Contents - Previous - Next
Aarts MCG & Vingerhoets AJJM (1993): Psychosocial factors and intrauterine fetal growth: a prospective study. J. Psychosom. Obstet. Gynaecol. 14, 249-258.
Arbuckle TE & Sherman GJ (1989): An analysis of birth weight by gestational age in Canada. Can. Med. Assoc. J. 140, 157-165.
Bruzzi P, Green SB, Byar DP, Brinton LA & Schairer C (1985): Estimating the population attributable risk for multiple risk factors using case-control data. Am. J. Epidemiol. 122, 904-914.
Clapp JF & Dickstein S (1984): Endurance exercise and pregnancy outcome. Med. Sci. Sport 16, 556-562.
Cliver SP, Goldenberg RL, Cutter GR, Hoffman HJ, Copper RL, Gotlieb SJ & Davis RO (1992): The relationship among psychosocial profile, maternal size, and smoking in predicting fetal growth retardation. Obstet. Gynecol. 80, 262-267.
Dawson I & Golder RY (1982): Birthweight by gestational age and its effect on perinatal mortality in white and in Punjabi births: experience at a district general hospital in West London 1967-1975. Br. J. Obstet. Gynaecol. 89, 896-899.
Division of Nutrition, National Center for Chronic Disease Prevention and Health Promotion (1994): Increasing incidence of low birth weight - United States, 1981-1991. 43, 335-339.
Dlugosz L & Bracken MB (1992): Reproductive effects of caffeine: a review and theoretical analysis. Epidemiol. Rev. 14, 83-100.
Eastman NJ & Jackson E (1968): Weight relationships in pregnancy: I. The bearing of maternal weight gain and pre-pregnancy weight on birth weight in full term pregnancies. Obstet. Gynecol. Surv. 23, 1003-1025.
Ericson A, Eriksson M, Källén B & Zetterström R (1993): Methods for the evaluation of social effects on birth weight-experiences with Swedish population registries. Scand. J. Soc. Med. 2, 69-76.
Flegal KM, Harlan WR & Landis JR (1988): Secular trends in body mass index and skinfold thickness with socioeconomic factors in young adult women. Am. J. Clin. Nutr. 48, 535-543.
Fortier I, Marcoux S & Beaulac-Baillargeon L (1993): Relation of caffeine intake during pregnancy to intrauterine growth retardation and preterm birth. Am. J. Epidemiol. 137, 931-940.
Guendelman S & English PB (1995): Effect of United States residence on birth outcomes among Mexican immigrants: an exploratory study. Am. J. Epidemiol. 142, S30-S38.
Hagland B, Cnattingius S & Nordström M-L (1993): Social differences in late fetal death and infant mortality in Sweden 1985-86. Paediatr. Perinat. Epidemiol. 7, 33-44.
Hatch EE & Bracken MB (1986): Effect of marijuana use in pregnancy on fetal growth. Am. J. Epidemiol 124, 986-993.
Hedegaard M, Henriksen TB, Sabroe S & Secher NJ (1996): The relationship between psychological distress during pregnancy and birth weight for gestational age. Acta Obstet. Gynecol. Scand. 75, 32-39.
Henriksen TB, Hedegaard M & Secher NJ (1995): Standing and walking at work and birthweight. Acta Obstet. Gynecol Scand 74, 509-516.
Henriksen TB, Hedegaard M, Secher NJ & Wilcox AJ (1995): Standing at work and preterm delivery. Br. J. Obstet. Gynaecol. 102, 198-206.
Hodnett ED (1994): Support from caregivers during at-risk pregnancy. In: Enkin MW, Keirse MJNC, Renfrew MJ, Meilson JP (eds). Pregnancy and Childbirth Module. 'Cochrane Database of Systematic Reviews': Review No. 04169, 27 April 1994. Published through 'Cochrane Updates on Disk.' Oxford: Update Software, Disk Issue I.
Homer CJ, Beresford SAA, James SA, Siegel E & Wilcox S (1990): Work related physical exertion and risk of preterm, low birthweight delivery. Paediatr. Perinat. Epidemiol. 4, 161-174.
Horon IL, Strobino DM & MacDonald HM (1983): Birth weights among infants born to adolescent and young adult women. Am. J. Obstet. Gynecol 146, 444-449.
Keppel KG & Taffel SM (1993): Pregnancy-related weight gain and retention: implications of the 1990 Institute of Medicine guidelines. Am. J. Public Health 83, 1100-1103.
Kessel SS, Villar J. Berendes HW & Nugent RP (1984): The changing pattern of low birth weight in the United States, 1970 to 1980. JAMA 251, 1978-1982.
Kleinman JC & Kopstein A (1987): Smoking during pregnancy, 1967-80. Am J. Public Health 77, 823-825.
Kogan MD (1995): Social causes of low birth weight. J. R. Soc. Med. 88, 611-615.
Kramer MS (1987): Determinants of low birth weight: methodological assessment and meta-analysis. Bull. WHO 65, 663-737.
