Secular change in size at birth from 1973 to 2003: national data from Denmark

Objective: To explore whether birth weight (BW) has been increasing in Denmark at the same level as in other countries and whether this increase is paralleled by an increase in birth length (BL) or whether body proportionality, expressed as ponderal index (PI), has changed. Research Methods and Procedures: This study used data analysis of information from The Danish Medical Birth Registry including all single live births in Denmark from 1973 to 2003 (n = 1,863,456). BW, BL, gestational age, maternal age, and smoking status (only from 1991 on) were measured. Results: Mean BW increased steadily during the period (160 grams; equivalent to ～5 g/yr) at a rate higher than that reported from other countries. BL showed only a minor increase (2.4 mm), leading to an increase in PI (0.8 kg/m³) during the period. Controlling for the effect of increasing maternal age and decreasing gestational age and maternal smoking prevalence (only data after 1991), there was still an increase in BW of ～4 g/yr. Discussion: During the last 30 years, neonates have become bigger, with a larger relative increase in BW than BL, leading to an increase in PI. The increasing BW and PI, which may be caused by increased maternal weight, could further promote the obesity epidemic.     

DNA methylation provides insight into intergenerational risk for preterm birth in African Americans

African Americans are at increased risk for spontaneous preterm birth (PTB). Though PTB is heritable, genetic studies have not identified variants that account for its intergenerational risk, prompting the hypothesis that epigenetic factors may also contribute. The objective of this study was to evaluate DNA methylation from maternal leukocytes to identify patterns specific to PTB and its intergenerational risk. DNA from peripheral leukocytes from African American women that delivered preterm (24–34 weeks; N = 16) or at term (39–41 weeks; N = 24) was assessed for DNA methylation using the HumanMethylation450 BeadChip. In maternal samples, 17,829 CpG sites associated with PTB, but no CpG site remained associated after correction for multiple comparisons. Examination of paired maternal-fetal samples identified 5,171 CpG sites in which methylation of maternal samples correlated with methylation of her respective fetus (FDR < 0.05). These correlated sites were enriched for association with PTB in maternal leukocytes. The majority of correlated CpG sites could be attributed to one or more genetic variants. They were also significantly more likely to be in genes involved in metabolic, cardiovascular, and immune pathways, suggesting a role for genetic and environmental contributions to PTB risk and chronic disease. The results of this study may provide insight into the factors underlying intergenerational risk for PTB and its consequences.     

Gestational Anemia and its effects on neonatal outcome,in the population of Hyderabad,Sindh, Pakistan

BackgroundAnemia in pregnancy is a globally health-related issue, that affects both mothers and their newborn. Anemia during pregnancy across the world involves approximately 38% of the world population. To evaluate the effect of gestational anemia on perinatal outcome in the population. The aim of present study is to evaluate the effect of gestational anemia on perinatal outcome in the population of Hyderabad, Sindh, Pakistan.MethodsA cross-sectional comparative analysis was conducted among pregnant mothers who were listed to give birth at Liaquat University of medical and health sciences Jamshoro/Hyderabad during the period of September 2018 to September 2019. The study population 400 were selected by convenient random sampling, and grouped into 2 on the basis of their Hb levels, with Hb < 11 gm% they were classified as anemic mothers, Hb ≥ 11 gm% were termed as non-anemic mothers, data was collected on the preformed questionnaire, and was analyzed on SPSS 21.ResultsThe prevalence of anemia was 51.5% in in total population out of which, the incidence of normocytic normochromic anemia was highest 52.4 %microcytic hypochromic anemia was found in 19.4%, Overall, extremely low Apgar was found in 53 anemics, and 8 non. anemic mother’s infants, LBW incidence was 47.5 %; in anemic mothers, and 15.4 % in non-anemic group, the term, small for gestational age infants were 14.5% in anemic mothers, and 3.6% in non-anemic mothers, there were 36 preterm births to anemic mothers and 10 in non-anemic mothers. The incidence of caesarian section is 53.3% in anemic mothers compared to 30.9% in non-anemic mothers.ConclusionsAnemia in pregnancy significantly increases risks of low Apgar, LBW, term SGA, preterm birth, and an increase incidence of caesarian section.     

