The 130th Annual Meeting of APHA

Abstract #50352

Xuguang Guo, PhD, Statistics and Public Health Research Division, Constella Health Sciences, 2605 Meridian Parkway, Suite 200, Durham, NC 27713, 919 333 7659, xguo@asciences.com and Beverly Warden, PhD, Statistics and Public Health Research Division, Analytical Sciences, Inc, 2605 Meridian Parkway, Suite 200, Durham, NC 27713.

Our study is based upon a follow-up study of Pathways to Adulthood in one of 12 centers from the US Collaborative Prenatal Project (CPP) and the National Health and Nutrition Examination Survey, 1988-1994 (NHANES III). IUGR was defined as a birth weight less than the 10th percentile for the gestational age. The prevalence of IUGR was 8.9% and 8.6% for the CPP adulthood survey and HANES III, respectively. 1640 newborn babies (53% of females) were followed-up from the period of 1959-1966 to 1993. They reported their health status and provided lifestyle information. All children with available birth weight and laboratory measurements for serum insulin and glucose were selected from NHANES III. After adjusting for age, sex, race or ethnicity, birth order, education, socioeconomic status, smoking, alcoholic use, height and BMI, the least square mean (LSMEAN) for fasting glucose and insulin tended to be higher in low birth weight children than in those whose birth weight was normal according to data from NHANES III. The adjusted odds ratio (OR) for the association between IUGR and diabetes mellitus in adulthood was 2.8 (p=0.042) with a 95% confidence interval of 1.04-7.49.

These results provide strong support for the “fetal origins” hypothesis that maternal nutritional status that causes IUGR may affect the fetus and lead to the development of diabetes mellitus in adulthood. Adequate prenatal care and improved maternal nutrition, through balanced caloric or protein supplementation, could lead to an overall increase in infant birth weight and to a decrease in IUGR and the rate of low birth weight deliveries.

Learning Objectives: OBJECTIVE

To determine whether the intrauterine growth retardation (IUGR) is associated with diabetes mellitus in adulthood, and whether this association was influenced by serum insulin and glucose concentration in childhood. Both longitudinal and cross-sectional studies are used to investigate these associations in the U.S. population. METHODS
Our study is based upon a follow-up study of Pathways to Adulthood in one of 12 centers from the US Collaborative Prenatal Project between (CPP) and the National Health and Nutrition Examination Survey, 1988-1994 (NHANES III). IUGR was defined as a birth weight less than the 10th percentile for the gestational age. RESULTS
The prevalence of IUGR was 8.9% and 8.6% for the CPP adulthood survey and HANES III, respectively. 1640 newborn babies (53% of females) were followed-up from the period of 1959-1966 to 199
• They reported their health status and provided lifestyle information in detail. 2980 children with available birth weight and laboratory measurements for serum insulin and glucose were selected from NHANES III. After adjusting for age, sex, race or ethnicity, birth order, education, socioeconomic status, smoking, alcoholic use, height and body mass index, the least square mean (LSMEAN) for fasting glucose and insulin tended to be higher in low birth weight children than in those whose birth weight was normal according to data from NHANES III. The adjusted odds ratio (OR) for the association between IUGR and diabetes mellitus in adulthood was 2.8 (p=0.04
• with aa 95% confidence interval of 1.04-7.4
• Similar studies were implicated on other adult-onset disorders. There was no association between IUGR and cardiovascular disease or hypertension. CONCLUSIONS
  These results provide strong support for the “fetal origins” hypothesis that maternal nutritional status that causes IUGR may affects the fetus and lead to the development of diabetes mellitus in adulthood. Adequate prenatal care and improved maternal nutrition, through balanced caloric or protein supplementation, could lead to an overall increase in infant birth weight and to a decrease in IUGR and the rate of low birth weight deliveries.

  Keywords: Low Birthweight, Adult Health

  Presenting author's disclosure statement:
  Organization/institution whose products or services will be discussed: Analytical Sciences, Inc
  I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
  Relationship: Employment

  Improving pregnancy outcomes and reducing infant mortality

  The 130th Annual Meeting of APHA