Cadmium, zinc, and copper from placental tissue and blood samples at the first trimester (n = 64) and at term (n = 152) were analyzed; the welfare of newborns and placental 7-ethoxycoumarin O-deethylase (ECOD) activities in vitro were determined. The study material was collected from Finland, Estonia, and Russia. The results demonstrate that Cd starts to accumulate in the placenta during the first trimester and that Zn and Cu contents were significantly higher at the first trimester than at term. Among nonsmokers a negative correlation was found between placental Cu content and birth weight of neonates. Among smokers a positive correlation between placental Zn content and birth weight and ECOD activity was found. The birth weights correlated inversely with the length of time the mothers smoked. The highest Cd concentrations were detected in the samples collected from St. Petersburg. The data demonstrate an inverse accumulation of Zn and Cd throughout the pregnancy in the placenta and maternal blood samples. Zn may act as a positive marker or even an enzymatic enhancement for the human placental vital functions. Smoking, parity, age, and especially the place of residence affect the Cd, Zn, and Cu contents and ratios in placenta and mother's blood.
This study was undertaken to evaluate the effects of repeated courses of antenatal corticosteroids (ACS) on foetal growth.
We studied 94 infants exposed to 2-9 courses of ACS. Mean gestational age (GA) at first exposure was 29 and at birth 34 weeks. Exposure data were retrieved from case record files. Information on potential confounders was collected from the Swedish Medical Birth Registry. Standard deviation scores (SDS) for birthweight (BW), birthlength (BL) and head circumference (HC) were calculated and considered as outcomes.
GA at start of ACS did not affect outcome. BW-SDS, BL-SDS and HC-SDS were -0.21, -0.19 and +0.25 in infants exposed to two courses, compared to -1.01, -1.04 and -0.23 in infants exposed to = 4 courses of ACS (p = 0.04-0.07). In multiple regression analyses, = 4 courses were associated with lower BW-SDS, BL-SDS and HC-SDS (p = 0.007-0.04) compared to SDS after 2-3 courses. The effects from = 4 courses on BW and BL were comparable to reduction in birth size seen in twins and on HC to that observed after maternal smoking.
Multiple courses of ACS are associated with a dose-dependent decline in foetal growth, which may affect later development and health.
In spite of the widespread use of antihypertensives during pregnancy, data on their risks and benefits for the newborn are limited. We investigated the risk of major congenital malformations or small-for-gestational-age newborns (SGA) in relation to gestational use of antihypertensives.
Within the Quebec Pregnancy Registry, we conducted two case-control studies. First, cases were defined as major congenital malformations diagnosed during the first year of life and controls were selected from the same cohort; index date was date of delivery. Gestational exposure was defined as filling a prescription for an antihypertensive during the 1st trimester of pregnancy. Next, cases (SGA) were defined as newborns with a birth weight or =10 percentile. Gestational exposure was defined as filling a prescription for an antihypertensive during the 2nd or 3rd trimester. Multivariate logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CI).
We found that overall antihypertensives use during the 2nd or 3rd trimesters of pregnancy was associated with a higher risk of SGA (OR 1.53, 95% CI 1.17-1.99). Moreover, selective beta-blocker (OR 6.00, 95% CI 1.06-33.87), alpha beta blocker (OR 2.26, 95% CI 1.04-4.88), or centrally-acting adrenergic agents use (OR 1.70, 95% CI 1.00-2.89) was associated with a higher risk of SGA compared to non-use.
Gestational use of antihypertensives, especially beta-blocker, alpha beta blocker, or centrally-acting adrenergic agents, may increase the risk of SGA.
Association of maternal serum concentrations of 2,2', 4,4'5,5'-hexachlorobiphenyl (CB-153) and 1,1-dichloro-2,2-bis (p-chlorophenyl)-ethylene (p,p'-DDE) levels with birth weight, gestational age and preterm births in Inuit and European populations.
Epidemiological studies on the association between maternal exposure to persistent organic pollutants (POPs) and fetal growth alteration report inconsistent findings which weights in favor of additional studies.
Blood samples were collected from interviewed pregnant women in Greenland (572), Kharkiv (611) and Warsaw (258) and were analyzed for CB-153 and p,p'-DDE by gas chromatography-mass spectrometry. Data on birth weight, gestational age and preterm birth were obtained for 1322 singleton live births. We examined the association between natural log-transformed serum POPs concentration and birth weight and gestational age using multiple linear regression and the association with prematurity using logistic regression controlling for potential confounding factors.
