Ethnic differences in fetal size and growth in a multi-ethnic population

Sletner, Line; Rasmussen, Svein; Jenum, Anne Karen; Nakstad, Britt; Jensen, Odd Harald Rognerud; Vangen, Siri

doi:10.1016/j.earlhumdev.2015.07.002

Cited by 31 publications

(34 citation statements)

References 33 publications

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“…The Norwegian multi-ethnic STORK Groruddalen study indicated that East Asian fetuses were consistently smaller throughout pregnancy than fetuses of white Europeans with regard to FL (À0.41 SD), but not with regard to HC. 33 The negative difference in FL (À0.5 SD) in our study was similar to that observed in the STORK Groruddalen cohort. The lack of difference in HC between white Europeans and East Asians in the Norwegian cohort may have resulted from the limited number of East Asians (4.7%).…”

Section: Discussionsupporting

confidence: 88%

“…Alternatively, the differences may be attributed to underlying differences in fetal size and growth. The Norwegian multi‐ethnic STORK Groruddalen study indicated that East Asian fetuses were consistently smaller throughout pregnancy than fetuses of white Europeans with regard to FL (−0.41 SD), but not with regard to HC . The negative difference in FL (−0.5 SD) in our study was similar to that observed in the STORK Groruddalen cohort.…”

Section: Discussionsupporting

confidence: 79%

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Impact of replacing Chinese ethnicity‐specific fetal biometry charts with the INTERGROWTH‐21^st standard

Cheng

Leung

Lao

et al. 2016

BJOG

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Objective To assess the impact of adopting the st biometry standards in a Chinese population.Design Retrospective cohort study.Setting A teaching hospital in Hong Kong.Population A total of 10 527 Chinese women with a singleton pregnancy having a second-or third-trimester fetal anomaly or growth scan between January 2009 and June 2014.Methods Z-scores were derived for fetal abdominal circumference (AC), head circumference (HC), and femur length (FL) using the INTERGROWTH-21 st and Chinese biometry standards.Pregnancies with aneuploidy, structural or skeletal abnormalities, or that developed pre-eclampsia were excluded. Z-scores were stratified as <2.5th, <5th, <10th, >90th, >95th, or >97.5th percentile. Birthweight centile, adjusted for gestation and gender, was categorised as ≤3rd, 3rd to ≤5th, 5th to ≤10th, and >10th. Pairwise comparison and the McNemar test were performed to assess biometry Z-score differences and concordance between the INTERGROWTH-21 st and Chinese standards.Main outcome measures The sensitivity of both the local and INTERGROWTH-21 st AC standards to identify pregnancies that were small-for-gestational-age (SGA) was assessed.Results INTERGROWTH-21 st AC, HC, and FL Z-scores were significantly lower than those obtained using our local reference for AC, HC, and FL (P < 0.0001 for all). The proportion of fetuses with biometry in the <2.5th, <5th, <10th, >90th, >95th, or >97.5th percentiles was statistically significant (P < 0.01 for all

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 79%

Impact of replacing Chinese ethnicity‐specific fetal biometry charts with the INTERGROWTH‐21^st standard

Cheng

Leung

Lao

et al. 2016

BJOG

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“…The difference in birthweight could suggest that women who smoked throughout pregnancy were underrepresented in our study sample. Women from non-Western countries give birth to infants with lower birthweight, 35 and they may be overrepresented among women without information about smoking habits. We made adjustment for year of delivery to account for changes in reporting or in the composition of the study sample that may have occurred during our study period.…”

Section: Discussionmentioning

confidence: 99%

Placental weight and birthweight: the relations with number of daily cigarettes and smoking cessation in pregnancy. A population study

Larsen

Haavaldsen

Bjelland

et al. 2018

International Journal of Epidemiology

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BackgroundWe studied associations of number of daily cigarettes in the first trimester with placental weight and birthweight in women who smoked throughout pregnancy, and in women who stopped smoking after the first trimester.MethodsWe included all women with delivery of a singleton in Norway (n = 698 891) during 1999–2014, by using data from the Medical Birth Registry of Norway. We assessed dose-response associations by applying linear regression with restricted cubic splines.ResultsIn total, 12.6% smoked daily in the first trimester, and 3.7% stopped daily smoking. In women who smoked throughout pregnancy, placental weight and birthweight decreased by number of cigarettes; however, above 11–12 cigarettes we estimated no further decrease (Pnon-linearity < 0.001). Maximum decrease in placental weight in smokers compared with non-smokers was 18.2 g [95% confidence interval (CI): 16.6 to 19.7], and for birthweight the maximum decrease was 261.9 g (95% CI: 256.1 to 267.7). In women who stopped smoking, placental weight was higher than in non-smokers and increased by number of cigarettes to a maximum of 16.2 g (95% CI: 9.9 to 22.6). Birthweight was similar in women who stopped smoking and non-smokers, and we found no change by number of cigarettes (Pnon-linearity < 0.001).ConclusionsIn women who smoked throughout pregnancy, placental weight and birthweight decreased non-linearly by number of cigarettes in the first trimester. In women who stopped smoking, placental weight was higher than in non-smokers and increased linearly by number of cigarettes; birthweight was almost similar to that of non-smokers.

