Epidemiological differences among birth weight and gestational age subgroups of newborns

For a sample of 16,113 women who received prenatal care from the Guatemalan Social Security Institute Hospital, we described the distribution of birth weight and gestational age subgroups and the association between known epidemiologic risk factors and the odds for 1) an appropriate-weight-for-gestational-age preterm vs. a small-for-gestational-age term infant, 2) a small-for-gestational-age preterm vs. a small-for-gestational-age term infant, and 3) a normal ponderal index vs. a low ponderal index term small-for-gestational-age infant. We found that low maternal income, education, height (3147 cm), prepregnancy weight (347.8 kg), and weight gain during pregnancy (30.72 kg) were associated with a greater odds for birth of a term small-for-gestational-age infant (particularly those with a normal ponderal index) than for the birth of a preterm appropriate-weight-for-gestational-age infant. Conversely, medical and pregnancy-related complications were associated with greater odds for a preterm birth of an appropriate- or a small-for-gestational-age infant. Implications of these findings for interventions and research are discussed.     

High ponderal index at birth predicts high estradiol levels in adult women.

Inter-individual variation in levels of sex hormones results from differences in genetic, developmental, and environmental factors. We tested a hypothesis that programming of the fetal neuroendocrine axis may predispose some women to produce higher levels of steroid hormones during their menstrual cycles as adults. One hundred forty-five regularly menstruating 24- to 36- year-old women collected daily saliva samples for one menstrual cycle. Data on women's birth weights and birth lengths were obtained from medical records. A positive relationship was observed between ponderal index at birth (an indicator of nutritional status, calculated as birth weight/(birth length)(3)) and levels of estradiol (E2) in menstrual cycles, after controlling for potential confounding factors. Mean E2 was 16.4 pmol/l in the low ponderal index tertile, 17.3 pmol/l in the moderate ponderal index tertile, and 19.6 pmol/l in the high ponderal index tertile (the high ponderal index group had significantly higher E2 than both low and moderate ponderal index groups, P=0.0001). This study shows a positive association between ponderal index recorded for women at birth and levels of E2 measured during their menstrual cycles as adults. This suggests that conditions during fetal life influence adult production of reproductive hormones and may contribute to inter-individual variation in reproductive function. In addition, because large size at birth is one of the factors linked with an increased risk of breast cancer, our findings provide a physiological link for the observed positive relationship between indicators of energetic conditions during fetal growth and breast cancer in women.     

Insulin sensitivity and insulin secretion at birth in intrauterine growth retarded infants

AIM: To study insulin sensitivity, secretion and relation of insulin levels with birth weight and ponderal index in intrauterine growth retarded (IUGR) infants at birth. METHODS: We studied 30 IUGR and 30 healthy newborns born at term by vaginal delivery in Jipmer, Pondicherry, India. Cord blood was collected at the time of delivery for measurement of plasma glucose and insulin. RESULTS: When compared with healthy newborns, IUGR newborns had lower plasma glucose levels (mean 2.3+/-0.98 versus 4.1+/-0.51 mmol/L, p<0.001); lower plasma insulin levels (mean 4.5+/-2.64 versus 11.03+/-1.68 microU/L, p<0.001); higher insulin sensitivity calculated using G/I ratio (mean 11.6+/-5.1 versus 6.7+/-0.31, p<0.001), HOMA IS (mean 5.5+/-6.0 versus 0.53+/-0.15, p<0.001), and QUICKI (mean 0.47+/-0.12 versus 0.34+/-0.02, p<0.001); and decreased pancreatic beta-cell function test measured as I/G (mean 0.10+/-0.037 versus 0.15+/-0.006, p<0.001). A positive correlation was identified between insulin levels and birth weight in both the healthy control group (r2 = 0.17, p = 0.024) and IUGR group (r2 = 0.13, p = 0.048). However correlation of insulin levels with ponderal index was much more confident in both healthy control (r2 = 0.90, p<0.001) and IUGR groups (r2 = 0.28, p = 0.003). Insulin status correlated both with birth weight and ponderal index more confidently in control group than in IUGR group. CONCLUSION: At birth, IUGR infants are hypoglycaemic, hypoinsulinaemic and display increased insulin sensitivity and decreased pancreatic beta-cell function. Insulin levels correlate with ponderal index much more confidently than with birth weight.     

