Trends in birth weight-specific and -adjusted infant mortality rates in Taiwan between 2004 and 2011.

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Liang, Fu-Wen; Chou, Hung-Chieh; Chiou, Shu-Ti; Chen, Li-Hua; Wu, Mei-Hwan; Lue, Hung-Chi; Chiang, Tung-Liang; Lu, Tsung-Hsueh

2018-06-01

A yearly increase in the proportion of very low birth weight (VLBW) live births has resulted in the slowdown of decreasing trends in crude infant mortality rates (IMRs). In this study, we examined the trends in birth weight-specific as well as birth weight-adjusted IMRs in Taiwan. We linked three nationwide datasets, namely the National Birth Reporting Database, National Birth Certification Registry, and National Death Certification Registry databases, to calculate the IMRs according to the birth weight category. Trend tests and mortality rate ratios in the periods 2010-2011 and 2004-2005 were used to examine the extent of reduction in birth weight-specific and birth weight-adjusted IMRs. The proportion of VLBW (births increased from 0.78% in 2004-2005 to 0.89% in 2010-2011, thus exhibiting a 15% increase. The extents of the decreases in birth weight-specific IMRs in the 500-999, 1000-1499, 1500-1999, 2000-2499, and 2500-2999 g birth weight categories were 15%, 33%, 43%, 30%, and 28%, respectively, from 2004-2005 to 2010-2011. The reduction in IMR in each birth weight category was larger than the reduction in the crude IMR (13%). By contrast, the IMR in the birth weight category exhibited a 56% increase during the study period. The IMRs were calculated by excluding all live births with a birth weight of birth weight-adjusted IMRs, which were calculated using a standard birth weight distribution structure for adjustment, exhibited similar extent reductions. In countries with an increasing proportion of VLBW live births, birth weight-specific or -adjusted IMRs are more appropriate than other indices for accurately assessing the real extent of reduction in IMRs. Copyright © 2017. Published by Elsevier B.V.

Cognition, academic progress, behavior and self-concept at 14 years of very low birth weight children.

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Rickards, A L; Kelly, E A; Doyle, L W; Callanan, C

2001-02-01

The aim of this study was to compare cognition, academic progress, behavior, and self-concept children of very low birth weight (VLBW, birth weight 2,499 g). At 14 years of age, 130 (84.4%) of 154 VLBW and 42 (70.0%) of 60 NBW children were assessed. Ten VLBW children and one NBW child who had cerebral palsy were excluded. VLBW children scored at a significantly lower level on all three composite scales of the Wechsler Intelligence Scale for Children, 3rd Edition. VLBW children were also significantly disadvantaged on more specific cognitive processes, including tests of visual processing and visual memory and on subtests reflecting learning and problem solving. Only in arithmetic was a difference between the groups discerned on tests of achievement. Significantly more VLBW children were rated by teachers as socially rejected and by their parents as having learning problems at school. VLBW children had significantly reduced self-esteem. VLBW children had more cognitive, academic, and behavioral problems and lower self-esteem at 14 years of age than NBW control subjects.

Outcome of Very Low Birth Weight Infants Over 3 Years Report From an Iranian Center

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Afjeh, Seyyed-Abolfazl; Sabzehei, Mohammad-Kazem; Fallahi, Minoo; Esmaili, Fatemeh