The median serum concentrations of CB-153 and p,p'-DDE were for Inuit mothers 105.6 and 298.9, for Kharkiv mothers 27.0 and 645.4 and for Warsaw mothers 10.7 and 365.2 ng/g lipids, respectively. Increase in CB-153 concentration by one unit on the log scale in Inuit mothers serum was associated with significant decrease in infant birth weight of -59 g and gestational age by -0.2 week. Decreases observed in the cohorts in Kharkiv (-10 g and -0.1 week) and in Warsaw (-49 g and -0.2 week) were not statistically significant. Increase in p,p'-DDE concentration by one unit on the log scale was associated with a statistically significant decrease in infant birth weight of -39.4 g and -104.3 g and shortening of gestational age of -0.2 week and -0.6 week in the Inuit and Warsaw cohorts, respectively. In the Kharkiv cohort decrease in birth weight (-30.5 g) was not significant, however a shortening of gestational age of -0.2 week per increase in p,p'-DDE concentration by one unit on the log scale was of the borderline significance. There was no significant association between CB-153 and p,p'-DDE concentrations and risk of preterm birth however, in all cohorts the odds ratio was above 1.
In utero exposure to POPs may reduce birth weight and gestational age of newborns however, new insights as to why results vary across studies were not apparent.
Cites: Am J Epidemiol. 2005 Oct 15;162(8):726-816120697
Cites: Arch Environ Contam Toxicol. 1997 Apr;32(3):329-369096084
Cites: Environ Health. 2005;4:2716283941
Cites: Annu Rev Public Health. 1997;18:211-449143718
Cites: Am J Epidemiol. 1998 Mar 1;147(5):493-5029525537
Cites: Pediatr Res. 1998 Oct;44(4):538-459773843
Cites: Environ Health Perspect. 1998 Feb;106(2):61-69432971
Cites: Environ Res. 2005 Feb;97(2):149-6215533331
Cites: Environ Health. 2004 Jan 28;3(1):114748928
Cites: Lancet. 2005 Aug 27-Sep 2;366(9487):763-7316125595
Three studies so far have investigated the effect of prenatal non-steroidal anti-inflammatory drug (NSAID) exposure on birth weight and gestational age. The aim in this study was to evaluate the association of prenatal ibuprofen with birth weight and gestational age at birth, using a sibling design in an attempt to adjust for the possibility of familial confounding.
Using data from the Norwegian Mother and Child Cohort Study (MoBa) and the Medical Birth Registry of Norway (MBRN), we identified 28 597 siblings, of whom 1080 were prenatally exposed to ibuprofen and 26 824 were not exposed to any NSAID. Random and fixed effects models with propensity score adjustment were used to evaluate the effects of ibuprofen exposure on birth weight and gestational age.
Ibuprofen exposure during the first trimester was associated with a decrease in birth weight of 79 grams (95% confidence interval -133 to -25 grams). In contrast, second and/or third trimester exposure, and duration of exposure had no impact on the effect estimates. We found no association between ibuprofen exposure and gestational age at birth.
Our results suggest that prenatal exposure to ibuprofen during the first trimester is associated with a slight decrease in birth weight. The association does not seem to be attributable to shared genetics and family environment, and could be explained by either exposure to ibuprofen, or to non-shared confounding between pregnancies.
Cites: Am J Perinatol. 2005 Aug;22(6):321-416118721
Cites: Int J Epidemiol. 2006 Oct;35(5):1146-5016926217
Cites: BMJ. 2001 Feb 3;322(7281):266-7011157526
Cites: Epidemiology. 2006 Jul;17(4):413-816755269
Cites: Am J Obstet Gynecol. 2012 Mar;206(3):228.e1-822196851
Polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and polychlorinated biphenyls (PCBs) were analyzed in 167 random human milk samples from urban and rural areas in Finland. Dietary habits and background information on each mother and child were gathered by questionnaire. Body mass indexes (BMI) before pregnancy and delivery in the rural area were 5-10% higher than in the urban area, but fat content of mother's milk was about 10% higher in the urban area. The mean weights of children (+/- standard deviation) were similar in the rural and urban areas among primiparae, 3,500 +/- 597 g and 3,505 +/- 454 g, respectively, although dioxin international toxic equivalents (I-TEQs) were significantly higher in the urban area. The mother's level of education did not affect the weight of the child, but concentrations of PCDDs/PCDFs (I-TEQ, 2,3,4,7,8-Cl5 dibenzofuran,1,2, 3,7,8-Cl5 dibenzodioxin) and PCBs [sum of PCBs (sumPCB), PCB-TEQ, and most PCB congeners] increased with advanced education. This is considered to be due to differences in the mother's consumption of fish. The birth weight, especially of boys, slightly decreased with increasing concentrations of I-TEQ, 2,3,4,7,8-Cl5 dibenzofuran, 1,2,3, 7,8-Cl5 dibenzodioxin, and 2,3,7,8-Cl4 dibenzodioxin; however, when the analysis was restricted to primiparae, there was no statistically significant correlation between birth weight and the concentrations of PCDDs/PCDFs. No correlation was found between the weight of the child and PCBs, PCB-TEQs, or individual PCB congeners in the whole material or among primiparae, or among boys or girls. The concentrations of PCDDs/PCDFs and PCBs inhuman milk were modeled for primiparae by weighing fish consumption, age of mother, milk fat content, and BMI before pregnancy. The linear regression resulted in values of R = 0.67 and 0.30 for the modeled dioxin I-TEQs in the urban and rural areas, respectively, and the corresponding values for sumPCBs of R = 0.60 and 0.11. The increase of PCDD/PCDF body burden was calculated to be on average 0.58 pg I-TEQ/g milk fat/year in the urban area and 0.39 pg I-TEQ/g milk fat/year in the rural area.