Genetic and environmental influences on infant weight and weight change: the Fels Longitudinal Study.

Despite significant progress in understanding the mechanisms by which the prenatal/maternal environment can alter development and adult health, genetic influences on normal variation in growth are little understood. This work examines genetic and nongenetic contributions to body weight and weight change during infancy and the relationships between weight change and adult body composition. The dataset included 501 white infants in 164 nuclear and extended families in the Fels Longitudinal Study, each with 10 serial measures of weight from birth to age 3 years and 232 with body composition data in mid-adulthood. Heritability and covariate effects on weight and weight z-score change from birth to 2 years of age were estimated using a maximum likelihood variance decomposition method. Additive genetic effects explained a high proportion of the variance in infant weight status (h2=0.61-0.95), and change in weight z-score (h2=0.56-0.82). Covariate effects explained 27% of the phenotypic variance at 0-1 month of age and declined in effect to 6.9% of phenotypic variance by 36 months. Significant sex, gestational age, birth order, birth year, and maternal body mass index effects were also identified. For both sexes, a significant increase in weight z-score (>2 SD units) (upward centile crossing) was associated with greater adulthood stature, fat mass, and percent body fat than decrease or stability in weight z-score. Understanding genetic influences on growth rate in a well-nourished, nutritionally stable population may help us interpret the causes and consequences of centile crossing in nutritionally compromised contexts.     

Prenatal diagnosis of distal arthrogryposis

We report the prenatal diagnosis of distal arthrogryposis type I by ultrasound at 18 wk gestation in a family with two other affected members (mother and sister of the fetus). The pregnancy was followed with serial ultrasounds, and the diagnosis was confirmed after birth. The clinical findings in all affected family members are described. A literature survey of prenatally diagnosed cases of multiple joint contractures is presented. These include cases with many different diagnoses. This is the first report of the prenatal diagnosis of distal arthrogryposis type I. It helps to illustrate the variability and prenatal natural history of the condition and the subtlety of the prenatal ultrasound findings.     

Genetic insights into fetal growth and measures of glycaemic regulation and adiposity in adulthood: a family-based study

Background

The genetics of fetal insulin release and/or action have been suggested to affect fetal growth, adult insulin resistance and adult body composition. The genetic correlation between body composition at birth versus glycaemic regulation and body composition in adulthood have, however, not been well studied. We therefore aimed to investigate these genetic correlations in a family-based cohort.

Methods

A Danish family cohort of 434 individuals underwent an oral glucose tolerance test with subsequent calculation of surrogate measures of serum insulin response and insulin sensitivity. Measures of fetal growth were retrieved from midwife journals. Heritability and genetic correlations were estimated using a variance component model.

Results

A high heritability of 0.80 was found for birth weight, whereas ponderal index had a heritability of 0.46. Adult insulin sensitivity measured as Matsuda index was genetically correlated with both birth weight and ponderal index (ρG?=?0.36 (95% CI: 0.03; 0.69) and ρG?=?0.52 (95% CI, 0.15; 0.89), respectively). Only birth weight showed a significant genetic correlation with adult weight (ρG?=?0.38 (95% CI: 0.09; 0.67)) whereas only ponderal index was genetically inversely correlated with fasting insulin (ρG?=?-?0.47 (95% CI: -?0.86; -?0.08) and area under the curve for insulin release during the oral glucose tolerance test (ρG?=?-?0.66 (95% CI: -?1.13; -?0.19)).Individual as well as combined adjustment for 45 selected birth weight, obesity and type 2 diabetes susceptibility gene variants did not affect the correlations.

