Effects Of Low Birth Weight Research Articles

Association of birth weight with type 2 diabetes mellitus and the mediating role of fatty acids traits: a two-step mendelian randomization study

BackgroundObservational studies have suggested an association between birth weight and type 2 diabetes mellitus, but the causality between them has not been established. We aimed to obtain the causal relationship between birth weight with T2DM and quantify the mediating effects of potential modifiable risk factors.MethodsTwo-step, two-sample Mendelian randomization (MR) techniques were applied using SNPs as genetic instruments for exposure and mediators. Summary data from genome-wide association studies (GWAS) for birth weight, T2DM, and a series of fatty acids traits and their ratios were leveraged. The inverse variance weighted (IVW) method was the main analysis approach. In addition, the heterogeneity test, horizontal pleiotropy test, Mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO) test, and leave-one-out analysis were carried out to assess the robustness.ResultsThe IVW method showed that lower birth weight raised the risk of T2DM (β: −1.113, 95% CI: −1.573 ∼ −0.652). Two-step MR identified 4 of 17 candidate mediators partially mediating the effect of lower birth weight on T2DM, including ratio of polyunsaturated fatty acids to monounsaturated fatty acids (proportion mediated: 7.9%), ratio of polyunsaturated fatty acids to total fatty acids (7.2%), ratio of omega-6 fatty acids to total fatty acids (8.1%) and ratio of linoleic acid to total fatty acids ratio (6.0%).ConclusionsOur findings supported a potentially causal effect of birth weight against T2DM with considerable mediation by modifiable risk factors. Interventions that target these factors have the potential to reduce the burden of T2DM attributable to low birth weight.

THE EFFECT OF LOW BIRTH WEIGHT (LBW) ON NEONATAL DEATH IN GORONTALO CITY

Indonesia is a developing country with high maternal and infant mortality rates. One of the causes of infant mortality in Indonesia is the incidence of Low Birth Weight (LBW) of 38.85%. The number of neonatal deaths in Gorontalo City between 2018 - 2021 is 83 cases. The novelty of this research is the effect of LBW on neonatal death. This study aims to see the impact of LBW on neonatal mortality in Gorontalo City after controlling for maternal risk factors in the form of a history of complications and the frequency of ANC. The research design used was analytic with a case-control approach. The sample in this study consisted of 30 cases and 60 controls. The results of the survey show that from the effects of bivariate analysis, the history of complications variable has an Odds Ratio Crude value of 55 and an Odds Ratio Adjusted of 13 and the Mantel-Haenszel test value: p-value α (0.000 0.05). In contrast, Antenatal Care has an Odds Ratio Crude value of 28 and Odds Ratio Adjusted by 17 and the value of the Mantel-Haenszel test: p-value α (0.000 0.05). The Odds Ratio value for LBW is 20 with a p-value α (0.000 0.05). This study concludes that LBW has a 20 times risk of neonatal death (95% CI = 6.506 – 61.485)

Associations between birth parameters and skin autofluorescence advanced glycation end products and ankle-brachial index in young adulthood: the Malmö Offspring Study.

Low birth weight (LBW), advanced glycation end-products (AGE), and ankle-brachial index (ABI) have all been independently associated with risk of cardiovascular disease. Evidence is lacking on the effect of LBW on adult AGE, a marker of glucose metabolism, and ABI, a marker of peripheral atherosclerosis. The objective was to study these associations in a population-based cohort. Data from the Malmö Offspring Study, Sweden, were used for 2012 participants (958 men, 1054 women) born between 1973 and 2000, linked to the Medical Birth Register. General linear regression analysis (with β coefficients and 95% confidence intervals) was applied for associations between birth weight and skin auto-fluorescence (sf)AGE as well as mean ABI (right/left), before and after adjusting for gestational age, sex, glucose, lipids, smoking, BMI and SBP. The mean (SD) age of men was 29.3 (7.3) and of women 28.6 (7.3) years. There was an average 0.054 decrease in sfAGE value per 1 kg increase in birth weight (adjusted for gestational age and sex). Similarly, 1 kg increase in birth weight (adjusted for gestational age and confounders) was associated with an average 0.016 decrease in mean ABI. Birth weight, adjusted for gestational age and other confounding variables, is inversely associated with ABI in young adulthood, an age range when ABI may represent hemodynamic changes more than atherosclerosis, but for sfAGE, the association was attenuated upon further adjustment. These risk markers may, therefore, represent mediating pathways for early life factors affecting cardiovascular risk later in life.

