A spectrum project: preterm birth and small-for-gestational age among infants with birth defects

ABSTRACT OBJECTIVE: The aim of this study is to investigate the association between birth defects (BDs), prematurity and small-for-gestational age (SGA) in a population-based sample. STUDY

DESIGN: Participants were singleton live births enrolled in the National Birth Defects Prevention Study, including 18 737 case infants with one or more BD and 7999 controls. Logistic

regression models to evaluate associations between BDs, prematurity and fetal growth were computed while adjusting for covariates. RESULT: Cases were significantly more likely to be born

prematurely than controls, particularly at 24 to 28 weeks of gestation. The highest odds ratios for preterm birth were found for intestinal atresia, anencephaly, gastroschisis and esophageal

atresia. Infants with BDs were also significantly more likely to be SGA than controls (17.2 and 7.8%). CONCLUSION: Infants with BDs are more likely than controls to be born prematurely and

SGA. Findings from this study present additional evidence demonstrating a complex interaction between the development of BDs, prematurity and intrauterine growth. Access through your

institution Buy or subscribe This is a preview of subscription content, access via your institution ACCESS OPTIONS Access through your institution Subscribe to this journal Receive 12 print

issues and online access $259.00 per year only $21.58 per issue Learn more Buy this article * Purchase on SpringerLink * Instant access to full article PDF Buy now Prices may be subject to

local taxes which are calculated during checkout ADDITIONAL ACCESS OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support SIMILAR CONTENT

BEING VIEWED BY OTHERS POSTNATAL GROWTH OF ETIOLOGICALLY CHARACTERIZED PRETERM NEWBORNS ACCORDING TO GESTATIONAL AGE AT BIRTH Article Open access 28 November 2024 UNDERSTANDING THE RELATIVE

CONTRIBUTIONS OF PREMATURITY AND CONGENITAL ANOMALIES TO NEONATAL MORTALITY Article 16 January 2022 SEVERITY OF SMALL-FOR-GESTATIONAL-AGE AND MORBIDITY AND MORTALITY AMONG VERY PRETERM

NEONATES Article 27 October 2022 REFERENCES * Kochanek KD, Xu J, Murphy SL, Minino AM, Kung HC . Deaths: preliminary data for 2009. _Natl Vital Stat Rep_ 2011; 59 (4): 1–51. PubMed  Google

Scholar  * Hamilton BE, Hoyert DL, Martin JA, Strobino DM, Guyer B . Annual summary of vital statistics: 2010-2011. _Pediatrics_ 2013; 131 (3): 548–558. Article  PubMed  Google Scholar  *

Honein MA, Kirby RS, Meyer RE, Xing J, Skerrette NI, Yuskiv N _et al_. The association between major birth defects and preterm birth. _Matern Child Health J_ 2009; 13 (2): 164–175. Article 

PubMed  Google Scholar  * Linhart Y, Bashiri A, Maymon E, Shoham-Vardi I, Furman B, Vardi H _et al_. Congenital anomalies are an independent risk factor for neonatal morbidity and perinatal

mortality in preterm birth. _Eur J Obstet Gynecol Reprod Biol_ 2000; 90 (1): 43–49. Article  CAS  PubMed  Google Scholar  * Davidoff MJ, Petrini J, Damus K, Russell RB, Mattison D . Neural

tube defect-specific infant mortality in the United States. _Teratology_ 2002; 66 (Suppl 1): S17–S22. Article  PubMed  Google Scholar  * Cannon C, Dildy GA, Ward R, Varner MW, Dudley DJ . A

population-based study of congenital diaphragmatic hernia in Utah: 1988-1994. _Obstet Gynecol_ 1996; 87 (6): 959–963. Article  CAS  PubMed  Google Scholar  * Adams-Chapman I, Hansen NI,

Shankaran S, Bell EF, Boghossian NS, Murray JC _et al_. Ten-year review of major birth defects in VLBW infants. _Pediatrics_ 2013; 132 (1): 49–61. Article  PubMed  PubMed Central  Google

