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Disproportionate early fetal growth predicts postnatal thymic size in humans

Published online by Cambridge University Press:  07 March 2013

A. J. C. Fulford ,
S. E. Moore ,
S. E. Arifeen ,
L. Å. Persson ,
L. M. Neufeld ,
Y. Wagatsuma  and
A. M. Prentice
A. J. C. Fulford*
Affiliation:
MRC Keneba, MRC Unit, Banjul, The Gambia Department of Population Health, MRC International Nutrition Group, London School of Hygiene and Tropical Medicine, London, UK
S. E. Moore
Affiliation:
MRC Keneba, MRC Unit, Banjul, The Gambia
S. E. Arifeen
Affiliation:
International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B), Dhaka, Bangladesh
L. Å. Persson
Affiliation:
Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden
L. M. Neufeld
Affiliation:
The Micronutrient Initiative, Elgin St. Suite, Ottawa, ON, Canada
Y. Wagatsuma
Affiliation:
Department of Epidemiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
A. M. Prentice
Affiliation:
MRC Keneba, MRC Unit, Banjul, The Gambia Department of Population Health, MRC International Nutrition Group, London School of Hygiene and Tropical Medicine, London, UK
*
*Address for correspondence: Dr A. J. C. Fulford, Department Population Health, MRC International Nutrition Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. Email tony.fulford@lshtm.ac.uk
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Abstract

Prenatal events can affect neonatal thymus size and adult immune function. The causal insults are unknown, although fetal nutrient restriction is suspected. We used ultrasound at three time points during pregnancy (14, 19 and 30 weeks) to measure the growth of six fetal dimensions in rural Bangladeshi women participating in the Maternal and Infant Nutrition Interventions, Matlab study. Postnatal ultrasound was used to calculate thymic index (TI) at birth, 2, 6 and 12 m. Of the 3267 women recruited, 2861 participated by providing data at least at one fetal biometry and one TI time point. Patterns of fetal growth were summarized using principal components calculated from fetal dimension z-scores. Random effects regression, controlling for infant size and season of measurement were used to relate these patterns to TI. We found that smaller leg length relative to head circumference, characteristic of head-sparing growth restriction, was predictive of lower TI. This association was significant at all time points but strongest in earlier pregnancy. Each standard deviation increase in leg–head proportion was associated with an increase in TI of ∼5%. We conclude that growth patterns typical of poor fetal nutrition are associated with poor thymic development. The greater strength of this association in the first trimester is consistent with a period of vulnerability during the early ontogeny of the thymus and suggests that preventative intervention would need to be given in early pregnancy.

Keywords

Bangladesh, fetal growth, thymus size, ultrasound
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 4 , Issue 3 , June 2013 , pp. 223 - 231
Copyright
Copyright © Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2013 

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