1. Co-causation of reduced newborn size by maternal undernutrition, infections, and inflammation
- Author
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Ashorn, Per, Hallamaa, Lotta, Allen, Lindsay H, Ashorn, Ulla, Chandrasiri, Upeksha, Deitchler, Megan, Doyle, Ronan, Harjunmaa, Ulla, Jorgensen, Josh M, Kamiza, Steve, Klein, Nigel, Maleta, Kenneth, Nkhoma, Minyanga, Oaks, Brietta M, Poelman, Basho, Rogerson, Stephen J, Stewart, Christine P, Zeilani, Mamane, Dewey, Kathryn G, Lääketieteen ja biotieteiden tiedekunta - Faculty of Medicine and Life Sciences, and University of Tampere
- Subjects
Rural Population ,Malawi ,Placenta ,pathways ,HIV Infections ,Reproductive health and childbirth ,Weight Gain ,Low Birth Weight and Health of the Newborn ,Body Mass Index ,Fetal Development ,Hemoglobins ,Pregnancy ,low-income countries ,Infant Mortality ,Birth Weight ,Body Size ,2.2 Factors relating to the physical environment ,Prospective Studies ,Aetiology ,Randomized Controlled Trials as Topic ,Pediatric ,Nutrition and Dietetics ,Naisten- ja lastentaudit - Gynaecology and paediatrics ,Orosomucoid ,Female ,Zero Hunger ,Adult ,Adolescent ,WAZ ,Kansanterveystiede, ympäristö ja työterveys - Public health care science, environmental and occupational health ,Nutritional Status ,Communicable Diseases ,Young Adult ,Preterm ,Humans ,Obesity ,Conditions Affecting the Embryonic and Fetal Periods ,Nutrition ,Inflammation ,Nutrition & Dietetics ,Prevention ,Malnutrition ,Infant ,Maternal Nutritional Physiological Phenomena ,Perinatal Period - Conditions Originating in Perinatal Period ,Newborn ,Malaria ,newborn size ,Good Health and Well Being ,Socioeconomic Factors ,LAZ - Abstract
More than 20 million babies are born with low birthweight annually. Small newborns have an increased risk for mortality, growth failure, and other adverse outcomes. Numerous antenatal risk factors for small newborn size have been identified, but individual interventions addressing them have not markedly improved the health outcomes of interest. We tested a hypothesis that in low-income settings, newborn size is influenced jointly by multiple maternal exposures and characterized pathways associating these exposures with newborn size. This was a prospective cohort study of pregnant women and their offspring nested in an intervention trial in rural Malawi. We collected information on maternal and placental characteristics and used regression analyses, structural equation modelling, and random forest models to build pathway maps for direct and indirect associations between these characteristics and newborn weight-for-age Z-score and length-for-age Z-score. We used multiple imputation to infer values for any missing data. Among 1,179 pregnant women and their babies, newborn weight-for-age Z-score was directly predicted by maternal primiparity, body mass index, and plasma alpha-1-acid glycoprotein concentration before 20weeks of gestation, gestational weight gain, duration of pregnancy, placental weight, and newborn length-for-age Z-score (p 
- Published
- 2018