title: Effect of intrauterine growth restriction on kidney function at young adult age: the Nord Trøndelag Health (HUNT 2) Study.
abstract: BACKGROUND
  The hypothesis of intrauterine origin of adult disease is debated. We tested whether intrauterine growth restriction is associated with later kidney function.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  7,457 Norwegian adults aged 20 to 30 years participating in the population-based Nord Trøndelag Health Study (1995-1997) with data for birth weight, gestational age, and maternal and perinatal risk factors registered at the Medical Birth Registry of Norway.
  
  
  METHODS
  Birth weight expressed as an SD score (SDS) to adjust for gestational age and sex. Subjects with a birth weight SDS less than -2.0, -2.0 to -1.3, and -1.3 to 1.3 were defined as very small, small, and appropriate for gestational age, corresponding to less than the 3rd, 3rd to 10th, and 10th to 90th percentiles, respectively.
  
  
  METHODS
  Kidney function estimated using the Cockcroft-Gault and isotope dilution mass spectrometry-traceable 4-variable Modification of Diet in Renal Disease (MDRD) Study equation. Values less than the sex-specific 10th percentile were defined as low-normal kidney function.
  
  
  RESULTS
  Compared with men with birth weight appropriate for gestational age (n = 2,755), odds ratios for low-normal creatinine clearance (<100 mL/min) were 1.66 (95% confidence interval [CI], 1.16 to 2.37) if small for gestational age (n = 261) and 2.40 (95% CI, 1.46 to 3.94) if very small for gestational age (n = 101). Kidney function estimated using the MDRD Study equation gave similar results. Women (n = 3,126, 283, and 112, respectively) had odds ratios of 1.65 (95% CI, 1.17 to 2.35) and 2.00 (95% CI, 1.21 to 3.29) for low-normal creatinine clearance (<80 mL/min), whereas the association was not significant using the MDRD Study equation. Using linear regression, creatinine clearance decreased by 4.0 mL/min (95% CI, 3.3 to 4.6) in men and 2.9 mL/min (95% CI, 2.2 to 3.5) in women per 1-SDS decrease. Adjusting for possible confounders did not influence results.
  
  
  CONCLUSIONS
  Selection bias could be a problem because the participation rate was 49%, but there were no statistically significant differences between participants and nonparticipants regarding maternal and perinatal characteristics. Adjusting kidney function for body size can be a special problem in people with intrauterine growth restriction.
  
  
  CONCLUSIONS
  Although effects were still small in young adulthood, intrauterine growth restriction was significantly associated with low-normal kidney function. The effect was weaker and less consistent in women compared with men.
authors.affiliation: Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. stein.hallan@ntnu.no
authors.forename: Stein
authors.initials: S
authors.lastname: Hallan
authors.forename: Anne M
authors.initials: AM
authors.lastname: Euser
authors.forename: Lorentz M
authors.initials: LM
authors.lastname: Irgens
authors.forename: Martijn J J
authors.initials: MJ
authors.lastname: Finken
authors.forename: Jostein
authors.initials: J
authors.lastname: Holmen
authors.forename: Friedo W
authors.initials: FW
authors.lastname: Dekker
mesh_terms: D000328:Adult; D000367:Age Factors; D001724:Birth Weight / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D015331:Cohort Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology* / Q000503:physiopathology; D005865:Gestational Age; D006305:Health Status Indicators; D006801:Humans; D007231:Infant, Newborn; D007668:Kidney / Q000502:physiology*; D007674:Kidney Diseases / Q000453:epidemiology / Q000503:physiopathology; D007677:Kidney Function Tests / Q000639:trends*; D008297:Male; D009664:Norway / Q000453:epidemiology; D011446:Prospective Studies; D012042:Registries