Birth weight changes in a major city under rapid socioeconomic transition in China

Jian-Rong He, Wei-Dong Li, Min-Shan Lu, Yong Guo, Fan-Fan Chan, Jin-Hua Lu, Li-Fang Zhang, Song-Ying Shen, Xiao-Yan Xia, Ping Wang, Wei-Jian Mo, Kin Bong Hubert Lam, Jane E Hirst, Hui-Min Xia, Xiu Qiu, Jian-Rong He, Wei-Dong Li, Min-Shan Lu, Yong Guo, Fan-Fan Chan, Jin-Hua Lu, Li-Fang Zhang, Song-Ying Shen, Xiao-Yan Xia, Ping Wang, Wei-Jian Mo, Kin Bong Hubert Lam, Jane E Hirst, Hui-Min Xia, Xiu Qiu

Abstract

Estimates of trends in birth weight may be useful in evaluating population health. We aimed to determine whether temporal changes in birth weight have occurred amongst 2.3 million neonates born in Guangzhou, China, during 2001-2015 and investigate the socioeconomic determinants of any changes. Trends in mean birth weight and annualized changes with the associated 95% confidence intervals (CIs) in the incidence of small for gestational age (SGA) and large for gestational age (LGA), defined as birth weight <10th or >90th centile respectively for gestational age and sex, were examined using linear and Poisson regression models. We found that mean birth weight declined by 1.07 grams/year from 2001 to 2015. After adjustment for gestational length, the decline in birth weight was attenuated (0.37 grams/year). The incidence of both SGA and LGA significantly decreased during the study period (annual decrease of 1.6% [95% CI, 1.5% to 1.7%] for SGA, 1.6% [95% CI, 1.5% to 1.8%] for LGA). We found a narrowing of disparities in SGA and LGA incidence across different maternal educational levels and residence location. Our results demonstrate that there has been an increase in the proportion of neonates born in the healthy birth weight range in Guangzhou.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Changes in the incidence of SGA (left panel) and LGA (right panel) based on maternal age group (a,b), education level (c,d), and residence location (e,f) during 2001–2015. SGA, small for gestational age; LGA, large for gestational age.

References

    1. Nationall Bureau of Statistics of China. Annual Matality Rate of Maternal and Children Age Under Five. Date of access: 16/04/ (2016).
    1. Statistics Bureau of Guangzhou Municipality. Principal Aggregate Indicators on National Economic and Social Development and Growth Rates in Annual Statistics of 2015. . Date of access: 16/04/2016.
    1. Weissmann-Brenner A, et al. Maternal and neonatal outcomes of large for gestational age pregnancies. Acta Obstet Gynecol Scand. 2012;91:844–849. doi: 10.1111/j.1600-0412.2012.01412.x.
    1. Boney CM, Verma A, Tucker R, Vohr BR. Metabolic syndrome in childhood: association with birth weight, maternal obesity, and gestational diabetes mellitus. Pediatrics. 2005;115:e290–296. doi: 10.1542/peds.2004-1808.
    1. Saenger P, Czernichow P, Hughes I, Reiter EO. Small for gestational age: short stature and beyond. Endocr Rev. 2007;28:219–251. doi: 10.1210/er.2006-0039.
    1. Henriksen T. The macrosomic fetus: a challenge in current obstetrics. Acta Obstet Gynecol Scand. 2008;87:134–145. doi: 10.1080/00016340801899289.
    1. Villar J, et al. International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. Lancet. 2014;384:857–868. doi: 10.1016/S0140-6736(14)60932-6.
    1. Guo Y, et al. Changes in birth weight between 2002 and 2012 in Guangzhou, China. PLoS One. 2014;9:e115703. doi: 10.1371/journal.pone.0115703.
    1. Morisaki N, Esplin MS, Varner MW, Henry E, Oken E. Declines in birth weight and fetal growth independent of gestational length. Obstet Gynecol. 2013;121:51–58. doi: 10.1097/AOG.0b013e318278d014.
    1. Ferre C, Handler A, Hsia J, Barfield W, Collins JW., Jr. Changing trends in low birth weight rates among non-Hispanic black infants in the United States, 1991–2004. Matern Child Health J. 2011;15:29–41. doi: 10.1007/s10995-010-0570-2.
    1. Oken E. Secular trends in birthweight. Nestle Nutr Inst Workshop Ser. 2013;71:103–114. doi: 10.1159/000342576.
    1. Donahue SM, Kleinman KP, Gillman MW, Oken E. Trends in birth weight and gestational length among singleton term births in the United States: 1990–2005. Obstet Gynecol. 2010;115:357–364. doi: 10.1097/AOG.0b013e3181cbd5f5.
    1. Diouf I, Charles MA, Blondel B, Heude B, Kaminski M. Discordant time trends in maternal body size and offspring birthweight of term deliveries in France between 1972 and 2003: data from the French National Perinatal Surveys. Paediatr Perinat Epidemiol. 2011;25:210–217. doi: 10.1111/j.1365-3016.2010.01188.x.
    1. Schiessl B, Beyerlein A, Lack N, von Kries R. Temporal trends in pregnancy weight gain and birth weight in Bavaria 2000-2007: slightly decreasing birth weight with increasing weight gain in pregnancy. J Perinat Med. 2009;37:374–379. doi: 10.1515/JPM.2009.068.
    1. Catov JM, Lee M, Roberts JM, Xu J. & Simhan, H. N. Race Disparities and Decreasing Birth Weight: Are All Babies Getting Smaller? Am J Epidemiol. 2016;183:15–23. doi: 10.1093/aje/kwv194.
    1. Lu Y, Zhang J, Lu X, Xi W, Li Z. Secular trends of macrosomia in southeast China, 1994–2005. BMC Public Health. 2011;11:818. doi: 10.1186/1471-2458-11-818.
    1. Pei L, Kang Y, Zhao Y, Cheng Y, Yan H. Changes in Socioeconomic Inequality of Low Birth Weight and Macrosomia in Shaanxi Province of Northwest China, 2010–2013: A Cross-sectional Study. Medicine (Baltimore) 2016;95:e2471. doi: 10.1097/MD.0000000000002471.
    1. Anderson, N. H., Sadler, L. C., McKinlay, C. J. & McCowan, L. M. INTERGROWTH-21st vs customized birthweight standards for identification of perinatal mortality and morbidity. Am J Obstet Gynecol214, 509, e501–507, doi:10.1016/j.ajog.2015.10.931 (2016).
    1. Poon LC, Tan MY, Yerlikaya G, Syngelaki A, Nicolaides KH. Birth weight in live births and stillbirths. Ultrasound Obstet Gynecol. 2016;48:602–606. doi: 10.1002/uog.17287.
    1. Kramer MS, et al. Why are babies getting bigger? Temporal trends in fetal growth and its determinants. J Pediatr. 2002;141:538–542. doi: 10.1067/mpd.2002.128029.
    1. Fu J, Yu M. A hospital-based birth weight analysis using computerized perinatal data base for a Chinese population. J Matern Fetal Neonatal Med. 2011;24:614–618. doi: 10.3109/14767058.2010.511337.
    1. He JR, et al. Ambient Temperature and the Risk of Preterm Birth in Guangzhou, China (2001–2011) Environ Health Perspect. 2016;124:1100–1106.
    1. He JR, et al. A new birthweight reference in Guangzhou, southern China, and its comparison with the global reference. Arch Dis Child. 2014;99:1091–1097. doi: 10.1136/archdischild-2013-305923.

Source: PubMed

3
Subskrybuj