Small vulnerable newborns, those born preterm or small for gestational age (SGA) stand for 80% of the neonatal deaths and are thus crucial to attain the Sustainable Development Goal target of ending preventable deaths in children. Those who survive often have lifelong health problems that may extend the vicious cycle of also the next generation having small vulnerable newborns.
In high-resource settings, there is direct evidence that women born preterm are more likely to have preterm children and pregnancy complications themselves. However, most evidence in low-resource settings remains circumstantial. We intend to study this transgenerational vicious cycle of early childhood vulnerability by following up women who were born preterm or SGA themselves until they give birth and to study their reproductive outcomes and their children’s health and wellbeing. We will pursue this in a unique birth cohort, the Lungwena Antenatal Intervention Study (LAIS) that has accurately measured gestational age of pregnancies and detailed birth phenotypes.
The specific objectives are:
- To assess rates of reproduction and pregnancy outcomes in women who were born preterm or SGA.
- To assess developmental and growth outcomes of offspring of women who themselves were born preterm or SGA.
- To assess how the associations are mediated through or modified by body size and stunting, glucose metabolism, systemic inflammation, mental health and underlying socioeconomic and environmental factors.