Risk factors for small‐for‐gestational‐age infants by customised birthweight centiles: data from an international prospective cohort study

Please cite this paper as: McCowan L, Roberts C, Dekker G, Taylor R, Chan E, Kenny L, Baker P, Moss‐Morris R, Chappell L, North R on behalf of the SCOPE consortium. Risk factors for small‐for‐gestational‐age infants by customised birthweight centiles: data from an international prospective cohort st...

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Veröffentlicht in:	BJOG : an international journal of obstetrics and gynaecology Jg. 117; H. 13; S. 1599 - 1607
Hauptverfasser:	McCowan, LME, Roberts, CT, Dekker, GA, Taylor, RS, Chan, EHY, Kenny, LC, Baker, PN, Moss‐Morris, R, Chappell, LC, North, RA
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	Oxford, UK Blackwell Publishing Ltd 01.12.2010 Blackwell Wiley Subscription Services, Inc
Schlagworte:	Adult Age Babies Biological and medical sciences Birth weight Birth Weight - physiology Birthweight Cigarettes customised birthweight centile Data analysis Diseases of mother, fetus and pregnancy Early Diagnosis Female Fertilization fetal growth restriction Fetal Growth Retardation - diagnosis Fruits Gynecology. Andrology. Obstetrics Humans Hypertension, Pregnancy-Induced - physiopathology Infant, Newborn Infant, Small for Gestational Age - physiology Infants Low-birth-weight Medical sciences Pregnancy Pregnancy Outcome Pregnancy. Fetus. Placenta Prenatal Diagnosis - methods Reference Values Risk Factors small for gestational age Australia, South Australia, Adelaide New Zealand, North I., Auckland British Isles, England, Greater Manchester, Manchester British Isles British Isles, England, Greater London, London PSE, Australia Human Intrauterine growth retardation Pregnancy disorders Gynecology Low birth weight Infant Obstetrics Fetal diseases Newborn diseases Prematurity Cohort study Risk factor Birth weight International
ISSN:	1470-0328, 1471-0528, 1471-0528
Online-Zugang:	Volltext
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Abstract	Please cite this paper as: McCowan L, Roberts C, Dekker G, Taylor R, Chan E, Kenny L, Baker P, Moss‐Morris R, Chappell L, North R on behalf of the SCOPE consortium. Risk factors for small‐for‐gestational‐age infants by customised birthweight centiles: data from an international prospective cohort study. BJOG 2010;117:1599–1607. Objective To identify clinical and ultrasound variables associated with the birth of small‐for‐gestational‐age (SGA) infants by customised centiles, subclassified according to whether their mothers were normotensive or developed hypertensive complications. Design Prospective, multicentre cohort study. Setting Participating centres of the Screening for Pregnancy Endpoints (SCOPE) study in Auckland, New Zealand, Adelaide, Australia, Manchester and London, UK, and Cork, Ireland. Population The 3513 nulliparous participants of the SCOPE study. Methods Women were interviewed at 15 ± 1 weeks, and had ultrasound growth measurements and umbilical and uterine Doppler studies at 20 ± 1 weeks. Variables associated with SGA infants were identifed using logistic regression. Main outcome measures Small for gestational age (i.e. a birthweight of less than the tenth customised centile), normotensive‐SGA and hypertensive‐SGA. Comparison groups for statistical analyses were non‐SGA, normotensive non‐SGA and hypertensive non‐SGA. Results Among 376 (10.7%) SGA infants, 281 (74.7%) were normotensive‐SGA and 95 (25.3%) were hypertensive‐SGA. Independent risk factors for normotensive‐SGA were low maternal birthweight, low fruit intake pre‐pregnancy, cigarette smoking, increasing maternal age, daily vigorous exercise, being a tertiary student, head and abdominal circumference of less than the tenth centile and increasing uterine artery Doppler indices at the 20‐week scan. Protective factors were: high green leafy vegetable intake pre‐pregnancy, and rhesus‐negative blood group. Risk factors for hypertensive‐SGA were conception by in vitro fertilisation, previous early pregnancy loss and femur length of less than tenth centile at the 20‐week scan. Conclusions Risk factors for infants who are SGA by customised centiles have been identified in a cohort of healthy nulliparous women. A number of these factors are modifiable; however, further studies are needed to replicate these findings.
