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

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dc.check.date2019-05-12
dc.check.infoAccess to this article is restricted until 12 months after publication by request of the publisher.en
dc.contributor.authorVieira, Matias C.
dc.contributor.authorMcCowan, Lesley M. E.
dc.contributor.authorNorth, Robyn A.
dc.contributor.authorMyers, Jenny E.
dc.contributor.authorWalker, James J.
dc.contributor.authorBaker, Philip N.
dc.contributor.authorDekker, Gustaaf A.
dc.contributor.authorKenny, Louise C.
dc.contributor.authorPoston, Lucilla
dc.contributor.authorPasupathy, Dharmintra
dc.contributor.funderScience Foundation Irelanden
dc.contributor.funderCoordenação de Aperfeiçoamento de Pessoal de Nível Superioren
dc.contributor.funderNational Health and Medical Research Councilen
dc.contributor.funderFoundation for Research, Science and Technologyen
dc.contributor.funderHealth Research Council of New Zealanden
dc.contributor.funderHealth Research Boarden
dc.contributor.funderNational Institute for Health Researchen
dc.contributor.funderBiotechnology and Biological Sciences Research Councilen
dc.contributor.funderGuy's and St Thomas' Charityen
dc.contributor.funderCerebraen
dc.contributor.funderTommy's Baby Charity
dc.date.accessioned2018-05-22T08:42:35Z
dc.date.available2018-05-22T08:42:35Z
dc.date.issued2018-05-12
dc.date.updated2018-05-18T11:37:24Z
dc.description.abstractIntroduction: 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.sponsorshipCoordenação 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.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationVieira, 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.13362en
dc.identifier.doi10.1111/aogs.13362
dc.identifier.issn0001-6349
dc.identifier.issn1600-0412
dc.identifier.journaltitleActa Obstetricia et Gynecologica Scandinavicaen
dc.identifier.urihttps://hdl.handle.net/10468/6166
dc.language.isoenen
dc.publisherJohn Wiley & Sons, Inc.en
dc.relation.projectinfo:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2272/IE/Irish Centre for Fetal and Neonatal Translational Research (INFANT)/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.subjectLarge for gestational ageen
dc.subjectMacrosomiaen
dc.subjectRisk factorsen
dc.subjectAdverse outcomeen
dc.subjectNeonatal morbidity.en
dc.titleAntenatal risk factors associated with neonatal morbidity in large for gestational age infants: an international prospective cohort studyen
dc.typeArticle (peer-reviewed)en
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