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Understanding how maternal social and biological factors are related to fetal growth in an urban South African cohort

  • Alessandra Prioreschi (a1), Stephanie V. Wrottesley (a1), Rihlat Said-Mohamed (a1), Lukhanyo Nyati (a1), Marie-Louise Newell (a2) (a3) and Shane A. Norris (a1)...

Abstract

The aim of this study was to identify social and biological drivers of fetal growth by examining associations with household, preconception, and pregnancy factors in a cohort from Soweto, South Africa. Complete data and ultrasound scans were collected on 519 women between 2013 and 2016 at 6 time points during pregnancy (<14, 14–18, 19–23, 24–28, 29–33 weeks, and 34–38 weeks). Household-level factors, preconception health, baseline body mass index (BMI), and demographic data were collected at the first visit. During pregnancy, gestational weight gain (GWG; kg/week) was calculated. At 24–28 weeks of gestation, oral glucose tolerance test was used to determine gestational diabetes mellitus (GDM) status, and hypertension status was characterised. Longitudinal growth in head circumference, abdominal circumference, biparietal diameter, and femur length were modelled using the Superimposition by Translation and Rotation, a shape-invariant model which produces growth curves against gestational age. A priori identified exposure variables were then included in a series of sex-stratified hierarchical regression models for each fetal growth outcome. No household-level factors were associated with fetal growth. Maternal BMI at baseline was positively associated with all outcome parameters in males and females. Both GWG (in males and females) and GDM (in males) were significant positive predictors of abdominal growth. Males showed more responsiveness to abdominal growth, while females were more responsive to linear growth. Thus, fetal growth was largely predicted by maternal biological factors, and sexual dimorphism in the responsiveness of fetal biometry to biological exposures was evident.

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Corresponding author

Address for correspondence: Dr Alessandra Prioreschi, MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Email: alessandra.prioreschi@wits.ac.za