Causal relationships between birth weight, childhood obesity and age at menarche: A two-sample Mendelian randomization analysis.

Observational studies suggest birth weight and childhood obesity are closely associated with age at menarche. However, the relationships between them are currently inconsistent and it remains elusive whether such associations are causal. Therefore, the aim of the study was to investigate whether there existed causal relationships between birth weight, childhood obesity and age at menarche. A two-sample Mendelian randomization (MR) study. The standard inverse variance weighted MR analyses were adopted to evaluate the causal effects of birth weight (n = 143,677), childhood body mass index (BMI) (n = 39,620) on age at menarche (n = 182,416) with summary statistics from large-scale genome-wide association studies(GWASs). Meanwhile, we validated our MR results with some sensitivity analyses including maximum likelihood, weighted-median and MR pleiotropy residual sum and outliermethods. The present study showed that each one standard deviation (1-SD) lower birth weight was predicted to result in a 0.1479 years earlier of age at menarche (β = .1479, 95% confidence interval [CI] = 0.0422-0.2535; p = 0.0061). We also found that genetically predicted 1-SD increase in childhood BMI was causally associated with early age at menarche (β = -.3966, 95%CI = -0.5294 to -0.2639; p = 4.73E-09). Our MR study suggests the causal effect of lower birth weight and higher childhood BMI on the increased risk of earlier menarche. It may be the opportune time to carry out weight control intervention in prenatal and early childhood development periods to prevent early menarche onset, thus decreasing the future adverse consequences.

Birth Weight and the Risk of Cardiovascular Outcomes: A Report From the Large Population-Based UK Biobank Cohort Study.

BackgroundBirth weight has been reported to be associated with the risk of incident cardiovascular disease (CVD); however, the relationship remains inconclusive. Here, we aimed to prospectively assess the associations between birth weight and CVD risk using the data from UK Biobank, a large-scale, prospective cohort study.MethodsWe included 270,297 participants who were free of CVD at baseline and reported their birth weight for analyses. The primary outcome was incident CVD. Hazard ratios (HRs) and 95% confidence intervals (CIs) for outcomes were calculated using Cox proportional hazards models adjusted for potential confounding variables.ResultsDuring a median follow-up of 8.07 years (IQR: 7.4–8.7 years), 10,719 incident CVD events were recorded. The HRs for low birth weight vs. normal birth weight (2.5–4.0 kg) were 1.23 (95% CI: 1.09–1.38) for risk of incident CVD, 1.52 (95% CI: 1.18–1.95) for stroke, 1.33 (95% CI: 1.07–1.64) for myocardial infarction, and 1.15 (95% CI: 1.01–1.32) for CHD. For the ones with low birth weight, the risk of CVD is reduced by 11% for every kilogram of birth weight gain. The association of low birth weight with CVD was stronger among those younger than 55 years (p = 0.001). No association between high birth weight and risk of cardiovascular outcomes was found.ConclusionLow birth weight was associated with an increased risk of cardiovascular events. These findings highlight the longstanding consequence of low birth weight on cardiovascular system.

Low birth weight predicts impaired cardiac structure and function in mid-adulthood

