Birth Anthropometry Research Articles

The role of maternal emotional states during pregnancy and early infancy on infant cortisol levels: A prospective study

AbstractCortisol plays an important role in human body functioning, stress response, and reactivity, and altered cortisol levels have been related to psychopathology throughout life. This study investigates several types of clinical and psychosocial prenatal, perinatal, and postnatal factors related to morning cortisol levels in 71 12‐month‐old infants. Several sociodemographic, obstetrical, environmental, and psychological predictors were taken into account. Regression models show that prenatal anxiety, type of birth, depressive symptoms at 6 months, and the mothers' feelings about the relationship with their child explain 32.9% of the variance in morning cortisol levels in 12‐month old infants. When sociodemographic, obstetrical, environmental, and psychological variables are taken into account, maternal emotional status and feelings about the mother–infant bonding are the most important factors that explain infant cortisol levels, which suggests that they should be included in obstetric and paediatric care routines to improve infant health.Highlights Cortisol has an important effect on human homeostasis, growth, neurodevelopment, stress response and reactivity; however, altered cortisol levels have been related to psychopathology throughout life. This study aims to investigate, prospectively from pregnancy, several types of clinical and psychosocial prenatal, perinatal and postnatal factors related to infant morning cortisol levels at 12 months. When several kind of factors are taken into account (prenatal life events, prenatal and postnatal nicotine exposure, gender, gestational age at birth, infant birth weight, parity, socioeconomic status, maternal psychopathology, breastfeeding status and anthropometry), prenatal anxiety, type of birth, postnatal depression and mothers' feelings about the relationship with their infant are the are the variables that better predict infant morning cortisol levels. Maternal emotional characteristics are the central axis for influencing the development of HPA axis. Healthcare professionals may pay more attention to the mother feelings and emotions along prenatal and postnatal infant development to promote infant mental health.

First-trimester maternal concentrations of polyfluoroalkyl substances and fetal growth throughout pregnancy

BackgroundSeveral studies have investigated the possible association between prenatal exposure to perfluoroalkyl substances (PFASs) and birth anthropometry. However, none has assessed fetal size longitudinally. We studied the possible association between PFASs and fetal biometry. MethodsIn 1230 mother–child pairs of three cohorts from the Spanish INMA-Project, we analyzed perfluorohexanesulfonic acid (PFHxS), perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and perfluorononanoic acid (PFNA) in first-trimester maternal plasma (collection: 2003–2008). We measured abdominal circumference (AC), femur length (FL), biparietal diameter (BPD), and estimated fetal weight (EFW) by ultrasounds at 12, 20, and 34 gestational weeks. We conducted multivariable linear regression analyses between log2-transformed (PFASs) and SD-scores of fetal parameters in each cohort and subsequent meta-analysis. We also assessed effect modification by sex and maternal smoking. ResultsPFHxS, PFOA, PFOS, and PFNA medians were: 0.58, 2.35, 6.05, and 0.65 ng/mL, respectively. There were no associations for the whole population in any trimester of pregnancy. However, we found an indication that maternal smoking modified the effect in different directions depending on the PFAS. Among smokers (31%), we found negative associations between both PFOA and PFNA and FL or EFW at week 20 (% change ranging between −6.8% and −5.7% per twofold PFAS increase) and positive associations between PFHxS or PFOS and BPD at week 34 (6.8% and 6.3%, respectively). ConclusionsResults did not suggest an overall association between prenatal PFASs and fetal growth. The results among smokers should be taken with caution and further studies are warranted to elucidate the possible role of smoking in this association.

Prenatal vitamin D and cord blood insulin-like growth factors in Dhaka, Bangladesh.

