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Biological indicators of the in-utero environment and their association with birth weight for gestational age

Published online by Cambridge University Press:  09 August 2011

N. M. Talge ,
C. Holzman ,
P. K. Senagore ,
M. Klebanoff  and
R. Fisher
N. M. Talge*
Affiliation:
Department of Epidemiology, Michigan State University, East Lansing, MI, USA
C. Holzman
Affiliation:
Department of Epidemiology, Michigan State University, East Lansing, MI, USA
P. K. Senagore
Affiliation:
Department of Physiology, Michigan State University, East Lansing, MI, USA
M. Klebanoff
Affiliation:
Department of Pediatrics, The Ohio State University, Columbus, OH, USA
R. Fisher
Affiliation:
Department of Pediatrics and Human Development, Michigan State University, East Lansing, MI, USA
*
*Address for correspondence: N. M. Talge, PhD, Department of Epidemiology, Michigan State University, B601 West Fee Hall, East Lansing, MI 48824, USA. (Email [email protected])
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Abstract

Birth weight for gestational age (BW/GA) has been associated with a risk of adverse health outcomes. Biological indices of pregnancy complications, maternal mid-pregnancy serum biomarkers and placental pathology may shed light on these associations, but at present, they are most often examined as single entities and offer little insight about overlap. In addition, these indices are typically assessed in relation to the extremes of the BW/GA distribution, leaving open the question of how they relate to the entire BW/GA distribution. Addressing issues such as these may help elucidate why postnatal health outcomes vary across the BW/GA continuum. In this study, we focused on a subset of women who participated in the Pregnancy Outcomes and Community Health Study (n = 1371). We examined BW/GA (i.e. gestational age and sex-referenced z-scores) in relation to obstetric complications, second trimester maternal serum screening results and histologic evidence of placental pathology along with maternal demographics, anthropometrics and substance use. In adjusted models, mean reductions in BW/GA z-scores were associated with preeclampsia (β = −0.70, 95% CI −1.04, −0.36), high maternal serum alpha fetoprotein (β = −0.28, 95% CI −0.43, −0.13), unconjugated estriol (β = −0.31/0.5 multiples of the median decrease, 95% CI −0.41, −0.21) and high levels of maternal obstructive vascular pathology in the placenta (β = −0.46, 95% CI −0.67, −0.25). The findings were similar when preterm infants, small-for-gestational age or large-for-gestational age infants were excluded. More research is needed to examine how the factors studied here might directly mediate or mark risk when evaluating the associations between BW/GA and postnatal health outcomes.

Keywords

alpha fetoproteinsbirth weightestriolplacentapregnancy complications
Type
Original Articles
Information
Journal of Developmental Origins of Health and Disease , Volume 2 , Issue 5 , October 2011 , pp. 280 - 290
Copyright
Copyright © Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2011