Abstract Aims We sought to determine the relationship of low birth weight (LBW) with adult cardiac structure and function and investigate potential causal pathways. Methods We followed 925 Australians (41.3% male) from childhood (7–15 years) to young- (26–36 years) and mid-adulthood (36–50 years). Left ventricular (LV) global longitudinal strain (GLS, %), LV mass index (LVMi, g/m2.7), LV filling pressure (E/e') and left atrial volume index (LAVi, g/m2) were measured by echocardiography in mid-adulthood. Birth weight category was self-reported in adulthood and classified as low (≤5 pounds or ≤2270 g), normal (5–8 pounds or 2271–3630 g) and high (>8 pounds or >3630 g). Results 7.5% (69/925) reported LBW. Compared with participants with normal birth weight, those with LBW had a 2.01-fold (1.19–3.41, p=0.009) higher risk of impaired GLS (GLS >−18%) and 2.63-fold (0.89–7.81, p=0.08) higher risk of LV hypertrophy (LVMi >48 g/m2.7 in men or >44 g/m2.7 in women) in adulthood independent of age, sex and any measures of socioeconomic status. Participants with LBW significantly increased body fat from childhood to adulthood relative to their peers, which was associated with greater levels of triglycerides, fasting blood glucose and arterial stiffness in adulthood. These factors were the strongest mediators in the association of LBW with impaired GLS in adulthood and together, explained half of the LBW effect size. The remaining half of this association was independent of any measured factors. Conclusions LBW was associated with impaired cardiac structure and function in mid-adulthood. This association was only partially explained by known risk factors. Funding Acknowledgement Type of funding sources: None.

FACTORS AFFECTING ANXIETY OF MOTHERS WITH LOW-BIRTH-WEIGHT BABIES IN SOUTHWEST SUMBA DISTRICT, EAST NUSA TENGGARA PROVINCE

The World Health Organization (WHO) states that 60-80% of the infant mortality rate (IMR) occurs due to low birth weight. Low Birth Weight (LBW) contributes 60% -80% of neonatal mortality. The Indonesian Health Demographic Survey (IDHS) in 2017 showed that the incidence of LBW in Indonesia reached 6.2% with a fairly high prevalence. These various effects of LBW are what then causes babies to often require intensive care in the hospital. This condition can then lead to anxiety in parents. Therefore, this study was conducted to determine the factors that influence anxiety in mothers who have babies with LBW conditions in Southwest Sumba Regency. This research was conducted on 20-26 March 2021 with a qualitative approach through interviews and measuring anxiety levels using the HARS questionnaire. The study population was all mothers who had LBW babies in Southwest Sumba. The research subjects were 6 respondents who were selected through the purposive sampling technique. The results showed that there were several factors that influenced the anxiety of mothers with LBW babies, including the mother's age at pregnancy, the amount of parity, and education.

When is it too Small to be Born?

Low birth weight is the leading cause of perinatal and child mortality and contributes to several disabilities among survivors. It commonly results from preterm birth either with intact membranes or following preterm premature rupture of membranes. Proper knowledge of risk factors of low birth weight is important for identifying mothers at risk in order to properly plan and take appropriate actions before or immediately after delivery to prevent these poor outcomes. In this review paper, we looked at the subdivision of low birth weight, risk factors for preterm birth, consequences of low birth weight, threshold for viability as well as the interventions to reduce infant morbidity and mortality.

A qualitative perinatal audit at a rural health facility in Eldoret, Kenya

Background: Objectives of the study were to ascertain the pattern of occurrence of perinatal mortality by applying the World Health Organization (WHO), International Classification of Diseases, tenth revision (ICD-10) to deaths during the perinatal period, ICD perinatal mortality (ICD-PM), following the introduction of a qualitative perinatal audit process at a rural health facility in Kenya.Methods: A single centre retrospective analysis demonstrating the application of the WHO, ICD-PM. Data pertaining to perinatal deaths for the period from 1st May 2017 to 31st August 2018 was obtained from Plateau Mission Hospital perinatal audit records.Results: There were 22 perinatal deaths during the study period, 17 were included in the study. The overall perinatal death rate was 11 per 1000 births. Antepartum deaths were as a consequence of fetal growth related problems (33.3%), infection (33.3%) or unexplained (33.3%) with pregnancy-related hypertensive disorders (gestational hypertension, pre-eclampsia and eclampsia) being the most frequent medical condition associated with the mortalities. Neonatal deaths (47.1%) were the most frequent in the study and were a consequence of low birth weight and prematurity (25.0%), Convulsions and disorders of cerebral status (25.0%). The maternal condition in most of these cases being complications of placenta, cord and membranes. Acute intrapartum events and were least in this setting accounting for 17.4% of deaths.Conclusions: The ICD-PM is generalizable and its use in perinatal death classification emphasises focus on both mother and baby. Our study showed the majority of perinatal deaths occurred in the early neonatal period & affected mostly preterm infants.

