Background: Impaired fetal growth is associated with increased risks of kidney diseases in later life. Because human development rates are highest during the first trimester, this trimester may be a particularly critical period for kidney outcomes. We have therefore examined the association of fetal first trimester growth with kidney outcomes in childhood. Methods: This study was embedded in a prospective population-based cohort study among 1176 pregnant women and their children. We used fetal first trimester crown–length as the growth measure among mothers with a regular menstrual cycle and a known first day of the last menstrual period. At the childhood age of 6 (median 5.7–6.8) years, we measured combined kidney volume, microalbuminuria and estimated glomerular filtration rate (eGFR) based on serum creatinine and cystatin C concentrations. Results: No consistent associations of fetal first trimester crown–rump length with childhood combined kidney volume, eGFR and microalbuminuria were observed. Compared to children with a fetal first trimester crown–rump length in the highest quintile, those in the lowest quintile had a larger childhood combined kidney volume (difference 5.32 cm3, 95 % confidence interval 1.06 to 9.57), but no differences in kidney function. Conclusion: Our results do not support the hypothesis that fetal first trimester growth restriction affects kidney size and function in childhood. Further studies are needed to focus on critical periods in early life for kidney function and disease in later life.

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Pediatric Nephrology
Generation R Study Group

Bakker, H., Gaillard, R., Hofman, A., Reiss, I., Steegers, E., & Jaddoe, V. (2017). Fetal first trimester growth is not associated with kidney outcomes in childhood. Pediatric Nephrology, 32(4), 651–658. doi:10.1007/s00467-016-3537-8