Scholar  * Iams JD . The epidemiology of preterm birth. _Clin Perinatol_ 2003; 30 (4): 651–664. Article  PubMed  Google Scholar  * Dolk H . Epidemiologic approaches to identifying

environmental causes of birth defects. _Am J Med Genet_ 2004; 125C (1): 4–11. Article  PubMed  Google Scholar  * Dolan SM, Callaghan WM, Rasmussen SA . Birth defects and preterm birth:

overlapping outcomes with a shared strategy for research and prevention. _Birth Defects Res A Clin Mol Teratol_ 2009; 85 (11): 874–878. Article  CAS  PubMed  Google Scholar  * Dolan SM,

Gross SJ, Merkatz IR, Faber V, Sullivan LM, Malone FD _et al_. The contribution of birth defects to preterm birth and low birth weight. _Obstet Gynecol_ 2007; 110 (2 Pt 1): 318–324. Article

  PubMed  Google Scholar  * Waller DK, Shaw GM, Rasmussen SA, Hobbs CA, Canfield MA, Siega-Riz AM _et al_. Prepregnancy obesity as a risk factor for structural birth defects. _Arch Pediatr

Adolesc Med_ 2007; 161 (8): 745–750. Article  PubMed  Google Scholar  * Correa A, Gilboa SM, Besser LM, Botto LD, Moore CA, Hobbs CA _et al_. Diabetes mellitus and birth defects. _Am J

Obstet Gynecol_ 2008; 199 (3): 237 e231–237 e239. Article  Google Scholar  * McDonald SD, Han Z, Mulla S, Beyene J . Overweight and obesity in mothers and risk of preterm birth and low birth

weight infants: systematic review and meta-analyses. _Br Med J_ 2010; 341: c3428. Article  Google Scholar  * Garite TJ, Clark R, Thorp JA . Intrauterine growth restriction increases

morbidity and mortality among premature neonates. _Am J Obstet Gynecol_ 2004; 191 (2): 481–487. Article  PubMed  Google Scholar  * Yoon PW, Rasmussen SA, Lynberg MC, Moore CA, Anderka M,

Carmichael SL _et al_. The National Birth Defects Prevention Study. _Public Health Rep_ 2001; 116 (Suppl 1): 32–40. Article  PubMed  PubMed Central  Google Scholar  * Crider KS, Cleves MA,

Reefhuis J, Berry RJ, Hobbs CA, Hu DJ . Antibacterial medication use during pregnancy and risk of birth defects: National Birth Defects Prevention Study. _Arch Pediatr Adolesc Med_ 2009; 163

(11): 978–985. Article  PubMed  Google Scholar  * Rasmussen SA, Olney RS, Holmes LB, Lin AE, Keppler-Noreuil KM, Moore CA . Guidelines for case classification for the National Birth Defects

Prevention Study. _Birth Defects Res Part A Clin Mol Teratol_ 2003; 67 (3): 193–201. Article  CAS  Google Scholar  * Botto LD, Lin AE, Riehle-Colarusso T, Malik S, Correa A . Seeking

causes: classifying and evaluating congenital heart defects in etiologic studies. _Birth Defects Res A Clin Mol Teratol_ 2007; 79 (10): 714–727. Article  CAS  PubMed  Google Scholar  * Oken

E, Kleinman KP, Rich-Edwards J, Gillman MW . A nearly continuous measure of birth weight for gestational age using a United States national reference. _BMC Pediatr_ 2003; 3: 6. Article 

PubMed  PubMed Central  Google Scholar  * Rasmussen SA, Moore CA, Paulozzi LJ, Rhodenhiser EP . Risk for birth defects among premature infants: a population-based study. _J Pediatr_ 2001;

138 (5): 668–673. Article  CAS  PubMed  Google Scholar  * Shaw GM, Savitz DA, Nelson V, Thorp JM Jr. . Role of structural birth defects in preterm delivery. _Paediatr Perinat Epidemiol_

2001; 15 (2): 106–109. Article  CAS  PubMed  Google Scholar  * Cosmi E, Fanelli T, Visentin S, Trevisanuto D, Zanardo V . Consequences in infants that were intrauterine growth restricted. _J