Low birth weight incidence in newborn' neonate in Qom, Iran: Risk factors and complications

Background: Low birth weight (LBW) is related with high morbidity of neonatal consequences and death. This study aimed to determine the incidence of LBW, its risk factors, and complications in born neonates in Qom, Iran 2017. Methods: This retrospective chart review was conducted with 602 newborns participants who were one of Qom hospitals in Iran. Data were extracted from the patients' medical records and entered into data collection sheet and were analyzed by t-test, Chi-square, Fisher exact, and independent t-tests in SPSS v. 18 software. Results: The overall incidence of LBW in born neonates was 9.6%, and the mean of maternal age was 28.8 years. Based on results, twin's birth (Odds ratio [OR] = 1.47), receiving corticosteroid (OR = 4.55), and premature rupture of membrane (PROM) (OR = 1.08) were the most important related factors of LBW and respiratory distress syndrome (RDS) (OR = 6.47.8), sepsis (OR = 5.36), and icterus (OR = 5.8) consequences of LBW. Nevertheless, poor feeding, hypoplasia, premature, tachypnea, meconium, intraventricular hemorrhage, hypotonic, and other neonatal complications do not show the significant relationship with LBW (P > 0.05). Conclusions: According to results, twin's births, receiving corticosteroid, and PROM are the important risk factors for LBW and RDS, sepsis and icterus were the most common complication of LBW. As a result, preventive programs for control of LBW and infant complications are essential.

Low birth weight incidence in newborn' neonate in Qom, Iran: Risk factors and complications

Background: Low birth weight (LBW) is related with high morbidity of neonatal consequences and death. This study aimed to determine the incidence of LBW, its risk factors, and complications in born neonates in Qom, Iran 2017. Methods: This retrospective chart review was conducted with 602 newborns participants who were one of Qom hospitals in Iran. Data were extracted from the patients' medical records and entered into data collection sheet and were analyzed by t-test, Chi-square, Fisher exact, and independent t-tests in SPSS v. 18 software. Results: The overall incidence of LBW in born neonates was 9.6%, and the mean of maternal age was 28.8 years. Based on results, twin's birth (Odds ratio [OR] = 1.47), receiving corticosteroid (OR = 4.55), and premature rupture of membrane (PROM) (OR = 1.08) were the most important related factors of LBW and respiratory distress syndrome (RDS) (OR = 6.47.8), sepsis (OR = 5.36), and icterus (OR = 5.8) consequences of LBW. Nevertheless, poor feeding, hypoplasia, premature, tachypnea, meconium, intraventricular hemorrhage, hypotonic, and other neonatal complications do not show the significant relationship with LBW (P > 0.05). Conclusions: According to results, twin's births, receiving corticosteroid, and PROM are the important risk factors for LBW and RDS, sepsis and icterus were the most common complication of LBW. As a result, preventive programs for control of LBW and infant complications are essential.

Discrimination learning and judgment bias in low birth weight pigs

Low birth weight (LBW) is a risk factor for cognitive and emotional impairments in humans. In pigs, LBW is a common occurrence, but its effects on cognition and emotion have received only limited scientific attention. To assess whether LBW pigs suffer from impaired cognitive and emotional development, we trained and tested 21 LBW and 21 normal birth weight (NBW) pigs in a judgment bias task. Judgment bias is a measure of emotional state which reflects the influence of emotion on an animal’s interpretation of ambiguous stimuli. Pigs were trained to perform a specific behavioral response to two auditory stimuli, predicting either a positive or negative outcome. Once pigs successfully discriminated between these stimuli, they were presented with intermediate, ambiguous stimuli. The pigs’ responses to ambiguous stimuli were scored as optimistic (performance of ‘positive’ response) or pessimistic (performance of ‘negative’ response). Optimistic or pessimistic interpretation of an ambiguous stimulus is indicative of a positive or negative emotional state, respectively. We found LBW pigs to require more discrimination training sessions than NBW pigs to reach criterion performance, suggesting that LBW causes a mild cognitive impairment in pigs. No effects of LBW on judgment bias were found, suggesting a similar emotional state for LBW and NBW pigs. This was supported by comparable salivary and hair cortisol concentrations for both groups. It is possible the enriched housing conditions and social grouping applied during our study influenced these results.