2013-01-01

Objective Very low birth weight (VLBW) infants are at high risk for morbidity and mortality. This article determines the frequency of disease, rate od survival, complications and risk factors for morbidity and mortality in VLBW neonates admitted to a level III neonatal intensive care unit (NICU) at Mahdieh Hospital in Tehran. Methods This cross-sectional retrospective study was performed from April 2007 to March 2010 on all hospitalized VLBW neonates. Relevant pre- and peri-natal data up to the time of discharge from the hospital or death, including complications during the course of hospitalization, were collected from the case notes, documented on a pre-designed questionnaire and analyzed. Findings Out of 13197 neonates, 564 (4.3%) were VLBW with 51.4% males. Mean gestational age was 29.6±2.5 weeks; mean birth weight 1179±257 grams. Mean birth weight, gestational age and Apgar scores were significantly higher in babies who survived than in those who died, (1275±189 vs. 944±253 grams; 30.5±2.2 vs. 27.5±2 weeks and 6.9±1.7 vs. 5±2.1 respectively, P<0.001 in all instances). Overall survival was 70.9%; in extremely low birth weight (ELBW) newborns this figure was 33.3% rising to 84.1% in infants weighing between 1001-1500 grams. Respiratory failure resulting from RDS in ELBW babies was the major factor leading to death. Need for mechanical ventilation, pulmonary hemorrhage and gastro-intestinal bleeding were also significant predictive factors for mortality. Conclusion Birth weight and mechanical ventilation are the major factors predicting VLBW survival. PMID:24800021

Daycare attendance and risk for respiratory morbidity among young very low birth weight children.

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Hagen, Erika W; Sadek-Badawi, Mona; Palta, Mari

2009-11-01

Daycare attendance and very low birth weight (VLBW, < or =1,500 g) are associated with respiratory morbidity during childhood. The objective of this study was to evaluate whether daycare attendance is associated with even higher risk for respiratory problems among VLBW children. We hypothesized that VLBW children attending daycare, in a private home or daycare center, are at higher risk for respiratory problems than VLBW children not attending daycare. We also investigated whether the effect of daycare is independent or synergistic with respiratory risk resulting from being VLBW, as indicated by having bronchopulmonary dysplasia (BPD) as a neonate. We conducted a prospective study of VLBW children followed from birth to age 2-3 (N = 715). Logistic regression was used to evaluate the relationship between daycare attendance and respiratory problems, adjusting for known neonatal risk factors for poor respiratory outcomes. Attending daycare in either a private home or in a daycare center was significantly associated with higher risk of lower respiratory infections than never attending. Attending a daycare center was also associated with higher risk for wheezy chest, cough without a cold, and respiratory medication use. While having BPD was associated with increased risk for respiratory problems, daycare attendance and BPD were not found to be synergistic risk factors for respiratory problems among VLBW children, but acted independently to increase risk. This implies that the increase in risk for respiratory problems associated with daycare attendance may be similar among VLBW children and those of normal birth weight.

Hope in Parents of Very-Low Birth Weight Infants and its Association with Parenting Stress and Quality of Life.

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Nordheim, Trond; Rustøen, Tone; Solevåg, Anne Lee; Småstuen, Milada Cvancarova; Nakstad, Britt

Being a parent of a very-low-birth-weight (VLBW) infant can be stressful. We aimed to describe parental hope 42months after the birth of a VLBW infant and determine whether there is an association between hope and parenting stress with quality of life (QoL), respectively. Fifty-nine parents of VLBW infants completed questionnaires about hope, parenting stress and QoL. Pearson correlation coefficients (r) and linear regression models were used to examine the relationship between the selected variables. To compare groups, t-test was used and Cohen's d for effect size was calculated. Parents of VLBW infants were more hopeful than the general population (phope were both independently associated with QoL (phope (p=0.041) and higher parenting stress (p=0.041) than parents of infants with birth weight 1000-1500g. Hope and parenting stress were both independent determinants of QoL. Parents of the presumably sickest infants had less hope and higher parenting stress than parents of VLBW infants with a birth weight over 1000g. Hope should be further explored as a coping mechanism in parents of VLBW infants. The clinical implications of the strong association between hope, parenting stress and QoL remain to be determined, but reducing stress and strengthening hope seem to be important. This should be taken into account both at hospital discharge and at follow-up, especially for lower-birth-weight infants. Copyright © 2017 Elsevier Inc. All rights reserved.

Postdischarge growth assessment in very low birth weight infants.