Conclusions

The genetics of both birth weight and ponderal index appear to be under the same genetic influence as adult insulin resistance. Furthermore, ponderal index and adult insulin release seem to be partly shared, as well as the genetics of birth weight and adult weight.Word count abstract: 281.

     

Effects of abuse pattern of gestational toluene exposure on metabolism, feeding and body composition

AIMS: Inhalant abuse during pregnancy lowers birth weight and impedes early development. These studies explored the effects of brief, repeated, prenatal toluene exposures in pregnant female rats on body weight, metabolic rate, body composition, and food intake in their offspring. METHOD: Rats were exposed to 0, 8000, 12,000, or 16,000 ppm of toluene twice daily for 15 min from gestational days 8 to 20. The effects of such exposures on post-weaning litter weights, oxygen consumption, carbon dioxide output, and body fat content were determined in 2 cohorts (n=23, n=24) of offspring. Food intakes and weight changes in response to 3 different diets (regular chow, purified diet, purified high fat diet) were examined in another cohort (n=24) from postnatal days 72 to 116. RESULTS: Litter weights showed a significant linear decrease as a function of toluene dose. Offspring exposed to the 16,000 ppm toluene dose displayed statistically lower energy expenditures than control rats. Male rats exposed to 8000 or 16,000 ppm toluene had significantly greater percentage of body fat as well as total body fat than the other groups. Toluene also significantly suppressed weight gain over the time chow was consumed compared to the 0 ppm control group. Finally there were trends for a main effect of toluene dose on food intake during chow and during high fat diet consumption, with rats in the 12,000 ppm group consuming more than the 0 ppm group on both diets. DISCUSSION: These data suggest that, in addition to other previously documented abnormalities in neurological development and behavior, the physiological regulation of metabolism and body composition in males as well as food intake and weight gain in both sexes may be altered by prenatal exposure to toluene.     

Randomized trial of vitamin supplements in relation to vertical transmission of HIV-1 in Tanzania

BACKGROUND: Observational studies suggest that poor nutritional status among HIV-infected pregnant women is associated with a higher risk of vertical transmission of HIV. METHODS: We randomized 1083 pregnant women infected with HIV-1 in a double-blind, placebo-controlled trial to examine the effects of supplements of vitamin A and/or multivitamins (excluding vitamin A) using a 2-x-2 factorial design. We report the effects of the supplements on HIV infection defined using polymerase chain reaction (PCR), or death up to 6 weeks postpartum. RESULTS: Of babies in the multivitamin arm 38, (10.1%) were HIV-positive at birth compared with 24 (6.6%) in the no-multivitamin arm (relative risk [RR] = 1.54; 95% CI, 0.94-2.51; p = .08). Of babies born to mothers in the vitamin A arm, 38 (10.0%) were HIV-positive at birth compared with 24 (6.7%) in the no-vitamin A arm (RR, 1.49; 95% CI, 0.91-2.43; p = 0.11). Neither multivitamins nor vitamin A had an effect on HIV status at 6 weeks among those who were HIV-negative at birth (RR = 1.04; 95% CI, 0.65-1.66; p = 0.88) and (RR = 1.30; 95% CI, 0.80-2.09; p = .29, respectively). Similarly, neither supplement was associated with being either HIV-infected or dead at birth (RR, 0.98; 95% CI, 0.76-1.27; p = .89 and RR, 1.01; 95% CI, 0.78-1.31; p = .95, respectively. A beneficial effect of multivitamins on birth weight was limited to babies who were HIV-negative at birth; babies in the multivitamin arm weighed +94 g more compared with those in the no-multivitamin arm (p = .02). Among babies who were HIV-positive at birth, the corresponding difference was -31 g (p = .82). CONCLUSIONS: Vitamin A and multivitamins did not affect the risk of vertical transmission of HIV in utero nor during the intrapartum and early breastfeeding periods. Multivitamins resulted in a significant improvement in birth weight of babies who were HIV-negative at birth but had no effect among those who were HIV-positive. The effect of vitamin supplements on HIV transmission through breastfeeding and on clinical progression of HIV disease is yet to be ascertained.     