Life course consequences of low birth weight: Evidence from Japan

This study provides the first evidence on a variety of life course outcomes of birth weight in Japan by employing new datasets covering the middle and older generations. We have several interesting observations. First, low birth weight is significantly associated with adverse outcomes in early life including school performance and self-rated health. Second, no negative effect of low birth weight is found on educational attainment or primary job status. Third, health outcomes due to low birth weight at older ages are not negatively affected except for difficulty in mobility and higher risk of diagnosis with hypertension or diabetes. Overall, our findings suggest that the negative effect of lower birth weight seems to fade out over the life course.

The role of birth weight on the causal pathway to child and adolescent ADHD symptomatology: a population‐based twin differences longitudinal design

BackgroundAvailable evidence points towards lower birth weight as a risk factor for the development of attention deficit/hyperactivity disorder (ADHD) symptoms. We probed the causal nature of this putative effect of birth weight on ADHD symptoms using the twin differences design, which accounts for genetic and shared environmental confounds.MethodIn a large population‐based twin sample – 3,499 monozygotic (MZ) and 6,698 dizygotic (DZ) pairs – parents, teachers or twins rated the twins’ ADHD symptoms at nine assessment waves (2–16 years). We implemented the twin differences design, which completely accounts for shared environmental and genetic confounding in MZ twins. We tested whether: (a) the lighter‐born twins had elevated ADHD symptoms compared to the heavier‐born twins, by regressing within‐pair differences of ADHD symptoms on within‐pair differences of birth weight among MZ twins; (b) the effect of birth weight on ADHD was moderated by gender, gestational age and low birth weight; (c) this effect changed with age at ADHD assessment using adapted latent growth curve models; and (d) results differed for inattention and hyperactivity/impulsivity.ResultsBirth weight significantly predicted ADHD symptoms from early childhood to late adolescence. The lighter‐born twin had more ADHD symptoms than the heavier‐born cotwin among MZ twins across assessment waves and raters. No moderation effect was detected. The magnitude of the effect of birth weight decreased significantly across time for hyperactivity/impulsivity, but the decrease failed to reach significance for inattention. Estimates for inattention were significantly larger than for hyperactivity/impulsivity at each time point, implying stronger effect of birth weight on inattention symptoms.ConclusionsOur findings provide stringent evidence for environmental effect of lower birth weight on the causal pathway to elevated ADHD symptoms. Effect of birth weight persists across a 14‐year period from childhood into late adolescence, in particular for inattention symptoms.

Differential Effects of Birth Weight on Early-Onset Type 2 Diabetes in Adolescents and Young Adults

Background: Type 2 diabetes mellitus (T2DM) is increasingly diagnosed in adolescents and young adults. However, the impact of birth weight (BW) on this early onset T2DM is not well quantified. Methods: A longitudinal study of Southwestern American Indians, aged ≥ 5 years, was conducted from 1965-2007. Subjects who had a recorded BW and at least one research exam that included an OGTT were followed until they developed T2DM or their last exam before the age of 40 years, whichever came first. Age-sex-adjusted incidence rate of T2DM was computed and Poisson regression models were used to estimate the effect of BW on the incidence of T2DM, adjusted for sex, BMI z-score (fitted as time-varying), and maternal variables, such as the presence of diabetes during pregnancy. The effect of BW on T2DM was non-proportional over time, and in some regression models, the effect was non-linear (quadratic). Therefore, all analyses were stratified by decade of age at follow-up and BW was analyzed as quintiles. Results: Among 4,275 subjects (52% females, median BW 3.45 kg), there were 728 incident cases of T2DM over a median follow-up of 20.6 years (7.5 cases per 1000 person-years). Incidence rates, stratified by decade of age at follow-up, were greater in females and in older age groups. In multivariable regression analyses, the effect of BW on T2DM risk varied by age group, showing a quadratic (U-shaped) effect at 10-19 years (P<0.05) and a negative linear effect at older age intervals (20-29 years, P=0.015; 30-39 years, P<0.001). We could not reliably estimate risk at 0-9 years because of few cases. Female sex, greater BMI z-score, and the presence of maternal diabetes in pregnancy added to the effect of BW on T2DM risk in all age groups. Conclusions: Both low and high BWs increased the risk of T2DM in adolescence, but only the effect of low BW persisted into young adulthood. Effects of female sex, accelerated growth, or being the offspring of a diabetic pregnancy added to the effect of BW on the risk of early onset T2DM. Disclosure M.T. Olaiya: None. M. Sinha: None. R.L. Hanson: None. S. Kobes: None. R. Nelson: None. W.C. Knowler: None.