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References

1.Barker, DJP. Fetal and Infant Origins of Adult Disease, 1992. BMJ Publishing Group: London.Google Scholar
2.Breslau, N, Paneth, N, Lucia, VC, Paneth-Pollak, R. Maternal smoking during pregnancy and offspring IQ. Int J Epidemiol. 2005; 34, 1047–1053.CrossRefGoogle ScholarPubMed
3.Thompson, C, Syddall, H, Rodin, I, Osmond, C, Barker, DJP. Birth weight and the risk of depressive disorder in late life. Br J Psychiatry. 2001; 179, 450–455.CrossRefGoogle ScholarPubMed
4.Lahti, J, Raikkonen, K, Kajantie, E, et al. Small body size at birth and behavioral symptoms of ADHD in children aged five to six years. J Child Psychol Psychiatry. 2006; 47, 1167–1174.Google ScholarPubMed
5.Devaskar, SU, Thamotharan, M. Metabolic programming in the pathogenesis of insulin resistance. Rev Endocr Metab Disord. 2007; 8, 105–113.CrossRefGoogle ScholarPubMed
6.Broekman, BFP, Chan, YK, Chong, YS, et al. The influence of birth size on intelligence in healthy children. Pediatrics. 2009; 123, e1011–e1016.CrossRefGoogle ScholarPubMed
7.Pesonen, AK, Raikkonen, K, Kajantie, E, et al. Fetal programming of temperamental negative affectivity among children born healthy at term. Dev Psychobiol. 2006; 48, 633–643.CrossRefGoogle ScholarPubMed
8.Barker, DJP, Osmond, C, Forsén, TJ, Kajantie, E, Eriksson, JG. Maternal and social origins of hypertension. Hypertension. 2007; 50, 565–571.CrossRefGoogle ScholarPubMed
9.Nathanielsz, PW. Animal models that elucidate basic principles of the developmental origins of adult diseases. ILAR J. 2006; 47, 73–82.Google ScholarPubMed
10.Nathanielsz, PW, Poston, L, Taylor, PD. In utero exposure to maternal obesity and diabetes: animal models that identify and characterize implications for future health. Clin Perinatol. 2007; 34, 515–526, v.CrossRefGoogle ScholarPubMed
11.Kajantie, E, Phillips, DI, Andersson, S, et al. Size at birth, gestational age and cortisol secretion in adult life: foetal programming of both hyper- and hypocortisolism? Clin Endocrinol (Oxf). 2002; 57, 635–641.CrossRefGoogle ScholarPubMed
12.Yogev, Y, Visser, GH. Obesity, gestational diabetes and pregnancy outcome. Semin Fetal Neonatal Med. 2009; 14, 77–84.CrossRefGoogle ScholarPubMed
13.Scott, A, Moar, V, Ounsted, M. The relative contributions of different maternal factors in small-for-gestational-age pregnancies. Eur J Obstet Gynecol Reprod Biol. 1981; 12, 157–165.CrossRefGoogle ScholarPubMed
14.Kramer, MS. Intrauterine growth and gestational duration determinants. Pediatrics. 1987; 80, 502–511.CrossRefGoogle ScholarPubMed
15.Xiong, X, Demianczuk, NN, Saunders, LD, Wang, FL, Fraser, WD. Impact of preeclampsia and gestational hypertension on birth weight by gestational age. Am J Epidemiol. 2002; 155, 203–209.CrossRefGoogle ScholarPubMed
16.Bernstein, PS, Divon, MY. Etiologies of fetal growth restriction. Clin Obstet Gynecol. 1997; 40, 723–729.Google ScholarPubMed
17.Langer, O. Fetal macrosomia: etiologic factors. Clin Obstet Gynecol. 2000; 43, 283–297.CrossRefGoogle ScholarPubMed
18.Yaron, Y, Cherry, M, Kramer, RL, et al. Second-trimester maternal serum marker screening: maternal serum alpha-fetoprotein, beta-human chorionic gonadotropin, estriol, and their various combinations as predictors of pregnancy outcome. Am J Obstet Gynecol. 1999; 181, 968–974.CrossRefGoogle ScholarPubMed
19.Kowalczyk, TD, Cabaniss, ML, Cusmano, L. Association of low unconjugated estriol in the second trimester and adverse pregnancy outcome. Obstet Gynecol. 1998; 91, 396–400.CrossRefGoogle ScholarPubMed
20.Dugoff, L, Hobbins, JC, Malone, FD, et al. Quad screen as a predictor of adverse pregnancy outcome. Obstet Gynecol. 2005; 106, 260–267.CrossRefGoogle ScholarPubMed
21.Goodwin, TM. A role for estriol in human labor, term and preterm. Am J Obstet Gynecol. 1999; 180, S208–S213.CrossRefGoogle ScholarPubMed
22.Peck, JD, Hulka, BS, Savitz, DA, et al. Accuracy of fetal growth indicators as surrogate measures of steroid hormone levels during pregnancy. Am J Epidemiol. 2003; 157, 258–266.CrossRefGoogle ScholarPubMed
23.Salafia, CM, Vintzileos, AM, Silberman, L, Bantham, KF, Vogel, CA. Placental pathology of idiopathic intrauterine growth retardation at term. Am J Perinat. 1992; 9, 179–184.CrossRefGoogle ScholarPubMed
24.Salafia, CM, Zhang, J, Charles, AK, et al. Placental characteristics and birthweight. Paediatr Perinat Epidemiol. 2008; 22, 229–239.CrossRefGoogle ScholarPubMed
25.Barker, DJP, Thornburg, KL, Osmond, C, Kajantie, E, Eriksson, JG. Beyond birthweight: the maternal and placental origins of chronic disease. J Dev Orig Health Dis. 2010; 1, 360–364.CrossRefGoogle ScholarPubMed
26.Holzman, C, Bullen, B, Fisher, R, Paneth, N, Reuss, L. Pregnancy outcomes and community health: the POUCH study of preterm delivery. Paediatr Perinat Ep. 2001; 15, 136–158.CrossRefGoogle ScholarPubMed