Fetal growth restriction is linked to adverse health outcomes and is prevalent in low- and middle-income countries; however, determinants of fetal growth are still poorly understood. The objectives were to determine the effect of prenatal vitamin D supplementation on the insulin-like growth factor (IGF) axis at birth, to compare the concentrations of IGF-I in newborns in Bangladesh to a European reference population and to estimate the associations between IGF protein concentrations and birth size. In a randomized controlled trial in Dhaka, Bangladesh, pregnant women enrolled at 17–24 weeks of gestation were assigned to weekly oral vitamin D3 supplementation from enrolment to delivery at doses of 4200 IU/week, 16,800 IU/week, 28,000 IU/week or placebo. In this sub-study, 559 woman–infant pairs were included for analysis and cord blood IGF protein concentrations were quantified at birth. There were no significant effects of vitamin D supplementation on cord blood concentrations of IGF-I (P = 0.398), IGF-II (P = 0.525), binding proteins (BPs) IGFBP-1 (P = 0.170), IGFBP-3 (P = 0.203) or the molar ratio of IGF-I/IGFBP-3 (P = 0.941). In comparison to a European reference population, 6% of girls and 23% of boys had IGF-I concentrations below the 2.5th percentile of the reference population. IGF-I, IGF-II, IGFBP-3 and the IGF-I/IGFBP-3 ratio were positively associated with at least one anthropometric parameter, whereas IGFBP-1 was negatively associated with birth anthropometry. In conclusion, prenatal vitamin D supplementation does not alter or enhance fetal IGF pathways.

Intrauterine Fetal Growth Delay During Late Pregnancy After Maternal Gastric Bypass Surgery.

To investigate intrauterine fetal growth development and birth anthropometry of fetuses conceived after maternal gastric bypass surgery. Longitudinal cohort study describing longitudinal growth estimated by ultrasound on 43 singleton pregnancies after gastric bypass compared to 43 BMI-matched controls. In fetuses after maternal gastric bypass surgery, growth percentiles decreased markedly from the beginning of the second trimester until the end of the third trimester (decrease of 3.1 fetal abdomen circumference percentiles (95 %CI 0.9-5.3, p = 0.007) per four gestational weeks). While in the second trimester, fetal anthropometric measures did not differ between the groups, the mean abdomen circumference percentiles appeared significantly smaller during the third trimester in offspring of mothers after gastric bypass (mean difference 25.1 percentiles, p < 0.001). Similar tendencies have been observed in estimated fetal weight resulting in significantly more SGA offspring at delivery in the gastric bypass group. In children born after maternal gastric bypass surgery, weight percentiles (32.12th vs. 55.86th percentile, p < 0.001) as well as placental weight (525.2 g vs. 635.7 g, p < 0.001) were significantly reduced compared to controls. In fetuses conceived after maternal gastric bypass, intrauterine fetal growth distinctively declined in the second and third trimester, most prominently observed in fetal abdomen circumferences. Birth weight and placental weight at birth was significantly lower compared to BMI-matched controls, possibly due to altered maternal metabolic factors and comparable to mothers experiencing chronic hunger episodes.

Lactoferrin level in maternal serum is related to birth anthropometry – an evidence for an indirect biomarker of intrauterine homeostasis?

Objective: To investigate the relation between level of antibodies against lactoferrin (LfAb) in maternal serum (MS) and birth anthropometry of healthy full-term newborns. Methods: The study included 105 pairs of mother-newborn. MS LfAb level was determined using ELISA kit. Spearman’s correlation and Kruskal–Wallis one-way analysis of variance (ANOVA) were applied to establish the relationship between MS LfAb level and birth weight (BW), birth weight-to-birth length ratio (BW/BL), and head circumference (HC) of newborns. Results: The U-shaped relation of MS LfAb and BW was demonstrated (p = .019). Negative correlation between MS LfAb and BW/BL was observed (p = .016). The most optimal birth weight and body proportion were observed in newborns of mothers with MS LfAb level of 49 ± 4 U/ml. Conclusions: Significant relationship between MS LfAb and birth anthropometry suggests serum Lf of pregnant women can be considered as a promising indirect biomarker of intrauterine homeostasis, verifiable noninvasively already during pregnancy and thus allowing predict, or even prevent, potential short- and long-term postnatal health consequences.

