Birth Weight and Perinatal Mortality: A Comparison of “Optimal” Birth Weight in Seven Western European Countries

Graafmans, Wilco C.; Richardus, Jan Hendrik; Borsboom, Gerard; Bakketeig, Leiv S.; Langhoff‐Roos, Jens; Bergsjø, Per; Macfarlane, Alison; Verloove-Vanhorick, S.P.; Mackenbach, Johan P.

doi:10.1097/00001648-200209000-00013

Cited by 73 publications

(48 citation statements)

References 31 publications

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“…It should be noted, however, that the optimum birth weight is a populationspecific finding; comparative studies suggesting that "optimal" birth weights (eg, those associated with the lowest perinatal mortality) differ between populations and are highly correlated with the population modal birth weight (ie, populations with a lower average birth weight also have a lower optimal birth weight). 24 This highlights the importance of viewing birth weight relative to the population-specific distribution rather than as an absolute figure. 25 A greater prevalence of diabetes or gestational diabetes among mothers of higher birth-weight babies may account for the reversal in the association at the high birth-weight end of the distribution 1 if pregnancy hyperglycemia influences both birth weight and later blood pressure in offspring.…”

Section: Discussionmentioning

confidence: 99%

Association Between Birth Weight and Blood Pressure Is Robust, Amplifies With Age, and May Be Underestimated

et al. 2006

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Abstract-Data on the early life origins of adult hypertension have been widely reported: however, recent research shows that the strength of association between small size at birth and higher blood pressure weakens as study size increases.In this article, we retest the association between birth weight and systolic blood pressure in a large cohort, examine whether age interacts with birth weight to predict blood pressure, and explore reasons why birth weight-blood pressure associations tend to weaken with increasing study size. Key Words: blood pressure Ⅲ epidemiology Ⅲ infant nutrition Ⅲ blood pressure determination T he "fetal origins" hypothesis suggests that "insults" at critical periods during fetal development can lead to permanent metabolic and structural changes in the fetus increasing the risk of many diseases in adulthood. 1 One key finding in support of this hypothesis is the observation, now replicated in many populations, that lower birth weight is associated with higher adult systolic blood pressure (SBP) 1,2 : an association observed independently of socioeconomic position. 3 Surprisingly, despite the wealth of literature in this field, the precise nature of the association between birth weight and blood pressure remains contentious.One important area of recent debate has focused on the strength of association between birth weight and blood pressure. In the most recent systematic review, Huxley et al 4 concluded that birth weight had little relevance in determining blood pressure levels in later life. This finding was at odds with previous systematic reviews, which have suggested that SBP decreases by between 2 and 4 mm Hg for each 1-kg increase in birth weight. 5,6 Central to the argument put forward by Huxley et al 4 was that after ordering studies by statistical size (derived from the inverse of the variance of the regression coefficient), a clear trend (PϽ0.0001) was observed toward weaker associations between birth weight and blood pressure in the larger studies. In small studies (typically with Ͻ1000 participants), a 1-kg increase in birth weight was associated with a 1.9 mm Hg decrease in SBP, whereas in large studies (typically with Ͼ3000 participants), SBP was reduced by only 0.6 mm Hg/kg. Huxley et al 4 suggested that this was evidence of publication bias, with smaller studies being more likely to be published if they found strong inverse birth weight-blood pressure associations. 7 The authors argued that because larger studies are known to be less prone to publication bias, a decrease of 0.6 mm Hg/kg was nearer to the true association. An additional contentious area in the literature has been the actual nature of the association between birth weight and blood pressure. Even within the large studies reviewed by Huxley et al, 4 the association was inconsistent, with some large studies reporting a perfectly linear association across the birth weight continuum 8 and others reporting a reverse J-shape pattern, whereby those individuals with the highest birth weight also tended toward slightly...