27.Gabbe, SG, Niebyl, JR, Simpson, JL. Obstetrics: Normal and Problem Pregnancies, 4th edn, 2002. Elsevier Science: Philadelphia, PA.Google Scholar
28.Levine, RJ, Hauth, JC, Curet, LB, et al. Trial of calcium to prevent pre-eclampsia. New Eng J Med. 1997; 337, 69–77.CrossRefGoogle Scholar
29.Zambrowski, . NHBPEP report on high blood pressure in pregnancy: a summary for family physicians. Am Fam Physician. 2001; 64, 264.Google Scholar
30.Gifford, RW, August, PA, Cunningham, G et al. Report of the National High Blood Pressure Education Program Working Group on high blood pressure in pregnancy. Am J Obstet Gynecol. 2000; 183, S1–S22.Google Scholar
31.Gargano, JW, Holzman, CB, Senagore, PK, et al. Polymorphisms in thrombophilia and renin-angiotensin system pathways, preterm delivery, and evidence of placental hemorrhage. Am J Obstet Gynecol. 2009; 201, 317, e311–319.CrossRefGoogle ScholarPubMed
32.Kelly, R, Holzman, C, Senagore, P, et al. Placental vascular pathology findings and pathways to preterm delivery. Am J Epidemiol. 2009; 170, 148–158.CrossRefGoogle ScholarPubMed
33.Holzman, C, Lin, X, Senagore, P, Chung, H. Histologic chorioamnionitis and preterm delivery. Am J Epidemiol. 2007; 166, 786–794.CrossRefGoogle ScholarPubMed
34.Kramer, MS, Platt, RW, Wen, SW, et al. A new and improved population-based Canadian reference for birth weight for gestational age. Pediatrics. 2001; 108, E35–E41.CrossRefGoogle ScholarPubMed
35.Salafia, CM, Silberman, C, Herrera, N, Mahoney, M. Placental pathology at term associated with elevated midtrimester maternal serum AFP concentration. Am J Obstet Gynecol. 1988; 158, 1064–1066.CrossRefGoogle Scholar
36.Kaijser, M, Granath, F, Jacobsen, G, Cnattingius, S, Ekbom, A. Maternal pregnancy estriol levels in relation to anamnestic and fetal anthropometric data. Epidemiology. 2000; 11, 315–319.CrossRefGoogle ScholarPubMed
37.Ilagan, JG, Stamilio, DM, Ural, SH, Macones, GA, Odibo, AO. Abnormal multiple marker screens are associated with adverse perinatal outcomes in cases of intrauterine growth restriction. Am J Obstet Gynecol. 2004; 191, 1465–1469.CrossRefGoogle ScholarPubMed
38.Bradley, LA, Canick, JA, Palomaki, GE, Haddow, JE. Undetectable maternal serum unconjugated estriol levels in the second trimester: risk of perinatal complications associated with placental sulfatase deficiency. Am J Obstet Gynecol. 1997; 176, 531–535.Google ScholarPubMed
39.Kashork, CD, Sutton, VR, Fonda Allen, JS, et al. Low or absent unconjugated estriol in pregnancy: an indicator for steroid sulfatase deficiency detectable by fluorescence in situ hybridization and biochemical analysis. Prenat Diagn. 2002; 22, 1028–1032.CrossRefGoogle ScholarPubMed
40.Lagiou, P, Samoli, E, Lagiou, A, Hsieh, C, Adami, H, Trichopoulos, D. Maternal height, pregnancy estriol, and birth weight in reference to breast cancer risk in Boston and Shanghai. Int J Cancer. 2005; 117, 494–498.CrossRefGoogle ScholarPubMed
41.Becroft, DMO, Thompson, JMD, Mitchell, EA. The epidemiology of placental infarction at term. Placenta. 2002; 23, 343–351.CrossRefGoogle ScholarPubMed
42.Baergen, RN. Manual of Benirschke and Kaufmann's Pathology of the Human Placenta, 2005. Springer: New York.CrossRefGoogle Scholar
43.Yudkin, PL, Wood, L, Redman, CW. Risk of unexplained stillbirth at different gestational ages. Lancet. 1987; 1, 1192–1194.Google ScholarPubMed
44.Joseph, KS. Incidence-based measures of birth, growth restriction, and death can free perinatal epidemiology from erroneous concepts of risk. J Clin Epidemiol. 2004; 57, 889–897.CrossRefGoogle ScholarPubMed
45.Zhu, MJ, Ford, SP, Means, WJ, Hess, BW, Nathanielsz, PW, Du, M. Maternal nutrient restriction affects properties of skeletal muscle in offspring. J Physiol. 2006; 575, 241–250.CrossRefGoogle ScholarPubMed
46.Gamborg, M, Andersen, PK, Baker, JL, et al. Life course path analysis of birth weight, childhood growth, and adult systolic blood pressure. Am J Epidemiol. 2009; 169, 1167–1178.CrossRefGoogle ScholarPubMed
47.Dahly, DL, Adair, LS, Bollen, KA. A structural equation model of HTE developmental origins of blood pressure. Int J Epidemiol. 2008; 38, 538–548.CrossRefGoogle Scholar
48.Smith, GC, Wood, AM, White, IR, Pell, JP, Hattie, J. Birth weight and the risk of cardiovascular disease in the maternal grandparents. Am J Epidemiol. 2010; 171, 736–744.CrossRefGoogle ScholarPubMed
49.Smith, GC, Pell, JP, Walsh, D. Pregnancy complications and maternal risk of ischaemic heart disease: a retrospective cohort study of 129,290 births. Lancet. 2001; 357, 2002–2006.CrossRefGoogle Scholar
50.Breslau, N, Chilcoat, H, DelDotto, J, Adreski, P, Brown, G. Low birth weight and neurocognitive status at six years of age. Biol Psychiat. 1996; 40, 389–397.CrossRefGoogle ScholarPubMed