The Influence of Ethnicity on Exclusively Breast-Fed Infants’ Anthropometry in a Multiethnic Asian Population

We studied the effects of ethnicity on early infant growth patterns in exclusively breast-fed (EBF) infants from a Singaporean multiethnic population. This was a prospective cohort study conducted in National University Hospital, Singapore. Healthy, EBF infants born at-term completing 37 weeks and above, and whose birthweight was appropriate for gestational age (>10th centile, <90th centile) were recruited. Infants were required to be EBF at least until the minimum age of weaning. All infants who were preterm and premature, formula-fed, required Intensive/High Dependency care, or born with major congenital anomalies were excluded. A multivariable linear regression analysis was conducted at 5 predetermined time-points (birth; 4-8 weeks; 3-4, 5-8, 12 months) to study the effects of antenatal/parental factors on infant growth. A total of 213 infants were recruited. Maternal age, height and body mass index positively influenced birthweights while maternal hypertension and paternal smoking negatively influenced birthweights. Mean duration of breastfeeding was 8.9 months. Chinese ethnicity did not influence birth anthropometry, but was the single consistent factor that significantly increased weight and length Z-scores from 4-8 weeks until 8 months of life. Chinese ethnicity did not influence head growth throughout the first year of life. EBF Chinese infants have increased weights and lengths compared to non-Chinese infants until 8 months' age, despite similar birth anthropometry. This period of discrepant growth coincides with the average duration of breastfeeding. We hypothesise that ethnic variations in breast milk macronutrient composition influence early somatic growth in infants.

Role of maternal health and infant inflammation in nutritional and neurodevelopmental outcomes of two-year-old Bangladeshi children.

BackgroundPrevious studies have shown maternal, inflammatory, and socioeconomic variables to be associated with growth and neurodevelopment in children from low-income countries. However, these outcomes are multifactorial and work describing which predictors most strongly influence them is lacking.Methodology/Principal findingsWe conducted a longitudinal study of Bangladeshi children from birth to two years to assess oral vaccine efficacy. Variables pertaining to maternal and perinatal health, socioeconomic status, early childhood enteric and systemic inflammation, and anthropometry were collected. Bayley-III neurodevelopmental assessment was conducted at two years. As a secondary analysis, we employed hierarchical cluster and random forests techniques to identify and rank which variables predicted growth and neurodevelopment. Cluster analysis demonstrated three distinct groups of predictors. Mother’s weight and length-for-age Z score (LAZ) at enrollment were the strongest predictors of LAZ at two years. Cognitive score on Bayley-III was strongly predicted by weight-for-age (WAZ) at enrollment, income, and LAZ at enrollment. Top predictors of language included Rotavirus vaccination, plasma IL 5, sCD14, TNFα, mother’s weight, and male gender. Motor function was best predicted by fecal calprotectin, WAZ at enrollment, fecal neopterin, and plasma CRP index. The strongest predictors for social-emotional score included plasma sCD14, income, WAZ at enrollment, and LAZ at enrollment. Based on the random forests’ predictions, the estimated percentage of variation explained was 35.4% for LAZ at two years, 34.3% for ΔLAZ, 42.7% for cognitive score, 28.1% for language, 40.8% for motor, and 37.9% for social-emotional score.Conclusions/SignificanceBirth anthropometry and maternal weight were strong predictors of growth while enteric and systemic inflammation had stronger associations with neurodevelopment. Birth anthropometry was a powerful predictor for all outcomes. These data suggest that further study of stunting in low-income settings should include variables relating to maternal and prenatal health, while investigations focusing on neurodevelopmental outcomes should additionally target causes of systemic and enteric inflammation.

Adiponectin and vitamin D-binding protein are independently associated at birth in both mothers and neonates.

