TY - JOUR
T1 - Sex- And growth-specific characteristics of small for gestational age infants
T2 - A prospective cohort study
AU - Van Der Vlugt, Eva R.
AU - Verburg, Petra E.
AU - Leemaqz, Shalem Y.
AU - McCowan, Lesley M.E.
AU - Poston, Lucilla
AU - Kenny, Louise C.
AU - Myers, Jenny
AU - Walker, James J.
AU - Dekker, Gustaaf A.
AU - Roberts, Claire T.
N1 - Funding Information:
We would like to thank Robyn North for her work in establishing the SCOPE study, Eliza Chan for her work on the database, MedSciNet for providing the database, the SCOPE midwives, and SCOPE participants and their families. CTR is supported by a NHMRC Investigator Grant (GNT1174971) and a Matthew Flinders Professorial Fellowship from Flinders University.
Funding Information:
New Zealand: Foundation for Research Science and Technology; Health Research Council; Evelyn Bond Charitable Fund. Australia: Premier’s Science and Research Fund. United Kingdom: Guy’s and St. Thomas’ Charity, Biotechnology and Biological Sciences Research Council, National Health Services NEAT Grant, University of Manchester Proof of Concept Funding, Tommy’s Baby Charity, Cerebra, Health Research Board.
Publisher Copyright:
© 2020 The Author(s).
PY - 2020/5/5
Y1 - 2020/5/5
N2 - Background: Asymmetric fetal growth and male sex are both associated with adverse neonatal outcome. However, less is known about the influence of asymmetric growth and fetal sex within SGA neonates, a group of infants already at increased risk for adverse neonatal outcomes. The aim of the present study was to provide insight into variance in risk factors for SGA in a fetal sex- and growth symmetry-specific way. Methods: For this prospective, multicenter cohort study, data from the Screening for Pregnancy Endpoints (SCOPE) study were used with 5628 nulliparous participants, of which 633 (11.3%) pregnancies were complicated with SGA and 3376 (60.0%) women had uncomplicated pregnancies. Association between risk factors for SGA, SGA subgroups, and uncomplicated pregnancies were assessed with multivariable analyses. Results: Prevalence of asymmetric growth varied from 45.8% of SGA infants to 5.5% of infants with a customized birthweight > 90th percentile (p < 0.001). Significantly more SGA males had asymmetric growth compared to SGA female infants (51.2% vs 40.4%, p = 0.009). Maternal pre-pregnancy diet and BMI < 20 and ≥ 30 were significantly associated with symmetric SGA but not with asymmetric SGA. Asymmetric SGA infants had not only lower customized birthweight percentile (4.4 (SD 2.8) vs 5.0 (SD 3.0), p < 0.001), but also lower rates of stillbirth (p = 0.041) and less often Apgar scores < 7 (p = 0.060). Conclusions: Among SGA infants, low customized birthweight percentiles and male sex are associated with asymmetric growth. Only symmetric SGA is significantly associated with maternal risk factors in early pregnancy. There is a substantial variance in risk factors and neonatal outcomes for SGA based on growth symmetry, implying a different pathogenesis.
AB - Background: Asymmetric fetal growth and male sex are both associated with adverse neonatal outcome. However, less is known about the influence of asymmetric growth and fetal sex within SGA neonates, a group of infants already at increased risk for adverse neonatal outcomes. The aim of the present study was to provide insight into variance in risk factors for SGA in a fetal sex- and growth symmetry-specific way. Methods: For this prospective, multicenter cohort study, data from the Screening for Pregnancy Endpoints (SCOPE) study were used with 5628 nulliparous participants, of which 633 (11.3%) pregnancies were complicated with SGA and 3376 (60.0%) women had uncomplicated pregnancies. Association between risk factors for SGA, SGA subgroups, and uncomplicated pregnancies were assessed with multivariable analyses. Results: Prevalence of asymmetric growth varied from 45.8% of SGA infants to 5.5% of infants with a customized birthweight > 90th percentile (p < 0.001). Significantly more SGA males had asymmetric growth compared to SGA female infants (51.2% vs 40.4%, p = 0.009). Maternal pre-pregnancy diet and BMI < 20 and ≥ 30 were significantly associated with symmetric SGA but not with asymmetric SGA. Asymmetric SGA infants had not only lower customized birthweight percentile (4.4 (SD 2.8) vs 5.0 (SD 3.0), p < 0.001), but also lower rates of stillbirth (p = 0.041) and less often Apgar scores < 7 (p = 0.060). Conclusions: Among SGA infants, low customized birthweight percentiles and male sex are associated with asymmetric growth. Only symmetric SGA is significantly associated with maternal risk factors in early pregnancy. There is a substantial variance in risk factors and neonatal outcomes for SGA based on growth symmetry, implying a different pathogenesis.
KW - Asymmetric growth
KW - Risk factor
KW - Sexual dimorphism
KW - Small for gestational age
KW - Symmetric growth
UR - http://www.scopus.com/inward/record.url?scp=85084327230&partnerID=8YFLogxK
U2 - 10.1186/s13293-020-00300-z
DO - 10.1186/s13293-020-00300-z
M3 - Review article
C2 - 32370773
AN - SCOPUS:85084327230
SN - 2042-6410
VL - 11
JO - Biology of Sex Differences
JF - Biology of Sex Differences
IS - 1
M1 - 25
ER -