Bibliography Tag: birthweight

Shah and Kingdom, 2011

Shah, Prakesh, & Kingdom, John; “Long-term neurocognitive outcomes of SGA/IUGR infants;” Obstetrics, Gynaecology & Reproductive Medicine, 2011, 21(5), 142-146; DOI: 10.1016/j.ogrm.2011.02.004.


With advances in the management of preterm neonates, the chances of survival have increased even among those who are intrauterine growth restricted (IUGR) or who are born small for gestational age (SGA). However, infants who are IUGR/SGA are considered at higher risk of physical and neurodevelopmental abnormalities, although the reported impacts of IUGR and SGA status at birth on neurodevelopmental outcomes in long-term outcomes studies have varied. In particular, some reports have indicated gradual improvement in neurodevelopmental functions over time in these infants. We have therefore reviewed all the available reports describing neurodevelopmental outcomes of preterm and term SGA infants beyond 5 years of age. Preterm SGA infants are at increased risk of impairment in neuromotor, cognitive, behavioural and scholastic attainments compared with preterm non-SGA infants. On the other hand, term SGA infants had problems in scholastic/vocational attainments compared with term non SGA infants, while adverse neuromotor, cognitive and behavioural outcomes were not consistently observed at higher rates. Limitations regarding the validity of studies of long-term outcomes of SGA infants are discussed and a potential approach is suggested. FULL TEXT

Haas et al., 2015

Haas, D. M., Parker, C. B., Wing, D. A., Parry, S., Grobman, W. A., Mercer, B. M., Simhan, H. N., Hoffman, M. K., Silver, R. M., Wadhwa, P., Iams, J. D., Koch, M. A., Caritis, S. N., Wapner, R. J., Esplin, M. S., Elovitz, M. A., Foroud, T., Peaceman, A. M., Saade, G. R., Willinger, M., Reddy, U. M., & NuMo, M. b study; “A description of the methods of the Nulliparous Pregnancy Outcomes Study: monitoring mothers-to-be (nuMoM2b);” American Journal of Obstetrics & Gynecology, 2015, 212(4), 539 e531-539 e524; DOI: 10.1016/j.ajog.2015.01.019.


OBJECTIVE: The primary aim of the “Nulliparous Pregnancy Outcomes Study: monitoring mothers-to-be” is to determine maternal characteristics, which include genetic, physiologic response to pregnancy, and environmental factors that predict adverse pregnancy outcomes.

STUDY DESIGN: Nulliparous women in the first trimester of pregnancy were recruited into an observational cohort study. Participants were seen at 3 study visits during pregnancy and again at delivery. We collected data from in-clinic interviews, take-home surveys, clinical measurements, ultrasound studies, and chart abstractions. Maternal biospecimens (serum, plasma, urine, cervicovaginal fluid) at antepartum study visits and delivery specimens (placenta, umbilical cord, cord blood) were collected, processed, and stored. The primary outcome of the study was defined as pregnancy ending at <37+0 weeks’ gestation. Key study hypotheses involve adverse pregnancy outcomes of spontaneous preterm birth, preeclampsia, and fetal growth restriction.

RESULTS: We recruited 10,037 women to the study. Basic characteristics of the cohort at screening are reported.

CONCLUSION: The “Nulliparous Pregnancy Outcomes Study: monitoring mothers-to-be” cohort study methods and procedures can help investigators when they plan future projects.


Chiu, 2017

Chiu, Y. H.,”Pesticide Residues in Fruits and Vegetables: Assessment and Their Associations With Reproductive Health Outcomes;” Dissertation at Harvard Universiry, (Doctor of Science in Nutrition and Epidemiology); 2017.


According to the Dietary Guideline, consumption of fruits and vegetables (FVs) are recommended throughout the lifespan, including during pregnancy. FVs, on the other hand, can serve as a vehicle of exposure to pesticide residues. In the US, Environmental Protection Agency (EPA) is responsible for regulating pesticides under the Federal Insecticide, Fungicide, and Rodenticide Act and the Food Quality Protection Act. While majority of the produce sampled through the US Department of Agriculture had residues below the EPA limits, there is a growing concern whether chronic exposure to these pesticide residues may have adverse health effects, especially among susceptible populations such as pregnant women. Yet, such research is scarce. This dissertation focuses on the assessment of pesticide residues in FVs and evaluates their associations with pregnancy outcomes.

We previously have developed the Pesticide Residue Burden Score (PRBS) based on selfreported diet and national surveillance data on food pesticide residues to characterize dietary exposure over the past year. In Chapter 1, we evaluated the association of the PRBS with urinary pesticide metabolites in the Environment and Reproductive Health (EARTH) Study. We found intake of high pesticide residues FVs was positively associated with urinary concentrations of pesticide biomarkers, suggesting that PRBS can characterize dietary exposure to select pesticides.