References

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1.Poirier, P, Giles, TD, Bray, GA, et al.Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association scientific statement on obesity and heart disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2006; 113, 898918.
2.Hanson, M, Gluckman, PDevelopmental origins of noncommunicable disease: population and public health implications. Am J Clin Nutr. 2011; 94, 1754S1758S.
3.Poston, L, Caleyachetty, R, Cnattingius, S, et al.Preconceptional and maternal obesity: epidemiology and health consequences. Lancet Diabetes Endocrinol. 2016; 4(12), 10251036.
4.Wedi, CO, Kirtley, S, Hopewell, S, Corrigan, R, Kennedy, SH, Hemelaar, J. Perinatal outcomes associated with maternal HIV infection: a systematic review and meta-analysis. Lancet HIV. 2016; 3, 3348.
5.Kapisi, J, Kakuru, A, Jagannathan, P, et al.Relationships between infection with Plasmodium falciparum during pregnancy, measures of placental malaria, and adverse birth outcomes. Malar J. 2017; 16, 400.
6.Rahman, MM, Abe, SK, Kanda, M, et al.Maternal body mass index and risk of birth and maternal health outcomes in low- and middle-income countries: a systematic review and meta-analysis. Obes Rev. 2015; 16, 758770.
7.Rahman, MM, Abe, SK, Rahman, MS, et al.Maternal anemia and risk of adverse birth and health outcomes in low- and middle-income countries: systematic review and meta-analysis. Am J Clin Nutr. 2016; 103, 495504.
8.Kim, D, Saada, A.The social determinants of infant mortality and birth outcomes in western developed nations: a cross-country systematic review. Int J Environ Res Public Health. 2013; 10, 22962335.
9.Aizer, A, Currie, J.The intergenerational transmission of inequality: maternal disadvantage and health at birth. Science. 2014; 344, 856861.
10.Richter, LM, Orkin, FM, Roman, GD, et al.Comparative models of biological and social pathways to predict child growth through age 2 years from birth cohorts in Brazil, India, the Philippines, and South Africa. J Nutr. 2018; 148(8), 13641371.
11.Accortt, EE, Cheadle, AC, Dunkel Schetter, C.Prenatal depression and adverse birth outcomes: an updated systematic review. Matern Child Health J. 2015; 19, 13061337.
12.Patra, J, Bakker, R, Irving, H, Jaddoe, VW, Malini, S, Rehm, J.Dose-response relationship between alcohol consumption before and during pregnancy and the risks of low birthweight, preterm birth and small for gestational age (SGA)-a systematic review and meta-analyses. BJOG. 2011; 118, 14111421.
13.Abraham, M, Alramadhan, S, Iniguez, C, et al.A systematic review of maternal smoking during pregnancy and fetal measurements with meta-analysis. PLoS One. 2017; 12, e0170946.
14.Ioannou, C, Talbot, K, Ohuma, E, et al.Systematic review of methodology used in ultrasound studies aimed at creating charts of fetal size. BJOG. 2012; 119(12), 14251439.
15.Black, RE, Victora, CG, Walker, SP, et al.Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013; 382, 27451.
16.Chawanpaiboon, S, Vogel, JP, Moller, AB, et al.Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. Lancet Glob Health. 2019; 7, e37e46.
17.Lee, AC, Katz, J, Blencowe, H, et al.National and regional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010. Lancet Glob Health. 2013; 1, e2636.
18.National Department of Health. The 2015 National Antenatal Sentinel HIV & Syphilis Survey, 2017. National Department of Health, Pretoria, South Africa.
19.Shisana, O, Labadarios, D, Rehle, T, et al.South African National Health and Nutrition Examination Survey (SANHANES-1), 2014. HSRC Press, Cape Town.
20.Macaulay, S, Munthali, RJ, Dunger, DB, Norris, SA.The effects of gestational diabetes mellitus on fetal growth and neonatal birth measures in an African cohort. Diabet Med. 2018; 35(10), 14251433.
21.Wrottesley, SV, Ong, KK, Pisa, PT, Norris, SA.Maternal traditional dietary pattern and antiretroviral treatment exposure are associated with neonatal size and adiposity in urban, black South Africans. Br J Nutr. 2018; 120(5), 557566.
22.Macaulay, S, Buchmann, EJ, Dunger, DB. Reliability and validity of last menstrual period for gestational age estimation in a low-to-middle-income setting. J Obstet Gynaecol Res. 2019; 45(1), 217225.
23.Papageorghiou, AT, Ohuma, EO, Altman, DG, et al.International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project. Lancet. 2014; 384, 869879.
24.Sarris, I, Ioannou, C, Ohuma, EO, et al.Standardisation and quality control of ultrasound measurements taken in the INTERGROWTH-21st project. BJOG. 2013; 120 (Suppl 2), 3337.
25.Cole, T, Donaldson, M, Ben-Shlomo, Y.SITAR-a useful instrument for growth curve analysis. Int J Epidemiol. 2010; 39(6), 15581566.
26.Griffiths, PL, Johnson, W, Cameron, N, Pettifor, JM, Norris, SA.In urban South Africa, 16 year old adolescents experience greater health equality than children. Econ Hum Biol. 2013; 11(4), 502514.
27.Kagura, J, Adair, LS, Pisa, PT, Griffiths, PL, Pettifor, JM, Norris, SA.Association of socioeconomic status change between infancy and adolescence, and blood pressure, in South African young adults: Birth to Twenty Cohort. BMJ Open. 2016; 6(3), e008805.
28.Krukowski, RA, West, DS, DiCarlo, M, et al.Are early first trimester weights valid proxies for preconception weight? BMC Pregnancy Childbirth. 2016; 16, 357.
29.World Health Organization. Diagnostic Criteria and Classification of Hyperglycaemia First Detected in Pregnancy, 2013. World Health Organization, Geneva, Switzerland
30.Barisic, T, Mandic, V, Barac, I.Associations of body mass index and gestational weight gain with term pregnancy outcomes. Mater Sociomed. 2017; 29(1), 5257.
31.Hunt, KJ, Alanis, MC, Johnson, ER, Mayorga, ME, Korte, JE.Maternal pre-pregnancy weight and gestational weight gain and their association with birthweight with a focus on racial differences. Matern Child Health J. 2012; 17(1), 8594.
32.Prioreschi, A, Wrottesley, S, Draper, CE, et al.Maternal and early life nutrition and physical activity: setting the research and intervention agenda for addressing the double burden of malnutrition in South African children. Glob Health Action. 2017; 10(1), 1301085.
33.Wrottesley, SV, Lamper, C, Pisa, PT.Review of the importance of nutrition during the first 1000 days: maternal nutritional status and its associations with fetal growth and birth, neonatal and infant outcomes among African women. J Dev Orig Health Dis. 2016; 7(2), 144162.
34.Ruager-Martin, R, Hyde, MJ, Modi, N.Maternal obesity and infant outcomes. Early Hum Dev. 2010; 86(11), 715722.
35.Gishti, O, Gaillard, R, Manniesing, R, et al.Fetal and infant growth patterns associated with total and abdominal fat distribution in school-age children. J Clin Endocrinol Metab. 2014; 99(7), 25572566.
36.Bamberg, C, Hinkson, L, Henrich, W.Prenatal detection and consequences of fetal macrosomia. Fetal Diagn Ther. 2013; 33(3), 143148.
37.Segovia, SA, Vickers, MH, Reynolds, CM.The impact of maternal obesity on inflammatory processes and consequences for later offspring health outcomes. J Dev Orig Health Dis. 2017; 8(05), 529540.
38.Bourke, CD, Berkley, JA, Prendergast, AJ.Immune dysfunction as a cause and consequence of malnutrition. Trends Immunol. 2016; 37(6), 386398.
39.Wells, JC, Chomtho, S, Fewtrell, MS.Programming of body composition by early growth and nutrition. Proc Nutr Soc. 2007; 66(3), 423434.
40.Macdonald-Wallis, C, Tilling, K, Fraser, A, Nelson, SM, Lawlor, DA.Gestational weight gain as a risk factor for hypertensive disorders of pregnancy. Am J Obstet Gynecol. 2013; 209(4), 327.e1327.e17.
41.Bakker, R, Steegers, EA, Hofman, A, Jaddoe, VW.Blood pressure in different gestational trimesters, fetal growth, and the risk of adverse birth outcomes: the generation R study. Am J Epidemiol. 2011; 174(7), 797806.
42.Eriksson, JG, Kajantie, E, Osmond, C, Thornburg, K, Barker, DJ.Boys live dangerously in the womb. Am J Hum Biol. 2010; 22(3), 330335.
43.Broere-Brown, ZA, Baan, E, Schalekamp-Timmermans, S, Verburg, BO, Jaddoe, VWV, Steegers, EAP.Sex-specific differences in fetal and infant growth patterns: a prospective population-based cohort study. Biol Sex Differ. 2016; 7(1), 65.

Keywords

Understanding how maternal social and biological factors are related to fetal growth in an urban South African cohort

  • Alessandra Prioreschi (a1), Stephanie V. Wrottesley (a1), Rihlat Said-Mohamed (a1), Lukhanyo Nyati (a1), Marie-Louise Newell (a2) (a3) and Shane A. Norris (a1)...

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