AbstractList	To identify clinical and ultrasound variables associated with the birth of small-for-gestational-age (SGA) infants by customised centiles, subclassified according to whether their mothers were normotensive or developed hypertensive complications. Prospective, multicentre cohort study. Participating centres of the Screening for Pregnancy Endpoints (SCOPE) study in Auckland, New Zealand, Adelaide, Australia, Manchester and London, UK, and Cork, Ireland. The 3513 nulliparous participants of the SCOPE study. Women were interviewed at 15 ± 1 weeks, and had ultrasound growth measurements and umbilical and uterine Doppler studies at 20 ± 1 weeks. Variables associated with SGA infants were identified using logistic regression. Small for gestational age (i.e. a birthweight of less than the tenth customised centile), normotensive-SGA and hypertensive-SGA. Comparison groups for statistical analyses were non-SGA, normotensive non-SGA and hypertensive non-SGA. Among 376 (10.7%) SGA infants, 281 (74.7%) were normotensive-SGA and 95 (25.3%) were hypertensive-SGA. Independent risk factors for normotensive-SGA were low maternal birthweight, low fruit intake pre-pregnancy, cigarette smoking, increasing maternal age, daily vigorous exercise, being a tertiary student, head and abdominal circumference of less than the tenth centile and increasing uterine artery Doppler indices at the 20-week scan. Protective factors were: high green leafy vegetable intake pre-pregnancy, and rhesus-negative blood group. Risk factors for hypertensive-SGA were conception by in vitro fertilisation, previous early pregnancy loss and femur length of less than tenth centile at the 20-week scan. Risk factors for infants who are SGA by customised centiles have been identified in a cohort of healthy nulliparous women. A number of these factors are modifiable; however, further studies are needed to replicate these findings. Please cite this paper as: McCowan L, Roberts C, Dekker G, Taylor R, Chan E, Kenny L, Baker P, Moss-Morris R, Chappell L, North R on behalf of the SCOPE consortium. Risk factors for small-for-gestational-age infants by customised birthweight centiles: data from an international prospective cohort study. BJOG 2010;117:1599-1607. Objective To identify clinical and ultrasound variables associated with the birth of small-for-gestational-age (SGA) infants by customised centiles, subclassified according to whether their mothers were normotensive or developed hypertensive complications. Design Prospective, multicentre cohort study. Setting Participating centres of the Screening for Pregnancy Endpoints (SCOPE) study in Auckland, New Zealand, Adelaide, Australia, Manchester and London, UK, and Cork, Ireland. Population The 3513 nulliparous participants of the SCOPE study. Methods Women were interviewed at 15±1weeks, and had ultrasound growth measurements and umbilical and uterine Doppler studies at 20±1weeks. Variables associated with SGA infants were identifed using logistic regression. Main outcome measures Small for gestational age (i.e. a birthweight of less than the tenth customised centile), normotensive-SGA and hypertensive-SGA. Comparison groups for statistical analyses were non-SGA, normotensive non-SGA and hypertensive non-SGA. Results Among 376 (10.7%) SGA infants, 281 (74.7%) were normotensive-SGA and 95 (25.3%) were hypertensive-SGA. Independent risk factors for normotensive-SGA were low maternal birthweight, low fruit intake pre-pregnancy, cigarette smoking, increasing maternal age, daily vigorous exercise, being a tertiary student, head and abdominal circumference of less than the tenth centile and increasing uterine artery Doppler indices at the 20-week scan. Protective factors were: high green leafy vegetable intake pre-pregnancy, and rhesus-negative blood group. Risk factors for hypertensive-SGA were conception by in vitro fertilisation, previous early pregnancy loss and femur length of less than tenth centile at the 20-week scan. Conclusions Risk factors for infants who are SGA by customised centiles have been identified in a cohort of healthy nulliparous women. A number of these factors are modifiable; however, further studies are needed to replicate these findings.