Adult body fat is associated with birth anthropometry, suggesting a role for metabolic regulators including vitamin D and the adipokines-adiponectin and irisin-which have been reported to interact but, as yet, data remain controversial. To study (i) the relationship between vitamin D, its binding protein (VDBP) and the adipokines, adiponectin, and irisin in mothers and neonates at birth and (ii) their effects on neonate anthropometric outcomes. Cross-sectional study for healthy mothers with full-term and uncomplicated births. Primary care. Seventy pairs of newly delivered neonates and their mothers. Biochemical markers from maternal and cord: VDBP, adiponectin, irisin, calcium, albumin, parathyroid hormone, 25OHD, 1,25(OH)2D. Maternal demographic and social characteristics and neonate anthropometric parameters were recorded. Maternal VDBP levels (364.1 ± 11.9 μg/ml) demonstrated a strong positive correlation with maternal adiponectin (4.4 ± 0.4 μg/ml) and irisin (308.8 ± 50.8 ng/ml) concentrations, which remained significant (p < 0.001 and p < 0.041, respectively) after adjustment with multiple parameters, including weeks of gestation, maternal age, and BMI. The finding of a strong association of VDBP (355.3 ± 29.2 μg/ml) and adiponectin (11.9 ± 2.0 μg/ml) but not irisin (174.4 ± 26.0 ng/ml) was also evident in neonates (p = 0.03 and p = 0.94, respectively). No association was observed in both maternal and neonatal vitamin D, adiponectin, and irisin. The main findings of this study are (i) the perspective of a potential independent interaction of VDBP and adiponectin in both mothers and neonates and (ii) the lack of a causative model effect of both maternal/neonatal vitamin D status and adipokine profile on neonatal anthropometry at birth, as a surrogate marker of future metabolic health of the offspring.

Maternal urinary cadmium levels during pregnancy associated with risk of sex-dependent birth outcomes from an e-waste pollution site in China

This study was to investigate whether exposure to cadmium (Cd) during pregnancy is associated with an increased risk of adverse birth outcomes in a sex-dependent manner. Cd concentrations in maternal urine (U-Cd) samples were measured in 237 subjects from Guiyu (e-waste area) and 212 subjects from Haojiang. A significance level of p <0.05 was used for all analyses. The maternal U-Cd levels in Guiyu residents were significantly higher than Haojiang. We found significant inverse associations between U-Cd concentrations and birth anthropometry (birth weight, birth length, Head Circumference and Apgar scores with 1min and 5 mins) in female neonates, but no significant associations were observed in male neonates except Apgar (1min) score after adjustment. The association was more pronounced among female neonates than male neonates, suggesting an association between Cd and adverse birth outcomes may be sex-specific.

Early life arsenic exposure, infant and child growth, and morbidity: a systematic review.

Epidemiological studies have suggested a negative association between early life arsenic exposure and fetal size at birth, and subsequently with child morbidity and growth. However, our understanding of the relationship between arsenic exposure and morbidity and growth is limited. This paper aims to systematically review original human studies with an analytical epidemiological study design that have assessed arsenic exposure in fetal life or early childhood and evaluated the association with one or several of the following outcomes: fetal growth, birth weight or other birth anthropometry, infant and child growth, infectious disease morbidity in infancy and early childhood. A literature search was conducted in PubMed, TOXLINE, Web of Science, SciFinder and Scopus databases filtered for human studies. Based on the predefined eligibility criteria, two authors independently evaluated the studies. A total of 707 studies with morbidity outcomes were identified, of which six studies were eligible and included in this review. For the growth outcomes, a total of 2959 studies were found and nine fulfilled the criteria and were included in the review. A majority of the papers (10/15) emanated from Bangladesh, three from the USA, one from Romania and one from Canada. All included studies on arsenic exposure and morbidity showed an increased risk of respiratory tract infections and diarrhea. The findings in the studies of arsenic exposure and fetal, infant, and child growth were heterogeneous. Arsenic exposure was not associated with fetal growth. There was limited evidence of negative associations between arsenic exposures and birth weight and growth during early childhood. More studies from arsenic-affected low- and middle-income countries are needed to support the generalizability of study findings.

