Incidence of infants born small- and large-for-gestational-age in an Italian cohort over a 20-year period and associated risk factors

Chiavaroli, Valentina; Castorani, Valeria; Guidone, Paola; Derraik, José G. B.; Liberati, Marco; Chiarelli, Francesco; Mohn, Angelika

doi:10.1186/s13052-016-0254-7

Cited by 62 publications

(58 citation statements)

References 43 publications

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“…Both our and prior findings suggest that PCOS is an independent risk factor for pregnancy‐related metabolic disorders, which is exacerbated by obesity. These are of critical importance for consideration in screening and management given that GDM, GHTN, and PE may proceed to life‐threatening complications for mother and offspring, increasing intervention for delivery, and increasing diabetes mellitus and cardiometabolic risk in both mothers and infants …”

Section: Discussionmentioning

confidence: 99%

Increased maternal pregnancy complications in polycystic ovary syndrome appear to be independent of obesity—A systematic review, meta‐analysis, and meta‐regression

et al. 2019

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Summary Polycystic ovary syndrome (PCOS) is associated with an increased risk of maternal pregnancy and delivery complications. However, the impact of clinical features of PCOS and other potential risk factors in PCOS is still unknown. We aimed to investigate the association of PCOS with maternal pregnancy and delivery complications with consideration of risk factors and potential confounders. The meta‐analysis included 63 studies. PCOS was associated with higher miscarriage, gestational diabetes mellitus, gestational hypertension, pre‐eclampsia, induction of labour, and caesarean section. The association of PCOS with these outcomes varied by geographic continent, PCOS phenotypes, and study quality. Pre‐eclampsia and induction of labour were not associated with PCOS on body mass index‐matched studies. No outcome was associated with PCOS on assisted pregnancies. Age was significantly associated with higher miscarriage on meta‐regression. There were no studies assessing perinatal depression. We confirm that PCOS is associated with an increased risk of maternal pregnancy and delivery complications. The association of PCOS with the outcomes is worsened in hyperandrogenic PCOS phenotypes, in specific geographic continents, and in the highest quality studies but disappears in assisted pregnancies. Future studies in PCOS are warranted to investigate proper timing for screening and prevention of maternal pregnancy and delivery complications with consideration of clinical features of PCOS.

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Section: Discussionmentioning

confidence: 99%

Increased maternal pregnancy complications in polycystic ovary syndrome appear to be independent of obesity—A systematic review, meta‐analysis, and meta‐regression

et al. 2019

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“…Stillbirth, preterm birth (PTB), and small for gestational age (SGA) (as a proxy for fetal growth restriction, FGR) continue to be major public health problems, despite improvements in health care. They are the leading cause of infant morbidity and mortality . Globally, around 2.6 million infants are stillborn each year .…”

Section: Introductionmentioning

confidence: 99%

Risk of stillbirth, preterm delivery, and fetal growth restriction following exposure in a previous birth: systematic review and meta‐analysis

Malacova

Regan

Nassar

et al. 2017

BJOG

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Why and how was the study carried out? Each year, around 2.6 million babies are stillborn, 15 million are born preterm (<37 weeks of gestation), and 32 million are born small for gestational age (less than tenth percentile for weight, smaller than usually expected for the relevant pregnancy stage). Being born preterm or small for gestational age can increase the chance of long-term health problems. The effect of having a stillbirth, preterm birth, or small-for-gestational-age infant in a previous pregnancy on future pregnancy health has not been summarised. We identified 3399 studies of outcomes of previous pregnancies, and 17 were summarised by our study. What were the main findings? The outcome of the previous pregnancy influenced the risk of poor outcomes in the next pregnancy. Babies born to mothers who had a previous preterm birth or small-for-gestational-age birth were more likely to be stillborn. The smaller and the more preterm the previous baby, the higher the risk of stillbirth in the following pregnancy. The risk of stillbirth in the following pregnancy was doubled if the previous baby was born both preterm and small for gestational age. Babies born to mothers who had a previous stillbirth were more likely to be preterm or small for gestational age. What are the limitations of the work? We included a small number of studies, as there are not enough studies in this area (adverse birth outcomes followed by adverse cross outcomes in the next pregnancy). We found very few studies that compared the risk of small for gestational age after preterm birth or stillbirth. Definitions of stillbirth, preterm birth categories, and small for gestational age differed across studies. We did not know the cause of stillbirth for most studies. What are the implications for patients? Women who have a history of poor pregnancy outcomes are at greater risk of poor outcomes in following pregnancies. Health providers should be aware of this risk when treating patients with a history of poor pregnancy outcomes.

