maternities.MethodsA retrospective population based study was performed over a period of 11 years (from January 1994 to December 2004) using the register of births database of the region of Monastir. We studied a total of 75,751 births. Gestational age of infants ranged from 28 to 43 weeks. Fifth, tenth, 25th, 50th, 75th, 90th and 95th percentiles for weight were calculated by polynomial linear regression of the following general form to construct the clinical curves (Y = a + bX + cX²).ResultsThe database included 38,646 males and 37,105 females (sex ratio: 1.04). The resulting male and female curves provide smoothed percentiles cutoffs for defining small and large for gestational age births. An actual difference does exist between our curves and those routinely used.ConclusionThese constructed smoothed gestational curves can be used as a useful tool for assessing birth weight and to evaluate clinical or public health interventions to enhance fetal growth.     

产前抑郁对新生儿出生体质量和分娩孕周的影响

目的探讨产前抑郁与胎儿出生体质量和分娩孕周的相关性。方法选取2011年8月-2018年5月在舟山市妇幼保健院产检的1 616例孕妇为研究对象,采用自编问卷采集研究对象一般社会人口学信息、器质性疾病、精神疾病、创伤史及分娩史,采用抑郁自评量表(SDS)评价抑郁状态,采用焦虑自评量表(SAS)评价焦虑状态,并从舟山市妇幼保健院电子医疗系统中提取分娩的相关信息,采用多元线性回归分析产前抑郁与胎儿出生体质量和分娩孕周的相关性。结果孕期无抑郁组脑力劳动者、高孕次人数、出现早孕反应及孕期存在焦虑的比例均少于孕期有抑郁组,差异均有统计学意义(均P<0. 001);无抑郁组平均文化水平高于有抑郁组,差异有统计学意义(P<0. 001)。多元线性回归分析结果显示,产前抑郁与孕妇分娩孕周无关;孕早期中重度抑郁能降低胎儿出生体质量(β=-69. 76,P=0. 039 1),各怀孕阶段中至少1期(β=-59. 05,P=0. 005 1)、至少2期(β=-61. 49,P=0. 027 1)出现抑郁均能降低胎儿出生体质量,至少1期出现中重度抑郁(β=-88. 03,P=0. 004 5)对降低胎儿出生体质量的效应更为显著。结论产前抑郁与胎儿出生体质量呈负相关关系,但与出生孕周无关,因此要加强孕妇的心理健康管理,维护母婴健康。     

CRIB score, birth weight and gestational age in neonatal mortality risk evaluation

OBJECTIVE: To evaluate the mortality rate of very low birth weight babies born at a Neonatal Intensive Care Unit (NICU) during a specified period of time according to variations in CRIB (Clinical Risk Index for Babies) score, birth weight and gestational age. METHODS: From January 1997 to December 2000, the CRIB score was prospectively applied to all newborn infants admitted to the NICU of an university hospital of Londrina, Brazil, with birthweight under 1,500 g and/or gestational age of less than 31 weeks. The exclusion criteria were: death before 12 hours of life, presence of lethal congenital malformations and newborns who had been referred from other hospital. RESULTS: Two hundred and eighty-four infants met the inclusion criteria. Mean birth weight was 1,148 +/- 248 g (median=1,180), mean gestational age was 30.2 +/- 2.4 weeks (median=30.0) and mean CRIB score was 3.8 +/- 4.4 (median=2.0). The neonatal mortality rate was 23.2%, varying according to mean birthweight <750 g (72.7%), gestational age <29 weeks (57.1%) and CRIB score >10 (79.4%). Receiver Operating Characteristic (ROC) curves were composed for CRIB score, birth weight and gestational age to assess the ability of each to predict hospital mortality and the areas under the curve were respectively 0.88, 0.76 and 0.81. Sensitivity, specificity and predictive values were evaluated and all variables were considered predictors of mortality (p<0.0001). The optimal cut off point based on the ROC curve for the CRIB score was 4 with sensitivity 75.8%, specificity 86.7, positive predictive value 63.3% and negative predictive value 92.2%. CONCLUSIONS: In this study infants with birthweight of less than 750 grams, less than 29 weeks gestational age and CRIB scores above 10 had higher mortality rates. However, a CRIB score higher than 4 proved to be a better predictor of mortality when compared to birthweight and gestational age.     

