SEARCHCOHORTpediatrics, obstetrics and gynecology

cohort·pediatrics, obstetrics and gynecology, epidemiology, research methods, observational study·PMC10069489

Application of multilevel linear spline models for analysis of growth trajectories in a cohort with repeat antenatal and postnatal measures of growth: a prospective cohort study

BMJ Open · 6 authors, 6 centres

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TL;DR

Growth rates were fastest in pregnancy or immediately after birth and progressively slowed through infancy and childhood, with all models demonstrating good fit between observed and predicted values.

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The best fitting models for abdominal circumference, head circumference, and weight included 5 linear spline periods, while length/height models used 3 spline periods from birth to 6 months, 6 months to 2 years, and 2 to 5 years. Growth rates were generally fastest in pregnancy or immediately post partum, with rates slowing after birth and continuing to decelerate through infancy and childhood.

STUDY TYPE

cohort

SPECIALTY

pediatrics

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ORIGINAL PAPER

PMC10069489

Application of multilevel linear spline models for analysis of growth trajectories in a cohort with repeat antenatal and postnatal measures of growth: a prospective cohort study

BMJ Open

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ABSTRACT

Objectives To model trajectories of antenatal and postnatal growth using linear spline multilevel models. Design Prospective cohort study. Setting Maternity hospital in Dublin, Ireland. Participants 720–759 mother–child pairs from the ROLO study (initially a randomised control trial of a low glycaemic index diet in pregnancy to prevent recurrence of macrosomia [birth weight >4 kg]). Primary outcomes Trajectories of growth from 20 weeks gestation (abdominal circumference [AC], head circumference [HC] and weight) or birth (length/height) to 5 years. Results Over 50% of women had third-level education and 90% were of white ethnicity. Women were a mean (SD) age of 32 years (4.2) at recruitment. The best fitting model for AC, HC and weight included a model with 5 linear spline periods. The best fitting models for length/height included a model with 3 linear spline periods from birth to 6 months, 6 months to 2 years and 2 years to 5 years. Comparison of observed and predicted values for each model demonstrated good model fit. For all growth measures, growth rates were generally fastest in pregnancy or immediately post partum (for length/height), with rates of growth slowing after birth and becoming slower still as infancy and childhood progressed. Conclusion We demonstrate the application of multilevel linear spline models for examining growth trajectories when both antenatal and postnatal measures of growth are available. The approach may be useful for cohort studies or randomised control trials with repeat prospective assessments of growth.

CITATION EXPORT

Linda M O'Keeffe, Cara A Yelverton, Helena C Bartels et al.. Application of multilevel linear spline models for analysis of growth trajectories in a cohort with repeat antenatal and postnatal measures of growth: a prospective cohort study. BMJ Open. (2023). https://doi.org/10.1136/bmjopen-2022-065701

AUTHORS

6 · 6 CENTRES

Linda M O'Keeffe, Cara A Yelverton, Helena C Bartels, Kate N O'Neill, Ciara McDonnell, Fionnuala M McAuliffe

1School of Public Health, University College Cork, Cork, Ireland
2MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, UK
3Population Health Sciences, University of Bristol, Bristol Medical School, Bristol, UK
4UCD Perinatal Research Centre, School of Medicine, University College Dublin, Dublin, Ireland
5Department of Paediatric Endocrinology & Diabetes, Children's Health Ireland at Temple Street, Dublin, Ireland
6Discipline of Paediatrics, School of Medicine, Trinity College Dublin, Dublin, Ireland