Pre‐pregnancy risk factors of small‐for‐gestational age births among parous women in Scandinavia

Bakketeig, Leiv S.; Jacobsen, Geir; Hoffman, Howard J.; Lindmark, Gunilla; Bergsjø, Per; Molne, K; Rødsten, Judith

doi:10.3109/00016349309068037

Cited by 145 publications

(159 citation statements)

References 22 publications

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“…The study is based on the Norwegian part of an international study among pregnant women in 1985 -1986, described in detail elsewhere (Bakketeig et al, 1993). Briefly, Caucasian women with one or two singleton births were included.…”

Section: Methodsmentioning

confidence: 99%

Association of size at birth with adolescent hormone levels, body size and age at menarche: relevance for breast cancer risk

et al. 2008

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Birth size has been positively associated with age at menarche and height in adolescence and adulthood, but the relevant biological mechanisms remain unclear. Among 262 Norwegian term-born singleton girls, birth size measures (weight, length, ponderal index, head circumference and subscapular skin-fold thickness) were analysed in relation to adolescent hormone levels (oestradiol, prolactin, dehydroepiandrosterone sulphate, androstenedione and free testosterone index), age at menarche and adolescent (ages 12.7 -15.5 years) and body size (height, weight, body mass index and waist-to-hip ratio) using survival analysis and general linear modelling. The results were adjusted for gestational age at birth, age and menarcheal status at measurement in adolescence and maternal age at menarche. Birth weight, birth length and head circumference were positively associated with adolescent weight and height, and small birth size was associated with earlier age at menarche. Subscapular skin-fold thickness at birth was not associated with adolescent body size, but low fold-thickness was associated with earlier age at menarche. Measures of birth size were inversely related to circulating levels of dehydroepiandrosterone sulphate in adolescence, but there was no clear association with other hormones. These results suggest that physical and sexual development in puberty and adolescence is influenced by prenatal factors, and in combination, these factors may influence health and disease later in life. (Trichopoulos, 1990) has stimulated studies of birth size in relation to risk factors for BC (Okasha et al, 2003). Birth size is an indicator of foetal growth and may reflect intrauterine exposure to oestrogen, the key factor that was originally proposed to explain a possible association between intrauterine factors and adult BC (Trichopoulos, 1990). Studies have shown that relatively large birth size is associated with later age at menarche (Adair, 2001;Sloboda et al, 2007) and taller body height, both in adolescence (Pietiläinen et al, 2001;Romundstad et al, 2003) and in adulthood (Loos et al, 2002). Adult tallness is associated with higher BC risk, and the positive association between birth size and body height suggests that longitudinal growth in childhood and adolescence may be important determinants for subsequent BC (Michels and Willett, 2004). Birth size has also been inversely related to adrenal androgen production during childhood (Ong et al, 2004) and adolescence (Ibanez et al, 1999). Adult levels of both adrenal and gonadal androgens have been associated with BC risk (Kaaks et al, 2005a, b). The fact that small birth size is associated with earlier age at menarche and higher circulating levels of adrenal androgens cannot be easily reconciled with known BC risk factors, as small birth size may be related to reduced risk, and both early age at menarche and androgens are expected to increase risk.We have examined the relation between birth size characteristics and potential BC risk factors (ESHRE Capri Workshop Group, 2004),...

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Section: Methodsmentioning

confidence: 99%

Association of size at birth with adolescent hormone levels, body size and age at menarche: relevance for breast cancer risk

et al. 2008

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“…This was a prospective study with an aim to identify causes and consequences of being born SGA. The design of the study has been published in detail elsewhere (20). Briefly, Scandinavian participants were recruited between 1 January 1986 and 31 March 1988 at the university hospitals in Trondheim and Bergen (Norway) and Uppsala (Sweden).…”

Section: Subjectsmentioning

confidence: 99%

Maternal testosterone levels during pregnancy are associated with offspring size at birth