Some essential elements in maternal and cord blood in relation to birth weight and gestational age of the baby

Maternal and cord blood were collected from 54 Indian women at parturition and analyzed for Zn, Cu, and Fe by flame atomic absorption spectrophotometry to determine the relationship between levels of these elements in mother’s and infant’s blood and maternal age, birth weight, and gestational age of the baby. The blood Zn level of mothers in the age group 24–28 yr was significantly higher than those of mothers in the age group of 18–23 yr (p<0.05). Similarly, mothers in the 24 to 28-yr group also had higher blood Fe level than mothers in the group 29–38 yr (p<0.05). The levels of Zn, Cu, and Fe were higher in the maternal blood and lower, but not significantly, in the cord blood of low-birth-weight babies than in those of normal-birth-weight babies. However, differences in the levels of Zn, Cu, and Fe between maternal and cord blood of the two birth-weight groups was statistically significant. There were no significant differences in the levels of the three elements in maternal or cord blood by the gestational age of the baby. A weak but significant correlation was found between the birth weight of the baby and the Fe level in the cord blood (r=0.26; p<0.05). Also, weak significant correlations were observed between gestational age of the baby and Fe (r=0.23; p<0.05) and Cu (r=0.31; p<0.05) levels in the cord blood. Although, there are many confounders of low birth weight and preterm deliveries, a diminished placental transfer of these essential elements could be one of the several etiological factors for low birth weight of newborns.     

Regulation of birthweight by placenta-derived miRNAs: evidence from an arsenic-exposed birth cohort in Bangladesh

Altered expression of microRNAs (miRNAs) is implicated in fetal growth. However, the mechanisms by which placenta-derived miRNAs regulate birthweight are not well understood. In Phase 1, we compared the expression of 754 miRNAs in the placenta of mothers from two extreme birthweight groups (0.8–2.2 kg vs. 3.3–3.9 kg, n = 77 each) selected from an arsenic-exposed Bangladeshi birth cohort (n = 1,141). We identified 49 miRNAs associated with the extreme birthweight groups and/or gestational age in Phase 1, which were further analyzed in Phase 2 among 364 randomly selected mother-infant pairs. Gestational age was determined by ultrasound. Causal mediation analysis was used to estimate the effect of miRNAs on birthweight considering gestational age a mediator, adjusting for core blood arsenic and other risk factors. miR-1290, miR-195, and let-7g showed significant inverse associations with gestational age, while miR-328 showed significant positive association [false discovery rate (FDR) <0.05]. Via changing gestational age, miR-1290, miR-195, and miR-27a showed significant inverse associations with birthweight, while miR-328 and miR-324-5p showed significant positive associations (FDR <0.05). The effect of miRNAs on birthweight varied by gestational age (for miR-1290, miR-195, miR-328) and in utero arsenic exposure (for miR-1290): stronger effect was observed among infants delivered early in gestation or exposed to higher concentrations of arsenic in cord blood. Gene enrichment analysis with in silico predicted targets identified cell proliferation, inflammation, apoptosis, insulin, and IGF family signaling cascades associated with these miRNAs. Future studies are warranted to replicate these findings and assess these miRNAs as early biomarkers of fetal growth.     

Association of paternal age with prevalence of selected birth defects

BACKGROUND: Unlike maternal age, the effect of paternal age on birth defect prevalence has not been well examined. We used cases from the Texas birth defect registry, born during 1996-2002, to evaluate the association of paternal age with the prevalence of selected structural birth defects. METHODS: Poisson regression was used to calculate prevalence ratios (PRs) and 95% confidence intervals (CIs) associated with paternal age for each birth defect, adjusting for maternal age, race/ethnicity, and parity. RESULTS: Relative to fathers ages 25-29 years, fathers 20-24 years of age were more likely to have offspring with gastroschisis (PR 1.47, 95% CI: 1.12-1.94), and fathers 40+ years old were less likely to have offspring with trisomy 13 (PR 0.40, 95% CI: 0.16-0.96). No association was seen between paternal age and prevalence of anencephaly and encephalocele. A selection bias was observed for the other birth defects in which cases of younger fathers were more often excluded from study. CONCLUSIONS: In studies of birth defect risk and paternal age, the source of information may affect the validity of findings.     