Urinary triclosan concentrations during pregnancy and birth outcomes

BackgroundTriclosan is an antimicrobial chemical used in consumer products, and exposure is ubiquitous among pregnant women in the United States. Triclosan may reduce the levels of thyroid hormones that are important for fetal growth and development. ObjectiveWe investigated the relationship of prenatal triclosan exposure with birth anthropometry and gestational duration. MethodsWe used data from 378 mother-child pairs participating in the Health Outcomes and Measures of the Environment (HOME) Study, a prospective pregnancy and birth cohort from Cincinnati, OH. We measured triclosan concentrations in maternal urine samples collected at 16 and 26 weeks of pregnancy. We abstracted information on neonatal anthropometry and gestational duration from medical records. We used multivariable linear regression to estimate the covariate-adjusted association between the average of the two urinary triclosan concentrations and gestational age standardized weight z-score, length, head circumference, and gestational age at birth. ResultsMedian urinary triclosan concentrations were 16ng/mL (range: <2.4 to 1501ng/mL). Each 10-fold increase in triclosan was associated with a predicted 0.15 standard deviation decrease (95% CI: −0.30, 0.00) in birth weight z-score, 0.4-cm decrease (95% CI: −0.8, 0.1) in birth length, 0.3-cm decrease (95% CI: −0.5, 0.0) in head circumference, and 0.3-week decrease (95% CI: −0.6, −0.1) in gestational age. Child sex did not modify the associations between triclosan and birth outcomes. ConclusionsIn this cohort, maternal urinary triclosan concentrations during pregnancy were inversely associated with infants’ birth weight, length, head circumference, and gestational age.

Deficits in anthropometric indices of nutritional status and motor performance among low birth weight children from Maputo City, Mozambique.

To evaluate associations between low birth weight (LBW) and anthropometry, body composition, physical fitness, and gross motor coordination among schoolchildren from Maputo, Mozambique. A total of 353 children aged 7 to 10 years old from both genders born in Maputo (Mozambique) were sampled. The sample was divided into two groups: LBW (n = 155) and normal birth weight (NBW, n = 198). Body composition measurements and indices weight-for-age, height-for-age, and weight-for-height were assessed. Physical fitness was assessed by handgrip strength, flexibility, agility, long jump, and running speed. Gross motor coordination was evaluated by using the Korper Koordination Test fur Kinder (KTK) battery. LBW children were lighter and smaller than NBW children with reduced indices for weight-for-age and height-for-age. They also showed a reduced performance in handgrip strength and sideways movement tests. These differences remained significant even after adjustment for age, gender, body size, and fatness skinfold thickness. LBW seems to be the major factor that influences anthropometry, and is a predictor of low muscle strength and low performance on sideways movement tests. This result suggests that growth faltering in LBW children is associated with adverse health consequences, even after controlling for gender, age, fatness, and body size.

Maternal systemic or cord blood inflammation is associated with birth anthropometry in a Tanzanian prospective cohort.

HIV infection is associated with chronic systemic inflammation, with or without antiretroviral therapy. Consequences for foetal growth are not understood, particularly in settings where multiple maternal infections and malnutrition are common. The study was designed to examine maternal systemic circulating and umbilical cord blood cytokine concentrations in relation to birth anthropometry in a Tanzanian prospective cohort. A 9-plex panel of maternal plasma cytokines in HIV-positive (n = 44) and HIV-negative (n = 70) mothers and the same cytokines in umbilical cord blood collected at delivery was assayed. Linear regression modelled associations between maternal or cord blood cytokines and birth anthropometry. Health indicators (haemoglobin, mid-upper-arm circumference, body mass index) in HIV-positive mothers without considerable immunosuppression did not differ from HIV-negative women. Despite this, HIV-exposed infants had lower birthweight and length. Subgroup analyses indicated that HIV management using HAART was associated with lower plasma TNF-α, as were longer durations of any antiretroviral therapy (≥2 months). Greater maternal plasma TNF-α was associated with earlier delivery (-1.7 weeks, P = 0.039) and lower birthweights (-287 g; P = 0.020), while greater umbilical cord TNF-α (-1.43 cm; P = 0.036) and IL-12p70 (-2.4 cm; P = 0.008) were associated with shorter birth length. Birthweight was inversely associated with cord IL-12p70 (-723 g; P = 0.001) and IFN-γ (-482 g, P = 0.007). Maternal cytokines during pregnancy did not correlate with umbilical cord cytokines at delivery. Systemic inflammation identified in maternal plasma or umbilical cord blood was associated with poorer birth anthropometrics in HIV-exposed and HIV-unexposed infants. Controlling maternal and/or foetal systemic inflammation may improve birth anthropometry.

