title: Fetal programming and systemic sclerosis.
abstract: OBJECTIVE
  This study investigated whether birthweight is linked to an increased risk of the development of systemic sclerosis.
  
  
  METHODS
  This was a multicenter case-control study with perinatal data that were obtained from 332 cases with systemic sclerosis and 243 control subjects. Birthweight was treated as a dichotomous variable (<2500 g vs ≥2500 g); low birthweight was defined as a weight <2500 g; small for gestational age was defined as birthweight <10th percentile for gestational age adjusted for sex. The relationship between systemic sclerosis and both low birthweight and small for gestational age was expressed with the crude (univariate analysis) and adjusted (multivariate analysis) odds ratio (OR).
  
  
  RESULTS
  Significantly increased ORs were observed in the univariate analysis for low birthweight (OR, 2.59; 95% confidence interval [CI], 1.39-5.05) and small for gestational age (OR, 2.60; 95% CI, 1.34-5.32) subjects. Similarly increased risks were confirmed for both conditions in the multivariate analysis (OR, 3.93; 95% CI, 1.92-8.07; and OR, 2.58; 95% CI, 1.28-5.19), respectively.
  
  
  CONCLUSIONS
  Low birthweight and small for gestational age at birth are risk factors for the adult onset of systemic sclerosis.
authors.affiliation: Department of Fetal-Neonatal Medicine, Meyer Children's Hospital, University of Florence, Florence, Italy. Electronic address: gianpaolo.donzelli@unifi.it.
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Donzelli
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Carnesecchi
authors.affiliation: Department of Fetal-Neonatal Medicine, Meyer Children's Hospital, University of Florence, Florence, Italy.
authors.forename: Carolina
authors.initials: C
authors.lastname: Amador
authors.affiliation: Department of Health Sciences, University of Florence, Florence, Italy.
authors.forename: Mariarosaria
authors.initials: M
authors.lastname: di Tommaso
authors.affiliation: Department of Fetal-Neonatal Medicine, Meyer Children's Hospital, University of Florence, Florence, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Filippi
authors.affiliation: Department of Rheumatology, University and IRCCS Foundation, Policlinico San Matteo, Pavia, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Caporali
authors.affiliation: Department of Rheumatology, University and IRCCS Foundation, Policlinico San Matteo, Pavia, Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Codullo
authors.affiliation: Department of Internal Medicine and Clinical Specialties, Rheumatology Unit, "La Sapienza" University, Rome, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Riccieri
authors.affiliation: Department of Internal Medicine and Clinical Specialties, Rheumatology Unit, "La Sapienza" University, Rome, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Valesini
authors.affiliation: Institute of General Clinical Medicine, Hematology, and Clinical Immunology, University of Ancona, Ancona, Italy.
authors.forename: Armando
authors.initials: A
authors.lastname: Gabrielli
authors.affiliation: Institute of General Clinical Medicine, Hematology, and Clinical Immunology, University of Ancona, Ancona, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Bagnati
authors.affiliation: Research, Innovation, and International Relations Office, Meyer Children's Hospital, University of Florence, Florence, Italy.
authors.forename: Kathleen S
authors.initials: KS
authors.lastname: McGreevy
authors.affiliation: Department of Fetal-Neonatal Medicine, Meyer Children's Hospital, University of Florence, Florence, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: De Masi
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Matucci Cerinic
mesh_terms: D017668:Age of Onset; D001724:Birth Weight; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007558:Italy / Q000453:epidemiology; D008297:Male; D008423:Maternal Age; D008875:Middle Aged; D015999:Multivariate Analysis; D011247:Pregnancy; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000453:epidemiology*
keywords: autoimmune disease; birthweight; epigenetics; fetal programming; scleroderma