2006

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Objective: Animal studies have indicated that maternal androgen levels influence the intrauterine environment and development of the offspring. Human data are missing. We therefore investigated the possible association between maternal androgens and offspring size at birth in humans. Design: A random sample of parous Caucasian women (nZ147) was followed prospectively through pregnancy. Methods: Maternal serum levels of dehydroepiandrosterone sulfate (DHEAS), androstenedione, testosterone and sex hormone-binding globulin (SHBG) were measured at gestational weeks 17 and 33. The main outcome measures were weight and length at birth. Associations between maternal androgen levels and offspring birth weight and length were investigated using multiple linear regression modeling adjusted for potential confounding by maternal height, pre-pregnancy body mass index, smoking, parity, offspring gender and gestational age at birth. Results: Elevated maternal testosterone levels at week 17 and 33 were both associated with lower birth weights and lengths. Accordingly, at week 17, an increase in maternal testosterone levels from the 25th to the 75th percentile was associated with a decrease in birth weight by 160 g (95% confidence interval (CI); 29-290 g), while at week 33 that estimate was 115 g (95% CI; 21-207 g). No similar associations were observed for DHEAS, androstenedione or SHBG. Conclusions: Elevated maternal testosterone levels during human pregnancy are associated with growth restriction in utero. Our results support animal studies, which have indicated that maternal androgen levels influence intrauterine offspring environment and development.

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“…If any of them delivered a child that was classified as SGA, the birth was considered eligible and included in the detailed follow-up during the first year of life and at 5 years, even if detailed prenatal data were not available. The recruitment of participants is described in detail by Bakketeig et al (6).…”

Section: Recruitment and Data Collection In The Successive Sga Studymentioning

confidence: 99%

“…That included a separate training program to improve and harmonize their skills in ultrasonography. At birth, comprehensive delivery and placenta information, including umbilical cord blood, was collected (6). A detailed pediatric examination was conducted according to a separate study protocol.…”

Section: Figurementioning

confidence: 99%

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The Scandinavian Small-for-Gestational Age (SGA) pregnancy and birth cohort – A source to continual insight into fetal growth restriction and long term physical and neurodevelopmental health in mother and offspring

Kjøbli¹,

Bach²,

Skogseth³

et al. 2016

Nor J Epidemiol

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Human in utero growth restriction (IUGR) is associated with an increased risk for perinatal mortality and morbidity among newborns and infants. To pursue this challenge, a Request For Proposals (RFP) was issued in 1983 by The U.S. Epidemiology and Biometry Research Program at the National Institute of Child Health and Human Development (NICHD). A consortium was set up at the universities and university hospitals in Trondheim, Bergen (Norway) and Uppsala (Sweden) and was funded by the NICHD to conduct the Scandinavian Successive Small-for-Gestational Age (SGA) Pregnancy and Birth Outcome Study. The study design included a comprehensive biobank with maternal and cord serum samples, placental tissue, and a multitude of data collected from interviews, questionnaires, and clinical examinations.The SGA cohort study involved 6,354 Caucasian pregnant women in the three study sites who expected their second or third child from 1986-88. The study women were screened in early second trimester and mothers who had an increased risk to deliver a smaller than expected newborn were followed in detail through the second half of pregnancy and at birth. Selected children were screened several times through their first and up to five years of age. Moreover, a highly selected subgroup in Trondheim has been followed at 14, 19, and 26 years' age.Almost thirty years later, we have searched the body of scientific publications that originated from this cohort study in an attempt to assess if and to what extent the main aims and objectives were achieved and to summarize the overall outcomes. The SGA cohort has resulted in close to 100 published papers in peer reviewed journals and some 40 graduate and undergraduate degrees. Risk factors of SGA, like maternal smoking, low prepregnancy weight and education attainment, and a previous SGA birth outcome were confirmed. Conversely, no totally new and unknown risk factors were identified. Serial ultrasound measures have enabled a distinction between SGA with restricted and normal intrauterine growth, and has further indicated that being born SGA is mainly a problem in combination with IUGR. Further, the consequences of IUGR are more pronounced at adolescence and young adulthood than at five years of age.An increased understanding of the pathogenesis of different categories of growth restriction is essential to recognize and diagnose IUGR properly, and to reduce the perinatal mortality and morbidity from SGA. Moreover, SGA is a significant predictor at follow-up of the child. An up to date biobank has ensured the quality of data and biological samples, and has been crucial for the outcome of the entire SGA study. It continues to be a valuable resource in future research.This is an open access article distributed under the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Pre‐pregnancy risk factors of small‐for‐gestational age births among parous women in Scandinavia

Cited by 145 publications

References 22 publications

Association of size at birth with adolescent hormone levels, body size and age at menarche: relevance for breast cancer risk

Association of size at birth with adolescent hormone levels, body size and age at menarche: relevance for breast cancer risk

Maternal testosterone levels during pregnancy are associated with offspring size at birth

The Scandinavian Small-for-Gestational Age (SGA) pregnancy and birth cohort – A source to continual insight into fetal growth restriction and long term physical and neurodevelopmental health in mother and offspring

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