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Park, Joon-Sik; Han, Jungho; Shin, Jeong Eun; Lee, Soon Min; Eun, Ho Seon; Park, Min-Soo; Park, Kook-In; Namgung, Ran

2017-03-01

The goal of nutritional support for very-low-birth-weight (VLBW) infants from birth to term is to match the in utero growth rates; however, this is rarely achieved. We evaluated postdischarge growth patterns and growth failure in 81 Korean VLBW infants through a retrospective study. Weight and height were measured and calculated based on age percentile distribution every 3 months until age 24 months. Growth failure was defined as weight and height below the 10th percentile at 24 months. For the subgroup analysis, small-for-gestational age (SGA) and extremely low birth weight (ELBW) infants were evaluated. The growth patterns based on the Korean, World Health Organization (WHO), or Centers for Disease Control and Prevention (CDC) standard were serially compared over time. At postconception age (PCA) 40 weeks, 47 (58%) and 45 infants (55%) showed growth failure in terms of weight and height, respectively. At PCA 24 months, 20 infants (24%) showed growth failure for weight and 14 (18%) for height. Growth failure rates were higher for the SGA infants than for the appropriate-weight-for-gestational age infants at PCA 24 months ( P =0.045 for weight and P =0.038 for height). Growth failure rates were higher for the ELBW infants than for the non-ELBW infants at PCA 24 months ( P <0.001 for weight and P =0.003 for height). Significant differences were found among the WHO, CDC, and Korean standards ( P <0.001). Advancements in neonatal care have improved the catch-up growth of VLBW infants, but this is insufficient. Careful observation and aggressive interventions, especially in SGA and ELBW infants, are needed.

Mental health, quality of life and social relations in young adults born with low birth weight

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Lund Line K

2012-12-01

Full Text Available Abstract Background Being born with low birth weight may have an impact on different aspects of mental health, psychosocial functioning and well-being; however results from studies in young adulthood have so far yielded mixed findings. The aim of this study was to assess the long-term impact in young adulthood on self-reported mental health, health-related quality of life, self-esteem and social relations by investigating differences between two low birth weight groups and a control group. Methods In a follow-up at 20 years of age, 43 preterm VLBW (birth weight ≤ 1500 g, 55 term SGA (birth weight  Results The VLBW and SGA groups reported significantly more mental health problems than controls. The VLBW group predominantly had internalizing problems, and the non-significant association with ASR Total score was reduced by the Intelligence Quotient (IQ. The SGA group had increased scores on both internalizing and externalizing problems, and the association with ASR Total score remained significant after adjusting for IQ in this group. Both low birth weight groups reported less interaction with friends and lower quality of life related to mental health domains than controls. Self-esteem scores were lower than in the control group for athletic competence (VLBW and social acceptance (SGA. Conclusion Our findings suggest that self-reported mental health and well-being in young adulthood may be adversely affected by low birth weight, irrespective of whether this is the result of premature birth or being born SGA at term.

Neonatal treatment philosophy in Dutch and German NICUs: Health-Related Quality of Life in Adulthood of VP/VLBW infants

NARCIS (Netherlands)

Breeman, L.D.|info:eu-repo/dai/nl/390776114; van der Pal, Sylvia; Verrips, Gijsbert; Baumann, Nicole; Bartmann, Peter; Wolke, Dieter

2017-01-01

Purpose. Although survival after very preterm birth (VP) / very low birth weight (VLBW) has improved, a significant number of VP/VLBW individuals develop physical and cognitive problems during their life course that may affect their health-related quality of life (HRQoL). We compared HRQoL in

Use of a computerized C-reactive protein (CRP based sepsis evaluation in very low birth weight (VLBW infants: a five-year experience.

