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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

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 gly...

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Autores principales: O'Keeffe, Linda M, Yelverton, Cara A, Bartels, Helena C, O'Neill, Kate N, McDonnell, Ciara, McAuliffe, Fionnuala M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10069489/
https://www.ncbi.nlm.nih.gov/pubmed/36972957
http://dx.doi.org/10.1136/bmjopen-2022-065701
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author O'Keeffe, Linda M
Yelverton, Cara A
Bartels, Helena C
O'Neill, Kate N
McDonnell, Ciara
McAuliffe, Fionnuala M
author_facet O'Keeffe, Linda M
Yelverton, Cara A
Bartels, Helena C
O'Neill, Kate N
McDonnell, Ciara
McAuliffe, Fionnuala M
author_sort O'Keeffe, Linda M
collection PubMed
description 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.
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spelling pubmed-100694892023-04-04 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 O'Keeffe, Linda M Yelverton, Cara A Bartels, Helena C O'Neill, Kate N McDonnell, Ciara McAuliffe, Fionnuala M BMJ Open Obstetrics and Gynaecology 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. BMJ Publishing Group 2023-03-27 /pmc/articles/PMC10069489/ /pubmed/36972957 http://dx.doi.org/10.1136/bmjopen-2022-065701 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Obstetrics and Gynaecology
O'Keeffe, Linda M
Yelverton, Cara A
Bartels, Helena C
O'Neill, Kate N
McDonnell, Ciara
McAuliffe, Fionnuala M
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Obstetrics and Gynaecology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10069489/
https://www.ncbi.nlm.nih.gov/pubmed/36972957
http://dx.doi.org/10.1136/bmjopen-2022-065701
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