Customized versus population birth weight charts for identification of newborns at risk of long-term adverse cardio-metabolic and respiratory outcomes: a population-based prospective cohort study

Abstract

Background Customized birth weight charts take into account physiological maternal characteristics that are known to influence fetal growth to differentiate between physiological and pathological abnormal size at birth. It is unknown whether customized birth weight charts better identify newborns at risk of long-term adverse outcomes than population birth weight charts. We aimed to examine whether birth weight classification according to customized charts is superior to population charts at identification of newborns at risk of adverse cardio-metabolic and respiratory health outcomes. Methods In a population-based prospective cohort study among 6052 pregnant women and their children, we measured infant catch-up growth, overweight, high blood pressure, hyperlipidemia, liver steatosis, clustering of cardio-metabolic risk factors, and asthma at age 10. Small size and large size for gestational age at birth was defined as birth weight in the lowest or highest decile, respectively, of population or customized charts. Association with birth weight classification was assessed using logistic regression models. Results Of the total of 605 newborns classified as small size for gestational age by population charts, 150 (24.8%) were reclassified as appropriate size for gestational age by customized charts, whereas of the total of 605 newborns classified as large size for gestational age by population charts, 129 (21.3%) cases were reclassified as appropriate size for gestational age by customized charts. Compared to newborns born appropriate size for gestational age, newborns born small size for gestational age according to customized charts had increased risks of infant catch-up growth (odds ratio (OR) 5.15 (95% confidence interval (CI) 4.22 to 6.29)), high blood pressure (OR 2.05 (95% CI 1.55 to 2.72)), and clustering of cardio-metabolic risk factors at 10 years (OR 1.66 (95% CI 1.18 to 2.34)). No associations were observed for overweight, hyperlipidemia, liver steatosis, or asthma. Newborns born large-size for gestational age according to customized charts had higher risk of catch-down-growth only (OR 3.84 (95% CI 3.22 to 4.59)). The direction and strength of the observed associations were largely similar when we used classification according to population charts. Conclusions Small-size-for-gestational-age newborns seem to be at risk of long-term adverse cardio-metabolic health outcomes, irrespective of the use of customized or population birth weight charts.

Maternal lipid levels in early pregnancy as a predictor of childhood lipid levels: a prospective cohort study

“…Blood samples were obtained, transported, and stored as described in detail previously [ 16 ]. Serum concentrations of total cholesterol, triglycerides and HDL-c were measured at the Erasmus Medical Centre with enzymatic methods (Cobas 8000, Roche, Almere, the Netherlands) [ 16 , 21 , 22 ]. Levels of LDL-c, remnant cholesterol and non-HDL-c were calculated [ 17 ].…”

Maternal and Perinatal Risk Factors for Pediatric Nonalcoholic Fatty Liver Disease: A Systematic Review

“…The influence of birthweight on developing NAFLD was investigated in nine papers. In two studies, a low birthweight and being born SGA were not significantly associated with the occurrence of NAFLD, with an OR of 1.40 (95% CI: 0.87 -2.26, P=0.17) 25 and 1.77 (95% CI: 0.88 -3.54), respectively 37 . However, rapid catch-up growth after SGA correlated with NAFLD in the study by Breij et al (with an OR of 11.7, 95% CI: 1.12 -113.3, P=0.016) 46 .…”

“…Different diagnostic tools were used for the diagnosis of NAFLD and/or NASH in the included studies: 6 (18.2%) studies employed biopsy 18-23 , 11 (33.3%) studies ultrasound [24][25][26][27][28][29][30][31][32][33][34] , 12 (36.4%) studies MRI 10,[35][36][37][38][39][40][41][42][43][44][45] and the remaining 4 (12.1%) studies the FLI [46][47][48][49] .…”

Second and third trimester fetal ultrasound population screening for risks of preterm birth and small-size and large-size for gestational age at birth: a population-based prospective cohort study

“…This suggests our third trimester screening model may aid in the identification of newborns who are pathologically small or large for their gestational age. We did not use customized birth weight centiles for classification of abnormal size at birth as a method to distinguish potential pathological SGA and LGA newborns from constitutional SGA or LGA newborns, as previous studies have not shown strong results regarding the use of customized charts to identify SGA or LGA newborns at higher risk of mortality and adverse short-term and long-term outcomes [40,41]. A limitation of our cohort is that we do not have extensive information available on neonatal morbidity.…”