[PUBLICATION ABSTRACT] Please cite this paper as: McCowan L, Roberts C, Dekker G, Taylor R, Chan E, Kenny L, Baker P, Moss‐Morris R, Chappell L, North R on behalf of the SCOPE consortium. Risk factors for small‐for‐gestational‐age infants by customised birthweight centiles: data from an international prospective cohort study. BJOG 2010;117:1599–1607. Objective To identify clinical and ultrasound variables associated with the birth of small‐for‐gestational‐age (SGA) infants by customised centiles, subclassified according to whether their mothers were normotensive or developed hypertensive complications. Design Prospective, multicentre cohort study. Setting Participating centres of the Screening for Pregnancy Endpoints (SCOPE) study in Auckland, New Zealand, Adelaide, Australia, Manchester and London, UK, and Cork, Ireland. Population The 3513 nulliparous participants of the SCOPE study. Methods Women were interviewed at 15 ± 1 weeks, and had ultrasound growth measurements and umbilical and uterine Doppler studies at 20 ± 1 weeks. Variables associated with SGA infants were identifed using logistic regression. Main outcome measures Small for gestational age (i.e. a birthweight of less than the tenth customised centile), normotensive‐SGA and hypertensive‐SGA. Comparison groups for statistical analyses were non‐SGA, normotensive non‐SGA and hypertensive non‐SGA. Results Among 376 (10.7%) SGA infants, 281 (74.7%) were normotensive‐SGA and 95 (25.3%) were hypertensive‐SGA. Independent risk factors for normotensive‐SGA were low maternal birthweight, low fruit intake pre‐pregnancy, cigarette smoking, increasing maternal age, daily vigorous exercise, being a tertiary student, head and abdominal circumference of less than the tenth centile and increasing uterine artery Doppler indices at the 20‐week scan. Protective factors were: high green leafy vegetable intake pre‐pregnancy, and rhesus‐negative blood group. Risk factors for hypertensive‐SGA were conception by in vitro fertilisation, previous early pregnancy loss and femur length of less than tenth centile at the 20‐week scan. Conclusions Risk factors for infants who are SGA by customised centiles have been identified in a cohort of healthy nulliparous women. A number of these factors are modifiable; however, further studies are needed to replicate these findings. Please cite this paper as: McCowan L, Roberts C, Dekker G, Taylor R, Chan E, Kenny L, Baker P, Moss‐Morris R, Chappell L, North R on behalf of the SCOPE consortium. Risk factors for small‐for‐gestational‐age infants by customised birthweight centiles: data from an international prospective cohort study. BJOG 2010;117:1599–1607. Objective To identify clinical and ultrasound variables associated with the birth of small‐for‐gestational‐age (SGA) infants by customised centiles, subclassified according to whether their mothers were normotensive or developed hypertensive complications. Design Prospective, multicentre cohort study. Setting Participating centres of the Screening for Pregnancy Endpoints (SCOPE) study in Auckland, New Zealand, Adelaide, Australia, Manchester and London, UK, and Cork, Ireland. Population The 3513 nulliparous participants of the SCOPE study. Methods Women were interviewed at 15 ± 1 weeks, and had ultrasound growth measurements and umbilical and uterine Doppler studies at 20 ± 1 weeks. Variables associated with SGA infants were identifed using logistic regression. Main outcome measures Small for gestational age (i.e. a birthweight of less than the tenth customised centile), normotensive‐SGA and hypertensive‐SGA. Comparison groups for statistical analyses were non‐SGA, normotensive non‐SGA and hypertensive non‐SGA. Results Among 376 (10.7%) SGA infants, 281 (74.7%) were normotensive‐SGA and 95 (25.3%) were hypertensive‐SGA. Independent risk factors for normotensive‐SGA were low maternal birthweight, low fruit intake pre‐pregnancy, cigarette smoking, increasing maternal age, daily vigorous exercise, being a tertiary student, head and abdominal circumference of less than the tenth centile and increasing uterine artery Doppler indices at the 20‐week scan. Protective factors were: high green leafy vegetable intake pre‐pregnancy, and rhesus‐negative blood group. Risk factors for hypertensive‐SGA were conception by in