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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

Journal of Perinatology volume 35, pages 689–694 (2015)Cite this article

Subjects

Abstract

Objective:

A negative impact of altitude on birth weight has been demonstrated for medium to high-altitude countries.

Study Design:

The present study aims to show a similar effect for a lower altitude range up to 1600 m in the country of Austria and to adjust for several further risk factors related to mother and infant. In addition, we analyzed whether the effect of altitude influenced birth weight independently or interacted with other factors. For the purpose of this study, almost 1.9 million individual birth certificates of Austrian newborns born between 1984 and 2013 were analyzed. In a multivariate linear regression model, birth weight was associated with altitude of living address and following variables: sex, birth length, gestational age, level of education, maternal age, year of birth, parity, time to previous birth and marital status.

Result:

Birth weight decreased by 150 g/1000 m altitude, demonstrating a clear effect of altitude on birth weight also in a low to medium altitude level. Additionally, we could show that this effect also depends on other factors, namely gestational age, education of the mother, sex, birth length, year of birth and time to previous delivery. All variables interacted significantly (p<0.0001) with altitude.

Conclusion:

We observed a negative effect of altitude in an altitude range up to 1600 m. Furthermore, this effect also depends on other risk factors. Therefore, unadjusted estimates as described in many studies may be biased. This population-based study describes the effect of low-to-medium altitude on birth weight in central Europe over a period of 30 years.

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References

  1. Yip R . Altitude and birth weight. J Pediatrics 1987; 111 (6 Pt 1): 869–876.

    Article  CAS  Google Scholar 

  2. Giussani DA, Phillips PS, Anstee S, Barker DJ . Effects of altitude versus economic status on birth weight and body shape at birth. Pediatric Res 2001; 49 (4): 490–494.

    Article  CAS  Google Scholar 

  3. Gonzales GF, Tapia V . Birth weight charts for gestational age in 63,620 healthy infants born in Peruvian public hospitals at low and at high altitude. Acta Paediatr 2009; 98 (3): 454–458.

    Article  Google Scholar 

  4. Jensen GM, Moore LG . The effect of high altitude and other risk factors on birthweight: independent or interactive effects? Am J Public Health 1997; 87 (6): 1003–1007.

    Article  CAS  Google Scholar 

  5. Khalid ME, Ali ME, Ali KZ . Full-term birth weight and placental morphology at high and low altitude. Int J Gynaecol Obstetr 1997; 57 (3): 259–265.

    Article  CAS  Google Scholar 

  6. Krampl E, Lees C, Bland JM, Espinoza Dorado J, Moscoso G, Campbell S . Fetal biometry at 4300m compared to sea level in Peru. Ultrasound Obstetr Gynecol 2000; 16 (1): 9–18.

    Article  CAS  Google Scholar 

  7. Lopez Camelo JS, Campana H, Santos R, Poletta FA . Effect of the interaction between high altitude and socioeconomic factors on birth weight in a large sample from South America. Am J Phys Anthropol 2006; 129 (2): 305–310.

    Article  Google Scholar 

  8. Zahran S, Breunig IM, Link BG, Snodgrass JG, Weiler S . A quasi-experimental analysis of maternal altitude exposure and infant birth weight. Am J Public Health 2014; 104 (Suppl 1): S166–S174.

    Article  Google Scholar 

  9. Niermeyer S, Andrade Mollinedo P, Huicho L . Child health and living at high altitude. Arch Dis Child 2009; 94 (10): 806–811.

    Article  CAS  Google Scholar 

  10. Wehby GL, Castilla EE, Lopez-Camelo J . The impact of altitude on infant health in South America. Econ Hum Biol 2010; 8 (2): 197–211.

    Article  Google Scholar 

  11. Moore LG . Fetal growth restriction and maternal oxygen transport during high altitude pregnancy. High Alt Med Biol 2003; 4 (2): 141–156.

    Article  Google Scholar 

  12. Zamudio S, Postigo L, Illsley NP, Rodriguez C, Heredia G, Brimacombe M et al. Maternal oxygen delivery is not related to altitude- and ancestry-associated differences in human fetal growth. J Physiol 2007; 582 (Pt 2): 883–895.