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Sarah A Coggins

Full Text Available Serial C-reactive protein (CRP values may be useful for decision-making regarding duration of antibiotics in neonates. However, established standard of practice for its use in preterm very low birth weight (<1500 g, VLBW infants are lacking.Evaluate compliance with a CRP-guided computerized decision support (CDS algorithm and compare characteristics and outcomes of compliant versus non-compliant cases. Measure correlation between CRPs and white blood count (WBC indices.We examined 3 populations: 1 all preterm VLBW infants born at Vanderbilt 2006-2011 - we assessed provider compliance with CDS algorithm and measured relevant outcomes; 2 all patients with positive blood culture results admitted to the Vanderbilt NICU 2006-2012 - we tested the correlation between CRP and WBC results within 7 days of blood culture phlebotomy; 3 1,000 randomly selected patients out of the 7,062 patients admitted to the NICU 2006-2012 - we correlated time-associated CRP values and absolute neutrophil counts.Of 636 VLBW infants in cohort 1, 569 (89% received empiric antibiotics for suspected early-onset sepsis. In 409 infants (72% the CDS algorithm was followed; antibiotics were discontinued ≤48 hours in 311 (55% with normal serial CRPs and continued in 98 (17% with positive CRPs, resulting in significant reduction in antibiotic exposure (p<0.001 without increase in complications or subsequent infections. One hundred sixty (28% were considered non-compliant because antibiotics were continued beyond 48 hours despite negative serial CRPs and blood cultures. Serial CRPs remained negative in 38 (12% of 308 blood culture-positive infants from cohort 2, but only 4 patients had clinically probable sepsis with single organisms and no immunodeficiency besides extreme prematurity. Leukopenia of any cell type was not linked with CRPs in cohorts 2 and 3.CDS/CRP-guided antibiotic use is safe and effective in culture-negative VLBW infants. CRP results are not affected by low WBC

Growth pattern and final height of very preterm vs. very low birth weight infants

NARCIS (Netherlands)

Hollanders, J.J.; Pal, S.M. van der; Dommelen, P. van; Rotteveel, J.; Finken, M.J.J.

2017-01-01

BackgroundBoth very preterm (VP; i.e., gestational age <32 weeks) and very low birth weight (VLBW; i.e., birth weight <1,500 g) are used as inclusion criteria by studies on preterm birth. We aimed to quantify the impact of these entities on postnatal growth until final height.MethodsSubjects born VP

Joint Attention Development in Low-risk Very Low Birth Weight Infants at Around 18 Months of Age.

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Yamaoka, Noriko; Takada, Satoshi

2016-10-18

The purpose of this study was to clarify the developmental characteristics of joint attention in very low birth weight (VLBW) infants with a low risk of complications. Section B of the Checklist for Autism in Toddlers (CHAT) was administered to 31 VLBW and 45 normal birth weight (NBW) infants aged 18-22 months, while the sessions were recorded with a video camera. A semi-structured observation scale was developed to assess infants' joint attention from the video footage, and was shown to be reliable. VLBW, compared to NBW, infants showed significantly poorer skills in 2 of 4 items on responding to joint attention, and in 6 of 10 items on initiating joint attention. VLBW infants need more clues in order to produce joint attention. The difficulty was attributed to insufficient verbal and fine motor function skills. Continuous follow-up evaluation is essential for both high-risk and low-risk VLBW infants and their parents.

Guidelines for Feeding Very Low Birth Weight Infants

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Sourabh Dutta

2015-01-01

Full Text Available Despite the fact that feeding a very low birth weight (VLBW neonate is a fundamental and inevitable part of its management, this is a field which is beset with controversies. Optimal nutrition improves growth and neurological outcomes, and reduces the incidence of sepsis and possibly even retinopathy of prematurity. There is a great deal of heterogeneity of practice among neonatologists and pediatricians regarding feeding VLBW infants. A working group on feeding guidelines for VLBW infants was constituted in McMaster University, Canada. The group listed a number of important questions that had to be answered with respect to feeding VLBW infants, systematically reviewed the literature, critically appraised the level of evidence, and generated a comprehensive set of guidelines. These guidelines form the basis of this state-of-art review. The review touches upon trophic feeding, nutritional feeding, fortification, feeding in special circumstances, assessment of feed tolerance, and management of gastric residuals, gastro-esophageal reflux, and glycerin enemas.

Effect of hospital nutrition support on growth velocity and nutritional status of low birth weight infants.