vitro fertilisation, previous early pregnancy loss and femur length of less than tenth centile at the 20‐week scan. Conclusions Risk factors for infants who are SGA by customised centiles have been identified in a cohort of healthy nulliparous women. A number of these factors are modifiable; however, further studies are needed to replicate these findings. To identify clinical and ultrasound variables associated with the birth of small-for-gestational-age (SGA) infants by customised centiles, subclassified according to whether their mothers were normotensive or developed hypertensive complications.OBJECTIVETo identify clinical and ultrasound variables associated with the birth of small-for-gestational-age (SGA) infants by customised centiles, subclassified according to whether their mothers were normotensive or developed hypertensive complications.Prospective, multicentre cohort study.DESIGNProspective, multicentre cohort study.Participating centres of the Screening for Pregnancy Endpoints (SCOPE) study in Auckland, New Zealand, Adelaide, Australia, Manchester and London, UK, and Cork, Ireland.SETTINGParticipating centres of the Screening for Pregnancy Endpoints (SCOPE) study in Auckland, New Zealand, Adelaide, Australia, Manchester and London, UK, and Cork, Ireland.The 3513 nulliparous participants of the SCOPE study.POPULATIONThe 3513 nulliparous participants of the SCOPE study.Women were interviewed at 15 ± 1 weeks, and had ultrasound growth measurements and umbilical and uterine Doppler studies at 20 ± 1 weeks. Variables associated with SGA infants were identified using logistic regression.METHODSWomen were interviewed at 15 ± 1 weeks, and had ultrasound growth measurements and umbilical and uterine Doppler studies at 20 ± 1 weeks. Variables associated with SGA infants were identified using logistic regression.Small for gestational age (i.e. a birthweight of less than the tenth customised centile), normotensive-SGA and hypertensive-SGA. Comparison groups for statistical analyses were non-SGA, normotensive non-SGA and hypertensive non-SGA.MAIN OUTCOME MEASURESSmall for gestational age (i.e. a birthweight of less than the tenth customised centile), normotensive-SGA and hypertensive-SGA. Comparison groups for statistical analyses were non-SGA, normotensive non-SGA and hypertensive non-SGA.Among 376 (10.7%) SGA infants, 281 (74.7%) were normotensive-SGA and 95 (25.3%) were hypertensive-SGA. Independent risk factors for normotensive-SGA were low maternal birthweight, low fruit intake pre-pregnancy, cigarette smoking, increasing maternal age, daily vigorous exercise, being a tertiary student, head and abdominal circumference of less than the tenth centile and increasing uterine artery Doppler indices at the 20-week scan. Protective factors were: high green leafy vegetable intake pre-pregnancy, and rhesus-negative blood group. Risk factors for hypertensive-SGA were conception by in vitro fertilisation, previous early pregnancy loss and femur length of less than tenth centile at the 20-week scan.RESULTSAmong 376 (10.7%) SGA infants, 281 (74.7%) were normotensive-SGA and 95 (25.3%) were hypertensive-SGA. Independent risk factors for normotensive-SGA were low maternal birthweight, low fruit intake pre-pregnancy, cigarette smoking, increasing maternal age, daily vigorous exercise, being a tertiary student, head and abdominal circumference of less than the tenth centile and increasing uterine artery Doppler indices at the 20-week scan. Protective factors were: high green leafy vegetable intake pre-pregnancy, and rhesus-negative blood group. Risk factors for hypertensive-SGA were conception by in vitro fertilisation, previous early pregnancy loss and femur length of less than tenth centile at the 20-week scan.Risk factors for infants who are SGA by customised centiles have been identified in a cohort of healthy nulliparous women. A number of these factors are modifiable; however, further studies are needed to replicate these findings.CONCLUSIONSRisk factors for infants who are SGA by customised centiles have been identified in a cohort of healthy nulliparous women. A number of these factors are modifiable; however, further studies are needed to replicate these findings. Please cite this paper as: McCowan