Maternal and Child Health Journal

, Volume 21, Issue 7, pp 1512–1521 | Cite as

The Intergenerational Transmission of Low Birth Weight and Intrauterine Growth Restriction: A Large Cross-generational Cohort Study in Taiwan

  • Mengcen QianEmail author
  • Shin-Yi Chou
  • Lea Gimenez
  • Jin-Tan Liu


Objectives Our research provides evidence on the intergenerational fetal programming effect by examining associations in the low birth weight (LBW, birth weight <2500 g) and intrauterine growth restriction (IUGR) status between two adjacent generations from both the maternal and paternal sides. Methods Birth certificate data of the entire Taiwanese population are used to construct three-consecutive-generational samples. The final samples consist of the third-generation children born during 1999–2006 to at least one second-generation (G2) parent born during 1978–1985. Maternal and paternal samples are distinguished based on the gender of G2. We first fit the samples with linear probability models while including extensive explanatory variables to control for myriad confounding factors. We then include G2 sibling fixed effects to account for family-specific heterogeneity. Alternative explanations of sample selection, parents’ assortative mating, and grandmothers’ postnatal investment are examined. Results We find that significant intergenerational associations in LBW and IUGR only occur matrilineally. Children born to LBW mothers are 2.28 (95% CI, 0.71–3.85; p < 0.01) percentage points, corresponding to 36%, more likely to be LBW compared to children born to non-LBW mothers who are sisters. These associations cannot be explained by the above alternative explanations. Conclusions Under G2 sibling comparisons, children born to LBW (IUGR) mothers are more likely to be LBW (IUGR), but children born to LBW (IUGR) fathers are not. The findings suggest that maternal health is pertinent and that socio-economic interventions may not yield the desired outcomes within a short period of time.


Low birth weight Intrauterine growth restriction Intergenerational associations Maternal and paternal lines Taiwan 


Author Contribution

All authors contributed equally to the work.


The authors received no grants or financial support for this study.

Compliance with Ethical Standards

Human and Animal Rights

Patients, service users, or lay people are not involved in this study.


