The association of maternal age with fetal growth and newborn measures: the Mumbai Nutrition Project (MMNP)

Chiara Di Gravio, Ashwin Lawande, Ramesh D. Potdar, Sirazul A. Sahariah, Meera Gandhi, Nick Brown, Harsha Chopra, Harshad Sane, Sarah H. Kehoe, Ella Marley-Zagar, Barrie M. Margetts, Alan A. Jackson, Caroline H.D. Fall

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Background:
    Young maternal age is associated with poorer birth outcomes, but the mechanisms are incompletely understood. Using data from a prospective cohort of pregnant women living in Mumbai slums, India, we tested whether lower maternal age was associated with adverse fetal growth.

    Methods:
    Fetal crown-rump length (CRL) was recorded at a median (interquartile range, IQR) of 10 weeks’ gestation (9-10 weeks). Head circumference (HC), biparietal diameter (BPD), femur length (FL), and abdominal circumference (AC) were recorded at 19 (19-20) and 29 (28-30) weeks. Newborns were measured at a median (IQR) of 2 days (1-3 days) from delivery. Gestation was assessed using prospectively collected menstrual period dates.

    Results:
    The sample comprised 1653 singleton fetuses without major congenital abnormalities, of whom 1360 had newborn measurements. Fetuses of younger mothers had smaller CRL (0.01 standard deviation [SD] per year of maternal age; 95% confidence interval CI: 0.00-0.021; P = .04), and smaller HC, FL, and AC at subsequent visits. Fetal growth of HC (0.04 cm; 95% CI: 0.02-0.05; P < .001), BPD (0.01 cm; 95% CI: 0.00-0.01; P = .009), FL (0.04 cm; 95% CI: 0.02-0.06; P < .001), and AC (0.01 cm; 95% CI: 0.00-0.01; P = .003) up to the third trimester increased with maternal age. Skinfolds, head, and mid-upper arm circumferences were smaller in newborns of younger mothers. Adjusting for maternal prepregnancy socioeconomic status, body mass index, height, and parity attenuated the associations between maternal age and newborn size but did not change those with fetal biometry.

    Conclusion:
    Fetuses of younger mothers were smaller from the first trimester onward and grew slower, independently of known confounding factors.
    Original languageEnglish
    Pages (from-to)918 - 927
    Number of pages10
    JournalReproductive Sciences
    Volume26
    Issue number7
    DOIs
    Publication statusPublished - 12 Nov 2018

    Keywords

    • fetal biometry
    • ultrasound
    • maternal age
    • pregnancy
    • newborn
    • India

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