Varying patterns of BMI increase in sex and birth cohorts of Korean adults

Objective: The Korean population has recently experienced a rapid increase in obesity associated with lifestyle changes arising from economic growth. We examined trends in BMI by analyzing sex‐specific birth cohorts using 3,400,727 measurements from 1,662,477 Korean adults. Research Methods and Procedures: Birth cohort data were collected from the employees of government organizations and schools and their dependents, 20 to 65 years of age, who participated in health examinations provided by the Korean National Health Insurance Corporation in 1992, 1996, and 2000. Results: The prevalence of obesity (BMI ≥ 30 kg/m²) was 0.8% among men and 0.3% among women in 1992, but by 2000, it had increased 2.5‐fold to 2.0% in men and 2.3‐fold to 0.7% in women. Over the 8‐year period, the mean BMI increased 0.8 kg/m² in men and 0.3 kg/m² in women. The rate of BMI increase over the 8 years varied markedly among the sex‐specific birth cohorts, with the steepest slopes representing the youngest men (0.2 kg/m² per year). Discussion: National health promotion activities should target younger men to prevent an increase in obesity‐related morbidity and mortality.     

Maternal intake of vitamin E and birth defects,national birth defects prevention study, 1997 to 2005

BACKGROUND In a recent study, high maternal periconceptional intake of vitamin E was found to be associated with risk of congenital heart defects (CHDs). To explore this association further, we investigated the association between total daily vitamin E intake and selected birth defects. METHODS: We analyzed data from 4525 controls and 8665 cases from the 1997 to 2005 National Birth Defects Prevention Study. We categorized estimated periconceptional energy‐adjusted total daily vitamin E intake from diet and supplements into quartiles (referent, lowest quartile). Associations between quartiles of energy‐adjusted vitamin E intake and selected birth defects were adjusted for demographic, lifestyle, and nutritional factors. RESULTS: We observed a statistically significant association with the third quartile of vitamin E intake (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.01–1.35) and all CHDs combined. Among CHD sub‐types, we observed associations with left ventricular outflow tract obstruction defects, and its sub‐type, coarctation of the aorta and the third quartile of vitamin E intake. Among defects other than CHDs, we observed associations between anorectal atresia and the third quartile of vitamin E intake (OR, 1.66; 95% CI, 1.01–2.72) and hypospadias and the fourth quartile of vitamin E intake (OR, 1.42; 95% CI, 1.09–1.87). CONCLUSION: Selected quartiles of energy‐adjusted estimated total daily vitamin E intake were associated with selected birth defects. However, because these few associations did not exhibit exposure‐response patterns consistent with increasing risk associated with increasing intake of vitamin E, further studies are warranted to corroborate our findings. Birth Defects Research (Part A), 100:647–657, 2014. © 2014 Wiley Periodicals, Inc.     

Relations among birth condition, maternal condition, and postnatal growth in captive common marmoset monkeys (Callithrix jacchus)

The present study characterizes the relations among maternal condition, litter size, birth condition, and growth in body weight for a population of common marmosets. The subjects of the study were marmosets born into a single colony between 1994 and 2001. Three sets of analyses were conducted to answer the following questions: 1) Is there a relationship between litter size, maternal condition, and birth condition? In the study population, maternal body weight, maternal age, litter size, and birth condition were related in a complex fashion. Birth weight and prenatal long‐bone growth, as reflected in knee–heel length, were both related to maternal age, with older mothers supporting higher prenatal growth. Age and maternal condition appeared to interact as determinants of long‐bone growth, as the combination of older and larger mothers resulted in significantly longer knee–heel lengths in their offspring. 2) Is there a relationship between birth condition or maternal condition and subsequent growth or final adult size? The early growth rate in this population was similar to early growth rates reported for three different marmoset colonies, suggesting that early growth may be relatively inflexible in this species. However, within this population, the variation that did occur in early growth rate was related to birth weight and maternal weight. Later growth and adult weight were related to birth weight and litter size: small twin infants displayed slower later growth rates and were smaller as adults than twins that began life at a higher birth weight, while the birth weight of triplets was not related to adult size. In these marmosets, small infants that were the result of increased litter size differed from small infants whose small birth size resulted from other factors. This reinforces the proposal that the causes of low birth weight will be relevant to the development of the marmoset as a model of prenatal environmental effects. Am. J. Primatol. 62:83–94, 2004. © 2004 Wiley‐Liss, Inc.     

初乳中主要组分的动态变化及产妇年龄和剖宫产的影响

测定了来自20位健康母亲(其中8位为剖宫产)的118份初乳(泌乳第1～7d)中乳糖和蛋白质浓度.通过线性模型,分析产妇年龄和剖宫产对乳糖和蛋白质含量的影响.结果表明,乳糖在泌乳第1d最低,在泌乳1w内增加,其中泌乳第1d的乳糖浓度极显著低于第7d(P＜0.01).乳蛋白的浓度在泌乳第1d最高,泌乳1w内下降,其中前3d水平显著或极显著高于第7d(P＜0.05或P＜0.01).初乳中乳糖和乳蛋白含量呈极显著负相关(r=-0.523,P＜0.01).剖宫产母亲初乳中乳糖含量显著低于顺产(P＜0.05),剖宫产与顺产母亲初乳中蛋白质含量差异不显著(P＞0.05).产妇年龄的大小与初乳中蛋白质和乳糖含量均无显著关系(P＞0.05).     