L, Roberts C, Dekker G, Taylor R, Chan E, Kenny L, Baker P, Moss-Morris R, Chappell L, North R on behalf of the SCOPE consortium. Risk factors for small-for-gestational-age infants by customised birthweight centiles: data from an international prospective cohort study. BJOG 2010; 117:1599-1607.Objective To identify clinical and ultrasound variables associated with the birth of small-for-gestational-age (SGA) infants by customised centiles, subclassified according to whether their mothers were normotensive or developed hypertensive complications.Design Prospective, multicentre cohort study.Setting Participating centres of the Screening for Pregnancy Endpoints (SCOPE) study in Auckland, New Zealand, Adelaide, Australia, Manchester and London, UK, and Cork, Ireland.Population The 3513 nulliparous participants of the SCOPE study.Methods Women were interviewed at 15 plus or minus 1 weeks, and had ultrasound growth measurements and umbilical and uterine Doppler studies at 20 plus or minus 1 weeks. Variables associated with SGA infants were identifed using logistic regression.Main outcome measures Small for gestational age (i.e. a birthweight of less than the tenth customised centile), normotensive-SGA and hypertensive-SGA. Comparison groups for statistical analyses were non-SGA, normotensive non-SGA and hypertensive non-SGA.Results Among 376 (10.7%) SGA infants, 281 (74.7%) were normotensive-SGA and 95 (25.3%) were hypertensive-SGA. Independent risk factors for normotensive-SGA were low maternal birthweight, low fruit intake pre-pregnancy, cigarette smoking, increasing maternal age, daily vigorous exercise, being a tertiary student, head and abdominal circumference of less than the tenth centile and increasing uterine artery Doppler indices at the 20-week scan. Protective factors were: high green leafy vegetable intake pre-pregnancy, and rhesus-negative blood group. Risk factors for hypertensive-SGA were conception by in vitro fertilisation, previous early pregnancy loss and femur length of less than tenth centile at the 20-week scan.Conclusions Risk factors for infants who are SGA by customised centiles have been identified in a cohort of healthy nulliparous women. A number of these factors are modifiable; however, further studies are needed to replicate these findings.
Author	Chan, EHY Roberts, CT Dekker, GA Chappell, LC McCowan, LME Taylor, RS Kenny, LC Moss‐Morris, R North, RA Baker, PN
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Keywords	Human Intrauterine growth retardation Pregnancy disorders Gynecology Low birth weight Infant Obstetrics Fetal diseases Newborn diseases Prematurity Cohort study Risk factor Birth weight International
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Snippet	Please cite this paper as: McCowan L, Roberts C, Dekker G, Taylor R, Chan E, Kenny L, Baker P, Moss‐Morris R, Chappell L, North R on behalf of the SCOPE... Please cite this paper as: McCowan L, Roberts C, Dekker G, Taylor R, Chan E, Kenny L, Baker P, Moss‐Morris R, Chappell L, North R on behalf of the SCOPE... To identify clinical and ultrasound variables associated with the birth of small-for-gestational-age (SGA) infants by customised centiles, subclassified... Please cite this paper as: McCowan L, Roberts C, Dekker G, Taylor R, Chan E, Kenny L, Baker P, Moss-Morris R, Chappell L, North R on behalf of the SCOPE...
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SubjectTerms	Adult Age Babies Biological and medical sciences Birth weight Birth Weight - physiology Birthweight Cigarettes customised birthweight centile Data analysis Diseases of mother, fetus and pregnancy Early Diagnosis Female Fertilization fetal growth restriction Fetal Growth Retardation - diagnosis Fruits Gynecology. Andrology. Obstetrics Humans Hypertension, Pregnancy-Induced - physiopathology Infant, Newborn Infant, Small for Gestational Age - physiology Infants Low-birth-weight Medical sciences Pregnancy Pregnancy Outcome Pregnancy. Fetus. Placenta Prenatal Diagnosis - methods Reference Values Risk Factors small for gestational age
Title	Risk factors for small‐for‐gestational‐age infants by customised birthweight centiles: data from an international prospective cohort study
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