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. 2017 Apr;32(4):651-658.
doi: 10.1007/s00467-016-3537-8. Epub 2016 Oct 27.

Fetal first trimester growth is not associated with kidney outcomes in childhood

Hanneke Bakker  1   2   3 , Romy Gaillard  1   2   3 , Albert Hofman  2   4 , Irwin K Reiss  3 , Eric A P Steegers  5 , Vincent W V Jaddoe  6   7   8
Affiliations

Fetal first trimester growth is not associated with kidney outcomes in childhood

Hanneke Bakker et al. Pediatr Nephrol. 2017 Apr.

Abstract

Background: Impaired fetal growth is associated with increased risks of kidney diseases in later life. Because human development rates are highest during the first trimester, this trimester may be a particularly critical period for kidney outcomes. We have therefore examined the association of fetal first trimester growth with kidney outcomes in childhood.

Methods: This study was embedded in a prospective population-based cohort study among 1176 pregnant women and their children. We used fetal first trimester crown-length as the growth measure among mothers with a regular menstrual cycle and a known first day of the last menstrual period. At the childhood age of 6 (median 5.7-6.8) years, we measured combined kidney volume, microalbuminuria and estimated glomerular filtration rate (eGFR) based on serum creatinine and cystatin C concentrations.

Results: No consistent associations of fetal first trimester crown-rump length with childhood combined kidney volume, eGFR and microalbuminuria were observed. Compared to children with a fetal first trimester crown-rump length in the highest quintile, those in the lowest quintile had a larger childhood combined kidney volume (difference 5.32 cm3, 95 % confidence interval 1.06 to 9.57), but no differences in kidney function.

Conclusion: Our results do not support the hypothesis that fetal first trimester growth restriction affects kidney size and function in childhood. Further studies are needed to focus on critical periods in early life for kidney function and disease in later life.

Keywords: Childhood; Crown–rump length; Fetal development; Kidney function; Kidney volume.

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Conflict of interest statement

Funding/support

The Generation R Study receives financial support from the Erasmus Medical Center, Rotterdam and The Netherlands Organization for Health Research and Development (ZonMw). The general design of Generation R Study is made possible by financial support from the Erasmus MC, University Medical Center, Rotterdam, the Netherlands Organization for Health Research and Development (ZonMw) and the Ministry of Health, Welfare and Sport. Vincent Jaddoe received additional grants from the Netherlands Organization for Health Research and Development (VIDI 016. 136. 361) and European Research Council (ERC Consolidator Grant, ERC-2014-CoG-648916).

Disclosure

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Figures

Fig. 1
Fig. 1
Flowchart of study design showing the inclusion of participants in the analyses
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