Sex differences in early-life programming of the hypothalamic–pituitary–adrenal axis in humans suggest increased vulnerability in females: a systematic review

Fetal glucocorticoid overexposure is a key mechanism linking early development with later-life disease. In humans, low birth weight associates with increased fasting cortisol, hypothalamic-pituitary-adrenal (HPA) axis reactivity, and with cardiovascular risk and cognitive decline. As there are sex differences in these adult diseases, we hypothesized that there may be sex differences in programming of the HPA axis in response to prenatal stressors. We conducted a systematic review following Meta-Analysis of Observational Studies in Epidemiology and Preferred Reporting Items for Systematic Reviews and Meta-Analysis. We searched Embase, MEDLINE and Web of Science from inception to 31 October 2016. We included studies related to sex differences, prenatal exposures and HPA axis. We excluded studies investigating specific disease states. The 23 included studies investigated the consequences of low birth weight, preterm birth and maternal stressors of asthma, psychosocial stress and glucocorticoid medications on HPA axis outcomes of placental glucocorticoid biology and offspring HPA axis function in early life and later life. Female offspring exposed to stressors had increased HPA axis reactivity compared with males. Furthermore, the female placenta increased its permeability to maternal glucocorticoids following maternal stress with changes in the expression of 11β-hydroxysteroid dehydrogenase enzymes in response to maternal glucocorticoid exposure or asthma. Among males there was some evidence of altered diurnal cortisol secretion. We conclude that although there is some evidence of male vulnerability leading to altered diurnal cortisol secretion, the female HPA axis is more vulnerable to programming, particularly in terms of its reactivity; this suggests a mechanism underlying sex differences in later-life diseases.

The WHO application of ICD-10 to deaths during the perinatal period (ICD-PM): results from pilot database testing in South Africa and United Kingdom.

To apply the World Health Organization (WHO) Application of the International Classification of Diseases, tenth revision (ICD-10) to deaths during the perinatal period: ICD-Perinatal Mortality (ICD-PM) to existing perinatal death databases. Retrospective application of ICD-PM. South Africa, UK. Perinatal death databases. Deaths were grouped according to timing of death and then by the ICD-PM cause of death. The main maternal condition at the time of perinatal death was assigned to each case. Causes of perinatal mortality, associated maternal conditions. In South Africa 344/689 (50%) deaths occurred antepartum, 11% (n=74) intrapartum and 39% (n=271) in the early neonatal period. In the UK 4377/9067 (48.3%) deaths occurred antepartum, with 457 (5%) intrapartum and 4233 (46.7%) in the neonatal period. Antepartum deaths were due to unspecified causes (59%), chromosomal abnormalities (21%) or problems related to fetal growth (14%). Intrapartum deaths followed acute intrapartum events (69%); neonatal deaths followed consequences of low birthweight/ prematurity (31%), chromosomal abnormalities (26%), or unspecified causes in healthy mothers (25%). Mothers were often healthy; 53%, 38% and 45% in the antepartum, intrapartum and neonatal death groups, respectively. Where there was a maternal condition, it was most often maternal medical conditions, and complications of placenta, cord and membranes. The ICD-PM can be a globally applicable perinatal death classification system that emphasises the need for a focus on the mother-baby dyad as we move beyond 2015. ICD-PM is a global system that classifies perinatal deaths and links them to maternal conditions.

