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Relationship between Birth Order and Postnatal Growth until 4 Years of Age: The Japan Environment and Children's
Aya Yoshida1, Kayo Kaneko2, Kohei Aoyama1
1Department of Pediatrics and Neonatology, Graduate School of Medical Sciences, Nagoya City University, Nagoya 4670001, Japan.
Insights
Later-born children show reduced growth in early childhood compared to first-borns. This birth order effect increases the risk of short stature by age four.
Area of Science:
- Pediatrics
- Human Growth and Development
- Epidemiology
Background:
- Later-born children are often shorter than first-borns in childhood and adulthood.
- Large-scale prospective studies on infant growth by birth order are limited.
Purpose of the Study:
- To investigate the association between birth order and growth during the first four years of life.
- To examine the relationship between birth order and the risk of short stature in early childhood.
Main Methods:
- A Japanese prospective birth cohort study included 26,249 full-term singleton births.
- General linear and multivariable logistic regression models were used for analysis.
- Adjustments were made for multiple confounding factors including birth weight, parental height, and socioeconomic status.
Main Results:
- Later-borns exhibited significantly lower length Z-scores from birth through 10 months compared to first-borns without siblings.
- This growth difference persisted up to 4 years of age.
- The adjusted odds ratio for short stature at 4 years increased with birth order, with third-borns or more having a 1.50 times higher risk compared to first-borns without siblings.
Conclusions:
- Birth order is significantly associated with postnatal growth in children.
- Later birth order may be a predisposing factor for short stature in early childhood.
Abstract:
Later-borns tend to be shorter than first-borns in childhood and adulthood. However, large-scale prospective studies examining growth during infancy according to birth order are limited. We aimed to investigate the relationship between birth order and growth during the first 4 years of life in a Japanese prospective birth cohort study. A total of 26,249 full-term singleton births were targeted. General linear and multivariable logistic regression models were performed and adjusted for birth weight, parents' heights, maternal age at delivery, gestational weight gain, maternal smoking and alcohol drinking status during pregnancy, household income, breastfeeding status, and Study Areas. The multivariate adjusted mean length Z-scores in "first-borns having no sibling", "first-borns having siblings", "second-borns", and "third-borns or more" were -0.026, -0.013, 0.136, and 0.120 at birth and -0.324, -0.330, -0.466, and -0.569 at 10 months, respectively. Results similar to those at 10 months were observed at 1.5, 3, and 4 years. The adjusted odds ratios (95% confidence intervals) of short stature at 4 years in "first-borns having siblings", "second-borns", and "third-borns or more" were 1.08 (0.84-1.39), 1.36 (1.13-1.62), and 1.50 (1.20-1.88), respectively, versus "first-borns having no sibling". Birth order was significantly associated with postnatal growth and may be a factor predisposing to short stature in early childhood.
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