Parental childhood growth and offspring birthweight : Pooled analyses from four birth cohorts in low and middle income countries

Funding Information Bill and Melinda Gates Foundation. Grant Number: OPP1020058 Wellcome Trust 089257/Z/09/Z Contract grant sponsor: the National Heart, Lung and Blood Institute at National Institutes of Health. Grant Number: HHSN 268200900028C to the Center of Excellence – INCAP/ Guatemala; and Grand Challenges Canada (Grant number: 0072‐03 to the Grantee, The Trustees of the University of Pennsylvania)Peer reviewedPublisher PD

Growth in utero and cognitive function in adult life: follow up study of people born between 1920 and 1943

OBJECTIVES--To examine the relation between fetal growth and cognitive function in adult life. DESIGN--A follow up study of men and women whose birth weights and other measurements of body size had been recorded at birth. SETTING--Hertfordshire, Preston, and Sheffield. SUBJECTS--1576 men and women born in Hertfordshire, Sheffield, or Preston between 1920 and 1943. MAIN OUTCOME MEASURES--Intelligence quotient as measured by the AH4 test and amount of decline in cognitive function with age as estimated by the difference between score on the Mill Hill vocabulary test and score on the AH4 test. RESULTS--Score on the intelligence test was higher in people who had a large biparietal head diameter at birth, but it was not related to any other measure of body size or proportions. No association was found between decline in cognitive function and any measure of size or proportions at birth. CONCLUSION--Impaired fetal growth was not associated with poorer cognitive performance in adult life. Adaptations made by the fetus in response to conditions that retard its growth seem to be largely successful in maintaining brain development

Contribution of the umbilical cord and membranes to untrimmed placental weight

The extent of placental trimming before weighing varies within and between obstetric units. Quantification of the contribution of the umbilical cord and membranes to placental weight is required to enable measurements to be compared across populations. In a sample of 50 neonates born in Southampton, placentae of liveborn singletons were weighed three times; after removing any obvious blood clots, after cutting the umbilical cord, and after stripping both the foetal and maternal membranes.The correlation between untrimmed and trimmed placental weight was 0.98. Since the combined weight of the cord and membranes increased with increasing trimmed weight (correlation=0.54), the percentage rather than absolute difference between untrimmed and trimmed weight was calculated. The median difference between untrimmed and trimmed weight was 16 per cent. No association was found between the percentage difference and infant sex, duration of gestation, birthweight, maternal age, labour onset and duration, and presentation at delivery. However, the mode of delivery had a significant effect on this difference; medians for vaginal and Caesarean section deliveries were 19 per cent and 14 per cent respectively

Does birth weight predict adult serum cortisol concentrations? Twenty-four-hour profiles in the United Kingdom 1920-1930 Hertfordshire birth cohort

Low birth weight and weight in infancy are associated with adult insulin resistance and type 2 diabetes. A proposed mechanism is programming of the hypothalamic-pituitary-adrenal axis by intrauterine undernutrition, leading to persistently elevated cortisol concentrations. We examined 24-h serum cortisol profiles (samples every 20 min) in 83 healthy elderly men and women whose birth weight and infant weight were recorded. Variables derived from these profiles included trough, peak, and area under the curve concentrations; the time of onset, rate of rise, duration, and peak of the early morning cortisol rise; postprandial secretion; and regularity of secretion (approximate entropy). None of these parameters was related to birth weight, weight at 1 yr, or change in weight SD score between birth and 1 yr. Consistent with other studies, 0730–0900 h cortisol concentrations were higher in men and women of lower birth weight, although this was not statistically significant (P = 0.08). Our findings do not support the hypothesis that reduced intrauterine and infant growth are associated with continuously raised cortisol concentrations in old age. Programmed effects on the hypothalamic-pituitary-adrenal axis may influence reactivity rather than resting secretion

Accelerometers for measuring physical activity behavior in Indian children

Objective: To examine the validity of accelerometers forcharacterizing habitual physical activity patterns in Indianchildren.Design: Cohort study.Setting: Holdsworth Memorial Hospital, Mysore.Subjects: Children (N=103, mean age 6.6 years) selectedfrom an ongoing birth cohort study.Methods: Physical activity was measured over 7 daysusing accelerometers (MTI Actigraph) and concurrentparent-maintained activity diaries. Actigraph counts perminute representing sedentary (<10), light (<400),moderate (<3000) and vigorous (?3000) activity weredetermined using a structured activity session in aseparate group of 10 children. In 46 children chosen forvalidating accelerometers, time spent in different activitylevels according to diaries was determined. EnergyExpenditure (EE) was calculated from diaries using afactorial method.Results: Ninety-eight children wore the monitor for ?4days. Total counts and time spent in different activity levelswere similar in boys and girls (P>0.2). Among 46 childrenchosen for comparisons, time spent in sedentary (r =0.48,P=0.001), light (r=0.70, P<0.001) and moderate activities(r=0.29, P=0.054) according to diaries correlated withthose derived from counts, and total Actigraph countscorrelated with EE (r=0.42, P=0.004). Bland-Altmananalysis showed systematic bias, and wide limits ofagreement between these methods for time spent indifferent activity levels.Conclusions: Accelerometers are a well tolerated andobjective way of measuring activity behavior in free-livingchildren. Though accelerometer counts correlate with timespent in activity of varying intensity and energyexpenditure derived from parent-maintained diaries, widelimits of agreement show that the limitations ofaccelerometers need to be recognized in interpreting thedata that they generate

Adiposity and cortisol response to stress in Indian adolescents

SETTING: Holdsworth Memorial Hospital, Mysore, India.OBJECTIVE: We examined associations of different adiposity measures with cortisol responses during the Trier Social Stress Test for children (TSST-C).DESIGN: Descriptive study.PARTICIPANTS: Adolescents aged 13.5y from a birth cohort were recruited (N=269, 133 boys).METHODS: The stressor (TSST-C) was 5-minutes each of public speaking and mental arithmetic tasks in front of two unfamiliar 'judges'. Salivary cortisol concentrations were measured at baseline and at regular intervals after TSST-C. Weight, height, sub scapular and triceps skinfold thickness, and waist and hip circumference were measured, and percentage body fat was estimated (fat%; bioimpedance). Body mass index (BMI) and Waist-to-hip ratio (WHR) were calculated. All variables were converted into within-cohort SD scores before analysis. Stress-induced change in cortisol concentrations from baseline (cortisol response) was examined in relation to adiposity.RESULTS: Stress increased cortisol concentrations significantly from baseline (mean (SD): 5.5 (6.4) ng/mL; P&lt;0.001). Higher WHR was associated with lower cortisol response at 20 and 30-minutes after stress (~0.13 SD decrease in cortisol response per SD higher WHR, P&lt;0.05). Higher fat% was also associated with lower cortisol response only in girls 20-minutes post-stress (0.23 SD lower response per SD higher fat%, P=0.004). Sum of skinfold thickness and BMI were not associated with cortisol responses.CONCLUSION: Abdominal adiposity is associated with reduced hypothalamic-pituitary-adrenal axis reactivity to stress in this adolescent population.</p

Patterns of fetal growth in a rural Indian cohort and a comparison with a western European population: data from the Pune Maternal Nutrition Study

The purpose of this study was to describe fetal size on sonography in a rural Indian population and compare it with those in European and urban Indian populations. Methods. Participants were from the Pune Maternal Nutrition Study of India. Fetal growth curves were constructed from serial ultrasound scans at approximately 18, 30, and 36 weeks’ gestation in 653 singleton pregnancies. Measurements included femur length (FL), abdominal circumference (AC), biparietal diameter (BPD), and occipitofrontal diameter, from which head circumference (HC) was estimated. Measurements were compared with data from a large population-based study in France and a study of urban mothers in Vellore, south India. Results. Fetal AC and BPD were smaller than the French reference at 18 weeks’ gestation (–1.38 and –1.30 SD, respectively), whereas FL and HC were more comparable (–0.77 and –0.59 SD). The deficit remained similar at 36 weeks for AC (–0.97 SD), FL (–0.43 SD), and HC (–0.52 SD) and increased for BPD (–2.3 SD). Sonography at 18 weeks underestimated gestational age compared with the last menstrual period date by a median of –1.4 (interquartile range, –4.6, 1.8) days. The Pune fetuses were smaller, even at the first scan, than the urban Vellore sample. Conclusions. Fetal size was smaller in a rural Indian population than in European and urban Indian populations, even in mid pregnancy. The deficit varied for different fetal measurements; it was greatest for AC and BPD and least for FL and H

Mother's lifetime nutrition and the size, shape and efficiency of the placenta

BackgroundStudies have shown that the shape and size of the placenta at birth predict blood pressure in later life. The influences that determine placental morphology are largely unknown. We have examined the role of mother’s body size. MethodsWe studied 522 neonates who were born in a maternity hospital in Mysore, South India. The weight of the placenta and the length and breadth of its surface, were measured after delivery.ResultsHigher maternal fat mass predicted a larger placental surface (p=0.02), while larger maternal head circumference predicted a more oval placental surface (p=0.03). Higher maternal fat mass and larger maternal head circumference were associated with greater placental efficiency, indicated by lower ratios of the length (p=0.0003 and p=0.0001 respectively) and breadth (p=0.0002 and p&lt;0.0001) of the surface to birthweight. In a sub-sample of 51 mothers whose own birthweight was available, higher maternal birthweight was related to lower ratios of the length and breadth of the surface to birthweight (p=0.01 and 0.002). Maternal height was unrelated to placental size or shape.ConclusionsHigher maternal fat mass, reflecting the mother’s current nutritional state, and larger maternal head circumference, reflecting the mother’s fetal/infant growth, are associated with changes in the shape and size of the placental surface and greater placental efficiency. We suggest that these associations reflect effects of the mother’s nutrition at different stages of her lifecourse on the development of the placenta and on materno-placento-fetal transfer of nutrients