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“…Some of the variation appears to be attributable to biology, [38, 39] but there is also substantial evidence for social and economic factors driving differences, [36, 40] and not always in the direction of minority groups being worse off [41, 42]. The results necessarily raise questions about the differential and synergistic effects of genetics, culture, and environment [37, 43].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with recovery from 1 minute Apgar score <4 in live, singleton, term births: an analysis of Malaysian National Obstetrics Registry data 2010–2012

Jeganathan

Karalasingam

Hussein

et al. 2017

BMC Pregnancy Childbirth

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BackgroundThe neonatal Apgar score at 5 min has been found to be a better predictor of outcomes than the Apgar score at 1 min. A baby, however, must pass through the first minute of life to reach the fifth. There has been no research looking at predictors of recovery (Apgar scores ≥7) by 5 min in neonates with 1 min Apgar scores <4.MethodsAn analysis of observational data was conducted using live, singleton, term births recorded in the Malaysian National Obstetrics Registry between 2010 and 2012. A total of 272,472 live, singleton, term births without congential anomalies were recorded, of which 1,580 (0.59%) had 1 min Apgar scores <4. Descriptive methods and bi- and multi-variable logistic regression were used to identify risk factors associated with recovery (5 min Apgar score ≥7) from 1 min Apgar scores <4.ResultsLess than 1% of births have a 1 min Apgar scores <4. Only 29.4% of neonates with 1 min Apgar scores <4 recover to a 5 min Apgar score ≥7. Among uncomplicated vaginal deliveries, after controlling for other factors, deliveries by a doctor of neonates with a 1 min Apgar score <4 had odds of recovery 2.4 times greater than deliveries of neonates with a 1 min Apgar score <4 by a nurse-midwife. Among deliveries of neonates with a 1 min Apgar score <4 by doctors, after controlling for other factors, planned and unplanned CS was associated with better odds of recovery than uncomplicated vaginal deliveries. Recovery was also associated with maternal obesity, and there was some ethnic variation – in the adjusted analysis indigenous (Orang Asal) Malaysians had lower odds of recovery.ConclusionsA 1 min Apgar score <4 is relatively rare, and less than a third recover by five minutes. In those newborns the qualification of the person performing the delivery and the type of delivery are independent predictors of recovery as is maternal BMI and ethnicity. These are associations only, not necessarily causes, and they point to potential areas of research into health systems factors in the labour room, as well as possible biological and cultural factors.

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Ethnic differences in fetal size and growth in a multi-ethnic population

Cited by 31 publications

References 33 publications

Impact of replacing Chinese ethnicity‐specific fetal biometry charts with the INTERGROWTH‐21^st standard

Impact of replacing Chinese ethnicity‐specific fetal biometry charts with the INTERGROWTH‐21^st standard

Placental weight and birthweight: the relations with number of daily cigarettes and smoking cessation in pregnancy. A population study

Factors associated with recovery from 1 minute Apgar score <4 in live, singleton, term births: an analysis of Malaysian National Obstetrics Registry data 2010–2012

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Ethnic differences in fetal size and growth in a multi-ethnic population

Cited by 31 publications

References 33 publications

Impact of replacing Chinese ethnicity‐specific fetal biometry charts with the INTERGROWTH‐21st standard

Impact of replacing Chinese ethnicity‐specific fetal biometry charts with the INTERGROWTH‐21st standard

Placental weight and birthweight: the relations with number of daily cigarettes and smoking cessation in pregnancy. A population study

Factors associated with recovery from 1 minute Apgar score <4 in live, singleton, term births: an analysis of Malaysian National Obstetrics Registry data 2010–2012

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Impact of replacing Chinese ethnicity‐specific fetal biometry charts with the INTERGROWTH‐21^st standard

Impact of replacing Chinese ethnicity‐specific fetal biometry charts with the INTERGROWTH‐21^st standard