Moderate Prenatal Cadmium Exposure and Adverse Birth Outcomes: a Role for Sex-Specific Differences?

Background/AimStudies on the effects of moderate prenatal exposure to cadmium (Cd) on birth outcomes have been contradictory and it has been suggested that effects may be partly masked by sex‐specific effects. Our aim was to examine the association of Cd exposure in a large group of pregnant women with birth outcomes in the whole group of participants and by sex.MethodsPregnant women were enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC). Whole blood samples for singleton pregnancies with a live birth were analysed for Cd (n = 4191). Data collected on the infants included anthropometric variables and gestational age at delivery. Data were analysed using SPSS v18.ResultsThere were adverse associations of maternal blood Cd level with birthweight (unstandardized B coefficient −62.7 g, 95% CI −107.0, −18.4) and crown–heel length (−0.28 cm, 95% CI −0.48, −0.07) in adjusted regression models. On stratification by sex, maternal blood Cd level was adversely associated with birthweight (−87.1 g, 95% CI −144.8, −29.4), head circumference (−0.22 cm, 95% CI −0.39, −0.04), and crown–heel length (−0.44 cm, 95% CI −0.71, −0.18) in girls but not in boys in adjusted regression models.ConclusionIn these pregnant women with moderate prenatal Cd exposure there evidence of adverse associations with birth anthropometry variables in the whole group. However, there was evidence of associations with anthropometric variables in girls that were not evident in boys. Sex‐specific effects require further investigation in large cohorts as a possible contributor to the lack of associations generally found in mixed‐sex studies.

Examination of in utero exposure to arsenic, placental permeability and birth outcomes in South African population

Introduction: Early life exposure to arsenic has shown to interfere with foetal and early childhood development. The purpose of this study was to evaluate exposure to arsenic in utero, to assess placental permeability and birth outcomes in South African populations. Methods: Arsenic (As) was measured in maternal blood of total cohort (n=650) and in paired cord blood and urine of subset cohort (n=317). Bivariate analyses between As exposure, sizes at birth and covariates were evaluated by Spearman’s correlation coefficient. Association between maternal blood As levels and size at birth and other factors were further evaluated using mixed-effects modelling. Results: The geometric mean (GM) of the As in maternal blood was 0.62 µg/L (n=650; 95%CI, 0.58-0.66), in cord blood 0.78 µg/L (n=317; 95% CI, 0.74-0.83) and in urine (creatinine – corrected) was 14.26 µg/L (n=317; 95% CI, 12.64-16.09). Linear correlation was found between maternal blood and cord blood As, indicating placental permeability and some protective mechanism to foetus. Birth outcomes showed geographical differences in gestational age (p&lt;0.001), birth length (p=0.028), head circumference (p&lt;0.001), Apgar score at 5min (p&lt;0.001) and parity (p&lt;0.002). In univariate analyses older age, having secondary education, consuming fresh fish, consuming root, leafy and vine vegetables, and dairy products as well as bottled water, were associated with lower As blood levels. Both in univariate and multivariate analyses being single, drinking outdoor tap water, borehole and river water resulted in higher As levels. In the higher percentile head circumference was positively correlated with maternal blood As levels both in total cohort (β=0.19, p=0.049) and in female babies (β=0.40, p=0.007). Conclusions: Exposure to arsenic in utero differed by geographical positions. The placental permeability for As was confirmed and some effect on birth anthropometry in girls was found that requires further investigation.

