Risk factors for small‐for‐gestational‐age infants by customised birthweight centiles: data from an international prospective cohort study

Abstract

Objective To identify clinical and ultrasound variables associated with the birth of small-for-gestational-age (SGA) infants by customised centiles, subclassified according to whether their mothers were normotensive or developed hypertensive complications.Design Prospective, multicentre cohort study.Setting Participating centres of the Screening for Pregnancy Endpoints (SCOPE) study in Auckland, New Zealand, Adelaide, Australia, Manchester and London, UK, and Cork, Ireland.Population The 3513 nulliparous participants of the SCOPE study.Methods Women were interviewed at 15 ± 1 weeks, and had ultrasound growth measurements and umbilical and uterine Doppler studies at 20 ± 1 weeks. Variables associated with SGA infants were identifed using logistic regression.Main outcome measures Small for gestational age (i.e. a birthweight of less than the tenth customised centile), normotensive-SGA and hypertensive-SGA. Comparison groups for statistical analyses were non-SGA, normotensive non-SGA and hypertensive non-SGA.Results Among 376 (10.7%) SGA infants, 281 (74.7%) were normotensive-SGA and 95 (25.3%) were hypertensive-SGA. Independent risk factors for normotensive-SGA were low maternal birthweight, low fruit intake pre-pregnancy, cigarette smoking, increasing maternal age, daily vigorous exercise, being a tertiary student, head and abdominal circumference of less than the tenth centile and increasing uterine artery Doppler indices at the 20-week scan. Protective factors were: high green leafy vegetable intake pre-pregnancy, and rhesus-negative blood group. Risk factors for hypertensive-SGA were conception by in vitro fertilisation, previous early pregnancy loss and femur length of less than tenth centile at the 20-week scan.Conclusions Risk factors for infants who are SGA by customised centiles have been identified in a cohort of healthy nulliparous women. A number of these factors are modifiable; however, further studies are needed to replicate these findings.

A functional variant in ANGPT1 and the risk of pregnancies with hypertensive disorders and small-for-gestational-age infants

“…The clinical variables used in our multivariable logistic regression models were previously shown to be associated with pre-eclampsia and SGA pregnancies in our study cohort (McCowan et al, 2010North et al, 2011). Our data show that the association of the maternal ANGPT1 rs2507800 polymorphism with pre-eclampsia, hypertensive SGA and SGA with abnormal Doppler is independent of these clinical risk factors.…”

“…Missing data were excluded from the analyses. The x adjusted for previously established risk factors (McCowan et al, 2010North et al, 2011). A false discovery rate (FDR) correction was performed to adjust for multiple comparisons controlling the FDR at 15% (Benjamini et al, 2001).…”

The effects of yoga in prevention of pregnancy complications in high-risk pregnancies: A randomized controlled trial

“…While there are many complications of pregnancy, this trial studied only PIH (Gifford et al, 2000), PE (Gifford et al, 2000), eclampsia (E) (Gifford et al, 2000), GDM (American Diabetes Association, 2004), premature rupture of amniotic membrane (PROM) (Beers et al, 2003), low birth weight (LBW) (Mahajan and Gupta, 1995), small for gestational age (SGA) (McCowan et al, 2010), large for gestational age (LGA) (McCowan et al, 2010), IUGR (Mandruzzato et al, 2008), APGAR score (Finster and Wood, 2005), and preterm deliveries (Mandruzzato et al, 2008) as defined in Table 2. Due to the diversity in demographics of the Indian population and the non-availability of normative birth weight graphs for Indian babies in Bengaluru, substantial amount of time was spent searching for suitable normograms to determine SGA or LGA.…”

Activation of Nod1 Signaling Induces Fetal Growth Restriction and Death through Fetal and Maternal Vasculopathy

“…Several conditions, such as maternal factors (e.g., pre-eclampsia, young or advanced age and preconception diet), fetal factors (e.g., genetic causes, congenital malformations, fetal infection), and the placental dysfunction, have been suggested as risk factors for IUGR (2). However, these risk factors are not apparent in 50% of cases (6,7).…”