Fetal growth and spontaneous preterm birth in high‐altitude pregnancy: A systematic review, meta‐analysis, and meta‐regression
Objective To understand the relationship between birth weight and altitude to improve health outcomes in high‐altitude populations, to systematically assess the impact of altitude on the likelihood of low birth weight (LBW), small for gestational age (SGA), and spontaneous preterm birth (sPTB), and...
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| Veröffentlicht in: | International journal of gynecology and obstetrics 2022-05, Vol.157 (2), p.221-229 |
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| container_title | International journal of gynecology and obstetrics |
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| creator | Grant, Imogen D. Giussani, Dino A. Aiken, Catherine E. |
| description | Objective
To understand the relationship between birth weight and altitude to improve health outcomes in high‐altitude populations, to systematically assess the impact of altitude on the likelihood of low birth weight (LBW), small for gestational age (SGA), and spontaneous preterm birth (sPTB), and to estimate the magnitude of reduced birth weight associated with altitude.
Methods
PubMed, OvidEMBASE, Cochrane Library, Medline, Web of Science, and clinicaltrials.gov were searched (from inception to November 11, 2020). Observational, cohort, or case‐control studies were included if they reported a high altitude (>2500 m) and appropriate control population.
Results
Of 2524 studies identified, 59 were included (n = 1 604 770 pregnancies). Data were ed according to PRISMA guidelines, and were pooled using random‐effects models. There are greater odds of LBW (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.33–1.62, P |
| doi_str_mv | 10.1002/ijgo.13779 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2539211917</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2539211917</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3659-f717aedcc68dd8a7b7adf397e291febe62146109e1e2187610e84daa6a7900a53</originalsourceid><addsrcrecordid>eNp9kE1PwjAYgBujEUQv_gDTozEM-25jpd4IEcSQcNHzUrZ3ULIPbItkNw_-AH-jv8TC0KOnNn2fPk0fQq6B9YAx_16tl1UPAs7FCWnDgAsvCLk4JW03ZB73hd8iF8asGWPAAc5JKwiBAfCwTT7HaGVOl7ra2RWVZUrNpiqtLLHaGrrRaFEXdKG0m6qSrtRy9f3xJXOr7DbFPbAsZZnUD3RITW0sFtKqhGp8V7jr0sLZ93wp89oo0z28cDx0VzUao6rykpxlMjd4dVw75HX8-DJ68mbzyXQ0nHlJEPWFl3HgEtMkiQZpOpB8wWWaBYKjLyDDBUY-hBEwgYC-y-C2OAhTKSPJBWOyH3TIbePd6Opti8bGhTIJ5nnz3djvB8IHEMAdetegia6M0ZjFG60KqesYWLyvHu-rx4fqDr45ereLAtM_9DezA6ABdirH-h9VPH2ezBvpD_35kqE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2539211917</pqid></control><display><type>article</type><title>Fetal growth and spontaneous preterm birth in high‐altitude pregnancy: A systematic review, meta‐analysis, and meta‐regression</title><source>Wiley Online Library - AutoHoldings Journals</source><source>MEDLINE</source><creator>Grant, Imogen D. ; Giussani, Dino A. ; Aiken, Catherine E.</creator><creatorcontrib>Grant, Imogen D. ; Giussani, Dino A. ; Aiken, Catherine E.</creatorcontrib><description>Objective
To understand the relationship between birth weight and altitude to improve health outcomes in high‐altitude populations, to systematically assess the impact of altitude on the likelihood of low birth weight (LBW), small for gestational age (SGA), and spontaneous preterm birth (sPTB), and to estimate the magnitude of reduced birth weight associated with altitude.
Methods
PubMed, OvidEMBASE, Cochrane Library, Medline, Web of Science, and clinicaltrials.gov were searched (from inception to November 11, 2020). Observational, cohort, or case‐control studies were included if they reported a high altitude (>2500 m) and appropriate control population.
Results
Of 2524 studies identified, 59 were included (n = 1 604 770 pregnancies). Data were ed according to PRISMA guidelines, and were pooled using random‐effects models. There are greater odds of LBW (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.33–1.62, P < 0.001), SGA (OR 1.88, 95% CI 1.08–3.28, P = 0.026), and sPTB (OR 1.23, 95% CI 1.04–1.47, P = 0.016) in high‐ versus low‐altitude pregnancies. Birth weight decreases by 54.7 g (±13.0 g, P < 0.0001) per 1000 m increase in altitude. Average gestational age at delivery was not significantly different.