Pregnancy_ 2011; 2011: 364381. Article  PubMed  PubMed Central  Google Scholar  * Khoury MJ, Erickson JD, Cordero JF, McCarthy BJ . Congenital malformations and intrauterine growth

retardation: a population study. _Pediatrics_ 1988; 82 (1): 83–90. CAS  PubMed  Google Scholar  * Malik S, Cleves MA, Zhao W, Correa A, Hobbs CA . Association between congenital heart

defects and small for gestational age. _Pediatrics_ 2007; 119 (4): e976–e982. Article  PubMed  Google Scholar  * Reigstad I, Reigstad H, Kiserud T, Berstad T . Preterm elective caesarean

section and early enteral feeding in gastroschisis. _Acta Paediatr_ 2011; 100 (1): 71–74. Article  CAS  PubMed  Google Scholar  * Sadler TW, Rasmussen SA . Examining the evidence for

vascular pathogenesis of selected birth defects. _Am J Med Genet A_ 2010; 152A (10): 2426–2436. Article  PubMed  Google Scholar  * Menon R, Pearce B, Velez DR, Merialdi M, Williams SM,

Fortunato SJ _et al_. Racial disparity in pathophysiologic pathways of preterm birth based on genetic variants. _Reprod Biol Endocrinol_ 2009; 7: 62. Article  PubMed  PubMed Central  Google

Scholar  * Carmichael SL, Shaw GM, Iovannisci DM, Yang W, Finnell RH, Cheng S _et al_. Risks of human limb deficiency anomalies associated with 29 SNPs of genes involved in homocysteine

metabolism, coagulation, cell-cell interactions, inflammatory response, and blood pressure regulation. _Am J Med Genet A_ 2006; 140 (22): 2433–2440. Article  PubMed  Google Scholar  * Hobbs

CA, Cleves MA, Karim MA, Zhao W, MacLeod SL . Maternal folate-related gene environment interactions and congenital heart defects. _Obstet Gynecol_ 2010; 116 (2 Pt 1): 316–322. Article 

PubMed  PubMed Central  Google Scholar  * Hobbs CA, Cleves MA, Melnyk S, Zhao W, James SJ . Congenital heart defects and abnormal maternal biomarkers of methionine and homocysteine

metabolism. _Am J Clin Nutr_ 2005; 81 (1): 147–153. Article  CAS  PubMed  Google Scholar  * Hobbs CA, Cleves MA, MacLeod SL, Erickson SW, Tang X, Li J _et al_. Conotruncal heart defects and

common variants in maternal and fetal genes in folate, homocysteine and transsulfuration pathways. _Birth Defects Res A Clin Mol Teratol_ 2014; 100 (2): 116–126. Article  CAS  PubMed  PubMed

Central  Google Scholar  * Zhao W, Mosley BS, Cleves MA, Melnyk S, James SJ, Hobbs CA . Neural tube defects and maternal biomarkers of folate, homocysteine, and glutathione metabolism. _BMC

Med Genet_ 2006; 76 (4): 230–236. CAS  Google Scholar  * Cleves MA, Hobbs CA, Zhao W, Krakowiak PA, MacLeod SL . National Birth Defects Prevention S Association between selected folate

pathway polymorphisms and nonsyndromic limb reduction defects: a case-parental analysis. _Paediatr Perinat Epidemiol_ 2011; 25 (2): 124–134. Article  PubMed  PubMed Central  Google Scholar 

* Carmichael SL, Yang W, Shaw GM . National Birth Defects Prevention S Maternal dietary nutrient intake and risk of preterm delivery. _Am J Perinatol_ 2013; 30 (7): 579–588. PubMed  Google

Scholar  * Chandler AL, Hobbs CA, Mosley BS, Berry RJ, Canfield MA, Qi YP _et al_. Neural tube defects and maternal intake of micronutrients related to one-carbon metabolism or antioxidant

activity. _Birth Defects Res A Clin Mol Teratol_ 2012; 94 (11): 864–874. Article  CAS  PubMed  PubMed Central  Google Scholar  * Werler MM, Louik C, Shapiro S, Mitchell AA . Prepregnant

weight in relation to risk of neural tube defects. _JAMA_ 1996; 275 (14): 1089–1128. Article  CAS  PubMed  Google Scholar  * Agopian AJ, Tinker SC, Lupo PJ, Canfield MA, Mitchell LE .