Season of birth is associated with first-lactation milk yield in Holstein Friesian cattle

The aim of the present research was to assess factors associated with first-lactation milk yield in dairy heifers, including maternal and environmental factors, factors related to the development of the heifer and factors related to its offspring such as gender of the calf. In addition, the potential underlying mechanism, in particular metabolic adaptations, was further explored. Data on body growth, reproduction and milk yield of 74 Holstein Friesian heifers on three herds in Flanders (Belgium) were collected. At birth, body measurements of the heifers were recorded and blood samples were taken (in order) to determine basal glucose and insulin concentrations. Body measurements were assessed every 3 months until first calving, and gender and weight of their first calf were recorded. Information on fertility and milk yield of the heifer and its dam were collected from the herd databases. Daily temperature and photoperiod were recorded from the database of the Belgian Royal Meteorological Institute. Linear mixed models were run with herd as a random factor, to account for differences in herd management. Heifers grew 867±80.7 g/day during their first year of life and were inseminated at 14.8±1.34 months. First calving took place at 24.5±1.93 months, at a weight of 642±61.5 kg and heifers produced 8506±1064 kg energy corrected milk during their first 305-day lactation. Regression models revealed that none of the maternal factors such as milk yield and parity, nor the growth of the heifer during the 1^st year of life were associated with milk yield during first lactation. Age, and to a lesser extent BW at first parturition were positively associated with first-lactation milk yield. In addition, the season of birth, but not calving, had a significant influence on milk yield, with winter-born heifers producing less than heifers born in any other season. The lower yielding winter-born heifers had higher insulin concentrations at birth, whereas glucose concentrations were similar, the latter being suggestive for lower insulin sensitivity of the peripheral tissues. Furthermore, environmental temperature at the end of gestation was negatively correlated with neonatal insulin concentrations. In conclusion, results of the present study suggest heifers born during the hotter months are born with a higher peripheral insulin sensitivity, finally leading to a higher first-lactation milk yield.     

Linking teratogen information service and birth defects registry databases to improve knowledge of birth defect status

BACKGROUND: Although teratogen information services (TISs) obtain maternal exposure information from their callers, such services often do not know if the pregnancies were affected by a birth defect. This study attempted to improve the completeness of this information for Texas Teratogen Information Service (TTIS) callers by linking their records with the Texas Birth Defects Registry (TBDR) and Texas birth certificates (TBCs). METHODS: A total of 344 expectant mothers called TTIS with expected dates of delivery between 1 January 2000 and 31 December 2001. These pregnancies were linked with TBDR and TBC data. The percentages of pregnancies with known birth defect information both before and after the linkage were compared. RESULTS: The TTIS originally collected birth defect status information for 101 of the 344 callers (29.4%) and 0.6% of all 344 callers or 2.0% of callers with birth defect status information had a pregnancy affected by a birth defect. Linking TTIS records with TBDR and TBC data helped to raise the percentage of callers with birth defect status information from 29.4% to 71.5%. Among those callers, the percentage known to have birth defects increased from 2.0% to 4.1%. The sensitivity of TTIS follow-up calls in identifying birth defects was 50%, and the specificity was 100%. CONCLUSIONS: Linking TTIS caller records with TBDR and TBC data significantly increased both the percentage of pregnancies with birth defect status information and the percentage of pregnancies identified as affected by birth defects. Such linkage may be a good approach by which TISs can increase the completeness of their birth defect status information.     

Infant birth weight and third trimester maternal plasma markers of vascular integrity: the MIREC study

Background: There is paucity of information on mechanisms constituting adverse birth outcomes. We assessed here the relationship between vascular integrity and adverse birth effects.

Methods and results: Third trimester maternal plasma (n?=?144) from the Maternal-Infant Research on Environmental Chemicals Study (MIREC) was analysed for vascular, inflammatory and oxidative stress markers by HPLC-fluorescence, protein array and EIA method. Analysis of the <25th and >75th percentile birth weight subgroups revealed markers associated with birth weight (ETs, MMP-9, VEGF, and 8-isoPGF-2α) and gestational age (ET-1, MMP-2, and VEGF).