  1. Almond, D., & Currie, J. Killing me softly: the fetal origins hypothesis. The Journal of Economic Perspectives 2011; pp. 153–172.Google Scholar
  2. Alwasel, S. H., Harrath, A., Aljarallah, J. S., Abotalib, Z., Osmond, C., Omar, S. Y., Khaled, I., & Barker, D. J. (2013). Intergenerational effects of in utero exposure to Ramadan in Tunisia. American Journal of Human Biology, 25(3), 341–343.CrossRefPubMedGoogle Scholar
  3. Barker, D. J. (1990). The fetal and infant origins of adult disease. British Medical Journal, 301(6761), 1111.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Barker, D. J. (1995). Fetal origins of coronary heart disease. British Medical Journal, 311(6998), 171–174.CrossRefPubMedPubMedCentralGoogle Scholar
  5. Brown, M. A., Davis, G. K., & McHugh, L. (2001). The prevalence and clinical significance of nocturnal hypertension in pregnancy. Journal of Hypertension, 19(8), 1437–1444.CrossRefPubMedGoogle Scholar
  6. Buchbinder, A., et al. (2002). Adverse perinatal outcomes are significantly higher in severe gestational hypertension than in mild preeclampsia. American Journal of Obstetrics and Gynecology, 186(1), 66–71.CrossRefPubMedGoogle Scholar
  7. Collins, J. W., David, R. J., Prachand, N. G., & Pierce, M. L. (2003). Low birth weight across generations. Maternal and Child Health Journal, 7(4), 229–237.CrossRefPubMedGoogle Scholar
  8. Collins, J. W., Wu, S. Y., & David, R. J. (2002). Differing intergenerational birth weights among the descendants of US-born and foreign-born Whites and African Americans in Illinois. American Journal of Epidemiology, 155(3), 210–216.CrossRefPubMedGoogle Scholar
  9. Currie, J., & Moretti, E. Biology as destiny? Short- and long-run determinants of intergenerational transmission of birth weight. Journal of Labor Economics 2007, 25 (2).Google Scholar
  10. Drake, A. J., & Walker, B. R. (2004). The intergenerational effects of fetal programming: Non-genomic mechanisms for the inheritance of low birth weight and cardiovascular risk. Journal of Endocrinology, 180(1), 1–16.CrossRefPubMedGoogle Scholar
  11. Fung W., Ha W. 2009. Intergenerational effects of the 1959-61 China famine. Risk, Shocks and Human Development. Palgrave Macmillan: Basingstoke.Google Scholar
  12. Gluckman, P. D., Hanson, M. A., & Beedle, A. S. (2007). Non-genomic transgenerational inheritance of disease risk. BioEssays: news and reviews in molecular, cellular and developmental biology, 29(2), 145–154.CrossRefGoogle Scholar
  13. Hales, C. N., & Barker, D. J. (2001). The thrifty phenotype hypothesis. British Medical Bulletin, 60(1), 5–20.CrossRefPubMedGoogle Scholar
  14. Jablonka E., Lamb M. J. (2006). Evolution in four dimensions: Genetic, epigenetic, behavioral, and symbolic variation in the history of life. MIT Press: CambridgeGoogle Scholar
  15. Klebanoff, M. A., Secher, N. J., Mednick, B. R., & Schulsinger, C. (1999). Maternal size at birth and the development of hypertension during pregnancy: A test of the Barker hypothesis. Archives of Internal Medicine, 159(14), 1607–1612.CrossRefPubMedGoogle Scholar
  16. Kramer, M. S. (1987). Determinants of low birth weight: Methodological assessment and meta-analysis. Bulletin of the World Health Organization, 65(5), 663.PubMedPubMedCentralGoogle Scholar
  17. Kuzawa, C. W., & Sweet, E. (2009). Epigenetics and the embodiment of face: Developmental origins of US racial disparities in cardiovascular health. American Journal of Human Biology, 21(1), 2–15.CrossRefPubMedGoogle Scholar
  18. Lang, U., et al. (2003). Uterine blood flow-A determinant of fetal growth. European Journal of Obstetrics and Gynecology and Reproductive Biology, 110, S55–S61.CrossRefPubMedGoogle Scholar
  19. Levitt, N. S., et al. (2000). Impaired glucose tolerance and elevated blood pressure in low birth weight, nonobese, young south African adults: Early programming of cortisol axis. The Journal of Clinical Endocrinology and Metabolism, 85(12), 4611–4618.PubMedGoogle Scholar
  20. Lumey, L. H. (1992). Decreased birthweights in infants after maternal in utero exposure to the Dutch famine of 1944–1945. Paediatric and Perinatal Epidemiology, 6(2), 240–253.CrossRefPubMedGoogle Scholar
  21. Magnus, P., Gjessing, H. K., Skrondal, A., & Skjaerven, R. (2001). Paternal contribution to birth weight. Journal of Epidemiology and Community Health, 55(12), 873–877.CrossRefPubMedPubMedCentralGoogle Scholar
  22. McTernan, C. L., et al. (2001). Reduced placental 11β-hydroxysteroid dehydrogenase type 2 mRNA levels in human pregnancies complicated by intrauterine growth restriction: An analysis of possible mechanisms. The Journal of Clinical Endocrinology and Metabolism, 86(10), 4979–4983.PubMedGoogle Scholar
  23. Meaney, M. J. (2001). Maternal care, gene expression, and the transmission of individual differences in stress reactivity across generations. Annual Review of Neuroscience, 24(1), 1161–1192.CrossRefPubMedGoogle Scholar
  24. Phillips, D. I., et al. (1998). Elevated plasma cortisol concentrations: A link between low birth weight and the insulin resistance syndrome? The Journal of Clinical Endocrinology and Metabolism, 83(3), 757–760.PubMedGoogle Scholar
  25. Reynolds, R. M., et al. (2001). Altered control of cortisol secretion in adult men with low birth weight and cardiovascular risk factors. The Journal of Clinical Endocrinology and Metabolism, 86(1), 245–250.PubMedGoogle Scholar
  26. Royer, H. (2009). Separated at girth: US twin estimates of the effects of birth weight. American Economic Journal: Applied Economics, 1(1), 49–85.Google Scholar
  27. Worthman, C. M., & Kuzara, J. (2005). Life history and the early origins of health differentials. American Journal of Human Biology, 17(1), 95–112.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Mengcen Qian
    • 1
    • 5
    Email author
  • Shin-Yi Chou
    • 2
  • Lea Gimenez
    • 3
  • Jin-Tan Liu
    • 4
  1. 1.Department of Health EconomicsFudan University School of Public HealthShanghaiChina
  2. 2.Department of EconomicsLehigh UniversityBethlehemUSA
  3. 3.Ministry of Finance of ParaguayAsunciónParaguay
  4. 4.Department of EconomicsNational Taiwan UniversityTaipeiTaiwan
  5. 5.ShanghaiChina

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