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Maternal exposure to low-to-medium altitude and birth outcomes: evidence from a population-based study in Chinese newborns

Published online by Cambridge University Press:  14 July 2020

Binyan Zhang Open the ORCID record for Binyan Zhang [Opens in a new window] ,
Wentao Wu ,
Guoshuai Shi ,
Baibing Mi ,
Fangyao Chen ,
Ruo Zhang ,
Danmeng Liu ,
Yijun Kang ,
Suhang Shang  and
Hong Yan
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Binyan Zhang
Affiliation:
Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi710061, People’s Republic of China
Wentao Wu
Affiliation:
Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi710061, People’s Republic of China
Guoshuai Shi
Affiliation:
Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi710061, People’s Republic of China
Baibing Mi
Affiliation:
Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi710061, People’s Republic of China
Fangyao Chen
Affiliation:
Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi710061, People’s Republic of China
Ruo Zhang
Affiliation:
Department of Endocrinology, The Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xi’an, 710004, People’s Republic of China
Danmeng Liu
Affiliation:
Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi710061, People’s Republic of China
Yijun Kang
Affiliation:
Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi710061, People’s Republic of China
Suhang Shang
Affiliation:
The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, People’s Republic of China
Hong Yan*
Affiliation:
Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi710061, People’s Republic of China Key Laboratory of Environment and Genes Related to Diseases, Xi’an Jiaotong University, Ministry of Education, Xi’an, Shaanxi710061People’s Republic of China
Shaonong Dang*
Affiliation:
Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi710061, People’s Republic of China Key Laboratory of Environment and Genes Related to Diseases, Xi’an Jiaotong University, Ministry of Education, Xi’an, Shaanxi710061People’s Republic of China
*
Address for correspondence: Shaonong Dang and Hong Yan, Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University Health Science Center, 76 Yanta West Road, Xi’an, Shaanxi710061, People’s Republic of China. Email: tjdshn@mail.xjtu.edu.cn; yanhonge@mail.xjtu.edu.cn
Address for correspondence: Shaonong Dang and Hong Yan, Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University Health Science Center, 76 Yanta West Road, Xi’an, Shaanxi710061, People’s Republic of China. Email: tjdshn@mail.xjtu.edu.cn; yanhonge@mail.xjtu.edu.cn
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Abstract

Despite high altitude was implicated in adverse birth outcomes, there remained a paucity of evidence on low-to-medium altitude effect. This study aimed to explore the association of low-to-medium altitude with birth outcomes. A population-based cross-sectional survey was performed using a stratified multistage random sampling method among women with their infants born during 2010–2013 in Northwestern China. Altitude was determined in meters based on the village or community of the mother’s living areas. Birth outcomes involved birth weight, gestational age, and small for gestational age (SGA). Generalized linear models were fitted to investigate the association of altitude with birth outcomes. Moreover, the dose–response relationship between altitude and birth outcomes was evaluated with a restricted cubic spline function. A total of 27 801 women with their infants were included. After adjusting for potential confounders, every 100-m increase in the altitude was associated with reduced birth weight by 6.4 (95% CI −8.1, −4.6) g, the slight increase of gestational age by 0.015 (95% CI 0.010, 0.020) week, and an increased risk of SGA birth (odds ratio 1.03, 95% CI 1.02, 1.04). Moreover, there was an inversely linear relationship between altitude and birth weight (P for overall < 0.001 and P for nonlinear = 0.312), and a positive linear relationship between altitude and SGA (P for overall < 0.001 and P for nonlinear = 0.194). However, a nonlinear relationship was observed between altitude and gestational age (P for overall < 0.001 and P for nonlinear = 0.010). The present results suggest that low-to-medium altitude is possibly associated with adverse birth outcomes.

Keywords

low-to-medium altitudebirth weightgestational agesmall for gestational age
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 12 , Issue 3 , June 2021 , pp. 443 - 451
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Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2020

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Footnotes

†

These authors contributed equally to this work.

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