Blunted Autonomic Responses and Low-Grade Inflammation in Mongolian Adults Born at Low Birth Weight.

Low birth weight (LBW) has been considered as a risk factor for adult hypertension that is associated with deterioration of autonomic functions and low-grade inflammation. To explore the above effects of LBW, we measured blood pressure (BP) and heart rate variability during postural change from a supine position to a sitting position in 21 healthy Mongolian adults aged 23-34 years: 4 with LBW (birth weight < 2,500 g), 13 with normal birth weight (NBW, 2,500 g ≤ birth weight < 4,000 g), and 4 with high birth weight (HBW, ≥ 4,000 g). Mongolian population is known to have higher prevalence of hypertension. The ratio of low frequency (LF, 0.04-0.15 Hz) to high frequency components (HF, 0.15-0.40 Hz) was used as an index of sympathetic nerve activity, and HF was used as an index of parasympathetic nerve activity. In contrast to the NBW group, the LBW and HBW groups showed no significant increase in heart rate, systolic BP and LF/HF following postural change. We also measured blood cell counts and other blood parameters related to inflammation. After adjusting for age, BMI, sex and family history of hypertension, LBW was retained as an independent predictor only for higher counts of leukocytes (β = -0.51, p < 0.05), basophils (β = -0.62, p < 0.01), eosinophils (β = -0.83, p < 0.001), and platelets (β = -0.61, p < 0.05). We propose that LBW leads to blunted autonomic responses and low-grade inflammation in seemingly healthy Mongolian adults.

Abstract 092: Low Birth Weight per se Is Not a Determinant of Vascular Dysfunction and Presumably Future Cardiovascular Risk in Humans

Background: Epidemiological studies suggest that low birth weight (BW) is associated with systemic vascular dysfunction and premature cardiovascular morbidity and mortality later in life. However, this association could be due to confounding factors associated with low BW, such as genetic factors, pathological events during intrauterine life, and maternal or early-life environmental insults. Studies of monozygotic twins born with significantly different BW provide a unique opportunity to control for these potential confounding factors, thereby allowing to directly study the effect of low BW per se on systemic vascular function later in life. Methods: We, therefore, measured flow-mediated dilation (FMD) of the brachial artery, carotid-femoral pulse wave velocity (PWV) and carotid intima-media thickness (IMT) in 13 monozygotic, monochorionic healthy twins pairs (mean±SD age, 13.5±3.4 years) who were born with significantly different BW (defined as &gt;20% BW difference within pairs, 2310±600 vs. 1800±520 g, P&lt;0.0001) and in 26 healthy age- and sex-matched control subjects born at term with normal BW (3460±360 g). None of the participants had suffered from intrauterine or perinatal complications. Results: The major new findings were two fold; 1) systemic vascular function was comparable in low and high BW twins (FMD, 9.0±1.8 vs. 8.7±2.0%; PWV, 6.5±1.3 vs. 6.6±0.9 m/s; IMT, 390±30 vs. 390±20μm, all P values &gt;0.2, low vs. high BW) and 2) systemic vascular function in twins was similar to the one observed in control singletons (FMD, 8.8±1.3 vs.8.9±1.8%, P=0.95; PWV: 6.5±1.1 vs. 6.6±1.2 m/s, P=0.80; IMT: 390±25 vs. 385±20μm, P=0.33, singletons vs. twins). Finally, there existed no relationship between BW and vascular function in the whole study population (FMD: r=0.001, P=0.99). Conclusions: This study provides the first direct evidence in humans that low BW per se is not a determinant of systemic vascular dysfunction (and presumably future cardiovascular risk). Moreover, it indicates that independent of BW, vascular function in twins is normal. We suggest that the association between low BW and increased cardiovascular risk reported in earlier epidemiological studies was related to confounding factors associated with low BW.

Maternal and child nutrition: The first 1,000 days

Maternal and child nutrition: The first 1,000 days