Prepregnancy weight, inappropriate gestational weight gain, and smoking: Relationships to birth weight.

This study was designed to test predictors of infant birth weight based on categories of prepregnancy body mass index (BMI), gestational weight gain, and smoking. Data were collected retrospectively from records of 233 mother-infant pairs enrolled in the Siouxland Women, Infants, and Children (WIC) Program in Sioux City, Iowa. Prepregnancy BMI and gestational weight gain were coded according to Institute of Medicine guidelines. Smoking behavior was coded based on reported smoking during the last 3 months of pregnancy. Multiple regression analysis was used to test predictors of infant birth weight. Forty-two percent of women gained more weight than recommended, and 16% gained less than recommended. Based on prepregnancy BMI, women were classified as underweight (12%), overweight (16%), or obese (31%). Twenty-four percent of mothers reported smoking late in gestation. Higher birth weight was predicted by prepregnancy obesity (+144 g). Lower infant birth weight was predicted by lower (-162 g) and higher (-153 g) than recommended weight gain, and by lower (-299 g) and higher (-168 g) levels of smoking. Depression of birth weight among women who gained excess weight may relate to inadequate early weight gain or pregnancy complications. More research is needed regarding physiological consequences of these maternal factors and their associated demographic risk factors.     

轴突导向因子-1在胎儿生长受限胎盘组织中的表达及意义

目的：探讨神经轴突导向因子?1（ netrin?1）在胎儿生长受限患者胎盘组织中的表达变化。方法分析33例胎儿生长受限患者（其中18例为胎儿生长受限合并妊娠期高血压患者）及24例正常妊娠孕妇相关数据,并利用Real time?polymerase chain reaction （ RT?PCR）和Western印迹检测netrin?1在胎盘组织中的表达差异。结果①临床数据显示胎儿生长受限患者与正常孕妇在年龄、孕周、体重指数、血压、胎盘重量和出生体重等方面存在显著差异（ P＜0．05或P＜0．01）;②免疫组化结果显示netrin?1在胎盘中存在表达。③ RT?PCR及蛋白质印迹法显示胎儿生长受限患者胎盘组织中netrin?1的表达明显降低。结论 ne?trin?1表达降低可能是导致宫内胎儿生长受限的机制之一。     

Early postnatal growth of low birthweight infants in the WIC program

Patterns of early postnatal growth were analyzed among low birthweight infants enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Infants were divided into four groups according to their neonatal status: (1) term, normal birthweight (NBW); (2) term, low birthweight (LBW); (3) moderately preterm LBW; and (4) very preterm LBW. Comparison of mean weight and length z‐scores indicated that term NBW and very preterm LBW infants were at or near the national reference averages at 8, 12, and 18 months. Term LBW and moderately preterm infants were lighter and shorter than the other two study groups at each visit. Term LBW and moderately preterm infants displayed evidence of catch‐up growth during the study period. Catch‐up growth was defined as a decrease in the percentage of infants below the 10th percentile for weight. The effect of neonatal body proportions on postnatal growth was investigated in term LBW infants. The infants were divided into two groups based on their ponderal index (PI) at birth (low PI and proportionate PI). Comparison of weight and length z‐scores indicated that both groups of term LBW infants improved in z‐scores between birth and the first visit (approximately 8 months). However, infants with evidence of asymmetric intrauterine growth restriction (low PI) continued to improve in weight and length z‐scores, whereas those with symmetric growth restriction (proportionate PI) remained lighter and shorter. Am. J. Hum. Biol. 13:261–267, 2001. © 2001 Wiley‐Liss, Inc.     

