| Reduced birthweight in short or primiparous mothers: physiological or pathological? | |
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MedLine Citation:
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PMID: 20618317 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Customisation of birthweight-for-gestational-age standards for maternal characteristics assumes that variation in birth weight as a result of those characteristics is physiological, rather than pathological. Maternal height and parity are among the characteristics widely assumed to be physiological. Our objective was to test that assumption by using an association with perinatal mortality as evidence of a pathological effect. DESIGN: Population-based cohort study. SETTING: Sweden. POPULATION: A total of 952 630 singletons born at > or =28 weeks of gestation in the period 1992-2001. METHODS: We compared perinatal mortality among mothers of short stature (<160 cm) versus those of normal height (> or =160 cm), and primiparous versus multiparous mothers, using an internal reference of estimated fetal weight for gestational age. The total effects of maternal height and parity were estimated, as well as the effects of height and parity independent of birthweight (controlled direct effects). All analyses were based on fetuses at risk, using marginal structural Cox models for the estimation of total and controlled direct effects. MAIN OUTCOME MEASURES: Perinatal mortality, stillbirth, and early neonatal mortality. RESULTS: The estimated total effect (HR; 95% CI) of short stature on perinatal death among short mothers was 1.2 (95% CI 1.1-1.3) compared with women of normal height; the effect of short stature independent of birthweight (controlled direct effect) was 0.8 (95% CI 0.6-1.0) among small-for-gestational-age (SGA) births, but 1.1 (95% CI 1.0-1.3) among non-SGA births. Similar results were observed for primiparous mothers. CONCLUSIONS: The effect of maternal short stature or primiparity on perinatal mortality is partly mediated through SGA birth. Thus, birthweight differences resulting from these maternal characteristics appear not only to be physiological, but also to have an important pathological component. |
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Authors:
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X Zhang; S L Mumford; S Cnattingius; E F Schisterman; M S Kramer |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Intramural; Research Support, Non-U.S. Gov't Date: 2010-07-07 |
Journal Detail:
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Title: BJOG : an international journal of obstetrics and gynaecology Volume: 117 ISSN: 1471-0528 ISO Abbreviation: BJOG Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-20 Completed Date: 2010-11-08 Revised Date: 2012-03-08 |
Medline Journal Info:
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Nlm Unique ID: 100935741 Medline TA: BJOG Country: England |
Other Details:
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Languages: eng Pagination: 1248-54 Citation Subset: AIM; IM |
Affiliation:
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Department of Pediatrics, McGill University, Faculty of Medicine, Montreal, QC, Canada. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Birth Weight / physiology* Body Height / physiology* Educational Status Female Gestational Age Humans Infant, Newborn Infant, Small for Gestational Age Male Maternal Age Parity / physiology* Perinatal Mortality Pregnancy Premature Birth / epidemiology Stillbirth / epidemiology Sweden / epidemiology |
| Grant Support | |
ID/Acronym/Agency:
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Z01 HD008761-05/HD/NICHD NIH HHS; Z99 HD999999/HD/NICHD NIH HHS; //Canadian Institutes of Health Research |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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