1MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, England.
2Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England.
Clin Epigenetics. 2018 Jun 27;10:86. doi: 10.1186/s13148-018-0520-1. eCollection 2018.
Gestational age at delivery is associated with health and social outcomes. Recently, cord blood DNA methylation data has been used to predict gestational age. The discrepancy between gestational age predicted from DNA methylation and determined by ultrasound or last menstrual period is known as gestational age acceleration. This study investigated associations of sex, socioeconomic status, parental behaviours and characteristics and birth outcomes with gestational age acceleration.
Using data from the Avon Longitudinal Study of Parents and Children ( = 863), we found that pre-pregnancy maternal overweight and obesity were associated with greater gestational age acceleration (mean difference = 1.6 days, 95% CI 0.7 to 2.6, and 2.9 days, 95% CI 1.3 to 4.4, respectively, compared with a body mass index < 25 kg/m, < .001). There was evidence of an association between male sex and greater gestational age acceleration. Greater gestational age acceleration was associated with higher birthweight, birth length and head circumference of the child (mean differences per week higher gestational age acceleration: birthweight 0.1 kg, 95% CI 0.1 to 0.2, < .001; birth length 0.4 cm, 95% CI 0.2 to 0.7, < .001; head circumference 0.2 cm, 95% CI 0.1 to - 0.4, < .001). There was evidence of an association between gestational age acceleration and mode of delivery (assisted versus unassisted delivery, odds ratio = 0.9 per week higher gestational age acceleration, 95% CI 0.7, 1.3 ( = .05); caesarean section versus unassisted delivery, odds ratio = 0.6, 95% CI 0.4 to 0.9 per week higher gestational age acceleration ( = .05)). There was no evidence of association for other parental and perinatal characteristics.
The associations of higher maternal body mass index and larger birth size with greater gestational age acceleration may imply that maternal overweight and obesity is associated with more rapid development of the fetus in utero. The implications of gestational age acceleration for postnatal health warrant further investigation.
分娩时的胎龄与健康和社会结果有关。最近，脐带血 DNA 甲基化数据已被用于预测胎龄。DNA 甲基化预测的胎龄与超声或末次月经确定的胎龄之间的差异称为胎龄加速。本研究调查了性别、社会经济地位、父母行为和特征以及出生结局与胎龄加速的关系。
使用来自雅芳纵向研究父母和儿童的数据（ = 863），我们发现，孕前母亲超重和肥胖与更大的胎龄加速有关（与 BMI<25kg/m 相比，平均差异分别为 1.6 天，95%CI 0.7 至 2.6，和 2.9 天，95%CI 1.3 至 4.4， < .001）。有证据表明，男性与更大的胎龄加速有关。胎龄加速越大，与孩子的出生体重、出生长度和头围越大（胎龄加速每增加一周的差异：出生体重 0.1kg，95%CI 0.1 至 0.2， < .001；出生长度 0.4cm，95%CI 0.2 至 0.7， < .001；头围 0.2cm，95%CI 0.1 至-0.4， < .001）。胎龄加速与分娩方式之间存在关联（每增加一周胎龄加速，辅助分娩与非辅助分娩的比值比为 0.9，95%CI 0.7，1.3（ = .05）；剖宫产与非辅助分娩的比值比为 0.6，95%CI 0.4 至 0.9，每增加一周胎龄加速（ = .05））。其他父母和围产期特征与胎龄加速无关。
较高的母体体重指数和较大的出生体重与更大的胎龄加速有关，这可能意味着母体超重和肥胖与胎儿在子宫内更快的发育有关。胎龄加速对产后健康的影响值得进一步研究。