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“…While some prior studies have reported that PCOS is associated with a higher rate of LGA babies, this was not supported by recent meta‐analyses . In the general population several factors including obesity, excessive GWG, diabetes mellitus, GDM, multiparity, age and certain ethnicities are associated with increased risk of LGA babies . As overweight and obesity and diabetes mellitus are elevated in PCOS and the older age of women with PCOS, it may be expected that PCOS would be associated with a greater prevalence of LGA babies .…”

Section: Discussionmentioning

confidence: 86%

“…Prior studies report an increased risk of adverse obstetric outcomes and also increased risk of metabolic complications in LGA babies later in life. 37,38 While some prior studies have reported that PCOS is associated with a higher rate of LGA babies, [39][40][41] this was not supported by recent meta-analyses. 23,42,43 In the general population several factors including obesity, excessive GWG, diabetes mellitus, GDM, multiparity, age and certain ethnicities are associated with increased risk of LGA babies.…”

Section: Discussionmentioning

confidence: 87%

“…We demonstrate a 38% lower risk of LGA among women with PCOS after adjustment for lifestyle and nonlifestyle factors. Prior studies report an increased risk of adverse obstetric outcomes and also increased risk of metabolic complications in LGA babies later in life . While some prior studies have reported that PCOS is associated with a higher rate of LGA babies, this was not supported by recent meta‐analyses .…”

Section: Discussionmentioning

confidence: 95%

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Lifestyle and pregnancy complications in polycystic ovary syndrome: The SCOPE cohort study

Khomami

Moran

Kenny

et al. 2019

Clinical Endocrinology

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Summary Objectives To investigate the risk of pregnancy complications in women with and without polycystic ovary syndrome after consideration of lifestyle factors. Design Prospective cohort. Patients and measurements Participants (n = 5628) were apparently healthy nulliparous women with singleton pregnancies from the Screening for Pregnancy Endpoints study in New Zealand, Australia, United Kingdom and Ireland. Multivariable regression models were performed assessing the association of self‐reported polycystic ovary syndrome status with pregnancy complications with consideration of lifestyle factors at the 15th week of gestation. Results Women with polycystic ovary syndrome (n = 354) were older, had a higher socio‐economic index and body mass index and were less likely to consume alcohol and smoke but more likely to do vigorous exercise and take multivitamins. In univariable analysis, polycystic ovary syndrome was associated with increased risk of gestational diabetes (OR: 2.2, 95% CI: 1.2, 4.0). In multivariable models, polycystic ovary syndrome was only significantly associated with decreased risk of large for gestational age (OR: 0.62, 95% CI: 0.40, 0.98) with a population attributable risk of 0.22%. None of the other outcomes were attributable to polycystic ovary syndrome status. Conclusions Polycystic ovary syndrome is associated with a lower risk of large for gestational age infants. In this low‐risk population, the risk of pregnancy complications was not increased in women with polycystic ovary syndrome who were following a healthy lifestyle. Further studies are warranted assessing the contribution of lifestyle factors to the risk of pregnancy complications in higher risk groups of women with and without polycystic ovary syndrome.

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Incidence of infants born small- and large-for-gestational-age in an Italian cohort over a 20-year period and associated risk factors

Cited by 62 publications

References 43 publications

Increased maternal pregnancy complications in polycystic ovary syndrome appear to be independent of obesity—A systematic review, meta‐analysis, and meta‐regression

Increased maternal pregnancy complications in polycystic ovary syndrome appear to be independent of obesity—A systematic review, meta‐analysis, and meta‐regression

Risk of stillbirth, preterm delivery, and fetal growth restriction following exposure in a previous birth: systematic review and meta‐analysis

Lifestyle and pregnancy complications in polycystic ovary syndrome: The SCOPE cohort study

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