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Postnatal growth in children born small for gestational age with and without smoking mother
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk obstetrik.ORCID-id: 0000-0003-4427-1075
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk obstetrik.ORCID-id: 0000-0001-6431-3303
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning.
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2019 (Engelska)Ingår i: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 85, nr 7, s. 961-966Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Maternal smoking impairs fetal growth; however, if postnatal growth differs between children born small for gestational age (SGA) with smoking and non-smoking mother is unknown.

Methods: Cohort-study of term born children born appropriate for gestational age with non-smoking mother (AGA-NS, n=30,561), SGA (birthweight <10th percentile) with smoking mother (SGA-S, n=171) or SGA with non-smoking mother (SGA-NS, n=1761). Means of height and weight measurements, collected at birth, 1.5, 3, 4 and 5 years, were compared using a generalized linear mixed effect model. Relative risks of short stature (<10th percentile) were expressed as adjusted risk ratios (aRR).

Results: At birth, children born SGA-S were shorter than SGA-NS, but they did not differ in weight. At 1.5 years, SGA-S had reached the same height as SGA-NS. At 5 years, SGA-S were 1.1 cm taller and 1.2 kg heavier than SGA-NS. Compared with AGA-NS, SGA-S did not have increased risk of short stature at 1.5 or 5 years, while SGA-NS had increased risk of short stature at both ages; aRRs 3.0 (95% CI 2.6;3.4) and 2.3 (95% CI 2.0;2.7), respectively.

Conclusions: Children born SGA-S have a more rapid catch-up growth than SGA-NS. This may have consequences for metabolic and cardiovascular health in children with smoking mothers.

Ort, förlag, år, upplaga, sidor
2019. Vol. 85, nr 7, s. 961-966
Nationell ämneskategori
Reproduktionsmedicin och gynekologi Pediatrik
Identifikatorer
URN: urn:nbn:se:uu:diva-374779DOI: 10.1038/s41390-019-0352-5ISI: 000468524800013PubMedID: 30808020OAI: oai:DiVA.org:uu-374779DiVA, id: diva2:1282145
Forskningsfinansiär
Vetenskapsrådet, 2014-3561Tillgänglig från: 2019-01-24 Skapad: 2019-01-24 Senast uppdaterad: 2019-09-05Bibliografiskt granskad
Ingår i avhandling
1. Born Small for Gestational Age: Beyond Size at Birth
Öppna denna publikation i ny flik eller fönster >>Born Small for Gestational Age: Beyond Size at Birth
2019 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Children born small for gestational age (SGA) run increased risk of perinatal morbidity and mortality, but also of long-term health impairment. Risks on long term may vary depending on postnatal growth patterns. The overall aim of the thesis was to gain further knowledge about long-term consequences of being born SGA, as well as the impact of perinatal exposures on postnatal growth patterns. The thesis is based on four register-based cohort studies.

In paper I, risk of chronic hypertension was assessed in 731,008 first-time mothers. Perinatal exposure to pre-eclampsia, being born SGA and preterm were all independently associated with increased risk of chronic hypertension. The risk was further enhanced after combined exposure. The strongest association was seen in combinations including pre-eclampsia.

In paper II, risk of poor school performance at time of graduation from compulsory school was assessed in 1,088,980 children born SGA at term. Being born SGA was associated with increased risk of poor school performance, following a dose-response pattern with increased risk even for birthweight for gestational age (GA) –1.01 to –2 SD. Boys with short adult stature were associated with higher risk of poor school performance than those with non-short stature.

In paper III, differences in postnatal growth patterns depending on SGA status and maternal smoking habits were assessed in 32,493 children. Children born SGA with smoking mothers had a more rapid catch-up growth than those with non-smoking mothers. Compared with children born appropriate for GA (AGA) with non-smoking mothers, only children born SGA with non-smoking mothers were associated with increased risk of short stature at 1.5 and 5 years.

In paper IV, differences in postnatal growth patterns until age five years, depending on SGA status and GA at birth, were assessed in 41,669 children born between 32-40 gestational weeks. Being born SGA and moderate to late preterm was associated with shorter stature and lower BMI, compared with being born AGA at term. SGA status had greater impact on growth and body proportions than GA at birth.

In conclusion, children born SGA are at higher risk of chronic hypertension and cognitive impairment than children born AGA. Postnatal growth patterns vary in children born SGA, depending on intrauterine exposure to smoking and GA at birth. This may modify risks of long-term health impairment.

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis, 2019. s. 89
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1543
Nyckelord
Small for Gestational Age, SGA, Epidemiology, Pregnancy, Postnatal growth, Intrauterine growth restriction, Chronic hypertension, School performance
Nationell ämneskategori
Reproduktionsmedicin och gynekologi
Forskningsämne
Obstetrik och gynekologi
Identifikatorer
urn:nbn:se:uu:diva-374782 (URN)978-91-513-0581-3 (ISBN)
Disputation
2019-04-12, Humanistiska teatern, Engelska parken, Thunbergsv. 3H, Uppsala, 13:15 (Svenska)
Opponent
Handledare
Tillgänglig från: 2019-03-21 Skapad: 2019-02-20 Senast uppdaterad: 2019-05-07

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Lindström, LindaWikström, Anna-KarinBergman, EvaMulic-Lutvica, AjlanaHögberg, UlfAhlsson, FredrikLundgren, Maria

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Lindström, LindaWikström, Anna-KarinBergman, EvaMulic-Lutvica, AjlanaHögberg, UlfAhlsson, FredrikLundgren, Maria
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Klinisk obstetrikObstetrisk och reproduktiv hälsoforskningPerinatal, neonatal och barnkardiologisk forskning
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