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Azzeh, Firas S; Alazzeh, Awfa Y; Dabbour, Ibrahim R; Jazar, Abdelelah S; Obeidat, Ahmed A

2014-10-01

Infants with low birth weights are provided with hospital nutrition support to enhance their survivability and body weights. However, different hospitals have different nutrition support formulas. Therefore, the effectiveness of these nutrition support formulas should be investigated. To assess the effect of hospital nutrition support on growth velocity and nutritional status of low birth weight infants at Al-Noor hospital, Saudi Arabia. A cross-sectional study was conducted between October, 2010 and December, 2012. Three hundred newborns were recruited from Al-Noor Hospital in Makkah city, Saudi Arabia. Infants were selected according to their birth weights and were divided equally into three groups; (i) Low Birth Weight (LBW) infants (1501- 2500 g birth weight), (ii) Very Low Birth Weight (VLBW) infants (1001-1500 g birth weight) and (iii) Extremely Low Birth Weight (ELBW) infants ( 0.05) were observed among groups. Serum calcium, phosphorus and potassium levels at discharge were higher (p < 0.05) than that at birth for ELBW and VLBW groups; while sodium level decreased in ELBW group to be within normal ranges. Albumin level was improved (p < 0.05) in ELBW group. Health care management for low birth weight infants in Al-Noor Hospital was not sufficient to achieve normal growth rate for low birth weight infants, while biochemical indicators were remarkably improved in all groups. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Outcome of Very Low Birth Weight Infants Over 3 Years Report From an Iranian Center

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Afjeh, Seyyed-Abolfazl; Sabzehei, Mohammad-Kazem; Fallahi, Minoo; Esmaili, Fatemeh

2013-01-01

Objective Very low birth weight (VLBW) infants are at high risk for morbidity and mortality. This article determines the frequency of disease, rate od survival, complications and risk factors for morbidity and mortality in VLBW neonates admitted to a level III neonatal intensive care unit (NICU) at Mahdieh Hospital in Tehran. Methods This cross-sectional retrospective study was performed from April 2007 to March 2010 on all hospitalized VLBW neonates. Relevant pre- and peri-natal data up to t...

Cerebral MRI findings in very-low-birth-weight and small-for-gestational-age children at 15 years of age

International Nuclear Information System (INIS)

Skranes, Jon S.; Brubakk, Ann-Mari; Martinussen, Marit; Smevik, Olaug; Myhr, Gunnar; Indredavik, Marit; Vik, Torstein

2005-01-01

A high prevalence of abnormal cerebral MRI findings has been reported in low-birth-weight children. To compare MRI findings in very-low-birth-weight (VLBW) and term small-for-gestational-age (SGA) children with controls in early adolescence. Cerebral MRI was used to examine 55 VLBW, 54 SGA and 66 controls at 15 years of age. The MR images were qualitatively assessed, and size of ventricles, white-matter and grey-matter abnormalities were reported. The VLBW teenagers had a higher prevalence of various MRI abnormalities than SGA children and controls. Dilation of the ventricular system, especially of the occipital horns, was found in 82% of the VLBW group, in 19% of the SGA group and in 21% of controls. White-matter reduction was found in 53% of the VLBW, in 6% of the SGA and in 2% of controls. Corpus callosum thinning was found in 47% of the VLBW, in 2% of the SGA and in 6% of controls. Periventricular gliosis was found in 29% of the VLBW, in 4% of the SGA and in 8% of controls. Cerebral MRI pathology in white matter is a common finding in VLBW teenagers. The findings may indicate minor perinatal PVL with resulting loss of white-matter tissue and ventricular dilation. (orig.)

Trends in birth weight-specific and -adjusted infant mortality rates in Taiwan between 2004 and 2011

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Fu-Wen Liang

2018-06-01

Conclusion: In countries with an increasing proportion of VLBW live births, birth weight-specific or -adjusted IMRs are more appropriate than other indices for accurately assessing the real extent of reduction in IMRs.

[A follow-up on first-year growth and development of 61 very low birth weight preterm infants].

