Effects of size at birth on health, growth and developmental outcomes in children up to age 18: an umbrella review

Abstract

BackgroundSize at birth, an indicator of intrauterine growth, has been studied extensively in relation to subsequent health, growth and developmental outcomes. Our umbrella review synthesises evidence from systematic reviews and meta-analyses on the effects of size at birth on subsequent health, growth and development in children and adolescents up to age 18, and identifies gaps.MethodsWe searched five databases from inception to mid-July 2021 to identify eligible systematic reviews and meta-analyses. For each meta-analysis, we extracted data on the exposures and outcomes measured and the strength of the association.FindingsWe screened 16 641 articles and identified 302 systematic reviews. The literature operationalised size at birth (birth weight and/or gestation) in 12 ways. There were 1041 meta-analyses of associations between size at birth and 67 outcomes. Thirteen outcomes had no meta-analysis.Small size at birth was examined for 50 outcomes and was associated with over half of these (32 of 50); continuous/post-term/large size at birth was examined for 35 outcomes and was consistently associated with 11 of the 35 outcomes. Seventy-three meta-analyses (in 11 reviews) compared risks by size for gestational age (GA), stratified by preterm and term. Prematurity mechanisms were the key aetiologies linked to mortality and cognitive development, while intrauterine growth restriction (IUGR), manifesting as small for GA, was primarily linked to underweight and stunting.InterpretationFuture reviews should use methodologically sound comparators to further understand aetiological mechanisms linking IUGR and prematurity to subsequent outcomes. Future research should focus on understudied exposures (large size at birth and size at birth stratified by gestation), gaps in outcomes (specifically those without reviews or meta-analysis and stratified by age group of children) and neglected populations.PROSPERO registration numberCRD42021268843.

Birth Body Mass Index (Bmi) of Late Preterm and Early-Term Newborns

“…The evolution analysis of BMI percentiles and/or z-score in the study of sample populations, according to the gestational age, is important to analyze whether the 50 percentile (median) and the 10 and 90 percentiles, usually used to assess the intrauterine growth of newborns, show a trend like the one observed for the newborn group as a whole 20,27,28 .…”

Establishment of a birth-to-education cohort of 1 million Palestinian refugees using electronic medical records and electronic education records

“…Since exposures, disease patterns, policies, and health systems differ by setting, our longitudinal dataset will provide new possibilities to study a wide spectrum of policy-relevant questions that apply to urban-poor populations. For example, a 2023 review found that most studies examining the effect of size at birth on subsequent child wellbeing outcomes have been in high-income countries [ 20 ] or have not considered size for gestational age; such analyses are possible in our birth cohort. Another unusual feature of our cohort is that it includes five settings and services clustered in 140 health facilities and 702 schools, allowing for context-specific and comparative questions.…”

Índice de massa corpórea de recém-nascidos de gestações de baixo risco segundo idade gestacional e sexo

“…A respeito do comprimento, trata-se do indicador de crescimento que melhor refletiria a massa magra e estaria menos sujeito à influência de fatores externos como, por exemplo, o ambiente intrauterino (JAMALUDDINE Z et.al, 2023;YOON SJ et.al, 2021;BLAIR EM et al, 2005). Cabe salientar que, para a tomada de ambas as medidas, é necessário contar com uma equipe suficientemente treinada, de maneira a preservar a acurácia dos valores mensurados (SBP, 2017).…”