    Article  CAS  Google Scholar 

  13. Zamudio S . The placenta at high altitude. High Alt Med Biol 2003; 4 (2): 171–191.

    Article  Google Scholar 

  14. Galan HL, Rigano S, Chyu J, Beaty B, Bozzo M, Hobbins JC et al. Comparison of low- and high-altitude Doppler velocimetry in the peripheral and central circulations of normal fetuses. Am J Obstetr Gynecol 2000; 183 (5): 1158–1161.

    Article  CAS  Google Scholar 

  15. Krampl E, Kametas NA, Nowotny P, Roden M, Nicolaides KH . Glucose metabolism in pregnancy at high altitude. Diabetes Care 2001; 24 (5): 817–822.

    Article  CAS  Google Scholar 

  16. Mortola JP, Frappell PB, Aguero L, Armstrong K . Birth weight and altitude: a study in Peruvian communities. J Pediatrics 2000; 136 (3): 324–329.

    Article  CAS  Google Scholar 

  17. Lehre AC, Laake P, Sexton JA . Differences in birth weight by sex using adjusted quantile distance functions. Stat Med 2013; 32 (17): 2962–2970.

    Article  Google Scholar 

  18. Kramer MS . Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Org 1987; 65 (5): 663–737.

    CAS  PubMed  Google Scholar 

  19. Rottensteiner S . Zusammenhang Geburtsgewicht von Neugeborenen und Seehöhe der Wohngemeinde in Österreich zwischen 1998 und 2008 adjustiert nach wichtigen geburtsbezogenen Parametern. Dr. thesis, Medical University of Vienna: Vienna, 2012.

  20. Statistik Austria Demographisches Jahrbuch. Statistik Austria: Austria, Vienna, 2012.

  21. SAS Institute Inc. SAS Institute Inc., 2002-2012. Cary, NC, USA, 2012.

  22. Bauer P, Pötscher B, Hackl P . Model Selection by multiple test procedures. Statistics 1988; 19 (1): 39–44.

    Article  Google Scholar 

  23. Notzon FC, Bobadilla JL, Coria I . Birthweight distributions in Mexico City and among US Southwest Mexican Americans: the effect of altitude. Am J Public Health 1992; 82 (7): 1014–1017.

    Article  CAS  Google Scholar 

  24. Fenton TR . A new growth chart for preterm babies: Babson and Benda's chart updated with recent data and a new format. BMC Pediatrics 2003; 3: 13.

    Article  Google Scholar 

  25. Roland MC, Friis CM, Godang K, Bollerslev J, Haugen G, Henriksen T . Maternal factors associated with fetal growth and birthweight are independent determinants of placental weight and exhibit differential effects by fetal sex. PLoS ONE 2014; 9 (2): e87303.

    Article  Google Scholar 

  26. Eriksson JG, Kajantie E, Osmond C, Thornburg K, Barker DJ . Boys live dangerously in the womb. Am J Hum Biol 2010; 22 (3): 330–335.

    Article  Google Scholar 

  27. Galan HL, Rigano S, Radaelli T, Cetin I, Bozzo M, Chyu J et al. Reduction of subcutaneous mass, but not lean mass, in normal fetuses in Denver, Colorado. Am J Obstetr Gynecol 2001; 185 (4): 839–844.

    Article  CAS  Google Scholar 

  28. Zhu BP, Rolfs RT, Nangle BE, Horan JM . Effect of the interval between pregnancies on perinatal outcomes. New Engl J Med 1999; 340 (8): 589–594.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria

    T Waldhoer

  2. Division of Neonatology, Department of Pediatrics, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Vienna, Austria

    K Klebermass-Schrehof

Authors
  1. T Waldhoer
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  2. K Klebermass-Schrehof
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Correspondence to T Waldhoer.

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Waldhoer, T., Klebermass-Schrehof, K. 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 (2015). https://doi.org/10.1038/jp.2015.30

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  • DOI: https://doi.org/10.1038/jp.2015.30

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