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Deng, Ying; Xiong, Fei; Wu, Meng-Meng; Yang, Fan

2016-06-01

To investigate the physical growth and psychomotor development of very low birth weight (VLBW) preterm infants in the first year after birth and related influencing factors. A total of 61 VLBW preterm infants received growth and development monitoring for 12 months. Z score was used to evaluate parameters for physical growth, and Denver Development Screen Test (DDST) was used for development screening. Among the 61 VLBW preterm infants, 27 (44.3%) were small-for-gestational-age (SGA) infants, and 34 (55.7%) were appropriate-for-gestational-age (AGA) infants. During the 1-year follow-up, the median weight-for-age Z-score (WAZ), height-for-age Z-score (HAZ), head circumference-for-age Z-score (HCZ), and weight-for-height Z score (WHZ) were >-1 SD in all age groups. The peaks of body mass index-for-age Z-score (BAZ) and WHZ appeared at 1 month of corrected age. At a corrected age of 40 weeks, the incidence rates of underweight, growth retardation, emaciation, microcephalus, overweight, and obesity were 15%, 16%, 11%, 13%, 20%, and 10%, respectively. Compared with those with a corrected age of 40 weeks, the infants with a corrected age of 6 months or 9-12 months had a significantly reduced incidence rate of overweight (3%) (P<0.05). Up to 1 year after birth, 15 infants (25%) had abnormal developmental quotient (DQ). The SGA group had a significantly higher incidence rate of abnormal DQ than the AGA group (P<0.05). SGA was the independent risk factor for retarded growth in the first year after birth in VLBW preterm infants. VLBW preterm infants experience an obvious growth deviation within 3 months of corrected age. Within the first year after birth, the proportion of infants with abnormal DQ screened by DDST is high.

A functional approach to cerebral visual impairments in very preterm/very-low-birth-weight children.

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Geldof, Christiaan J A; van Wassenaer-Leemhuis, Aleid G; Dik, Marjolein; Kok, Joke H; Oosterlaan, Jaap

2015-08-01

Cerebral visual impairment (CVI) is a major cause of visual impairment, with very preterm birth/very low birth weight (VP/VLBW) being a major risk factor. There is no generally accepted definition of CVI. This study aims to investigate the usefulness of an empirically-based functional definition of CVI. One-hundred-five VP/VLBW children and 67 controls participated. CVI was defined after comprehensive oculomotor, visual sensory and perceptive assessment, and validated against vision problems in daily life and in terms of intellectual, behavioral, emotional and social functioning, as well as use of therapeutic services. Twenty-four per cent of the VP/VLBW children met criteria for CVI, compared to 7% of controls (P = 0.006, OR: 3.86, 95% CI: 1.40-10.70). VP/VLBW children with CVI had lower performance IQ, but not verbal IQ, than those without CVI. Visual problems in daily life were confirmed in VP/VLBW children classified with CVI. Additionally, difficulties in behavioral and social functioning were most prominent among VP/VLBW children with CVI. In VP/VLBW children, CVI defined in terms of visual function deficits is accompanied by intellectual, behavioral, and social impairments, validating our operational definition of CVI. CVI might act as a marker for developmental problems in VP/VLBW children.

The effect of glutamine-enriched enteral nutrition on intestinal permeability in very-low-birth-weight infants : A randomized controlled trial

NARCIS (Netherlands)

van den Berg, Anemone; Fetter, Willem P. F.; Westerbeek, Elisabeth A. M.; van der Vegt, Ina M.; van der Molen, Hilda R. A.; van Elburg, Ruurd M.

2006-01-01

Background: Very-low-birth-weight (VLBW) infants are susceptible to glutamine depletion. Glutamine depletion has negative effects on intestinal integrity. The lower infection rate in VLBW infants receiving glutamine-enriched enteral nutrition may originate from improved intestinal integrity, as

The effect of glutamine-enriched enteral nutrition on intestinal permeability in very-low-birth-weight infants: A randomized controlled trial

NARCIS (Netherlands)

van den Berg, Anemone; Fetter, Willem P. F.; Westerbeek, Elisabeth A. M.; van der Vegt, Ina M.; van der Molen, Hilda R. A.; van Elburg, Ruurd M.