Conclusion
Globally, the likelihood of adverse perinatal outcomes, including LBW, SGA, and sPTB, increases in high‐altitude pregnancies. There is an inverse relationship between birth weight and altitude. These findings have important implications for the increasing global population living at altitudes above 2500 m.
Prevalence of small for gestational age infants, low birth weight infants, and preterm birth is higher at high altitudes.</description><identifier>ISSN: 0020-7292</identifier><identifier>EISSN: 1879-3479</identifier><identifier>DOI: 10.1002/ijgo.13779</identifier><identifier>PMID: 34101174</identifier><language>eng</language><publisher>United States</publisher><subject>Altitude ; Birth Weight ; Female ; Fetal Development ; growth restriction ; high‐altitude pregnancy ; Humans ; Infant, Newborn ; Infant, Small for Gestational Age ; low birth weight ; Pregnancy ; Pregnancy Outcome - epidemiology ; Premature Birth - epidemiology ; small for gestational age</subject><ispartof>International journal of gynecology and obstetrics, 2022-05, Vol.157 (2), p.221-229</ispartof><rights>2021 The Authors. published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics</rights><rights>2021 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3659-f717aedcc68dd8a7b7adf397e291febe62146109e1e2187610e84daa6a7900a53</citedby><cites>FETCH-LOGICAL-c3659-f717aedcc68dd8a7b7adf397e291febe62146109e1e2187610e84daa6a7900a53</cites><orcidid>0000-0003-4105-880X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fijgo.13779$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fijgo.13779$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34101174$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Grant, Imogen D.</creatorcontrib><creatorcontrib>Giussani, Dino A.</creatorcontrib><creatorcontrib>Aiken, Catherine E.</creatorcontrib><title>Fetal growth and spontaneous preterm birth in high‐altitude pregnancy: A systematic review, meta‐analysis, and meta‐regression</title><title>International journal of gynecology and obstetrics</title><addtitle>Int J Gynaecol Obstet</addtitle><description>Objective
To understand the relationship between birth weight and altitude to improve health outcomes in high‐altitude populations, to systematically assess the impact of altitude on the likelihood of low birth weight (LBW), small for gestational age (SGA), and spontaneous preterm birth (sPTB), and to estimate the magnitude of reduced birth weight associated with altitude.
Methods
PubMed, OvidEMBASE, Cochrane Library, Medline, Web of Science, and clinicaltrials.gov were searched (from inception to November 11, 2020). Observational, cohort, or case‐control studies were included if they reported a high altitude (>2500 m) and appropriate control population.
Results
Of 2524 studies identified, 59 were included (n = 1 604 770 pregnancies). Data were ed according to PRISMA guidelines, and were pooled using random‐effects models. There are greater odds of LBW (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.33–1.62, P < 0.001), SGA (OR 1.88, 95% CI 1.08–3.28, P = 0.026), and sPTB (OR 1.23, 95% CI 1.04–1.47, P = 0.016) in high‐ versus low‐altitude pregnancies. Birth weight decreases by 54.7 g (±13.0 g, P < 0.0001) per 1000 m increase in altitude. Average gestational age at delivery was not significantly different.
Conclusion
Globally, the likelihood of adverse perinatal outcomes, including LBW, SGA, and sPTB, increases in high‐altitude pregnancies. There is an inverse relationship between birth weight and altitude. These findings have important implications for the increasing global population living at altitudes above 2500 m.
