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1. Evidence that highly canalized fetal traits are sensitive to intergenerational effects of maternal developmental nutrition

   https://doi.org/10.1002/ajpa.24883  

   Ragsdale, Haley B. ; Lee, Nanette R. ; Kuzawa, Christopher W. ( November 2023 , American Journal of Biological Anthropology)

   Maternal experiences before pregnancy predict birth outcomes, a key indicator of health trajectories, but the timing and pathways for these effects are poorly understood. Here we test the hypothesis that maternal pre‐adult growth patterns predict pregnancy glucose and offspring fetal growth in Cebu, Philippines.

   Using multiple regression and path analysis, gestational age‐adjusted birthweight and variables reflecting infancy, childhood, and post‐childhood/adolescent weight gain (conditional weights) were used to predict pregnancy HbA1c and offspring birth outcomes among participants in the Cebu Longitudinal Health and Nutrition Survey.

   Maternal early/mid‐childhood weight gain predicted birth weight, length, and head circumference in female offspring. Late‐childhood/adolescent weight gain predicted birth length, birth weight, skinfold thickness, and head circumference in female offspring, and head circumference in male offspring. Pregnancy HbA1c did not mediate relationships between maternal growth and birth size parameters.

   In Cebu, maternal growth patterns throughout infancy, childhood, and adolescence predict fetal growth via a pathway independent of circulating glucose, with stronger impacts on female than male offspring, consistent with a role of developmental nutrition on offspring fetal growth. Notably, the strength of relationships followed a pattern opposite to what occurs in response to acute pregnancy stress, with strongest effects on head circumference and birth length and weakest on skinfolds. We speculate that developmental sensitivities are reversed for stable, long‐term nutritional cues that reflect average local environments. These findings are relevant to public health and life‐history theory as further evidence of developmental influences on health and resource allocation across the life course.

    

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2. Early life growth and adult telomere length in a Filipino cohort study

   https://doi.org/10.1002/ajhb.23299  

   Masterson, Erin E. ; Hayes, M. Geoffrey ; Kuzawa, Christopher W. ; Lee, Nanette R. ; Eisenberg, Dan T. A. ( August 2019 , American Journal of Human Biology)

   We investigated the relationship between early life growth patterns and blood telomere length (TL) in adulthood using conditional measures of lean and fat mass growth to evaluate potentially sensitive periods of early life growth.

   This study included data from 1562 individuals (53% male; age 20‐22 years) participating in the Cebu Longitudinal Health and Nutrition Survey, located in metropolitan Cebu, Philippines. Primary exposures included length‐for‐agez‐score (HAZ) and weight‐for‐agez‐score (WAZ) at birth and conditional measures of linear growth and weight gain during four postnatal periods: 0‐6, 6‐12, and 12‐24 months, and 24 months to 8.5 years. TL was measured at ~21 years of age. We estimated associations using linear regression.

   The study sample had an average gestational age (38.5 ± 2 weeks) and birth size (HAZ = –0.2 ± 1.1, WAZ = –0.7 ± 1.0), but by age 8.5 years had stunted linear growth (HAZ = –2.1 ± 0.9) and borderline low weight (WAZ = –1.9 ± 1.0) relative to World Health Organization references. Heavier birth weight was associated with longer TL in early adulthood (P= .03), but this association was attenuated when maternal age at birth was included in the model (P= .07). Accelerated linear growth between 6 and 12 months was associated with longer TL in adulthood (P= .006), whereas weight gain between 12 and 24 months was associated with shorter TL in adulthood (P= .047).

   In Cebu, individuals who were born heavier have longer TL in early adulthood, but that birthweight itself may not explain the association. Findings suggest that childhood growth is associated with the cellular senescence process in adulthood, implying early life well‐being may be linked to adult health.

    

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3. Cesarean birth and the growth of Yucatec Maya and Toba/Qom children

   https://doi.org/10.1002/ajhb.23228  

   Veile, Amanda ; Valeggia, Claudia ; Kramer, Karen L. ( February 2019 , American Journal of Human Biology)

   Cesarean delivery is often epidemiologically associated with childhood obesity. However, little attention is paid to post‐birth modulatory environments, and most studies are conducted in settings where obesity arises for a number of reasons in addition to birth mode. We therefore assess population differences in the relationship between birth mode and childhood growth using data from rural and peri‐urban Latin American indigenous populations, and test predictions developed using life history theory.