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Section: Discussionmentioning

confidence: 99%

Association Between Birth Weight and Blood Pressure Is Robust, Amplifies With Age, and May Be Underestimated

et al. 2006

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“…Risk ratios (RR) of gestational hypertension/preeclampsia were calculated for low birth weight using cut-off Ͻ2750 g because of low prevalence of birth weight of Յ2500 g in Finland 19 and in preterm (Ͻ37 gestational weeks) groups.…”

Section: Discussionmentioning

confidence: 99%

Manifestations of Metabolic Syndrome After Hypertensive Pregnancy

et al. 2004

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Abstract-Small follow-up studies of hospital-based series indicate women with preeclampsia have an increased risk of insulin resistance postpartum. However, long-term data are lacking among women with gestational hypertension without proteinuria. Using a general population-based sample of 5889 women from Northern Finland followed longitudinally since birth in 1966, we examined these associations and the influence of the subject's own birth weight and gestational age on this relationship. At age 31, blood pressure was measured and blood samples collected from 2678 women, of which 1463 women had had at least 1 singleton pregnancy. Of these, 45 had been hospitalized because of gestational hypertension and 49 because of preeclampsia. Women who had had either gestational hypertension or preeclampsia during their first pregnancy (average age 25 years) had increased blood pressure at 31 years compared with women with previous normotensive pregnancy, even after adjustment for body mass index (PϽ0.001 in gestational hypertension, Pϭ0.023 in preeclampsia group). When compared with the whole female population, women with previous gestational hypertension at same age still had higher blood pressure, while this difference was weaker for women with previous preeclampsia. Women with gestational hypertension and preeclampsia also had higher waist circumference, waist/hip ratio, and body mass index, as well as increased serum insulin levels and lower glucose/insulin ratio than women with previous normotensive pregnancy. The associations remained after adjustment for participant's own birth weight or gestational age. Women born before gestational week 37 had a 2-fold risk for gestational hypertension in their first pregnancy (RR: 2.53; 95% CI: 1.0, 6.2). Key Words: cohort studies Ⅲ hypertension Ⅲ low birth weight Ⅲ insulin resistance Ⅲ longitudinal studies Ⅲ preeclampsia Ⅲ pregnancy T he pathophysiology of de novo hypertension in pregnancy, ie, preeclampsia and transient gestational (nonproteinuric) hypertension, is poorly understood. 1 There are some indications that insulin resistance may play a role. 2 Five postpartum studies showed that women with a history of preeclampsia are more often hyperinsulinemic 3-7 than those with normotensive pregnancies, although this has not been confirmed in all studies. 8 These women may be at higher risk for cardiovascular diseases, 9 -11 but so far the study populations of the postpartum studies of insulin resistance were small and the follow-up periods short (Ͻ1 year), except 2 studies until postmenopause. 5,7 To our knowledge, there are no previous long-term studies of insulin resistance in women with a history of gestational hypertension. Several studies also suggest that low birth weight is associated with increased cardiovascular disease risk in adults, 12,13 and 2 indicate a positive association between own preterm birth/low birth weight and later preeclampsia, 14,15 although data are lacking for women with gestational hypertension only.In this population-based prospective study, we tes...

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“…Ethnicity has also an important effect on fetal growth [29] and birth weight [21-26, 28, 30] . Graafmans et al [30] compared birth weights in 7 Western European countries and found substantial differences between countries. They concluded that to improve the identification of growth-restricted infants, population-specific standards for birth weight should be developed.…”

Section: Physiological Factors Influencing Birth Weightmentioning

confidence: 99%

Should We Customize Fetal Growth Standards?

Figueras

Gardosi

2009

Fetal Diagn Ther

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Several maternal and fetal physiological characteristics account for a substantial proportion of the variation in birth weight. These characteristics can be used to calculate an individualized optimal birth weight and to adjust or ‘customize’ the birth weight standard. Customized birth weight standards improve the distinction between constitutional and pathological smallness, and there is evidence that this finding can be extrapolated into the fetal period to evaluate intrauterine growth, but further studies are required to evaluate and quantify the effectiveness of customized versus conventional charts in improving the diagnosis of pathological smallness before birth.

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Birth Weight and Perinatal Mortality: A Comparison of “Optimal” Birth Weight in Seven Western European Countries

Abstract: Our results confirm those of previous studies that compared two populations. To improve the identification of small babies at high risk of perinatal death, population-specific standards for birth weight should be developed and used.

Cited by 73 publications

References 31 publications

Association Between Birth Weight and Blood Pressure Is Robust, Amplifies With Age, and May Be Underestimated

Association Between Birth Weight and Blood Pressure Is Robust, Amplifies With Age, and May Be Underestimated

Manifestations of Metabolic Syndrome After Hypertensive Pregnancy

Should We Customize Fetal Growth Standards?

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