Cites: J Pediatr. 1984 Aug;105(2):315-206431068
Cites: J Pediatr. 1986 Aug;109(2):335-413090217
Cites: Environ Health Perspect. 1994 Jan;102 Suppl 1:173-858187706
PURPOSE: To investigate the influence of maternal antiepileptic drug (AED) treatment on pregnancy duration, birth weight, body length, head circumference, and intrauterine growth in infants exposed in utero to antiepileptic drugs in Sweden between 1973-1997, with 963 singleton infants. METHODS: Data collected from (a) 1973-1981 (record linkage between a hospital discharge register and a medical birth register); (b) 1984-1995 (prospectively collected information in one defined catchment area with two delivery hospitals); and (c) 1995-1997 (medical birth register data). Observed numbers of infants below a defined size for body measurements compared with expected numbers calculated from all births in Sweden after stratification for year of birth, maternal age, parity, and education or smoking habits in early pregnancy. Standard deviation scores estimated with same stratification procedures. RESULTS: Fraction of monotherapy exposures increased from approximately 40% to approximately 90% from 1973 to 1997. Significantly increased numbers of infants with small body measurements found in exposed group. Negative influence on body dimensions decreased over time. More marked effects found in infants exposed to polytherapy. In monotherapy, only infants exposed to carbamazepine consistently showed reduction in body dimensions. Significant effect on gestational age in girls and on number of small for gestational age (
Maternal caffeine intake has repeatedly been linked to babies being born small for gestational age (SGA). SGA babies are known to be at increased risk for adverse neonatal outcomes. The aim of this study was to explore the associations between prenatal caffeine exposure and neonatal health.
The study is based on 67,569 full-term singleton mother-infant pairs from the Norwegian Mother and Child Cohort Study. Caffeine consumption from different sources was self-reported in gestational week 22. Neonatal compound outcomes, namely (1) morbidity/mortality and (2) neonatal intervention, were created based on the Medical Birth Registry of Norway. Adjusted logistic regression was performed.
Caffeine exposure was associated to SGA (OR?=?1.16, 95%CI: 1.10; 1.23) and being born SGA was significantly associated with neonatal health (OR?=?3.09, 95%CI: 2.54; 3.78 for morbidity/mortality; OR?=?3.94, 95%CI: 3.50; 4.45 for intervention). However, prenatal caffeine exposure was neither associated with neonatal morbidity/mortality (OR?=?1.01, 95%CI: 0.96; 1.07) nor neonatal intervention (OR?=?1.02, 95%CI: 1.00; 1.05 for a 100?mg caffeine intake increase). Results did not change after additional adjustment for SGA status.
OBJECTIVES--The purpose of the study was to assess reproductive outcomes, especially birthweight, and the consumption of fatty fish from the Baltic Sea, contaminated with persistent organochlorine compounds, among women from the Swedish east coast. MATERIAL AND METHODS--Cohorts of fishermen's wives from the Swedish east and west coasts were established and linked to the Swedish Medical Birth Register for 1973-1991; 1501 children were born in the eastcoast cohort and 3553 in the westcoast cohort. Comparisons were made with regional populations and between the cohorts. Dietary interviews were made with 69 randomly selected women from the cohorts and 69 referents. RESULTS--The women interviewed from the east- and westcoast cohorts ate locally caught fish more than twice as often as their referents. Compared with the regional population, the women in the eastcoast cohort gave birth to an increased number of infants with low birthweights (