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BMC Pregnancy and Childbirth

, 15:344

First Online: 22 December 2015Received: 22 May 2015Accepted: 04 December 2015

Abstract

BackgroundRecent reports have shown a decrease in birth weight, a change from prior steady increases. Therefore we sought to describe the demographic and anthropometric changes in singleton term fetal growth.

MethodsThis was a retrospective cohort analysis of term singleton deliveries 37–42 weeks from January 1, 1995 to January 1, 2010 at a single tertiary obstetric unit. We included all 43,217 neonates from term, singleton, non-anomalous pregnancies. Data were grouped into five 3-year intervals. Mean and median birth weight BW, birth length BL, and Ponderal Index PI were estimated by year, race and gestational age. Our primary outcome was change in BW over time. The secondary outcomes were changes in BL and PI over time.

ResultsMean and median BW decreased by 72 and 70 g respectively p < 0.0001 over the 15 year period while BL also significantly decreased by 1.0 cm P < 0.001. This contributed to an increase in the neonatal PI by 0.11 kg-m P < 0.001. Mean gestational age at delivery decreased while maternal BMI at delivery, hypertension, diabetes, and African American race increased. Adjusting for gestational age, race, infant sex, maternal BMI, smoking, diabetes, hypertension, and parity, year of birth contributed 0.1 % to the variance −1.7 g-year; 26 g of BW, 1.8 % −0.06 cm-year; 0.9 cm of BL, and 0.7 % +0.008 kg-m-year; 0.12 kg-m of PI. These findings were independent of the proportional change in race or gestational age.

ConclusionsWe observed a crude decrease in mean BW of 72 g and BL of 1 cm over 15 years. Furthermore, once controlling for gestational age, race, infant sex, maternal BMI, smoking, diabetes, hypertension, and parity, we identified that increasing year of birth was associated with a decrease in BW of 1.7 g-year. The significant increase in PI, despite the decrease in BW emphasizes the limitation of using birth weight alone to define changes in fetal growth.

KeywordsBirth weight Birth length Ponderal index AbbreviationsAGAAverage for gestational age

BMIBody mass index

BWBirth weight

LGALarge for gestational age

PIPonderal index

SGASmall for gestational age

Electronic supplementary materialThe online version of this article doi:10.1186-s12884-015-0777-8 contains supplementary material, which is available to authorized users.

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Autor: Kelly S. Gibson - Thaddeus P. Waters - Douglas D. Gunzler - Patrick M. Catalano

Fuente: https://link.springer.com/







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