- Email: [email protected]
P2-159 Birthweight, postnatal growth, and age at menarche
S174
Posters
Results: Maternal psychosocial stress during pregnancy is associated with lower birth weight (d = 0.15, p < 0.0001), higher prevalence of intrauterine growth restriction (d = 0.10, p < 0.01), as well as shorter gestational length (d = 0.19, p < 0.01), and higher prevalence of prematurity (d = 0.09, p < 0.01). The effect sizes are modest in magnitude and fairly consistent across studies. Conclusions: Maternal psychosocial stress is significantly associated with adverse birth outcomes after adjusting for the effects of other obstetric, sociodemographic and behavioral risk factors. Further research is required to elucidate specific characteristics of prenatal stress in terms of their nature, timing of occurrence as well as their interaction with other environmental and genetic factors. P2-158 Waist hip ratio predicts menstrual cycle irregularity but only in overweight and obese young women. Findings from the Southampton Women’s Survey S.L. Duggleby1,2 *, K.M. Godfrey1 , H.M. Inskip1 , A.A. Jackson2 , Southampton Women’s Survey Study Group1 . 1 MRC Epidemiology Resource Centre, 2 Institute of Human Nutrition, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK E-mail: [email protected] Aims: Women with an irregular menstrual cycle may have both reduced fecundity and an increased risk of cardiovascular disease later in life. We investigated the lifestyle and body composition factors associated with menstrual cycle irregularity. Study design: Analysis of data from women characterised when not pregnant in the Southampton Women’s Survey. We asked about menstrual cycle pattern, socio-demographic and lifestyle characteristics, and measured height, weight, waist and hip circumferences. Subjects: 5974 white Caucasian women aged 20 34 y, not taking the oral contraceptive pill or other hormonal treatment. Outcome measures: Reported menstrual cycle pattern. Results: 32% (1,938) of women reported an irregular menstrual cycle that varied by more than 5 days. Both higher body mass index (BMI) and higher waist hip ratio (WHR) were associated with an increased probability of reporting an irregular menstrual cycle. There was, however, also a significant interaction between BMI and WHR: WHR was not associated with an irregular menstrual cycle in women with a BMI < 25 kg/m2 , but was in overweight (BMI 25 & <30 kg/m2 ) and obese women (BMI 30 kg/m2 ) (Figure). Other strong independent factors influencing risk of irregular menstrual cycle were younger age, being parous, and reporting higher levels of stress; however, adjusting for these did not change the relations between anthropometry and menstrual cycle irregularity.
Probability of reporting an irregular menstrual cycle
.7 .6 .5 .4 .3 .2 .6
.7
BMI < 25 kg/m²
.8 .9 Waist/hip ratio BMI ? 25 & < 30 kg/m²
1
1.1
BMI ? 30 kg/m²
Conclusions: Women who have a high WHR and who are overweight or obese are more likely to report an irregular menstrual cycle. Reducing body weight may be more important for women with a high WHR.
P2-159 Birthweight, postnatal growth, and age at menarche J.F. Ferris *, D. Esserman, J. Flom, M.B. Terry. Columbia University Mailman School of Public Health, USA E-mail: [email protected] Aims: To investigate the influence of birthweight and postnatal growth patterns on age at menarche. Study design: Adult follow-up of the New York site of the U.S. National Collaborative Perinatal Project (NCPP) birth cohort. Prospective data collection included maternal (weight, pregnancy weight gain, age at menarche, smoking), infant (birthweight, birth length), childhood growth (from birth 4 months, 4 12 months, and 1 7 years), and family-level variables (race, socioeconomic status, number of siblings and father present or absent). Subjects: Girls born between 1959 1966 who were followed into adulthood (n = 263). Women who we enrolled did not differ with respect to birthweight or other postnatal body measures compared to women we did not enroll. Outcome measures: Self-reported age at menarche. We estimated these associations using both linear and logistic regression modeling early (12 years) versus late age at menarche (>12). Results: Using an adjusted logistic regression model, we observed no association between birthweight by itself and earlier age at menarche (Odds ratio [OR] = 1.07, 95% Confidence Interval [CI] = 0.63 1.82), though the point estimate increased after adjusting for postnatal growth (OR = 2.59, 95% CI = 0.79 8.53). After adjusting for birth length, percentile change of height and socioeconomic status, rapid weight gain from 1 7 years was associated with earlier age at menarche (OR = 1.18, 95% CI = 1.02 1.36, respectively for 10% change in percentile rank). Conclusions: These data add to accumulating evidence that rapid growth early in life is associated with earlier age at menarche. P2-160 Ethnic differences in preterm birth subtypes; the effect of a cumulative risk profile G. Goedhart1,2 *, M. van Eijsden1,2 , M.F. van der Wal1 , G.J. Bonsel2,3 . 