Skip to main content

Advertisement

SpringerLink
Log in

The Association of Maternal Age With Fetal Growth and Newborn Measures: The Mumbai Maternal Nutrition Project (MMNP)

  • Original Article
  • Published:
Reproductive Sciences Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bottomley C, Daemen A, Mukri F, et al. Assessing first trimester growth: the influence of ethnic background and maternal age. Hum Reprod. 2009;24(2):284–290.

    Article  PubMed  Google Scholar 

  2. Fall C, Sachdev H, Osmond C, et al. Association between maternal age at childbirth and child and adult outcomes in the offspring: a prospective study in five low-income and middle-income countries (COHORTS collaboration). Lancet Glob Health. 2015;3(7):e366–e377.

    Article  PubMed  Google Scholar 

  3. Kramer K, Lancaster J. Teen motherhood in cross-cultural perspective. Ann Hum Biol. 2010;37(5):613–628.

    Article  PubMed  Google Scholar 

  4. Bakker R, Steegers E, Biharie A, Mackenbach J, Hofman A, Jaddoe V. Explaining differences in birth outcomes in relation to maternal age: the Generation R Study. BJOG. 2011;118(4):500–509.

    Article  CAS  PubMed  Google Scholar 

  5. Mook-Kanamori D, Steegers E, Eilers P, Raat H, Hofman A, Jaddoe V. Risk factors and outcomes associated with first-trimester fetal growth restriction. JAMA. 2010;303(6):527–534.

    Article  CAS  PubMed  Google Scholar 

  6. Jolly M, Sebire N, Harris J, Robinson S, Regan L. The risks associated with pregnancy in women aged 35 years or older. Hum Reprod. 2000;15(11):2433–2437.

    Article  CAS  PubMed  Google Scholar 

  7. Kenny L, Lavender T, McNamee R, O’Neill S, Mills T, Khashan A. Advanced maternal age and adverse pregnancy outcome: evidence from a large contemporary cohort. PLos One. 2013;8(2):e56583.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Kozuki N, Lee A, Silveira M, et al. The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: a meta-analysis. BMC Public Health. 2013;13(suppl 2):S2.

    Article  PubMed  PubMed Central  Google Scholar 

  9. King J. The risk of maternal nutritional depletion on poor outcomes increases in early or closely spaced pregnancies. J Nutr. 2003;133(5 suppl 2):1732S–1736S.

    Article  CAS  PubMed  Google Scholar 

  10. Lamminpää R, Vehviläinen-Julkunen K, Gissler M, Heinonen S. Preeclampsia complicated by advanced maternal age: a registry-based study on primiparous women in Finland 1997–2008. BMC Pregnancy and Childbirth. 2012;12:47.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Potdar R, Sahariah S, Gandhi M, et al. Improving women’s diet quality preconceptionally and during gestation: effects on birth weight and prevalence of low birth weight—a randomized controlled efficacy trial in India (Mumbai Maternal Nutrition Project). Am J Clin Nutr. 2014;100(5):1257–1268.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Lawande A, Di Gravio C, Potdar R, et al. Effect of a micronutrient-rich snack taken preconceptionally and throughout pregnancy on ultrasound measures of fetal growth: the Mumbai Maternal Nutrition Project (MMNP). Matern Child Nutr. 2018;14(1):e12441.

    Article  PubMed  Google Scholar 

  13. International Institute for Population Sciences. National Family Health Survey (NFHS-2). India, 1998-99.Maharashtra, Mumbai: International Institute for Population Sciences; 2001.

  14. Chopra H, Chheda P, Kehoe S, et al. Dietary habits of female urban slum-dwellers in Mumbai, India. Indian J Matern Child Health.2012;14(2):1–13.

    PubMed  PubMed Central  Google Scholar 

  15. Hadlock F. Sonographic estimation of fetal age and weight. Radiol Clin North Am. 1990;28(1):39–50.

    Article  CAS  PubMed  Google Scholar 

  16. Papageorghiou A, Ohuma E, Altman D, et al. International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project. Lancet. 2014;384(9946):869–879.