Fetal programming of temperamental negative affectivity among children born healthy at term

The fetal programming hypothesis suggests that an adverse in utero environment, reflected in small body size at birth, has life-long effects on different physiological systems that may affect both health and behavior. We explored whether fetal growth was associated with biologically based temperamental outcomes (negative affectivity scales, the CBQ) among 5(1/2)-year-old children (n = 416) born healthy at term (gestational weeks 37-42). In line with the hypotheses, small body size at birth (thinness measured by ponderal index, kg/m(3)) was related to increased negative affectivity and its subscales: anger-, discomfort-, and sadness-proneness in childhood. Longer length at birth was predictive of higher levels of child anger- and sadness-proneness. Length of gestation moderated the associations of weight and length at birth with negative affectivity. The results suggest that the biological basis of temperament may be subjected to antenatal environmental influences, and that the mechanisms, proposed to be related to fetal glucocorticoid environment, may operate even within the normal range of term birth.     

Thrombocytopenia in preterm infants with intrauterine growth restriction

Sick preterm infants often have thrombocytopenia at birth, and this is often associated with intrauterine growth restriction (IUGR), or birth weights less than the 10th percentile. The pathogenesis of the thrombocytopenia and its importance in IUGR are still unclear. We studied the characteristics of preterm IUGR infants with thrombocytopenia. Twenty-seven singleton Japanese preterm IUGR infants were born between January 2002 and June 2007 at Okayama University Hospital. Infants with malformation, chromosomal abnormalities, alloimmune thrombocytopenia, sepsis, and maternal aspirin ingestion were excluded. The infants were divided into group A (n=8), which had thrombocytopenia within 72 h after birth, and group B (n=19), which did not. There were significant differences in birth weight, head circumference, umbilical artery (UA)-pulsatility index (PI), middle cerebral artery-PI, UA-pH, UA-pO2, and UA-pCO2. The infants in group A were smaller, had abnormal blood flow patterns, and were hypoxic at birth. We speculate that the infants with thrombocytopenia were more severely growth-restricted by chronic hypoxia. Thrombocytopenia is an important parameter for chronic hypoxia in the uterine.     

胰岛素样生长因子Ⅰ与胎儿生长受限的相关性研究

目的探讨胰岛素样生长因子-Ⅰ（IGF-Ⅰ）与胎儿生长受限（FGR）的相关性。方法采用放射免疫法和免疫放射法测定20例FGR孕妇（FGR组）和17例正常孕妇（对照组）的血清及新生儿脐血IGF-Ⅰ水平,并对其结果进行相关性研究。结果 FGR组孕妇血清IGF-Ⅰ（115.44±4.34）μg/L,低于对照组（121.92±10.51）μg/L（P〈0.01）,差异有统计学意义;FGR组脐血清IGF-Ⅰ（121.48±5.85）μg/L,低于正常组的（124.24±10.08）μg/L（P〈0.01）,差异有统计学意义;孕妇血清IGF-Ⅰ水平与新生儿出生体重无相关性（r=0.189,P〉0.05）。新生儿脐血IGF-Ⅰ水平与新生儿出生体重呈正相关（r=0.575,P〈0.05）。结论 IGF-Ⅰ可能在FGR的发病中有重要的作用,并可能为将来诊断和治疗FGR提供新的途径。     

Fetal brain to liver weight ratio as a measure of intrauterine growth retardation: analysis of 182 stillborn autopsies.

