Sex- and growth-specific characteristics of small for gestational age infants: a prospective cohort study



van der Vlugt, Eva R, Verburg, Petra E, Leemaqz, Shalem Y, McCowan, Lesley ME, Poston, Lucilla, Kenny, Louise C ORCID: 0000-0002-9011-759X, Myers, Jenny, Walker, James J, Dekker, Gustaaf A and Roberts, Claire T
(2020) Sex- and growth-specific characteristics of small for gestational age infants: a prospective cohort study. BIOLOGY OF SEX DIFFERENCES, 11 (1). 25-.

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Abstract

<h4>Background</h4>Asymmetric fetal growth and male sex are both associated with adverse neonatal outcome. However, less is known about the influence of asymmetric growth and fetal sex within SGA neonates, a group of infants already at increased risk for adverse neonatal outcomes. The aim of the present study was to provide insight into variance in risk factors for SGA in a fetal sex- and growth symmetry-specific way.<h4>Methods</h4>For this prospective, multicenter cohort study, data from the Screening for Pregnancy Endpoints (SCOPE) study were used with 5628 nulliparous participants, of which 633 (11.3%) pregnancies were complicated with SGA and 3376 (60.0%) women had uncomplicated pregnancies. Association between risk factors for SGA, SGA subgroups, and uncomplicated pregnancies were assessed with multivariable analyses.<h4>Results</h4>Prevalence of asymmetric growth varied from 45.8% of SGA infants to 5.5% of infants with a customized birthweight > 90th percentile (p < 0.001). Significantly more SGA males had asymmetric growth compared to SGA female infants (51.2% vs 40.4%, p = 0.009). Maternal pre-pregnancy diet and BMI < 20 and ≥ 30 were significantly associated with symmetric SGA but not with asymmetric SGA. Asymmetric SGA infants had not only lower customized birthweight percentile (4.4 (SD 2.8) vs 5.0 (SD 3.0), p < 0.001), but also lower rates of stillbirth (p = 0.041) and less often Apgar scores < 7 (p = 0.060).<h4>Conclusions</h4>Among SGA infants, low customized birthweight percentiles and male sex are associated with asymmetric growth. Only symmetric SGA is significantly associated with maternal risk factors in early pregnancy. There is a substantial variance in risk factors and neonatal outcomes for SGA based on growth symmetry, implying a different pathogenesis.<h4>Trial registration</h4>ACTRN12607000551493.

Item Type: Article
Uncontrolled Keywords: Small for gestational age, Sexual dimorphism, Risk factor, Asymmetric growth, Symmetric growth
Depositing User: Symplectic Admin
Date Deposited: 20 Aug 2020 10:52
Last Modified: 18 Jan 2023 23:36
DOI: 10.1186/s13293-020-00300-z
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3098216