National Birth Defects Prevention Study. Proportion of neural tube defects attributable to known risk factors. _Birth Defects Res A Clin Mol Teratol_ 2013; 97 (1): 42–46. Article  CAS 

PubMed  PubMed Central  Google Scholar  * Parker SE, Werler MM, Shaw GM, Anderka M, Yazdy MM . National Birth Defects Prevention Study. Dietary glycemic index and the risk of birth defects.

_Am J Epidemiol_ 2012; 176 (12): 1110–1120. Article  PubMed  PubMed Central  Google Scholar  * Patel SS, Burns TL, Botto LD, Riehle-Colarusso TJ, Lin AE, Shaw GM _et al_. Analysis of

selected maternal exposures and non-syndromic atrioventricular septal defects in the National Birth Defects Prevention Study, 1997-2005. _Am J Med Genet A_ 2012; 158A (10): 2447–2455.

Article  PubMed  Google Scholar  * DiFranza JR, Lew RA . Effect of maternal cigarette smoking on pregnancy complications and sudden infant death syndrome. _J Fam Pract_ 1995; 40 (4):

385–394. CAS  PubMed  Google Scholar  * Hoyt AT, Browne M, Richardson S, Romitti P, Druschel C . The National Birth Defects Prevention Study. Maternal caffeine consumption and small for

gestational age births: results from a population-based case-control study. _Matern Child Health J_ 2013; 18 (6): 1540–1551. Article  Google Scholar  * Pappas A, Shankaran S, Hansen NI, Bell

EF, Stoll BJ, Laptook AR _et al_. Outcome of extremely preterm infants (<1,000 g) with congenital heart defects from the National Institute of Child Health and Human Development

Neonatal Research Network. _Pediatr Cardiol_ 2012; 33 (8): 1415–1426. Article  PubMed  PubMed Central  Google Scholar  * Walden RV, Taylor SC, Hansen NI, Poole WK, Stoll BJ, Abuelo D _et

al_. Major congenital anomalies place extremely low birth weight infants at higher risk for poor growth and developmental outcomes. _Pediatrics_ 2007; 120 (6): e1512–e1519. Article  PubMed 

Google Scholar  Download references ACKNOWLEDGEMENTS We thank the generous participation of the numerous families who made this research study possible. This research was supported by the

Centers for Disease Control and Prevention (5U01DD000491) and the Arkansas Biosciences Institute. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Neonatology Section, College of Medicine,

University of Arkansas for Medical Sciences, Arkansas Children’s Hospital Research Institute, Little Rock, AR, USA, F Miquel-Verges * Department of Pediatrics, Birth Defects Research

Section, College of Medicine, University of Arkansas for Medical Sciences, Arkansas Children’s Hospital Research Institute, Little Rock, AR, USA B S Mosley, A S Block & C A Hobbs Authors

* F Miquel-Verges View author publications You can also search for this author inPubMed Google Scholar * B S Mosley View author publications You can also search for this author inPubMed 

Google Scholar * A S Block View author publications You can also search for this author inPubMed Google Scholar * C A Hobbs View author publications You can also search for this author

inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to C A Hobbs. ETHICS DECLARATIONS COMPETING INTERESTS The authors declare no conflict of interest. ADDITIONAL INFORMATION

Supplementary Information accompanies the paper on the Journal of Perinatology website SUPPLEMENTARY INFORMATION SUPPLEMENTARY TABLE 1 (DOC 68 KB) RIGHTS AND PERMISSIONS Reprints and

permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Miquel-Verges, F., Mosley, B., Block, A. _et al._ A spectrum project: preterm birth and small-for-gestational age among infants with birth

defects. _J Perinatol_ 35, 198–203 (2015). https://doi.org/10.1038/jp.2014.180 Download citation * Received: 16 April 2014 * Revised: 17 July 2014 * Accepted: 05 August 2014 * Published: 02

October 2014 * Issue Date: March 2015 * DOI: https://doi.org/10.1038/jp.2014.180 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable

link Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative