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Recurrence of low birth weight in siblings
M J Khoury1, E E Calle, R M Joesoef
1Division of Birth Defects and Developmental Disabilities, Centers for Disease Control, Atlanta, GA 30333.
Insights
Low birth weight (LBW) recurrence in siblings is significantly higher, especially for preterm births. Familial factors, potentially genetic, contribute to this increased risk and require further study.
Area of Science:
- Perinatal epidemiology
- Genetics and public health
Background:
- Low birth weight (LBW) is a significant global health concern.
- Understanding recurrence risks within families is crucial for prevention strategies.
Purpose of the Study:
- To investigate the recurrence risk of low birth weight (LBW) in full siblings.
- To differentiate recurrence risks for preterm LBW (LBW/p) versus term LBW (LBW/t).
Main Methods:
- Retrospective cohort study of 3286 infants born to 1677 U.S. Army veterans.
- Analysis of sibling birth weights and LBW status using medical records.
- Logistic regression to assess familial risks and control for other factors.
Main Results:
- Infants with a sibling history of LBW had a 9.9% risk of LBW, versus 2.8% for those without (OR=3.8).
- This excess risk was primarily driven by LBW/p (OR=9.2), not LBW/t (OR=2.0).
- Familial recurrence risk could not be explained by shared environmental risk factors.
Conclusions:
- A significant familial aggregation of LBW exists, particularly for preterm births.
- Familial factors, possibly genetic, play a role in LBW and prematurity.
- Further epidemiologic research is needed to elucidate these familial influences.
Abstract:
The recurrence of low birth weight (LBW, less than 2500 g) in full siblings was studied in 3286 singleton infants born between 1966 and 1986 to 1677 male U.S. Army veterans who were part of a nationwide health study. Hospital of birth medical records were abstracted for these children. Mean birth weights, risks of LBW, LBW occurring with preterm delivery (less than 37 weeks) (LBW/p), and LBW in term infants (LBW/t) were examined in successive singleton siblings according to LBW status of prior siblings. The risk of LBW in infants who had prior siblings with LBW was 9.9%, compared with a risk of 2.8% in infants who had prior siblings without LBW (OR = 3.8, 95% CI 2.0-7.3). The excess recurrence of LBW was specifically due to LBW/p. Infants with prior siblings with LBW/p were at high tisk of LBW/p (OR = 9.2, CI 4.4-19.6) but not of LBW/t (OR = 2.0, CI 0.1-9.1). Using modified logistic regression techniques that incorporate familial risks and the effects of other risk factors, the excess sibling recurrence risk of LBW and LBW/p could not be explained by the tendency for recurrence in siblings of other risk factors for LBW, such as pregnancy complications, maternal illnesses, and birth defects. Although the familial factors involved in LBW may or may not be genetic in nature, such factors need to be investigated in epidemiologic studies of LBW and prematurity.