Prenatal mercury exposure and birth outcomes

BackgroundResults regarding the association between mercury exposure and anthropometry at birth, gestational length and placental weight are inconsistent, as is the role of seafood intake in these associations. ObjectiveWe assessed whether prenatal mercury exposure is associated with anthropometry at birth, placental weight and gestational length in a population with a relatively high exposure to mercury from seafood consumption. MethodsTotal mercury (T–Hg) was determined in cord blood from 1869 newborns with birth outcome measures, within the Spanish multicenter INMA cohort from 2004 to 2008. We adjusted cohort specific linear and Cox regression models to evaluate the association between T–Hg and birth anthropometry (weight, length, and head circumference), placental weight and gestational length. Non-spontaneous labor was taken to be censoring in the survival analysis. Final estimates were obtained using meta-analysis. ResultsGeometric mean T–Hg was 8.2μg/L. A doubling of T–Hg was associated with a 7.7g decrease in placental weight (95% CI: −13.6, −1.8) and marginally with head circumference (beta: −0.052cm, 95% CI: −0.109, 0.005). T–Hg was also inversely related to weight and length, although with weaker estimates. Mercury exposure was not associated with the length of gestation. The inverse relation between T–Hg and growth was enhanced when the intake of different seafood groups was adjusted for in the models. ConclusionsPrenatal mercury exposure may be associated with reduced placental and fetal growth. Confounding by fish intake should be considered when assessing these relationships.

Prenatal Exposure to Cadmium, Placental Permeability and Birth Outcomes in Coastal Populations of South Africa

BackgroundThe impact of prenatal exposure to cadmium (Cd) on birth outcomes is an area of concern. This study aimed to assess an impact of prenatal Cd exposure on birth outcomes in distinct coastal populations of South Africa.MethodsCadmium was measured in maternal blood (CdB) (n = 641), cord blood and in maternal urine (n = 317). This investigation assessed the associations between CdB (non-transformed) and birth outcomes across the 25th, 50th, and 75th percentile for birth weight, birth length and head circumference, to test for a linear trend. Associations between natural log-transformed maternal CdB, size at birth and other factors were further evaluated using linear mixed-effects modelling with random intercepts.ResultsThe average gestational age in the total sample was 38 weeks; 47% of neonates were female, average birth weight was 3065 g and 11% were of low birth weight (< 2500 g). The geometric mean (GM) of the maternal CdB level was 0.25 μg/L (n = 641; 95% CI, 0.23–0.27). The cord blood Cd level was 0.27 μg/L (n = 317; 95% CI, 0.26–0.29) and urine (creatinine-corrected) Cd level was 0.27 μg/L (n = 318; 95% CI, 0.24–0.29). The CdB cord:maternal ratio in the sub-cohort was 1, suggesting that the placenta offers no protective mechanism to the foetus. An inverse association was found between CdB and the lower birth weight percentile in female neonates only (β = - 0.13, p = 0.047). Mothers who reported eating vine vegetables daily had lower levels of CdB (β = - 0.55, p = 0.025). Maternal smoking was associated with an elevation in natural log-transformed CdB levels in both male and female cohorts.DiscussionSignificant inverse associations between prenatal Cd exposure and birth anthropometry were found in female neonates but not in male neonates, suggesting potential sex differences in the toxico-kinetics and toxico-dynamics of Cd.

Associations between gestational anthropometry, maternal HIV, and fetal and early infancy growth in a prospective rural/semi-rural Tanzanian cohort, 2012-13.