Prevalence of small for gestational age infants, low birth weight infants, and preterm birth is higher at high altitudes.</description><subject>Altitude</subject><subject>Birth Weight</subject><subject>Female</subject><subject>Fetal Development</subject><subject>growth restriction</subject><subject>high‐altitude pregnancy</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Infant, Small for Gestational Age</subject><subject>low birth weight</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome - epidemiology</subject><subject>Premature Birth - epidemiology</subject><subject>small for gestational age</subject><issn>0020-7292</issn><issn>1879-3479</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNp9kE1PwjAYgBujEUQv_gDTozEM-25jpd4IEcSQcNHzUrZ3ULIPbItkNw_-AH-jv8TC0KOnNn2fPk0fQq6B9YAx_16tl1UPAs7FCWnDgAsvCLk4JW03ZB73hd8iF8asGWPAAc5JKwiBAfCwTT7HaGVOl7ra2RWVZUrNpiqtLLHaGrrRaFEXdKG0m6qSrtRy9f3xJXOr7DbFPbAsZZnUD3RITW0sFtKqhGp8V7jr0sLZ93wp89oo0z28cDx0VzUao6rykpxlMjd4dVw75HX8-DJ68mbzyXQ0nHlJEPWFl3HgEtMkiQZpOpB8wWWaBYKjLyDDBUY-hBEwgYC-y-C2OAhTKSPJBWOyH3TIbePd6Opti8bGhTIJ5nnz3djvB8IHEMAdetegia6M0ZjFG60KqesYWLyvHu-rx4fqDr45ereLAtM_9DezA6ABdirH-h9VPH2ezBvpD_35kqE</recordid><startdate>202205</startdate><enddate>202205</enddate><creator>Grant, Imogen D.</creator><creator>Giussani, Dino A.</creator><creator>Aiken, Catherine E.</creator><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4105-880X</orcidid></search><sort><creationdate>202205</creationdate><title>Fetal growth and spontaneous preterm birth in high‐altitude pregnancy: A systematic review, meta‐analysis, and meta‐regression</title><author>Grant, Imogen D. ; Giussani, Dino A. ; Aiken, Catherine E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3659-f717aedcc68dd8a7b7adf397e291febe62146109e1e2187610e84daa6a7900a53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Altitude</topic><topic>Birth Weight</topic><topic>Female</topic><topic>Fetal Development</topic><topic>growth restriction</topic><topic>high‐altitude pregnancy</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infant, Small for Gestational Age</topic><topic>low birth weight</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome - epidemiology</topic><topic>Premature Birth - epidemiology</topic><topic>small for gestational age</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Grant, Imogen D.</creatorcontrib><creatorcontrib>Giussani, Dino A.</creatorcontrib><creatorcontrib>Aiken, Catherine E.</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Online Library (Open Access Collection)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of gynecology and obstetrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Grant, Imogen D.</au><au>Giussani, Dino A.</au><au>Aiken, Catherine E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fetal growth and spontaneous preterm birth in high‐altitude pregnancy: A systematic review, meta‐analysis, and meta‐regression</atitle><jtitle>International journal of gynecology and obstetrics</jtitle><addtitle>Int J Gynaecol Obstet</addtitle><date>2022-05</date><risdate>2022</risdate><volume>157</volume><issue>2</issue><spage>221</spage><epage>229</epage><pages>221-229</pages><issn>0020-7292</issn><eissn>1879-3479</eissn><abstract>Objective
To understand the relationship between birth weight and altitude to improve health outcomes in high‐altitude populations, to systematically assess the impact of altitude on the likelihood of low birth weight (LBW), small for gestational age (SGA), and spontaneous preterm birth (sPTB), and to estimate the magnitude of reduced birth weight associated with altitude.
Methods
PubMed, OvidEMBASE, Cochrane Library, Medline, Web of Science, and clinicaltrials.gov were searched (from inception to November 11, 2020). Observational, cohort, or case‐control studies were included if they reported a high altitude (>2500 m) and appropriate control population.
Results
Of 2524 studies identified, 59 were included (n = 1 604 770 pregnancies). Data were ed according to PRISMA guidelines, and were pooled using random‐effects models. There are greater odds of LBW (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.33–1.62, P < 0.001), SGA (OR 1.88, 95% CI 1.08–3.28, P = 0.026), and sPTB (OR 1.23, 95% CI 1.04–1.47, P = 0.016) in high‐ versus low‐altitude pregnancies. Birth weight decreases by 54.7 g (±13.0 g, P < 0.0001) per 1000 m increase in altitude. Average gestational age at delivery was not significantly different.
Conclusion
Globally, the likelihood of adverse perinatal outcomes, including LBW, SGA, and sPTB, increases in high‐altitude pregnancies. There is an inverse relationship between birth weight and altitude. These findings have important implications for the increasing global population living at altitudes above 2500 m.
Prevalence of small for gestational age infants, low birth weight infants, and preterm birth is higher at high altitudes.</abstract><cop>United States</cop><pmid>34101174</pmid><doi>10.1002/ijgo.13779</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-4105-880X</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0020-7292 |
| ispartof | International journal of gynecology and obstetrics, 2022-05, Vol.157 (2), p.221-229 |
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| language | eng |
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| source | Wiley Online Library - AutoHoldings Journals; MEDLINE |
| subjects | Altitude Birth Weight Female Fetal Development growth restriction high‐altitude pregnancy Humans Infant, Newborn Infant, Small for Gestational Age low birth weight Pregnancy Pregnancy Outcome - epidemiology Premature Birth - epidemiology small for gestational age |
| title | Fetal growth and spontaneous preterm birth in high‐altitude pregnancy: A systematic review, meta‐analysis, and meta‐regression |
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