The fetal brain/liver weight ratio of 182 stillborn fetuses was analyzed for its value as a measure of intrauterine growth retardation. The ratio was evaluated as a test for the detection of small-for-gestational age fetuses, compared with the ponderal index, and evaluated for correlation with maternal histories that were compatible with fetal growth retardation. Both brain/liver ratio and ponderal index were insensitive and relatively nonspecific indicators of low fetal body weight in this population. Brain/liver weight ratio was considerably more sensitive in those cases that were at least 20 weeks of gestational age, and specificity increased as the cut-off point was increased above 3. Those cases with maternal history or placental findings compatible with asymmetrical-type intrauterine growth retardation were statistically more likely to have elevated brain/liver weight ratios and depressed ponderal indices, but there was considerable overlap among cases with different disease types. Prosectors of fetal autopsies must make use of all the information available to them. The fetal brain/liver weight ratio and the ponderal index may be useful, but they are not satisfactory indicators of intrauterine growth retardation by themselves, and they also may be inadequate for the detection of growth retardation etiology.     

A developmental transition in prehension modeled as a cusp catastrophe

The purpose of the study was to show that the change from reaching without grasping to reaching with grasping during the first 6 months of life carried the characteristics of a discontinuous phase transition (catastrophe). A cross-sectional study was carried out with 58 infants between 60 and 408 days old. The infants were seated in a specially designed seat, and presented with nine detachable balls on a black curved board within reaching distance at shoulder height. The number of reaches without and with grasping were scored from video. A cusp catastrophe model was fitted to the data. A Likelihood-Ratio test indicated that the likelihood of the cusp model was significantly higher, p<.001, than a linear regression model. The cusp model was also compared with a logistic model. Akaike's Information criterion for the cusp catastrophe exceeded the logistic model, thus indicating a general better fit. Based on prior research, the following potential control parameters were chosen: crown–heel length, total body weight, arm length, arm circumference, ponderal index, arm volume, arm weight, and body position relative to the horizontal. The cusp model predicted that arm weight and arm circumference significantly contributed to the control parameters. It was found that these two variables had their largest contribution to the asymmetry control parameters. © 1998 John Wiley & Sons, Inc. Dev Psychobiol 32: 23–35, 1998     

L-精氨酸治疗胎儿生长受限胎儿发育的临床观察

目的通过L-精氨酸治疗对胎儿生长受限的临床观察,探讨L-精氨酸对胎儿生长受限的治疗效果。方法将胎儿生长受限患者60例,随机分为常规治疗组（A组）30例,L-精氨酸治疗组（B组）30例,孕期定期用B型超声监测两组胎儿生长发育参数,产后比较新生儿出生体重和围产儿结局。结果生长参数：治疗后A组与B组比较,B组双顶径（BPD）、股骨长（FL）及腹围（AC）的增长幅度较高（P均〈0.05）。新生儿出生体重和围产儿结局：B组的治愈率显著高于A组（P〈0.05）,新生儿平均出生体重高于A组,小于胎龄儿（SGA）的发生率低于A组。结论L-精氨酸治疗较常规治疗疗效更显著,能更好地增加胎儿体重促进胎儿发育。     

Prenatal phthalate exposure,infant growth,and global DNA methylation of human placenta

Prenatal phthalate exposure has been shown to be associated with reduced fetal growth. Epigenetic changes such as DNA methylation might be a molecular mechanism through which phthalate exposure affects fetal growth. In this study, we examined associations between prenatal phthalate exposure, infant growth, and global DNA methylation in human placenta samples. We measured global DNA methylation of 119 subjects [55 fetal growth restriction (FGR) cases and 64 normal controls], as assessed by long interspersed nuclear element‐1 (LINE‐1) methylation, via quantitative polymerase chain reaction‐pyrosequencing. Prenatal phthalate exposure was assessed by measuring maternal urinary phthalate metabolites concentrations using high‐performance liquid chromatography‐tandem mass spectrometry. Concentrations of mono (2‐ethyl‐5‐hydroxyhexyl) phthalate (MEHHP), mono (2‐ethyl‐5‐oxohexyl) phthalate (MEOHP), and SumDEHP (molar sum of MEHP, MEHHP, and MEOHP) were significantly higher in FGR cases than those in normal controls (P = 0.002, 0.003, and 0.002, respectively). Placental LINE‐1 methylation were found to be positively associated with fetal birth weight standard deviation scores, and negatively associated with urinary phthalate metabolites concentrations (MEHHP and SumDEHP). Every natural‐log unit increase in urinary concentrations of MEHHP and SumDEHP was associated with 0.015 (β = ?0.015, P = 0.150) and 0.012 kg (β = ?0.012, P = 0.167) decrease in birth weight mediated through LINE‐1 methylation. These findings suggest that changes in placental LINE‐1 methylation might be part of the underlying biological pathway between prenatal phthalate exposure and adverse fetal growth. Environ. Mol. Mutagen. 56:286–292, 2015. © 2014 Wiley Periodicals, Inc.     

