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Abstract

Klebermass-Schrehof Katrin, Thomas Waldhoer, and Lin Yang. The effect of altitude on birthweight/length ratio: a population-based study over 36 years in an altitude range from sea level to 1,700 m. High Alt Med Biol. 23:90–95, 2022.

Objective:

The negative effect of altitude on fetal growth has been documented, but it is unknown whether this effect changes over time. We investigated the effect of altitude on infant birthweight/length ratio as well as its potential dependence on gestational age and year of birth in the range from sea level up to 1,700 m (Austria).

Materials and Methods:

Data on maternal characteristics, infant birthweights, and infant lengths were extracted from all Austrian birth certificates between 1984 and 2019.

Results:

A total of 2,240,439 birth certificates were identified and analyzed. The effect of altitude on birthweight/length ratio was −2.66 g/cm (95% confidence interval [CI]: −2.77 to −2. 54) per 1,000 m increased altitude in 1984–1986, which decreased to −1.96 g/cm (95% CI: −2.09 to −1.82) in 2017–2019. The effect of altitude on birthweight/length ratio remained constant for preterm infants, which fluctuated around −1.5 g/cm. For term infants, the negative effect of altitude on birthweight/length ratio attenuated from −3 to −1.9 g/cm over time with a stronger decrease for infants born between 41 and 42 compared with those between 37 and 40 weeks of gestation.

Conclusion:

In summary, our data demonstrate a strong effect of altitude on birthweight/length ratio over 36 years with a smaller effect in recent years and a stronger effect in infants born around term age compared with preterm infants.

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References

Aksoy

, Batmaz

, Dane

, Kucur

, and Gozukara

. (2015). Effects of altitude changes on Doppler flow parameters for uterine, umbilical, and mid-cerebral arteries in term pregnancy: A pilot study. J Turk Ger Gynecol Assoc, 16:237–240.

Bailey

, Euser

, Bol

, Julian

, and Moore

. (2022). High-altitude residence alters blood-pressure course and increases hypertensive disorders of pregnancy. J Matern Fetal Neonatal Med, 2022:1264–1271.

Bailey

, Donnelly

, Bol

, Moore

, and Julian

. (2019). High altitude continues to reduce birth weights in Colorado. Matern Child Health J, 23:1573–1580.

Barker

. (1990). The fetal and infant origins of adult disease. BMJ, 301:1111.

Bertagnon

, de Mattos Segre

, and Dall Colletto

. (2003). Weight-for-length relationship at birth to predict neonatal diseases. Sao Paulo Med J, 121:149–154.

Camerota

, and Bollen

. (2016). Birth weight, birth length, and gestational age as indicators of favorable fetal growth conditions in a US sample. PLoS One, 11:e0153800.

Giussani

, Phillips

, Anstee

, and Barker

. (2001). Effects of altitude versus economic status on birth weight and body shape at birth. Pediatr Res, 49:490–494.

Jensen

, and Moore

. (1997). The effect of high altitude and other risk factors on birthweight: Independent or interactive effects?. Am J Public Health, 87:1003–1007.

Keyes

, Armaza

, Niermeyer

, Vargas

, Young

, and Moore

. (2003). Intrauterine growth restriction, preeclampsia, and intrauterine mortality at high altitude in Bolivia. Pediatr Res, 54:20–25.

10.

Khalid

MEM

, Ahmed

, Osman

, and Al Hashem

. (2016). The relationship of birth weight, body shape and body composition at birth to altitude in Saudi Arabia. Int J Morphol, 34:1109–1116.

11.

Krampl

, Kametas

, Nowotny

, Roden

, and Nicolaides

. (2001). Glucose metabolism in pregnancy at high altitude. Diabetes Care, 24:817–822.

12.

Krampl

, Lees

, Bland

, Espinoza Dorado

, Moscoso

, and Campbell

. (2000). Fetal biometry at 4300 m compared to sea level in Peru. Ultrasound Obstet Gynecol, 16:9–18.

13.

Leodolter

. (1978). Short report: The mother-child health passport: Austria's successful weapon against infant mortality. Prev Med, 7:561–563.

14.

Moore

. (2003). Fetal growth restriction and maternal oxygen transport during high altitude pregnancy. High Alt Med Biol, 4:141–156.

15.

Moore

, Charles

, and Julian

. (2011). Humans at high altitude: Hypoxia and fetal growth. Respir Physiol Neurobiol, 178:181–190.

16.

Moore

, Shriver

, Bemis

, Hickler

, Wilson

, Brutsaert

, Parra

, and Vargas

. (2004). Maternal adaptation to high-altitude pregnancy: An experiment of nature—A review. Placenta 25 Suppl, A:S60–S71.

17.

Palmer

, Moore

, Young

, Cregger

, Berman

, and Zamudio

. (1999). Altered blood pressure course during normal pregnancy and increased preeclampsia at high altitude (3100 meters) in Colorado. Am J Obstet Gynecol, 180:1161–1168.

18.

Rosso

, and Kava

. (1980). Effects of food restriction on cardiac ouput and blood flow to the uterus and placenta in the pregnant rat. J Nutr, 110:2350–2354.

19.

Sharma

, Shastri

, and Sharma

. (2016). Intrauterine growth restriction: Antenatal and postnatal aspects. Clin Med Insights Pediatr, 10:67–83.

20.

Soria

, Julian

, Vargas

, Moore

, and Giussani

. (2013). Graduated effects of high-altitude hypoxia and highland ancestry on birth size. Pediatr Res, 74:633–638.

21.

Statistik

Austria

. Demographisches

Jahrbuch

. Statistik

Austria

, Austria

Vienna

. 2012. http://wko.at/statistik/jahrbuch/2012_Deutsch.pdf Accessed July 22, 2018.

22.

Unger

, Weiser

, McCullough

, Keefer

, and Moore

. (1988). Altitude, low birth weight, and infant mortality in Colorado. JAMA, 259:3427–3432.

23.

Waldhoer

, and Klebermass-Schrehof

. (2015a). The impact of altitude on birth weight depends on further mother- and infant-related factors: A population-based study in an altitude range up to 1600 m in Austria between 1984 and 2013. J Perinatol, 35:689–694.

24.

Waldhoer

, and Klebermass-Schrehof

. (2015b). The impact of altitude on birth weight depends on further mother- and infant-related factors: A population-based study in an altitude range up to 1600 m in Austria between 1984 and 2013. J Perinatol, 35:689–694.

25.

Yang

, Helbich-Poschacher

, Cao

, Klebermass-Schrehof

, and Waldhoer

. (2020). Maternal altitude and risk of low birthweight: A systematic review and meta-analyses. Placenta, 101:124–131.

26.

Yau

, and Chang

. (1993). Weight to length ratio—A good parameter for determining nutritional status in preterm and full-term newborns. Acta Paediatr, 82:427–429.

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The Effect of Altitude on Birthweight/Length Ratio: A Population-Based Study Over 36 Years in an Altitude Range from Sea Level to 1,700 m

Abstract

Objective:

Materials and Methods:

Results:

Conclusion:

Get full access to this article

References

Supplementary Material