In Chapter 2, we assessed the relation between preconception intake of high and low FVs and assisted reproductive technology outcomes in EARTH study. We found that intake of high pesticide residues FVs was associated with lower probability of clinical pregnancy and live birth, while intake of low pesticide residue FVs had the opposite relations among women undergoing infertility treatment. This is the first report of such relation in humans.

In Chapter 3, we examine the association between maternal intake of high and low pesticide residue FVs with birth outcomes in a pre-birth cohort. We found that maternal intake of high pesticide residue FVs during the first trimester was associated with higher risks of small-for-gestational-age among white women, while these exposures was associated with large-for-gestational-age among nonwhite women.

In conclusion, this work demonstrated the usefulness of PRBS in assessing pesticide residue intake through FVs. Using this method, these studies suggest exposure to pesticide residues may adversely affect pregnancy and birth outcomes.


Ichikawa et al., 2019

Ichikawa, G., Kuribayashi, R., Ikenaka, Y., Ichise, T., Nakayama, S. M. M., Ishizuka, M., Taira, K., Fujioka, K., Sairenchi, T., Kobashi, G., Bonmatin, J. M., & Yoshihara, S.; “LC-ESI/MS/MS analysis of neonicotinoids in urine of very low birth weight infants at birth;” Plos One, 2019, 14(7), e0219208; DOI: 10.1371/journal.pone.0219208.



Neonicotinoid insecticides are widely used systemic pesticides with nicotinic acetylcholine receptor agonist activity that are a concern as environmental pollutants. Neonicotinoids in humans and the environment have been widely reported, but few studies have examined their presence in fetuses and newborns. The objective of this study is to determine exposure to neonicotinoids and metabolites in very low birth weight (VLBW) infants.


An analytical method for seven neonicotinoids and one neonicotinoid metabolite, N-desmethylacetamiprid (DMAP), in human urine using LC-ESI/MS/MS was developed. This method was used for analysis of 57 urine samples collected within 48 hours after birth from VLBW infants of gestational age 23-34 weeks (male/female = 36/21, small for gestational age (SGA)/appropriate gestational age (AGA) = 6/51) who were admitted to the neonatal intensive care unit of Dokkyo Hospital from January 2009 to December 2010. Sixty-five samples collected on postnatal day 14 (M/F = 37/22, SGA/AGA = 7/52) were also analyzed.


DMAP, a metabolite of acetamiprid, was detected in 14 urine samples collected at birth (24.6%, median level 0.048 ppb) and in 7 samples collected on postnatal day 14 (11.9%, median level 0.09 ppb). The urinary DMAP detection rate and level were higher in SGA than in AGA infants (both p<0.05). There were no correlations between the DMAP level and infant physique indexes (length, height, and head circumference SD scores).


These results provide the first evidence worldwide of neonicotinoid exposure in newborn babies in the early phase after birth. The findings suggest a need to examine potential neurodevelopmental toxicity of neonicotinoids and metabolites in human fetuses.


Donahue et al., 2010

Donahue, S. M., Kleinman, K. P., Gillman, M. W., & Oken, E., “Trends in birth weight and gestational length among singleton term births in the United States: 1990-2005,” Obstetrics and Gynecology, 2010, 115(2 Pt 1), 357-364. DOI: 10.1097/AOG.0b013e3181cbd5f5.


OBJECTIVE: To estimate changes over time in birth weight for gestational age and in gestational length among term singleton neonates born from 1990 to 2005.

METHODS: We used data from the U.S. National Center for Health Statistics for 36,827,828 singleton neonates born at 37-41 weeks of gestation, 1990-2005. We examined trends in birth weight, birth weight for gestational age, large and small for gestational age, and gestational length in the overall population and in a low-risk subgroup defined by maternal age, race or ethnicity, education, marital status, smoking, gestational weight gain, delivery route, and obstetric care characteristics.

RESULTS: In 2005, compared with 1990, we observed decreases in birth weight (-52 g in the overall population, -79 g in a homogenous low-risk subgroup) and large for gestational age birth (-1.4% overall, -2.2% in the homogenous subgroup) that were steeper after 1999 and persisted in regression analyses adjusted for maternal and neonate characteristics, gestational length, cesarean delivery, and induction of labor. Decreases in mean gestational length (-0.34 weeks overall) were similar regardless of route of delivery or induction of labor.

CONCLUSION: Recent decreases in fetal growth among U.S., term, singleton neonates were not explained by trends in maternal and neonatal characteristics, changes in obstetric practices, or concurrent decreases in gestational length.



Catov et al., 2016

Catov, J. M., Lee, M., Roberts, J. M., Xu, J., & Simhan, H. N., “Race Disparities and Decreasing Birth Weight: Are All Babies Getting Smaller?,” American Journal of Epidemiology, 2016, 183(1), 15-23. DOI: 10.1093/aje/kwv194.


The mean infant birth weight in the United States increased for decades, but it might now be decreasing. Given race disparities in fetal growth, we explored race-specific trends in birth weight at Magee-Womens Hospital, Pittsburgh, Pennsylvania, from 1997 to 2011. Among singleton births delivered at 37-41 weeks (n = 70,607), we evaluated the proportions who were small for gestational age and large for gestational age and changes in mean birth weights over time. Results were stratified by maternal race/ethnicity. Since 1997, the number of infants born small for their gestational ages increased (8.7%-9.9%), whereas the number born large for their gestational ages decreased (8.9%-7.7%). After adjustment for gestational week at birth, maternal characteristics, and pregnancy conditions, birth weight decreased by 2.20 g per year (P < 0.0001). Decreases were greater for spontaneous births. Reductions were significantly greater in infants born to African-American women than in those born to white women (-3.78 vs. -1.88 per year; P for interaction = 0.010). Quantile regression models indicated that birth weight decreased across the entire distribution, but reductions among infants born to African-American women were limited to those in the upper quartile after accounting for maternal factors. Limiting the analysis to low-risk women eliminated birth weight reductions. Birth weight has decreased in recent years, and reductions were greater in infants born to African-American women. These trends might be explained by accumulation of risk factors such as hypertension and prepregnancy obesity that disproportionately affect African-American women. Our results raise the possibility of worsening race disparities in fetal growth. FULL TEXT

Milesi et al., 2018

Milesi, Maria M, Lorenz, Virginia, Pacini, Guillermina, Repetti, Maria R, Demonte, Luisina D, Varayoud, Jorgelina, & Luque, Enrique H, “Perinatal exposure to a glyphosate-based herbicide impairs female reproductive outcomes and induces second-generation adverse effects in Wistar rats,” Archives of Toxicology, 2018, 92(8), 2629-2643. DOI: 10.1007/s00204-018-2236-6.


Glyphosate-based herbicides (GBHs) are the most globally used herbicides raising the risk of environmental exposition. Here, we investigated whether perinatal exposure to low doses of a GBH alters the female reproductive performance, and/or induced second-generation effects related to congenital anomalies or growth alterations. Pregnant rats (F0) received a GBH through food, in a dose of 2 mg (GBH-LD: GBH-low dose group) or 200 mg (GBH-HD: GBH-high dose group) of glyphosate/kg bw/day from gestational day (GD) 9 until weaning. Body weight gain and vaginal canal-opening of F1 females were recorded. Sexually mature F1 females were mated to evaluate their reproductive performance by assessing the pregnancy rate, and on GD19, the number of corpora lutea, the implantation sites (IS) and resorption sites. To analyze second-generation effects on F2 offspring, we analyzed the fetal morphology on GD19, and assessed the fetal length and weight, and the placental weight. GBH exposure neither altered the body weight gain of F1 females, nor vaginal opening onset. Although all GBH-exposed F1 rats became pregnant, a lower number of IS was detected. F2 offspring from both GBH groups showed delayed growth, evidenced by lower fetal weight and length, associated with a higher incidence of small for gestational age fetuses. In addition, higher placental weight and placental index were found in F2 offspring from GBH-HD dams. Surprisingly, structural congenital anomalies (conjoined fetuses and abnormally developed limbs) were detected in the F2 offspring from GBH-HD group. In conclusion, perinatal exposure to low doses of a GBH impaired female reproductive performance and induced fetal growth retardation and structural congenital anomalies in F2 offspring. FULL TEXT

Sathyanarayana et al., 2010

Sheela Sathyanarayana MD MPH, Olga Basso PhD, Catherine J. Karr MD PhD MS, Paula Lozano MD MPH, Michael Alavanja PhD, Dale P. Sandler PhD & Jane A. Hoppin ScD, “Maternal Pesticide Use and Birth Weight in the Agricultural Health Study,” Journal of Agromedicine, 15:2, 2010, DOI: 10.1080/10599241003622699


Studies examining the association between maternal pesticide exposure and low birth weight yield conflicting results. The authors examined the association between maternal pesticide use and birth weight among women in the Agricultural Health Study, a large study of pesticide applicators and their spouses in Iowa and North Carolina. The authors evaluated self-reported pesticide use of 27 individual pesticides in relation to birth weight among 2246 farm women whose most recent singleton birth occurred within 5 years of enrollment (1993–1997). The authors used linear regression models adjusted for site, preterm birth, medical parity, maternal body mass index, height, and smoking. The results showed that mean infant birth weight was 3586 g (± 546 g), and 3% of the infants were low birth weight (<2500 g). First-trimester pesticide-related tasks were not associated with birth weight. Ever use of the pesticide carbaryl was associated with decreased birth weight (−82 g, 95% confidence interval [CI] = −132, −31). This study thus provides limited evidence about pesticide use as a modulator of birth weight. Overall, the authors observed no associations between birth weight and pesticide-related activities during early pregnancy; however, the authors have no data on temporal specificity of individual pesticide exposures prior to or during pregnancy and therefore cannot draw conclusions related to these exposure windows. Given the widespread exposure to pesticide products, additional evaluation of maternal pregnancy exposures at specific time windows and subsequent birth outcomes is warranted.