The effects of birth weight and postnatal growth patterns on fat depth and plasma leptin concentrations in juvenile and adult pigs

Low birth weight is associated with altered adipose tissue deposition and regulation of leptin production. This study determined the effects of naturally occurring variations in birth weight in pigs on postnatal growth patterns, body fat depth and plasma leptin and other hormone concentrations. Low (< 1.47 kg) and high (> 1.53 kg) birth weight piglets were studied at 3 months (juvenile; n = 47) and 12 months of age (young adult; n = 17). At each age, arterial and venous catheters were inserted under general anaesthesia. Plasma leptin, cortisol, glucose, insulin and catecholamine concentrations were determined in basal blood samples. Body fat depth was measured by ultrasound at 12 months of age. Overall, adult fat depth was greater in low compared to high birth weight pigs and increased fat depth was associated with thinness at birth and poor early growth rates. These effects were strongest in females. Fat depth was related to current weight only in males. Compared to high birth weight pigs, plasma leptin concentrations were reduced in low birth weight females at 3 months and in low birth weight males at 12 months of age. This study demonstrates sex-specific effects of low birth weight on postnatal growth and body fatness and on plasma leptin concentrations in pigs.     

Prenatal Origins of Poor Sleep in Children

Study Objectives:

We examined whether small body size at birth and prenatal tobacco or alcohol exposure predict poor sleep and more sleep disturbances in children.

Design:

An epidemiologic cohort study of 289 eight-year-old children born at term.

Measurements and results:

Sleep duration and efficiency were measured by actigraphy for 7 consecutive nights (mean = 7.1, SD = 1.2). We used both continuous measures of poor sleep and binary variables of short sleep and low sleep efficiency ( ≤ 10^th percentiles). Parents completed the Sleep Disturbance Scale for Children. Lower birth weight and shorter length at birth were associated with lower sleep efficiency. For every 1-SD decrease in weight and length at birth, the odds for low sleep efficiency increased by 1.7 fold (95% confidence interval [CI]: 1.1 to 2.7) and 2.2 fold (95% CI: 1.3 to 3.7), respectively. For every 1-SD decrease in ponderal index at birth, the risk of parent-reported sleep disorders increased by 1.4 fold (95% CI: 1.0 to 2.0). Moreover, children exposed prenatally to alcohol had a 2.9-fold (95% CI: 1.1 to 7.6) and 3.6-fold (95% CI: 1.3 to 10.0) increased risk for having short sleep and low sleep efficiency, respectively. The associations were not confounded by sex, gestational length, prenatal and perinatal complications, body mass index at 8 years, asthma, allergies, or parental socioeconomic status.

Conclusions:

Poor sleep in children may have prenatal origins. Possible mechanisms include alcohol consumption during pregnancy and other conditions associated with small body size at birth.

Citation:

Pesonen AK; Röaikköonen K; Matthews K; Heinonen K; Paavonen JE; Lahti J; Komsi N; Lemola S; Jöarvenpöaöa AL; Kajantie E; Strandberg T. Prenatal origins of poor sleep in children. SLEEP 2009;32(8):1086-1092.