Associations of Fetal and Infant Growth Patterns With Early Markers of Arterial Health in School-Aged Children

Gonçalves, Romy; Wiertsema, Clarissa J; Silva, Carolina C V; Monasso, Giulietta S; Gaillard, Romy; Steegers, Eric A.P.; Santos, Susana; Jaddoe, Vincent W. V.

doi:10.1001/jamanetworkopen.2022.19225

Cited by 4 publications

(2 citation statements)

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“…In present study, we have expanded on these findings to FL and AC in the CRGS before delivery. Given the importance of this developmental stage for childhood cognitive function and cardiovascular health in later life, our study provides valuable insights into a potential pathway by which maternal depressive symptoms can contribute to adverse health outcomes via late-pregnancy fetal growth restriction.…”

Section: Discussionmentioning

confidence: 99%

“…This critical stage also plays a crucial role in the development and maturation of fetal white matter, [9][10][11] with synapse formation peaking at 34 weeks of gestation, 12 playing a fundamental role in shaping early neural circuits. 13 Due to the essential role of CRGS, disrupted fetal growth during this stage has complex and profound implications for offspring health, which have been shown to be associated with early markers of impaired arterial health 14 as well as increased overweight and obesity risk at age 4 years. 15 However, understanding of the risk factors associated with fetal growth during this critical stage remains limited.…”

Section: Introductionmentioning

confidence: 99%

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Maternal Prenatal Depressive Symptoms and Fetal Growth During the Critical Rapid Growth Stage

Zhang,

Li,

et al. 2023

JAMA Netw Open

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ImportanceFetal growth in the critical rapid growth stage (CRGS) before delivery, approximately between 30 to 37 gestational weeks, carries significant implications for subsequent overweight, obesity, and arterial health. Previous evidence has demonstrated the association between maternal depressive symptoms and fetal growth trajectories from early to late pregnancy, but there remains limited understanding of the association of these symptoms with the longitudinal fetal growth change within the CRGS.ObjectiveTo investigate the association between maternal depressive symptoms and fetal growth during the CRGS before delivery.Design, Setting, and ParticipantsThis prospective birth cohort study was conducted from January 2018 to December 2020. Volunteer pregnant women were enrolled in their first trimester of prenatal visits. Women with severe disease before pregnancy and multiple births, fetuses with congenital anomalies, and preterm or postterm births were excluded. This multicenter study was based in 13 hospitals covering 81 counties across 12 cities in Sichuan Province, China. Follow-up visits were performed at the second trimester, the third trimester, and 24 hours after delivery. The analysis was conducted from January to May 2023.ExposuresMaternal depressive symptoms, as a continuous variable, measured by the Edinburgh Postpartum Depression Scale (EPDS) at a median gestational week of 24 (range, 14 to 27) weeks of gestation. A higher score on the EPDS indicates worse depressive symptoms.Main Outcomes and MeasuresThe main outcomes included ultrasonography-measured biparietal diameter (BPD), femur length (FL), and abdominal circumference (AC), along with calculated estimated fetal weight (EFW). These parameters were evaluated longitudinally at a median gestational week of 30 (range, 28 to 32) and 37 (range, 35 to 39) weeks. Linear mixed models were used to estimate the associations between maternal depressive symptoms and fetal growth parameters.ResultsA total of 2676 mother-offspring dyads were included, in which the mean (SD) age of mothers was 28.0 (4.4) years, and 1294 (48.4%) of the offspring were female. The median (IQR) maternal EPDS score was 5.0 (4.0 to 9.0). After adjustment for confounders, a significant correlation was found between a higher score of depressive symptoms in mothers and a slower rate of fetal growth across FL (β = −0.40; 95% CI, −0.58 to −0.22), AC (β = −1.97; 95% CI, −2.90 to −1.03), and EFW (β = −50.11; 95% CI, −68.46 to −31.75). These associations were stronger in female fetuses or those with better family socioeconomic conditions.Conclusions and RelevanceIn this prospective cohort study, maternal depressive symptoms were associated with slower fetal growth rate in the CRGS before delivery. Early screening for depressive disorders in pregnant women appears to be essential for fetal growth and later health.

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Section: Discussionmentioning

confidence: 99%