Babies' growth in the womb and their size at birth, especially their length, are strikingly similar the world over -- when babies are born to healthy, well-educated and well-nourished mothers. That's the finding of a landmark¹ international study, INTERGROWTH-21st, led by Oxford² University researchers, which involved almost 60,000 pregnancies³ in eight defined urban areas in Brazil, China, India, Italy, Kenya, Oman, the UK and USA.

 

Worldwide there are wide disparities in the average size of babies at birth. This has significant consequences for future health, as small for gestational（妊娠期的） age babies who are already undernourished at birth often face severe short- and long-term health consequences.

 

It has previously⁴ been suggested that 'race' and 'ethnicity' are largely responsible for differences in the size of babies born in different populations and countries. These new results show that race and ethnicity are not the primary factors. What matters more is the educational, health and nutritional⁵ status of the mothers, and care provided during pregnancy⁶.

 

The researchers carried out ultrasound scans from early pregnancy to delivery to measure babies' bone growth in the womb, using identical methods in all countries and the same ultrasound machines provided by Philips Healthcare. They also measured the length and head circumference⁷ of all babies at birth.

 

They have demonstrated that if mothers' educational, health and nutritional status and care during pregnancy are equally good, babies will have equal chances of healthy growth in the womb and future good health.

 

The researchers report their findings in The Lancet, Diabetes⁸ & Endocrinology. They were funded by the Bill & Melinda Gates Foundation.

 

'Currently we are not all equal at birth. But we can be,' said the lead author Professor Jose Villar of the Nuffield Department of Obstetrics & Gynaecology, University of Oxford. 'We can create a similar start for all by making sure mothers are well educated and nourished, by treating infection and by providing adequate antenatal care.

 

'Don't tell us nothing can be done. Don't say that women in some parts of the world have small children because they are predestined（注定的） to do so. It's simply not true.'

 

Key points The study involved almost 60,000 pregnancies in eight defined urban areas in Brazil, China, India, Italy, Kenya, Oman, the UK and USA. Babies' bone growth in the womb and their length and head circumference at birth are strikingly similar the world over -- when babies are born to educated, healthy and well-nourished mothers. Overall, no more than 4% of the total difference in fetal growth and birth size could be attributed to differences between the eight populations in the study. Improving the education, health and nutrition of mothers everywhere will boost the health of their babies throughout life within the next generation. Results are in complete agreement with the previous WHO study using the same methodology（方法论） from birth to 5 years of age.

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