    Article  PubMed  Google Scholar 

  17. Hadlock FP, Harrist RB, Sharman RS, Deter RL, Park SK. Estimation of fetal weight with the use of head, body, and femur measurements—a prospective study. Am J Obstet Gynecol. 1985;151(3):333–337.

    Article  CAS  PubMed  Google Scholar 

  18. Villar J, Ismail LC, Victora CG, et al. International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. Lancet. 2014;384(9946):857–868.

    Article  PubMed  Google Scholar 

  19. Cole T, Green P. Smoothing reference centile curves; the LMS method and penalized likelihood. Stat Med. 1992;11(10):1305–1319.

    Article  CAS  PubMed  Google Scholar 

  20. Rigby R, Stasinopoulos D. Generalized additive models for location, scale and shape (with discussion). J R Stat Soc Ser C Appl Stat. 2005;54:507–554.

    Article  Google Scholar 

  21. Gaillard R, Steegers E, de Jongste J, Hofman A, Jaddoe V. Tracking of fetal growth characteristics during different trimesters and the risk of adverse birth outcomes. Int J Epidemiol.2014;43(4):1140–1153.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Thame M, Hsu J, Gibson R, et al. Adaptation of in vivo amino acid kinetics facilitates increased amino acid availability for fetal growth in adolescent and adult pregnancies alike. Br J Nutr. 2014;112(11):1779–1786.

    Article  CAS  PubMed  Google Scholar 

  23. Hsu J, Thame M, Gibson R, et al. Unlike pregnant adult women, pregnant adolescent girls cannot maintain glycine flux during late pregnancy because of decreased synthesis from serine. Br J Nutr. 2016;115(5):759–763.

    Article  CAS  PubMed  Google Scholar 

  24. Barker D. Mothers, Babies and Disease in Later Life. Edinburgh, Scotland: Churchill Livingstone; 1995.

    Google Scholar 

  25. Jaquiery A, Oliver M, Honeyfield-Ross M, Harding J, Bloomfield F. Periconceptional undernutrition in sheep affects adult phenotype only in males. J Nutr Metab. 2012;2012:123610. doi: https://doi.org/10.1155/2012/123610

    Article  PubMed  PubMed Central  Google Scholar 

  26. Rumball C, Bloomfield F, Oliver M, Harding J. Different periods of periconceptional undernutrition have different effects on growth, metabolic and endocrine status in fetal sheep. Pediatr Res. 2009;66(12):605–613.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, United Kingdom

    Chiara Di Gravio MSc, Sarah H. Kehoe PhD, Ella Marley-Zagar PhD & Caroline H. D. Fall DM

  2. Dr Joshi Imaging Clinic, Mumbai, India

    Ashwin Lawande MBBS

  3. Centre for the Study of Social Change, Mumbai, India

    Ramesh D. Potdar MD, Sirazul A. Sahariah MD, Meera Gandhi MSW, Harsha Chopra PhD & Harshad Sane PhD

  4. International Centre for Maternal and Child Health, Akademia Sjukhuset, University of Uppsala MTC-huset, Uppsala, Sweden

    Nick Brown MBChB

  5. Public Health Nutrition, University of Southampton, Southampton, United Kingdom

    Barrie M. Margetts PhD

  6. NIHR Southampton Biomedical Research Centre, Southampton, United Kingdom

    Alan A. Jackson MD

Authors
  1. Chiara Di Gravio MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ashwin Lawande MBBS
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ramesh D. Potdar MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sirazul A. Sahariah MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Meera Gandhi MSW
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nick Brown MBChB
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Harsha Chopra PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Harshad Sane PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Sarah H. Kehoe PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ella Marley-Zagar PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Barrie M. Margetts PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Alan A. Jackson MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Caroline H. D. Fall DM
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chiara Di Gravio MSc.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Di Gravio, C., Lawande, A., Potdar, R.D. et al. The Association of Maternal Age With Fetal Growth and Newborn Measures: The Mumbai Maternal Nutrition Project (MMNP). Reprod. Sci. 26, 918–927 (2019). https://doi.org/10.1177/1933719118799202

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1177/1933719118799202

Keywords

Search

Navigation