BackgroundHealthcare access and resources differ considerably between urban and rural settings making cross-setting generalizations difficult. In resource-restricted rural/semi-rural environments, identification of feasible screening tools is a priority. The objective of this study was to evaluate gestational anthropometry in relation to birth and infant growth in a rural/semi-rural Tanzanian prospective cohort of mothers and their infants.MethodsMothers (n = 114: 44 HIV-positive) attending antenatal clinic visits were recruited in their second or third trimester between March and November, 2012, and followed with their infants through 6-months post-partum. Demographic, clinical, and infant feeding data were obtained using questionnaires administered by a Swahili-speaking research nurse on demographic, socioeconomic, clinical, and infant feeding practices. Second or third trimester anthropometry (mid-upper arm circumference [MUAC], triceps skinfold thickness, weight, height), pregnancy outcomes, birth (weight, length, head circumference) and infant anthropometry (weight-for-age z-score [WAZ], length-for-age z-score [LAZ]) were obtained. Linear regression and mixed effect modeling were used to evaluate gestational factors in relation to pregnancy and infant outcomes.Results and discussionGestational MUAC and maternal HIV status (HIV-positive mothers = 39 %) were associated with infant WAZ and LAZ from birth to 6-months in multivariate models, even after adjustment for infant feeding practices. The lowest gestational MUAC tertile was associated with lower WAZ throughout early infancy, as well as lower LAZ at 3 and 6-months. In linear mixed effects models through 6-months, each 1 cm increase in gestational MUAC was associated with a 0.11 increase in both WAZ (P < 0.001) and LAZ (P = 0.001). Infant HIV-exposure was negatively associated with WAZ (β = -0.65, P < 0.001) and LAZ (β = -0.49, P < 0.012) from birth to 6-months.ConclusionsLower gestational MUAC, evaluated using only a tape measure and minimal training that is feasible in non-urban clinic and community settings, was associated with lower infant anthropometric measurements. In this rural and semi-rural setting, HIV-exposure was associated with poorer anthropometry through 6-months despite maternal antiretroviral access. Routine assessment of MUAC has the potential to identify at-risk women in need of additional health interventions designed to optimize pregnancy outcomes and infant growth. Further research is needed to establish gestational MUAC reference ranges and to define interventions that successfully improve MUAC during pregnancy.

Efeito da idade relativa na antropometria, maturação biológica e desempenho em jovens futebolistas

The study examined the presence of the relative age effect (RAE) and association between birth quartile and anthropometry, biological maturation and physical and technical performance of young Brazilian soccer players. The sample included 119 male players, 74 of U-15 category and 45 of U-17 category, which were divided into quartiles according to the birth year. Biological maturation was assessed using the method of skeletal age of Fels. Anthropometric measurements included body weight, stature and subcutaneous adiposity. Physical fitness assessment included strength tests in the lower limbs, speed, aerobic endurance and anaerobic power. Technical skills included ball control, dribbling and kicking accuracy. Overall, 65.5% of soccer players were born on the first half of the year (c2= 8.069, p = 0.04); however, in the analysis by category, there was no significant difference in the distribution of birth dates for quartile when compared with the reference population (U-15: c2=6.322, p=0.10; U-17: c2=2.339, p=0.50). MANCOVA revealed no significant differences between anthropometry, biological maturation and physical and technical performance in both competitive categories. These results suggest that there is a higher proportion of young Brazilian soccer born on the first months of the year, but that RAE does not necessarily constitute an advantage under the anthropometric, physical and technical standpoint. The process of biological maturation of individuals should be considered by coaches in the selection of athletes.

Elevated Umbilical Cord Cytokines are Related to Birth Size in HIV‐exposed and Unexposed Infants

BackgroundInfection causes immune activation and inflammatory cytokines may be mediators of intrauterine growth restriction (IUGR). While infection and IUGR are common in developing regions, the intrauterine cytokine environment and its impact on birth size is undefined. Understanding the fetal environment mediated by multiple cytokines may inform interventions targeting birth anthropometry. ObjectiveTo investigate the relationship between umbilical cord cytokines and birth size. MethodsUmbilical cord cytokines (IFN‐γ, IL‐1β, IL‐2, IL‐6, TNF‐α, IL‐12p70, IL‐10, IL‐13) were multiplexed from 50 singleton deliveries of women residing in rural Tanzania (38% HIV‐positive). Birth weight and length were assessed using linear regression models adjusted for maternal age, nutritional status, HIV, and infant gender. &#x0D;ResultsCord IFN‐γ, IL‐1β, TNF‐α, IL‐12p70, and IL‐10 were each associated with reduced birth weight (grams; ‐532, P&lt;0.01; ‐372, P=0.04; ‐315, P=0.03; ‐721, P&lt;0.01; ‐278, P=0.04; respectively) and IFN‐γ, TNF‐α, and IL‐12p70 with reduced length.imageimageCord cytokines were not associated with gestational age at delivery and did not differ based on maternal HIV status. &#x0D;ConclusionsElevated cord blood cytokines, which suggest intrauterine immune activation and inflammation, were associated with clinically important reductions in birth weight and length. Understanding these relationships may be key to optimizing fetal growth outcomes in this setting.