Launer LJ, Villar J. Kestler E & De Onis M (1990): The effect of maternal work on fetal growth and duration of pregnancy: a prospective study. Br. J. Obstet. Gynaecol 97, 62-70.
Levin ML (1953): The occurrence of lung cancer in man. Acta Unio Internationalis Contra Cancrum 19, 531-541.
Linn S. Schoenbaum SC, Monson RR, Rosner R. Stubblefield PC & Ryan KJ (1983): The association of marijuana use with outcome of pregnancy. Am. J. Public Health 73, 1161-1164.
Lobel M, Dunkel-Schetter C & Scrimshaw SCM (1992): Prenatal maternal stress and prematurity: a prospective study of socioeconomically disadvantaged women. Health Psychol. 11, 32-40.
Lou HC, Nordentoft M, Jensen F, Pryds O, Nim J & Hemmingsen R (1992): Psychosocial stress and severe prematurity. Lancet 340, 54.
Mamelle N, Laumon B & Lazar P (1984): Prematurity and occupational activity during pregnancy. Am. J. Epidemiol. 119, 309-322.
Martin TR & Bracken MB (1987): The association between low birth weight and caffeine consumption during pregnancy. Am. J. Epidemiol. 126, 813-821.
Moore WMO, Bannister RP, Ward BS, Hillier VF & Bamford FN (1995): Fetal and postnatal growth to age 2 years by mother's country of birth. Early Hum. Dev. 42, 111-121.
Munroe M, Shah CP, Badgley R & Bain HW (1984): Birth weight, length, head circumference and bilirubin level in Indian newborns in the Sioux Lookout Zone, Northwestern Ontario. Can. Med. Assoc. J. 131, 453-456.
Newton RW & Hunt LP (1984): Psychosocial stress in pregnancy and its relation to low birth weight. Br. Med. J. 288, 1191-1194.
Ng E & Wilkins R (1994): Maternal demographic characteristics and rates of low birth weight in Canada, 1961 to 1990. Health Rep. 6, 241-252.
Niswander K & Jackson EC (1974): Physical characteristics of the gravida and their association with birth weight and perinatal death. Am. J. Obstet. Gynecol. 119, 306-313.
Nordentoft M, Lou HC, Hansen D, Nim J, Pryds O, Rubin P & Hemmingsen R (1996): Intrauterine growth retardation and premature delivery: the influence of maternal smoking and psychosocial factors. Am. J. Public Health 86, 347-354.
Nuckolls KB, Cassel J & Kaplan BH (1972): Psychosocial assets, life crisis, and the prognosis of pregnancy. Am. J. Epidemiol, 95, 431-441.
Olsen J & Frische G (1993): Social differences in reproductive health. Scand. J. Soc. Med. 2, 90- 97.
Parker JD, Schoendorf KC & Kiely JL (1994): Associations between measures of socioeconomic status and low birth weight, small for gestational age, and premature delivery in the United States. Ann. Epidemiol. 44, 271-278.
Saurel-Cubizolles MJ & Kaminski M (1987): Pregnant women's working conditions and their changes during pregnancy: a national study in France. Br. J. Ind. Med. 44, 236-243.
Sayers SM & Powers JR (1993): Birth size of Australian Aboriginal babies. Med. J. Aust. 159, 586-591.
Seward JF & Stanley FJ (1981): Comparison of births to Aboriginal and Caucasian mothers in Western Australia. Med. J. Aust. 2, 80-84.
Shiono PH, Klebanoff MA, Nugent RP, Cotch MF, Wilkins DG, Rollins DG, Carey JC & Behrman RE (1995): The impact of cocaine and marijuana use on low birth weight and preterm birth: a multicenter study. Am. J. Obstet. Gynecol. 172, 19-27.
Showstack J, Budetti PP & Minkler D (1984): Factors associated with birthweight: an exploration of the role of prenatal care and length of gestation. Am. J. Public Health 74, 1003-1008.
Subcommittee on Nutritional Status and Weight Gain During Pregnancy, Food and Nutrition Board, U.S. Institute of Medicine/National Academy of Sciences (1990): Nutrition During Pregnancy. National Academy Press: Washington, D.C.
Taffel SM (1986): Maternal weighs gain and the outcome of pregnancy: United States, 1980. Vital Health Statistics, Series 21, No. 44. DHHS Pub. No. (PHS) 86-1922.
Thomson AM & Billewicz WZ (1963): Nutritional status, maternal physique and reproductive efficiency. Proc. Nutr. Soc. 22, 55-60.
Thomson M (1990): Heavy birthweight in Native Indians of British Columbia. Can. J. Pub. Health 81, 443-446.
Villar J & Belizan, JM (1982): The timing factor in the pathophysiology of the intrauterine growth retardation syndrome. Obstet. Gynecol. Surv. 37, 499-506.
Walpole I, Zubrick S & Pontré J (1990): Is there a fetal effect with low to moderate alcohol use before or during pregnancy? J. Epidemiol. Comm. Health 44, 297-301.