Parvez et al., 2018

S. Parvez, R. R. Gerona, C. Proctor, M. Friesen, J. L. Ashby, J. L. Reiter, Z. Lui, and P. D. Winchester, “Glyphosate exposure in pregnancy and shortened gestational length: a prospective Indiana birth cohort study,” Environmental Health, 17:23, March 9, 2018, DOI: 10.1186/s12940-018-0367-0.


BACKGROUND: Glyphosate (GLY) is the most heavily used herbicide worldwide but the extent of exposure in human pregnancy remains unknown. Its residues are found in the environment, major crops, and food items that humans, including pregnant women, consume daily. Since GLY exposure in pregnancy may also increase fetal exposure risk, we designed a birth-cohort study to determine exposure frequency, potential exposure pathways, and associations with fetal growth indicators and pregnancy length.

METHOD: Urine and residential drinking water samples were obtained from 71 women with singleton pregnancies living in Central Indiana while they received routine prenatal care. GLY measurements were performed using liquid chromatography-tandem mass spectrometry. Demographic and survey information relating to food and water consumption, stress, and residence were obtained by questionnaire. Maternal risk factors and neonatal outcomes were abstracted from medical records. Correlation analyses were used to assess relationships of urine GLY levels with fetal growth indicators and gestational length.

RESULTS: The mean age of participants was 29 years, and the majority were Caucasian. Ninety three percent of the pregnant women had GLY levels above the limit of detection (0.1 ng/mL). Mean urinary GLY was 3.40 ng/mL (range 0.5–7.20 ng/mL). Higher GLY levels were found in women who lived in rural areas (p = 0.02), and in those who consumed > 24 oz. of caffeinated beverages per day (p = 0.004). None of the drinking water samples had detectable GLY levels. We observed no correlations with fetal growth indicators such as birth weight percentile and head circumference. However, higher GLY urine levels were significantly correlated with shortened gestational lengths (r = − 0.28, p = 0.02).

CONCLUSIONS: This is the first study of GLY exposure in US pregnant women using urine specimens as a direct measure of exposure. We found that > 90% of pregnant women had detectable GLY levels and that these levels correlated significantly with shortened pregnancy lengths. Although our study cohort was small and regional and had limited racial/ethnic diversity, it provides direct evidence of maternal GLY exposure and a significant correlation with shortened pregnancy. Further  investigations in a more geographically and racially diverse cohort would be necessary before these findings could be generalized. FULL TEXT

Winchester et al., 2016

Winchester P, Proctor C, Ying J, “County-level pesticide use and risk of shortened gestation and preterm birth,” Acta Paediatrica, 2016, 105:3, DOI: 10.1111/apa.13288.


AIM: This study assesses the association between pesticide exposure in pregnancy, preterm birth (PTB) and shortened gestation.

METHODS: Pregnancy information was abstracted from the Centers for Disease Control (CDC) Non-Public Use Natality Datasets 1990-2005. Pesticide use in maternal county of residence was calculated using California Pesticide Use Reporting (PUR) data 1990-2005. Counties were ranked by pesticide use, and birth months were sorted by peak (May-June) or nonpeak (other months) pesticide use. Multivariate logistical regression models were used.

RESULTS: Counties with higher pesticide use were associated with higher PTB (low 8.59 ± 0.11%, moderate 9.25 ± 0.07%, high 10.0 ± 0.06%, p’s < 0.001) and shorter gestations (low 39.197 ± 0.014 weeks, moderate 39.126 ± 0.011 weeks, high 39.049 ± 0.011 weeks, p’s < 0.001). Peak pesticide months were associated with higher PTB (10.01 ± 0.05% vs. 9.36 ± 0.05%, p < 0.001) and shorter gestations (39.069 ± 0.007 weeks vs. 39.122 ± 0.007 weeks, p < 0.001). The pesticide effect on shortened gestation and higher PTB was found in all racial groups. Pesticide use was highest for fungicides > insecticides > fumigants > herbicides > others. Each pesticide type was found to be associated with higher PTB and shorter gestation.

CONCLUSION: PTB and shortened gestation were significantly associated with pesticide use in maternal county of residence regardless of race, gestation at birth, and in most risk categories.   FULL TEXT