Antenatal risk factors associated with neonatal morbidity in large for gestational age infants: an international prospective cohort study

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dc.contributor.author Vieira, Matias C.
dc.contributor.author McCowan, Lesley M. E.
dc.contributor.author North, Robyn A.
dc.contributor.author Myers, Jenny E.
dc.contributor.author Walker, James J.
dc.contributor.author Baker, Philip N.
dc.contributor.author Dekker, Gustaaf A.
dc.contributor.author Kenny, Louise C.
dc.contributor.author Poston, Lucilla
dc.contributor.author Pasupathy, Dharmintra
dc.date.accessioned 2018-05-22T08:42:35Z
dc.date.available 2018-05-22T08:42:35Z
dc.date.issued 2018-05-12
dc.identifier.citation Vieira, M. C., McCowan, L. M. E., North, R. A., Myers, J. E., Walker, J. J., Baker, P. N., Dekker, G. A., Kenny, L. C., Poston, L. and Pasupathy, D. on behalf of the SCOPE consortium (2018) 'Antenatal risk factors associated with neonatal morbidity in large for gestational age infants: an international prospective cohort study', Acta Obstetricia et Gynecologica Scandinavica. doi:10.1111/aogs.13362 en
dc.identifier.issn 0001-6349
dc.identifier.issn 1600-0412
dc.identifier.uri http://hdl.handle.net/10468/6166
dc.identifier.doi 10.1111/aogs.13362
dc.description.abstract Introduction: Large for gestational age (LGA) infants are associated with increased risk of neonatal morbidity and mortality, however most of them will not have adverse outcomes. Our aim was to identify antenatal clinical factors associated with neonatal morbidity in LGA infants. Material and methods: Nulliparous women from the Screening for Pregnancy Endpoints (SCOPE) study were included. We compared maternal and fetal factors between LGA infants (birthweight >90th customized centile) with and without neonatal morbidity, defined as admission to neonatal intensive care unit or severe neonatal morbidity. Factors were selected based on a‐priori hypotheses of association and included maternal demography, anthropometric measures and self‐reported physical activity (15 and 20 weeks), fetal biometry (20 weeks), and clinical information. Multivariable logistic regression was used to identify risk factors. Stratified analyses were performed by maternal obesity and physical activity. Results: Amongst term pregnancies, prevalence of LGA infants was 9.3% (491/5,255), with 11.8% (58/491) prevalence of neonatal morbidity. Random glucose at 20 weeks (OR 1.52; 95% CI1.17 to 1.97, per 1mmol/L increase) and no regular physical activity at 20 weeks (3.93; 1.75 to 8.83) were associated with increased risk of neonatal morbidity after adjustment for birthweight, gestational age at delivery and gestational diabetes. The increased risk associated with higher glucose levels was not evident in women with regular physical activity or without obesity. Conclusions: Regular physical activity in mid‐pregnancy is associated with lower risk for neonatal morbidity in LGA infants and seems to offer protection against the increased risk associated with higher maternal glucose levels. en
dc.description.sponsorship Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Science Without Borders Fellowship BEX: 9571/13-2); South Australian Government (Premier’s Science and Research Fund); National Health and Medical Research Council (Project grant GNT519225); Foundation for Research Science and Technology (New Enterprise Research Fund); Health Research Council of New Zealand (04/198); Auckland District Health Board Charitable Trust (Evelyn Bond Fund); Health Research Board (CSA/2007/2); National Institute for Health Research( NEAT Grant FSD025); Biotechnology and Biological Sciences Research Council (GT084); University of Manchester (Proof of Concept Funding) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher John Wiley & Sons, Inc. en
dc.rights © 2018, John Wiley & Sons Inc. This is the peer reviewed version of the following article: Vieira, M. C., McCowan, L. M. E., North, R. A., Myers, J. E., Walker, J. J., Baker, P. N., Dekker, G. A., Kenny, L. C., Poston, L. and Pasupathy, D. on behalf of the SCOPE consortium (2018) 'Antenatal risk factors associated with neonatal morbidity in large for gestational age infants: an international prospective cohort study', Acta Obstetricia et Gynecologica Scandinavica. doi:10.1111/aogs.13362, which has been published in final form at https://doi.org/10.1111/aogs.13362. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. en
dc.subject Large for gestational age en
dc.subject Macrosomia en
dc.subject Risk factors en
dc.subject Adverse outcome en
dc.subject Neonatal morbidity. en
dc.title Antenatal risk factors associated with neonatal morbidity in large for gestational age infants: an international prospective cohort study en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Louise Kenny, Obstetrics & Gynaecology, University College Cork, Cork, Ireland. +353-21-490-3000 Email: l.kenny@ucc.ie en
dc.internal.availability Full text available en
dc.check.info Access to this article is restricted until 12 months after publication by request of the publisher. en
dc.check.date 2019-05-12
dc.date.updated 2018-05-18T11:37:24Z
dc.description.version Accepted Version en
dc.internal.rssid 438122171
dc.contributor.funder Science Foundation Ireland en
dc.contributor.funder Coordenação de Aperfeiçoamento de Pessoal de Nível Superior en
dc.contributor.funder National Health and Medical Research Council en
dc.contributor.funder Foundation for Research, Science and Technology en
dc.contributor.funder Health Research Council of New Zealand en
dc.contributor.funder Health Research Board en
dc.contributor.funder National Institute for Health Research en
dc.contributor.funder Biotechnology and Biological Sciences Research Council en
dc.contributor.funder Guy's and St Thomas' Charity en
dc.contributor.funder Cerebra en
dc.contributor.funder Tommy's Baby Charity
dc.description.status Peer reviewed en
dc.identifier.journaltitle Acta Obstetricia et Gynecologica Scandinavica en
dc.internal.copyrightchecked Yes en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress L.Kenny@ucc.ie en
dc.internal.bibliocheck In press. Check for vol. / issue / page numbers. Amend citation as necessary.
dc.relation.project info:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2272/IE/Irish Centre for Fetal and Neonatal Translational Research (INFANT)/ en


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