Analysis of relationship between birth weight by gestational age and decreasing birth weight in Kumamoto Prefecture, 1979-1997

OBJECTIVES: This study was conducted to investigate possible factors associated with the recent decrease in birth weight in Kumamoto Prefecture between 1979 and 1997. METHODS: Vital statistics on birth between 1979 and 1997 were obtained from the records of the Ministry of Health and Welfare, Japan, on the basis of which, infants were divided into low-birth weight (LBW: <2500 g) group and the normal-birth-weight (> or =2500 g) group, and the proportions of birth and birth weights by gestational age (from 22 to 42 weeks) of both groups between 1979 and 1997 were compared. RESULTS: For the normal-birth-weight group, the peaks of the proportions of birth and birth weights by gestational age in 1997 shifted to early gestation, compared with the peaks in 1979. The birth weight by gestational age in 1997 decreased, compared with that in 1979 among the normal-birth-weight group, in particular, the birth weight from 37 to 40 gestational ages decreased significantly, and the mean birth weight showed a linear relationship with these gestational ages as observed in normal fetal development. However, in the LBW group, the mean birth weight showed a small increase after 1992 and a large increase in birth weight by gestational age in the last month of pregnancy in 1997. CONCLUSIONS: The changes in the proportions of birth and birth weights by gestational age among the normal-birth-weight group were found to be the important factors the recent decrease in birth weight. These factors might be associated with advances in medical technology and the fact that young women diet in order to slim.     

Risk factors for preterm, low birth weight and small for gestational age birth in urban Aboriginal and Torres Strait Islander women in Townsville

OBJECTIVES: To assess the characteristics of Indigenous births and to examine the risk factors for preterm (<37 weeks), low birth weight (<2,500 g) and small for gestational age (SGA) births in a remote urban setting. DESIGN: Prospective cohort of singleton births to women attending Townsville Aboriginal and Islander Health Services (TAIHS) for shared antenatal care between 1 January 2000 and 31 December 2003. MAIN OUTCOME MEASURES: Demographic, obstetric, and antenatal care characteristics are described. Risk factors for preterm birth, low birth weight and SGA births are assessed. RESULTS: The mean age of the mothers was 25.0 years (95% CI 24.5-25.5), 15.8% reported hazardous or harmful alcohol use, 15.1% domestic violence, 30% had an inter-pregnancy interval of less than 12 months and 9.2% an unwanted pregnancy. The prevalence of infection was 50.2%. Predictors of preterm birth were a previous preterm birth, low body mass index (BMI) and inadequate antenatal care, with the subgroup at greatest risk of preterm birth being women with a previous preterm birth and infection in the current pregnancy. Predictors of a low birth weight birth were a previous stillbirth, low BMI and an interaction of urine infection and non-Townsville residence; predictors of an SGA birth were tobacco use, pregnancy-induced hypertension and interaction of urine infection and harmful alcohol use. CONCLUSION: The prevalence of demographic and clinical risk factors is high in this group of urban Indigenous women. Strategies addressing potentially modifiable risk factors should be an important focus of antenatal care delivery to Indigenous women and may represent an opportunity to improve perinatal outcome in Indigenous communities in Australia.     

极低出生体重儿适于胎龄儿与小于胎龄儿危险因素及并发症的比较

目的:探讨极低出生体重适于胎龄儿(AGA)与小于胎龄儿(SGA)的危险因素及并发症的特点及差异。方法:将125例极低出生体重儿分为两组,其中AGA组95例,SGA组30例,比较两组的危险因素及并发症的差异是否有统计学意义。结果:极低出生体重儿中AGA组和SGA组母亲妊娠期高血压疾病发生率的差异有统计学意义,其余危险因素两组间差异均无统计学意义,AGA组和SGA组新生儿并发症中新生儿呼吸窘迫综合征(RDS)和低血糖症发生率的差异有统计学意义,其余并发症发生率两组间差异均无统计学意义。结论:母亲妊娠期高血压疾病是极低出生体重SGA患儿发病的高危因素,极低出生体重SGA患儿RDS发生率低于AGA患儿,而低血糖症的发生率高于AGA患儿。     