1 Municipal Health Service, Department of Epidemiology, Documentation and Health Promotion, Amsterdam, The Netherlands, 2 Academic Medical Centre, University of Amsterdam, Department of Social Medicine, Amsterdam, The Netherlands, 3 Institute of Health Policy & Management, Erasmus Medical Center, Rotterdam, the Netherlands E-mail: [email protected] Aims: To examine the ethnic differences in spontaneous (SPB) and medically indicated (IPB) preterm births, and to what extent an accumulation of risk factors explains these differences. Study design: Prospective community-based cohort study: the Amsterdam Born Children and their Development study. Subjects: 7,604 unselected pregnant women, living in Amsterdam, with a Dutch, Surinamese, Antillean, Turkish, Moroccan or Ghanaian background, delivering a singleton. Outcome measures: Odds ratio (OR) and 95% confidence interval (CI) for spontaneous and medically indicated preterm births. Results: Common risk factors for SPB and IPB were primiparity and smoking. Specific risk factors for SPB were: previous preterm birth, previous miscarriage/stillbirth, and for IPB: hypertension, obesity, advanced maternal age. After adjustment for all risk factors, Surinamese women had a higher risk for SPB (OR = 1.6; 95% CI: 1.1 2.3) and IPB (OR = 2.0; 95% CI: 1.0 4.2) compared to the Dutch women, while Antillean (OR = 3.2; 95% CI: 1.0 10.1) and Ghanaian (OR = 3.0; 95% CI: 1.0 9.6) women had only a higher risk for IPB. All ethnic minority groups had a higher accumulation of risk factors (risk score ranging from 2.1 3.7) compared to the Dutch group (risk score: 1.7). Adjustment for the risk score decreased the preterm risk of Surinamese (OR = 1.3; 95% CI: 0.9 1.8), Antillean (OR = 1.2; 95% CI:0.6 2.4) and Ghanaian (OR = 1.4; 95% CI:0.8 2.4) women. Conclusions: Surinamese, Antillean and Ghanaian women had a higher risk for spontaneous and/or medically indicated preterm birth compared to Dutch women after adjustment for conventional risk factors. A cumulative risk profile, mainly observed among the
Posters
Results: Maternal psychosocial stress during pregnancy is associated with lower birth weight (d = 0.15, p < 0.0001), higher prevalence of intrauterine growth restriction (d = 0.10, p < 0.01), as well as shorter gestational length (d = 0.19, p < 0.01), and higher prevalence of prematurity (d = 0.09, p < 0.01). The effect sizes are modest in magnitude and fairly consistent across studies. Conclusions: Maternal psychosocial stress is significantly associated with adverse birth outcomes after adjusting for the effects of other obstetric, sociodemographic and behavioral risk factors. Further research is required to elucidate specific characteristics of prenatal stress in terms of their nature, timing of occurrence as well as their interaction with other environmental and genetic factors. P2-158 Waist hip ratio predicts menstrual cycle irregularity but only in overweight and obese young women. Findings from the Southampton Women’s Survey S.L. Duggleby1,2 *, K.M. Godfrey1 , H.M. Inskip1 , A.A. Jackson2 , Southampton Women’s Survey Study Group1 . 1 MRC Epidemiology Resource Centre, 2 Institute of Human Nutrition, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK E-mail: [email protected] Aims: Women with an irregular menstrual cycle may have both reduced fecundity and an increased risk of cardiovascular disease later in life. We investigated the lifestyle and body composition factors associated with menstrual cycle irregularity. Study design: Analysis of data from women characterised when not pregnant in the Southampton Women’s Survey. We asked about menstrual cycle pattern, socio-demographic and lifestyle characteristics, and measured height, weight, waist and hip circumferences. Subjects: 5974 white Caucasian women aged 20 34 y, not taking the oral contraceptive pill or other hormonal treatment. Outcome measures: Reported menstrual cycle pattern. Results: 32% (1,938) of women reported an irregular menstrual cycle that varied by more than 5 days. Both higher body mass index (BMI) and higher waist hip ratio (WHR) were associated with an increased probability of reporting an irregular menstrual cycle. There was, however, also a significant interaction between BMI and WHR: WHR was not associated with an irregular menstrual cycle in women with a BMI < 25 kg/m2 , but was in overweight (BMI 25 & <30 kg/m2 ) and obese women (BMI 30 kg/m2 ) (Figure). Other strong independent factors influencing risk of irregular menstrual cycle were younger age, being parous, and reporting higher levels of stress; however, adjusting for these did not change the relations between anthropometry and menstrual cycle irregularity.
