The Associations of Birthweight for Gestational Age Status with Its Differential 0–2 Year Growth Trajectory and Blood Pressure at Two Years of Age in Chinese Boys and Girls

Abstract

The first 1000 days of life represents a critical period for lifelong metabolic health. This study prospectively examined the contrasts between the growth trajectories of large, small, and appropriate sizes for gestational age (LGA, SGA, and AGA) term-born infants in their first two years, and their blood pressure at two years. In 2012–2013, 806 Chinese mother-newborn dyads were enrolled in the Shanghai Obesity and Allergy Birth Cohort Study. Repeated anthropometric measures were obtained at age 42 days, and at 3, 6, 9, 12, 18 and 24 months. Systolic and diastolic blood pressure (SBP, DBP) were measured at two years of age. Linear random effect models were employed to evaluate growth trajectory differences between LGA, SGA, and AGA infants. Of the study infants, 12.4% were LGA and 4.0% SGA. Length, weight, and weight-for-length z-score (ZWFL) were all consistently higher in LGA infants and lower in SGA infants than AGA infants. SGA infants had a higher ZWFL (0.11 unit/month; 95% CI: 0.04, 0.19) and a higher BMI (0.19; 95% CI: 0.09, 0.28 kg/m2 per month) growth velocity at age 0–6 months, relative to AGA infants. SGA was associated with 6.4 (0.4–12.4) mmHg higher SBP, and LGA was associated with 2.9 (95% CI −5.2, −0.5) mmHg lower DBP at two years of age in boys, however, not in girls. In conclusion, in this prospective birth cohort with repeated anthropometric measures and BP at two years of age, LGA, SGA, and AGA term-born infants manifested differential patterns of weight growth trajectory and BP, providing new insight into developmental origins of cardiometabolic health.

Maternal Prenatal Factors and Child Adiposity in Associations with Cardiometabolic Risk Factors in Term-Born Chinese Children at the Age of 2 Years

“…Another study among children with OWO (mean age 11.8 years) also reported that, compared to being born appropriate for gestational age (AGA), SGA was associated with a higher risk of hypertensive BP and low HDL, while large for gestational age (LGA) was associated with a lower risk of hypertensive BP [25]. Our recent study likewise showed that SGA was associated with higher SBP, and LGA with lower DBP at two years of age in boys, though not in girls, adjusting for child current ZWFL [17]. This can be explained by the capacityload mode, where birth weight is a marker of capacity and childhood BMI or skinfolds are markers of load [6].…”

“…Higher birth weight was associated with higher child weight measures (for example, BMIZ or ZWFL), and SGA was associated with lower child weight measure at ages of 2, 4, and 7 years [17,23]. However, birth weight has been negatively associated with SBP at the age of 4 years and lower SBP and DBP at the age of 7 years [23].…”

“…This study used data from children at the age of 2 years from the Shanghai Obesity and Allergy Cohort Study, a prospective study which was conducted in Shanghai, China. The primary objective of this prospective cohort study was to evaluate early life environmental and maternal risk factors for childhood obesity and allergic diseases [17]. Pregnant women were enrolled when they were admitted to two study hospitals for delivery, namely, Xinhua Hospital and the International Peace Maternity and Child Hospital, two large tertiary teaching hospitals, from June 2012 to February 2013.…”

Predictive Models for Calculating Body Weight and Assessing the Likelihood of Overweight and Obesity in Young Children

“…Женщины с избыточным весом и ожирением имеют повышенный риск гестационного сахарного диабета (СД), гипертензивных расстройств, плацентарных нарушений, задержки роста плода и фетальной макросомии. В последующем разные постнатальные траектории массо-ростовых показателей компенсируют как внутриутробное ограничение, так и избыточный рост плода [2,8]. У крупновесных младенцев в первые годы после рождения отмечается снижение темпов прироста антропометрических показателей.…”

The Role of Dynamic Anthropometric Characteristics in the Early Diagnosis and Prevention of Obesity in Large for Gestational Age Children Born at Labor

“…Женщины с избыточным весом и ожирением имеют повышенный риск гестационного сахарного диабета (ГСД), гипертензивных расстройств, плацентарных нарушений, задержки роста плода и фетальной макросомии. В последующем разные постнатальные траектории массо-ростовых показателей компенсируют как внутриутробное ограничение, так и избыточный рост плода [2,7]. У большинства детей, рожденных маловесными, наблюдается догоняющий рост, а у младенцев, рожденных крупновесными, в первые годы жизни наблюдается снижение темпов прироста антропометрических показателей.…”