Term Birth Weight and Neurodevelopmental Outcomes

Abstract

Background: Preterm birth is an important risk factor for neurodevelopmental disabilities. The vast majority of these disabilities occur, however, among term births. The role of fetal growth restriction specifically among term babies has been incompletely described. Methods: We conducted a population-based study of term birth weight and its link to a range of neurodevelopmental outcomes using Norwegian health registries. To remove the influence of preterm birth, we restricted our analyses to 1.8 million singleton babies born during a narrow range of term gestational age (39-41 weeks). Babies with malformations were excluded. We adjusted analyses simply for year of birth, as further adjustments for sex, parity, maternal age, smoking, marital status, immigrant status, and parental education had trivial influence. An additional sibling analysis controlled for unmeasured family-based confounding. Results: The risk of neurodevelopmental disabilities at term steadily increased at birth weights lower than 3.5 kg. Using the category of 3.5-3.9 kg as the reference, the odds reached 25-fold for cerebral palsy at the smallest weights (95% confidence interval 8.0, 79), 16-fold for vision/hearing disability (4.0, 65), 11-fold for intellectual impairment (6.9, 17), 7-fold for schizophrenia (1.0, 50), 5.4-fold for epilepsy (2.6, 12), and 3.5-fold for autism spectrum (1.3, 9.4) and behavioral disorders including attention-deficit hyperactivity disorder (2.1, 5.4). Associations remained robust with sibling controls. Conclusions: Reduced fetal growth is a powerful predictor of a wide variety of neurodevelopmental disabilities independent of preterm delivery.

Benefits and harms associated with an increase in gestational diabetes diagnosis in Queensland, Australia: a retrospective cohort comparison of diagnosis rates, outcomes, interventions and medication use for two periods, 2011–2013 and 2016–2018, using a large perinatal database

“…Infant mortality until 1 year of age is lowest in LGA babies, with mortality rates also increasing as birth weights decrease 74. The reduction of birth weight with GDM treatment reduces lean mass more than fat,75 and decreasing birth weights across most of the birth weight range are associated with increased adult all-cause mortality, cardiovascular disease, stroke and type 2 diabetes,76–78 decreased child, adolescent and adult lean mass, muscularity, strength, cardiovascular fitness and bone density,79–85 increased adolescent abdominal adiposity,86 and adverse neurodevelopmental outcomes (including cerebral palsy, autism, intellectual impairment and attention deficit hyperactivity disorder) 87 88. Neonatal adiposity may actually be associated with improved childhood insulin sensitivity and decreased adult cardiovascular disease 89 90…”

Preterm birth, poor foetal growth and anxiety disorders in a Finnish nationwide register sample

“…Comorbid depressive (ICD‐10: F32–F39) and neurodevelopmental disorders (ICD‐10: F70–F71, F78–F84, F90, F95) were chosen, and these diagnoses were given at any time during the study period. These comorbidities have been reported to be common among children and adolescents with anxiety disorders, 2,18 and they have been associated with preterm birth or poor foetal growth 9,10,19,20 …”

“…The diagnoses were obtained from the Care Register for Health Care, and the clinician made diagnoses included the following International Classification of Diseases, among children and adolescents with anxiety disorders, 2,18 and they have been associated with preterm birth or poor foetal growth. 9,10,19,20 The group of pure anxiety disorders comprised of those cases, who had no other psychiatric disorder diagnoses during the study period.…”

Characterizing the physical and mental health profile of children, adolescents and adults with autism spectrum disorder in Spain

“…All of these areas are amenable to further investigation. Although the conclusions are still speculative, there seems to exist an association with maternal lifestyle and subsequent diseases (obesity, diabetes, epilepsy and antiepileptic drugs, among others), exposure to specific nutrients and pollutants during pregnancy, advanced parental age and birth complications associated with neonatal hypoxia/ischemia (56, [75][76][77]. Unfortunately, those risk conditions were not included in the registry, and more research is needed to explore their contribution to ASD etiology.…”