Measures of placental growth in relation to birth weight and gestational age

Fetal growth depends in part on placental growth. The authors tested placental measures derived from digital images for reliability and to evaluate their association with birth weight and gestational age. A total of 628 women recruited into the Pregnancy, Infection, and Nutrition Study, a prospective cohort study of preterm birth in central North Carolina between 2002 and 2004, delivered singleton liveborn infants after 24 completed weeks' gestation. Novel chorionic plate morphometric parameters captured off digital images of the gross placenta were analyzed as estimators of gestational age and birth weight. Without acknowledgment to placental weight, digitally obtained lateral chorionic plate growth measures accounted for 17 percent of gestational age variance and 35 percent of birth weight variance, overall. Chorionic plate measures accounted for 10 percent of birth weight variance beyond that accounted for by placental weight alone. Among preterm births, 34 percent of gestational age variance and 63 percent of birth weight variance were accounted for by lateral chorionic plate growth measures. Intraclass correlation coefficients for the novel digital measures ranged from 0.96 to 0.98. Reliable digital measures of lateral chorionic plate growth estimate birth weight variance more strongly than gestational age, project variance that is not accounted for by placental weight, and project these outcomes to a greater degree in preterm births than at term.     

Associations of prenatal exposure to organophosphate pesticide metabolites with gestational age and birth weight

Background: Prenatal exposure to organophosphate (OP) insecticides, a widely used class of pesticides, may be associated with decreased gestational age and lower birth weight. Single nucleotide polymorphisms in paroxanase (PON1) enzyme genotypes may modify the relationships between OP exposure and perinatal outcomes.Objective: We examined the relationship of prenatal OP insecticide exposure, measured using urinary dialkyl phosphate (DAP) metabolite concentrations, with gestational age and birth weight.Methods: We measured the concentrations of six nonspecific DAP metabolites of OP insecticides in two maternal spot urine samples collected in a prospective birth cohort. We performed multivariable regression to examine associations between the sum of six DAP concentrations (ΣDAP) with gestational age and birth weight. We also examined whether these associations differed according to infant PON1₁₉₂ and PON1_–108 genotypes.Results: Among 306 mother–infant dyads, a 10-fold increase in ΣDAP concentrations was associated with a decrease in covariate-adjusted gestational age [–0.5 weeks; 95% confidence interval (CI): –0.8, –0.1] and birth weight (–151 g; CI: –287, –16); the decrements in birth weight were attenuated after adjusting for gestational age. The relationship between ΣDAP concentrations and gestational age was stronger for white (–0.7 weeks; CI: –1.1, –0.3) than for black (–0.1 weeks; 95% CI: –0.9, 0.6) newborns. In contrast, there was a greater decrease in birth weight with increasing urinary ΣDAP concentrations for black (–188 g; CI: –395, 19) than for white (–118 g; CI: –296, 60) newborns. Decrements in birth weight and gestational age associated with ΣDAP concentrations were greatest among infants with PON1_192QR and PON_–108CT genotypes.Conclusions: Prenatal urinary ΣDAP concentrations were associated with shortened gestation and reduced birth weight in this cohort, but the effects differed by race/ethnicity and PON1_192/108 genotypes.     

Racial differences in the relation of birth weight and gestational age to neonatal mortality

Utilizing South Carolina live birth-infant death cohort files for the period 1975-80, this study examines the bivariate distribution of birth weight-gestational age (BW-GA), intrauterine growth curves, and BW-GA specific neonatal mortality rates (NMRs) by race. Comparison of BW-GA distributions revealed an appreciable shift between racial subgroups. Nonwhites, on the average, were born 1 week earlier and 270 grams lighter in weight than whites. In addition to racial differences in rates of intrauterine growth, nonwhites experienced lower BW-GA NMRs than whites in BW-GA categories less than 3,000 grams and less than 38 weeks. However, the improved mortality experience of nonwhites at more immature BW-GA categories was not consistently present when different cause-specific NMRs were considered. These persistent racial variations highlight continuing issues regarding both the use of a single norm for defining low birth weight or prematurity and the role of nonsocioeconomic factors related to racial BW-GA distribution and mortality disparities. As birth weight and gestational age represent empirical indicators of the maturity and survivability of an infant at birth, these data and previous supporting research raise further concerns regarding the ability of these indicators to accurately reflect equivalent fetal development and subsequent risk of mortality among racial groups.     

The association of shift work and nitrous oxide exposure in pregnancy with birth weight and gestational age.