Wen SW, Kramer MS & Usher RH (1995): Comparison of birth weight distributions between Chinese and Caucasian infants. Am. J. Epidemiol. 141, 1177-1187.
Wilcox MA, Smith SJ, Johnson IR, Maynard PV & Chilvers CE (1995): The effect of social deprivation on birthweight, excluding physiological and pathological effects. Br. J. Obstet. Gynaecol. 102, 918-924.
Wilkins R, Sherman G & Best PAF (1991): Birth outcomes and infant mortality by income in urban Canada, 1986. Health Rep 3, 7-31.
Yudkin PL, Harlap S & Baras M (1983): High birthweight in an ethnic group of low socioeconomic status. Br. J. Obstet. Gynaecol. 90, 291-296.
Zuckerman B, Frank DA, Hingson R, Amaro H, Levenson SM, Kayne H, Parker S, Vinci R, Aboagye K, Fried LE, Cabral H, Timperi R & Bauchner H (1989): Effects of maternal marijuana and cocaine use on fetal growth. N. Engl. J. Med. 320, 762-768.
Zuckerman BS & Hingson R (1986):
Alcohol consumption during pregnancy: a critical review. Dev. Med. Child Neurol. 28,
The mother's nutritional status before conception (reflected by maternal BMI) and her weight gain during pregnancy are important determinants of fetal growth in developing countries and, to a somewhat lesser extent, in developed countries. In initially thinner women, the effect of weight gain on fetal growth is greater than in fatter ones. In very thin women, even a high weight gain during pregnancy may not be able to fully compensate (even with the interaction effect) the higher risk of having an IUGR baby. Being well-nourished before conception has a buffering effect and, in women with a prepregnancy BMI > 27, weight gain during pregnancy will no longer have much of an effect on fetal growth.
The Subcommittee on Nutritional Status and Weight Gain During Pregnancy of the US Institute of Medicine made recommendations in 1990, recognizing the relationship between prepregnancy BMI and desirable weight gain, but looking at outcomes in babies, not mothers. It recommended weight gains that, throughout the range of prepregnancy BMIs, were considerably higher than recommendations in other countries, including Europe. Several authors have drawn attention to the fact that the residual weight the mother retains after giving birth is dependent on the weight she gained during pregnancy. If recommended weight gains during pregnancy are relatively high, this results in a tendency to increasing BMIs after each pregnancy and can become a public health concern. The effects of recommending high weight gains during pregnancy on the birthweight distribution is less clear; a shift to the right would mean fewer IUGR babies and that would be an advantage; but it would also mean more macrosomic babies and possibly more complications at birth and a greater percentage of mothers needing Cesarean sections, which would be a disadvantage. An intriguing observation is that black women in the US tend to have babies with a lower mean birth weight, even though their body weight tends to be higher than that of white women. Making recommendations on weight gains during pregnancy is not an aim of this workshop, but several discussants are of the opinion that the next committee that will be charged with making such recommendations in the US may have to correct current estimates downwards.
A more general question is whether making recommendations has any effect on observed weight gains. What little literature exists on this subject suggests that recommendations given by health providers to pregnant women can and often do result in a change in knowledge but rarely produce changes in behavior and practice. Three randomized trials on the effect of nutritional advice given to pregnant women are not very strong methodologically. They show only a very modest effect on maternal weight gain and practically no effect on birthweight. On the other hand, it looks as if a more relaxed, less restrictive general attitude towards weight gain has led to a secular increase in birthweight, primarily among term infants. Unfortunately, this would also affect women with a high prepregnancy BMI.
A widely held belief is that since fetal growth is greatest in the third trimester, interventions are also likely to have their greatest effect during the third trimester. The Dutch women whose third trimester of pregnancy coincided with the famine towards the end of WW2 were the ones who gave birth to the lightest babies, and in The Gambia the prevalence of LBW babies is highest in women whose third trimester of pregnancy coincides with the hungry season in summer. Dietary supplementation of Taiwanese women before and during the whole pregnancy did not have more of an effect on birthweight than did similar supplementation trials during the last trimester only. However, the evidence bearing on earlier nutritional effects is not completely uniform. A study among adolescents showed that greater weight gain early in pregnancy had more of an effect than larger weight gains later. A study of rural Guatemalan women showed an interaction between gastrointestinal parasitosis and maternal height. In women of average height and weight, mebendazol therapy had little effect on birthweight, but in short women it did. In this study too, therapy had a greater effect during the first half of pregnancy than during the second half.
The assumption is frequently made that early growth restriction will result in small but proportionate babies, whereas growth restriction during the latter part of pregnancy will result in wasted babies of approximately normal length. Kramer argued that this generalization had its limits because of a strong association between wasting and severity of growth restriction. The theory explaining the high rate of growth-retarded babies born to teenagers by a competition for nutrients received support from a recent study in which knee height (as an indicator of bone growth) was monitored in pregnant teenage mothers. The birthweights of the babies were inversely related to maternal bone growth.
Genital and urinary tract infections
seem to result more in preterm births than in IUGR.
Contents - Previous - Next