Approximately one-third of medically indicated late preterm births are complicated by fetal growth restriction

Carreño, Carlos A.; Costantine, Maged M.; Holland, Marium; Ramin, Susan M.; Saade, George R.; Blackwell, Sean C.

doi:10.1016/j.ajog.2010.12.004

Cited by 35 publications

(31 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Infection and inflammation are regarded as one of the most important and potentially preventable causes of preterm birth (Burdet et al, 2014; Kallapur, Presicce, Rueda, Jobe, & Chougnet, 2014; Romero et al, 2014), but this biological mechanism would not explain the higher numbers of CD4 T and B cells. Third, a number of exposures experienced by preterm infants can also independently influence cord blood cell type proportions and may explain some of our unexpected study findings, as well the higher variability in blood cell type proportion in the cluster corresponding to earlier gestational age (Carreno et al, 2011; Romero et al, 2014). For example, fetal exposure to maternal smoking is associated with normal to higher counts of T cells (Remington et al, 2001).…”

Section: Discussionmentioning

confidence: 90%

See 1 more Smart Citation

DNA Methylation Patterns in Cord Blood of Neonates Across Gestational Age

et al. 2017

View full text Add to dashboard Cite

BackgroundA statistical methodology is available to estimate the proportion of cell types (cellular heterogeneity) in adult whole blood specimens used in epigenome-wide association studies (EWAS). However, there is no methodology to estimate the proportion of cell types in umbilical cord blood (also a heterogeneous tissue) used in EWAS.ObjectivesThe objectives of this study were to determine whether differences in DNA methylation (DNAm) patterns in umbilical cord blood are the result of blood cell type proportion changes that typically occur across gestational age and to demonstrate the effect of cell type proportion confounding by comparing preterm infants exposed and not exposed to antenatal steroids.MethodsWe obtained DNAm profiles of cord blood using the Illumina HumanMethylation27k BeadChip array for 385 neonates from the Boston Birth Cohort. We estimated cell type proportions for six cell types using the deconvolution method developed by Houseman et al. (2012).ResultsThe cell type proportion estimates segregated into two groups that were significantly different by gestational age, indicating that gestational age was associated with cell type proportion. Among infants exposed to antenatal steroids, the number of differentially methylated CpGs dropped from 127 to 1 after controlling for cell type proportion.DiscussionEWAS utilizing cord blood are confounded by cell type proportion. Careful study design including correction for cell type proportion and interpretation of results of EWAS using cord blood are critical.

show abstract

Section: Discussionmentioning

confidence: 90%

“…Glucocorticosteroids are a common exposure in preterm infants, and yet, research indicates that steroid application is associated with changes in DNAm (Carreno et al, 2011; Romero, Dey, & Fisher, 2014). The question is whether controlling for cell type proportions would impact this finding.…”

mentioning

confidence: 99%

DNA Methylation Patterns in Cord Blood of Neonates Across Gestational Age

et al. 2017

View full text Add to dashboard Cite

show abstract

“…In the majority of the available studies risk factors for preterm births (<37 gw) are presented [6,15]. The main interest of this study is the fact that we have included only LPB, a population that may differ from the overall preterm births and we analysed separately the risk factors for medically indicated and spontaneous LPB.…”

Section: Resultsmentioning

confidence: 99%

Risk Factors for Late Preterm Births: A Case-Control Study

Mandruzzato¹

2013

Gynecol Obstet (Sunnyvale)

View full text Add to dashboard Cite

show abstract

“…Because hypertensive conditions have been linked to MI LPB, 27,31 analyses were repeated excluding women with clinical diagnoses of hypertensive disorders (N=85) or placental findings linked to these conditions (N=134), and were performed on the entire analytic sample to maximize cell sizes (see Methods). In each of the analyses (Table 5), the unadjusted and adjusted associations of MI LPB with hyperactivity and ADHD Index scores were no longer significant; effect sizes also decreased ( d =.06–.25).…”

Section: Resultsmentioning

confidence: 99%

“…Because MI LPB was significantly associated with child attention problems (see Results/Table 3) and hypertensive conditions have been implicated in MI LPBs, 3,28,31 the final models were repeated after removing women with indicators linked to hypertensive disorders during pregnancy (e.g., high MV-O/MV-D or SGA birth) to see if such factors partially or fully accounted for the findings. Because indices of inflammatory conditions and bleeding have also been associated with LPB, 32,33 we repeated analyses following the removal of women with severe histologic chorioamnionitis (HCA) or placental abruption to further probe the specificity of any observed associations.…”

Section: Methodsmentioning

confidence: 99%

Late-Preterm Birth by Delivery Circumstance and Its Association With Parent-Reported Attention Problems in Childhood

Talge

Holzman

Egeren

et al. 2012

Journal of Developmental &Amp; Behavioral Pediatrics

View full text Add to dashboard Cite

Objective Late-preterm birth (LPB: 34–36 weeks) has been associated with an increased risk of attention problems in childhood relative to full-term birth (FTB: ≥ 37 weeks), but little is known about factors contributing to this risk. We investigated the contributions of clinical circumstances surrounding delivery using follow-up data from the Pregnancy Outcomes and Community Health (POUCH) Study. Methods Women who delivered late-preterm or full-term and completed the sex- and age-referenced Conners’ Parent Rating Scales-Short Form: Revised (CPRS-R:S) were included in the present analysis (N=762: children’s ages: 3–9 years). The CPRS-R:S measures dimensions of behavior linked to attention problems, including: oppositionality, inattention, hyperactivity, and a global attention problem index. Using general linear models, we evaluated whether LPB subtype (medically indicated (MI) or spontaneous) was associated with these dimensions relative to FTB. Results After adjustment for parity, socio-demographics, child age, and maternal symptoms of depression and serious mental illness during pregnancy and at the child survey, only MI LPB was associated with higher hyperactivity and global index scores (mean difference from FTB=3.8 [95%CI 0.5,7.0] and 3.1 [95%CI 0.0, 6.2]). These findings were largely driven by children between 6 and 9 years. Removal of women with hypertensive disorders during pregnancy (N=85) or placental findings related to hypertensive conditions (obstruction, decreased maternal spiral artery conversion; N=134) reduced the differences below significance thresholds. Conclusion Among LPBs, only MI LPB was associated with higher levels of parent-reported childhood attention problems, suggesting that complications motivating medical intervention during the late-preterm period mark increased risk for such problems. Hypertensive disorders appear to play a role in these associations.

show abstract

Approximately one-third of medically indicated late preterm births are complicated by fetal growth restriction

Cited by 35 publications

References 19 publications

DNA Methylation Patterns in Cord Blood of Neonates Across Gestational Age

DNA Methylation Patterns in Cord Blood of Neonates Across Gestational Age

Risk Factors for Late Preterm Births: A Case-Control Study

Late-Preterm Birth by Delivery Circumstance and Its Association With Parent-Reported Attention Problems in Childhood

Contact Info

Product

Resources

About