Conclusions: Mechanistic insights into adverse birth outcome pathways can be achieved by integrating information on multiple biomarkers, physiology using systems biology approach.     

Association between reported venlafaxine use in early pregnancy and birth defects,national birth defects prevention study, 1997–2007

BACKGROUND

Few epidemiologic studies have investigated the use of venlafaxine (Effexor XR capsules, Product Monograph, Wyeth, Montreal, Canada), an antidepressant used to treat major depression and anxiety disorders in adults, during pregnancy. Our objective was to determine whether use of venlafaxine during pregnancy is associated with specific birth defects.

METHODS

We used data from the National Birth Defects Prevention Study (NBDPS), a population‐based, case‐control study in the United States. Our analysis included mothers with pregnancies affected by one of 30 selected birth defects (cases) and babies without birth defects (controls) with estimated dates of delivery between 1997 and 2007. Exposure was any reported use of venlafaxine from 1 month preconception through the third month of pregnancy. We calculated adjusted odds ratios (aORs) and 95% Fisher Exact confidence intervals (CIs) for 24 birth defect groups for which at least 400 case mothers were interviewed. Our adjusted analyses controlled for maternal age and race/ethnicity.

RESULTS

Among the 27,045 NBDPS participants who met inclusion criteria, 0.17% (14/8002) of control mothers and 0.40% (77/19,043) of case mothers reported any use of venlafaxine from 1 month preconception through the third month of pregnancy. Statistically significant associations were found for anencephaly, atrial septal defect (ASD) secundum, or ASD not otherwise specified, coarctation of the aorta, cleft palate, and gastroschisis.

CONCLUSIONS

Our data suggest associations between periconceptional use of venlafaxine and some birth defects. However, sample sizes were small, CIs were wide, and additional studies are needed to confirm these results. Birth Defects Research (Part A), 2013. © 2012 Wiley Periodicals, Inc.     

Preconceptional folic acid‐containing supplement use in the national birth defects prevention study

Background: Despite public health campaigns encouraging women to take a daily folic acid supplement, the proportion of reproductive age women, in the United States, who comply with this recommendation is less than optimal. The objective of this analysis was to identify predictors of preconceptional folic acid‐containing supplement use to define subgroups of women who may benefit from targeted folic acid campaigns. Methods: This study included 6570 mothers of live born infants from the control population of National Birth Defects Prevention Study (1997–2005). Logistic regression analyses were used to identify predictors of preconceptional folic acid supplementation. A classification and regression tree (CART) analysis was used to define subgroups of women with different patterns of preconceptional folic acid supplementation. Results: Race/ethnicity, education, age at delivery, nativity, employment, income, number of dependents, smoking, and birth control use were significantly associated with preconceptional folic acid‐containing supplement use. Based on a CART analysis, education, race/ethnicity, and age were the most distinguishing factors between women with different preconceptional supplementation patterns. Non‐white women with <4 years of a college education were the least likely to use folic acid‐containing supplements (11%). However, even in the most compliant subgroup (women with ≥4 years of college), only 60% of women supplemented with folic acid. Conclusion: These results demonstrate the need for continued efforts to increase folic acid supplementation among all reproductive aged women. However, the success of such efforts may be improved if maternal characteristics such as education, race/ethnicity, and age, are considered in the development of future interventions. Birth Defects Research (Part A) 100:472–482, 2014. © 2014 Wiley Periodicals, Inc.     

Why do women stop reproducing before menopause? A life-history approach to age at last birth

Evolutionary biologists have long considered menopause to be a fundamental puzzle in understanding human fertility behaviour, as post-menopausal women are no longer physiologically capable of direct reproduction. Menopause typically occurs between 45 and 55 years of age, but across cultures and history, women often stop reproducing many years before menopause. Unlike age at first reproduction or even birth spacing, a woman nearing the end of her reproductive cycle is able to reflect upon the offspring she already has—their numbers and phenotypic qualities, including sexes. This paper reviews demographic data on age at last birth both across and within societies, and also presents a case study of age at last birth in rural Bangladeshi women. In this Bangladeshi sample, age at last birth preceded age at menopause by an average of 11 years, with marked variation around that mean, even during a period of high fertility. Moreover, age at last birth was not strongly related to age at menopause. Our literature review and case study provide evidence that stopping behaviour needs to be more closely examined as an important part of human reproductive strategies and life-history theory. Menopause may be a final marker of permanent reproductive cessation, but it is only one piece of the evolutionary puzzle.