Probability of reporting an irregular menstrual cycle
.7 .6 .5 .4 .3 .2 .6
.7
BMI < 25 kg/m²
.8 .9 Waist/hip ratio BMI ? 25 & < 30 kg/m²
1
1.1
BMI ? 30 kg/m²
Conclusions: Women who have a high WHR and who are overweight or obese are more likely to report an irregular menstrual cycle. Reducing body weight may be more important for women with a high WHR.
P2-159 Birthweight, postnatal growth, and age at menarche J.F. Ferris *, D. Esserman, J. Flom, M.B. Terry. Columbia University Mailman School of Public Health, USA E-mail: [email protected] Aims: To investigate the influence of birthweight and postnatal growth patterns on age at menarche. Study design: Adult follow-up of the New York site of the U.S. National Collaborative Perinatal Project (NCPP) birth cohort. Prospective data collection included maternal (weight, pregnancy weight gain, age at menarche, smoking), infant (birthweight, birth length), childhood growth (from birth 4 months, 4 12 months, and 1 7 years), and family-level variables (race, socioeconomic status, number of siblings and father present or absent). Subjects: Girls born between 1959 1966 who were followed into adulthood (n = 263). Women who we enrolled did not differ with respect to birthweight or other postnatal body measures compared to women we did not enroll. Outcome measures: Self-reported age at menarche. We estimated these associations using both linear and logistic regression modeling early (12 years) versus late age at menarche (>12). Results: Using an adjusted logistic regression model, we observed no association between birthweight by itself and earlier age at menarche (Odds ratio [OR] = 1.07, 95% Confidence Interval [CI] = 0.63 1.82), though the point estimate increased after adjusting for postnatal growth (OR = 2.59, 95% CI = 0.79 8.53). After adjusting for birth length, percentile change of height and socioeconomic status, rapid weight gain from 1 7 years was associated with earlier age at menarche (OR = 1.18, 95% CI = 1.02 1.36, respectively for 10% change in percentile rank). Conclusions: These data add to accumulating evidence that rapid growth early in life is associated with earlier age at menarche. P2-160 Ethnic differences in preterm birth subtypes; the effect of a cumulative risk profile G. Goedhart1,2 *, M. van Eijsden1,2 , M.F. van der Wal1 , G.J. Bonsel2,3 . 1 Municipal Health Service, Department of Epidemiology, Documentation and Health Promotion, Amsterdam, The Netherlands, 2 Academic Medical Centre, University of Amsterdam, Department of Social Medicine, Amsterdam, The Netherlands, 3 Institute of Health Policy & Management, Erasmus Medical Center, Rotterdam, the Netherlands E-mail: [email protected] Aims: To examine the ethnic differences in spontaneous (SPB) and medically indicated (IPB) preterm births, and to what extent an accumulation of risk factors explains these differences. Study design: Prospective community-based cohort study: the Amsterdam Born Children and their Development study. Subjects: 7,604 unselected pregnant women, living in Amsterdam, with a Dutch, Surinamese, Antillean, Turkish, Moroccan or Ghanaian background, delivering a singleton. Outcome measures: Odds ratio (OR) and 95% confidence interval (CI) for spontaneous and medically indicated preterm births. Results: Common risk factors for SPB and IPB were primiparity and smoking. Specific risk factors for SPB were: previous preterm birth, previous miscarriage/stillbirth, and for IPB: hypertension, obesity, advanced maternal age. After adjustment for all risk factors, Surinamese women had a higher risk for SPB (OR = 1.6; 95% CI: 1.1 2.3) and IPB (OR = 2.0; 95% CI: 1.0 4.2) compared to the Dutch women, while Antillean (OR = 3.2; 95% CI: 1.0 10.1) and Ghanaian (OR = 3.0; 95% CI: 1.0 9.6) women had only a higher risk for IPB. All ethnic minority groups had a higher accumulation of risk factors (risk score ranging from 2.1 3.7) compared to the Dutch group (risk score: 1.7). Adjustment for the risk score decreased the preterm risk of Surinamese (OR = 1.3; 95% CI: 0.9 1.8), Antillean (OR = 1.2; 95% CI:0.6 2.4) and Ghanaian (OR = 1.4; 95% CI:0.8 2.4) women. Conclusions: Surinamese, Antillean and Ghanaian women had a higher risk for spontaneous and/or medically indicated preterm birth compared to Dutch women after adjustment for conventional risk factors. A cumulative risk profile, mainly observed among the