   Child height and weight were measured monthly in 80 Yucatec Maya and 58 Toba/Qom children aged 1‐48 months (2007‐2014, 3812 observations). Random‐effects linear mixed models were used to compare children's growth by population, sex, and birth mode, accounting for potential confounders.

   Cesarean delivery rates were 47% (Toba/Qom) and 20% (Yucatec Maya). Childhood obesity and overweight rates were low in both populations. Cesarean‐delivered children had significantly greater weight gain (but similar height grain) compared to vaginally‐delivered children. By age 4, cesarean delivered Yucatec Maya girls and boys, and Toba/Qom boys (not girls), had significantly higher weight‐for‐age compared to vaginally‐delivered children from their own sex and population.

   This provides one of the first attempts to document differences in children's growth patterns according to mode of birth in modernizing indigenous populations. Cesarean delivery is associated with young children's growth patterns, even in the absence of many obesity‐inducing factors. There are also population, age, and sex differences in the relationship between birth mode and childhood weight trajectories that warrant future investigation.

    

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4. Childhood body mass is positively associated with cesarean birth in Y ucatec M aya subsistence farmers

   https://doi.org/10.1002/ajhb.22920  

   Veile, Amanda ; Kramer, Karen L. ( October 2016 , American Journal of Human Biology)

   The epidemiologic link between cesarean birth and childhood obesity is unresolved, partly because most studies come from industrialized settings where many post‐birth factors affect the risk for obesity. We take advantage of an unusual ethnographic situation where hospital and cesarean birth modes have recently been introduced among Yucatec Maya subsistence farmers, but young children have had minimal exposure to the nutritional transition. While we expect to find very low rates of childhood obesity, we predict that cesarean‐born children will be larger and heavier than vaginally born children.

   Weight and height were collected monthly on 108 children aged 0–5 (3576 observations total). Birth mode and birthweight were collected by maternal interview. Data were analyzed using linear mixed models that compare child growth [Maya population‐specificZ‐scores for weight‐for‐age and body mass index‐for‐age (WAZ and BMIZ)] in cesarean and vaginally born children aged 0–5 years.

   The cesarean rate was 20%, no children were obese, and 5% were overweight. Cesarean birth was a significant predictor of child WAZ and BMIZ after accounting for maternal effects, child birthweight, and sex. Children who were born by cesarean to mothers with high BMI had the highest WAZ of all children by 5 years of age, and the highest BMIZ of all children at all ages.

   Cesarean‐born Maya children had higher BMI than vaginally born children, even in the absence of many known confounding factors that contribute to childhood obesity. Child growth was most sensitive to birth mode when mothers had high BMI.

    

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5. Household conditions modulate associations between cesarean delivery and childhood growth

   https://doi.org/10.1002/ajpa.24563  

   Veile, Amanda J. ; Kramer, Karen Leslie ; Otárola‐Castillo, Erik ( July 2022 , American Journal of Biological Anthropology)

   Cesarean delivery is associated with childhood obesity in urbanized and sanitized environments, but this is not well‐studied across broader epidemiologic settings. We examine birth mode, household conditions, and child growth in a Yucatec Maya farming community with limited sanitary infrastructure. We test the hypotheses that household infrastructure and epidemiologic conditions: (1)modulateassociations between cesarean delivery and growth, and (2) are more strongly associated with growth compared to birth mode.

   Birth mode, household characteristics (construction materials/waste disposal/water variables) and growth were examined in 106 children (0–5 years, 3554 longitudinal observations). Ahousehold modification index(HMI) was created to indicate “baseline” (more traditional) versus “modified” (more modernized) houses. Weight/height/BMI Z‐scores (WHO‐standards) were modeled with respect to HMI and birth mode using nested generalized linear mixed‐effects models. A series of interaction models were then compared.

   Four household modification variables (concrete roof and floor, latrine/septic tank, burning trash) were associated with greater growth gains and used to compose the HMI. Cesarean delivery was associated with slightly higher Z‐scores for most anthropometric outcomes. HMI modulated the association between birth mode and children's weight and height, but not BMI, trajectories. Weight and BMI Z‐scores, but not height Z‐scores, were higher at all ages under high HMI (“modified”) versus low HMI (“baseline”) conditions regardless of birth mode.

   Understudied household conditions can modulate the association between cesarean delivery and childhood growth. These findings contribute to a large body of literature linking cesarean delivery to a variety of child health outcomes including obesity.

    

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