We examined the relation between shift work and occupational nitrous oxide exposure in the second trimester of pregnancy and birth weight and gestational age at delivery among the members of the Swedish Midwives Association. Eighty-four per cent of members who were registered in 1989 responded to a postal questionnaire concerning occupational exposures, including work schedule and the use of nitrous oxide, in relation to each of their pregnancies. We obtained information on births from the Swedish Medical Birth Register. We used models with allowance for dependence between births for the same woman and found that night work was associated with preterm birth (<37 weeks) [odds ratio (OR) = 5.6; 95% confidence limits (CL) = 1.9, 16.4] and to a lesser extent with low birth weight [OR = 1.9 (95% CL = 0.6, 5.8)]. Three-shift work schedule (day, evening, and night rotation) showed a possible association with preterm birth [OR = 2.3 (95% CL = 0.7, 7.3)]. Exposure to nitrous oxide use was associated with reduced birth weight (-77 gm; 95% CL = -129, -24) and an increase in the odds of infants being small for gestational age (< or = 10th percentile of weight for gestational week) (OR = 1.8; 95% CL = 1.1, 2.8).     

Maternal pregravid weight, age, and smoking status as risk factors for low birth weight births.

The Illinois Department of Public Health, in cooperation with the Centers for Disease Control (CDC), monitors trends in the prevalence of prenatal risk factors that are major predictors of infant mortality and low birth weight (LBW). Analyzed data from CDC are available to the department annually. During 1988, a total of 26,767 records of Illinois women giving birth were submitted to CDC. These surveillance data support the fact that women older than 30 years who smoke and enter pregnancy underweight are at greatest risk of delivering LBW babies. Overall, 13.9 percent of underweight smokers had LBW infants compared with 8 percent of underweight nonsmokers. Prevalence of LBW among underweight and smoking women older than 34 years was much higher (29.6 percent) than among those between ages 30 and 34 (15.2 percent). The prevalence of LBW decreased as the pregravid weight increased among normal weight smokers (10 percent) and overweight smokers (8.6 percent).     

Effect of caffeine exposure during pregnancy on birth weight and gestational age

Epidemiologic studies have been unable to conclusively evaluate whether caffeine intake during pregnancy is associated with reduced birth weight and/or fetal growth restriction. The authors conducted a prospective, population-based cohort study to investigate the effect of caffeine on birth weight, gestational age, and birth weight standardized for gestational age (birth weight ratio). Of 953 women recruited in early pregnancy in Uppsala County, Sweden, from 1996 to 1998, 873 women delivering liveborn singleton infants were included in the analysis. Caffeine exposures were ascertained from in-person interviews at 6-12 and 32-34 completed gestational weeks, and maternal plasma was analyzed for cotinine levels as an indicator of smoking. Analysis of variance was used to estimate the effect of caffeine on birth weight, gestational age at delivery, and birth weight ratio after accounting for the effects of other covariates, such as maternal sociodemographic characteristics, plasma cotinine, and pregnancy symptoms. There were no associations between caffeine consumption and birth weight, gestational age, and birth weight ratio, neither when caffeine exposure was averaged from conception to the 32nd to 34th gestational weeks, nor when caffeine exposure was stratified by trimesters of pregnancy. These results do not support an association between moderate caffeine consumption and reduced birth weight, gestational age, or fetal growth.     

Risk of intellectual disability in children born appropriate-for-gestational-age at term or post-term: impact of birth weight for gestational age and gestational age

European Journal of Epidemiology - Children born small for gestational age have a higher risk of intellectual disability. We investigated associations of birth weight for gestational age percentile...     

先天潜伏梅毒儿出生体重、胎龄与母孕期驱梅的关系

【目的】分析26例先天潜伏梅毒儿的胎龄、出生体重，阐明埘孕期驱梅治疗对新生儿生长发育的霞要性。【方法】总结杭州师范学院医学院附属医院收治的26例先天梅毒新生儿的临床资料。根据患儿的母亲产前是否驱梅治疗将本组新生儿分为治疗组（母亲孕期有过正规驱梅治疗）和未治疗组（母亲孕期朱行驱梅治疗），统计患儿出生时的胎龄和体重；分别进行两组间比较分析。【结果】26例新生儿血清梅毒螺旋体明胶凝集试验（TPPA）全部阳性，8例梅毒快速血浆反应素环状卡片试验（RPR）阳性。人院时全身情况良好，无明娃症状。治疗组和未治疗组．两组间孕周数比较及出生体重比较差异有显著性（P均〈0．05）。【结论】有梅毒史母亲孕期正规驱梅治疗能促进胎儿生长发育，减少低体重及早产儿的出生。