2006-01-01

Background: Very-low-birth-weight (VLBW) infants are susceptible to glutamine depletion. Glutamine depletion has negative effects on intestinal integrity. The lower infection rate in VLBW infants receiving glutamine-enriched enteral nutrition may originate from improved intestinal integrity, as

Intraventricular Hemorrhage and Post Hemorrhagic Hydrocephalus among Very-Low-Birth-Weight Infants in Korea.

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Ahn, So Yoon; Shim, So-Yeon; Sung, In Kyung

2015-10-01

Here, we aimed to evaluate the incidence and mortality of intraventricular hemorrhage (IVH) and post-hemorrhagic hydrocephalus (PHH) among very-low-birth-weight (VLBW) infants in Korea and assess the associated factors of PHH. This cohort study used prospectively collected data from the Korean Neonatal Network (KNN). Among 2,386 VLBW infants in the KNN database born between January 2013 and June 2014, 63 infants who died without brain ultrasonography results were excluded. Maternal demographics and neonatal clinical characteristics were assessed. The overall incidence of IVH in all the VLBW infants was 42.2% (987 of 2,323), while those of IVH grade 1, 2, 3, and 4 were 25.1%, 7.0%, 4.8%, and 5.5%, respectively. The incidence and severity of IVH showed a negatively correlating trend with gestational age and birth weight. PHH developed in 0%, 3.5%, 36.1%, and 63.8% of the surviving infants with IVH grades 1, 2, 3, and 4, respectively. Overall, in the VLBW infants, the IVH-associated mortality rate was 1.0% (24/2,323). Only IVH grade severity was proven to be an associated with PHH development in infants with IVH grades 3-4. This is the first Korean national report of IVH and PHH incidences in VLBW infants. Further risk factor analyses or quality improvement studies to reduce IVH are warranted.

The emergence of grammar in very-low-birth-weight Finnish children at two years of age.

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Stolt, Suvi; Matomäki, Jaakko; Haataja, Leena; Lapinleimu, Helena; Lehtonen, Liisa

2013-03-01

It is not well understood how grammar emerges in very-low-birth-weight (VLBW) children. The main aim of the present study was to gain information on the emergence of grammar in this group at 2 ; 0. The Finnish version of the Communicative Development Inventory was used to collect data from VLBW children (N = 156) and full-term controls (N = 146). At a group level, the grammatical skills of the VLBW children were significantly weaker than those of the controls. However, when the effect of lexicon size and premature birth on the emergence of grammar was analyzed in detail, few significant differences were found between the groups. The results suggest that even though grammar emerges more slowly for the VLBW children, it emerges in a manner comparable to that of the controls, when the effect of lexicon size is taken into consideration.

Fractional anisotropy in white matter tracts of very-low-birth-weight infants

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Dudink, Jeroen; Conneman, Nikk; Goudoever, Johannes van; Govaert, Paul [Erasmus MC-Sophia Children' s Hospital, Division of Neonatology, Department of Paediatrics, P.O. Box 2060, Rotterdam (Netherlands); Lequin, Maarten [Erasmus MC-Sophia Children' s Hospital, Division of Paediatrics, Department of Radiology, Rotterdam (Netherlands); Pul, Carola van [Maxima Medical Center, Department of Clinical Physics, Veldhoven (Netherlands); Buijs, Jan [Maxima Medical Center, Division of Neonatology, Department of Paediatrics, Veldhoven (Netherlands)

2007-12-15

Advances in neonatal intensive care have not yet reduced the high incidence of neurodevelopmental disability among very-low-birth-weight (VLBW) infants. As neurological deficits are related to white-matter injury, early detection is important. Diffusion tensor imaging (DTI) could be an excellent tool for assessment of white-matter injury. To provide DTI fractional anisotropy (FA) reference values for white-matter tracts of VLBW infants for clinical use. We retrospectively analysed DTI images of 28 VLBW infants (26-32 weeks gestational age) without evidence of white-matter abnormalities on conventional MRI sequences, and normal developmental outcome (assessed at age 1-3 years). For DTI an echoplanar sequence with diffusion gradient (b = 1,000 s/mm{sup 2}) applied in 25 non-collinear directions was used. We measured FA and apparent diffusion coefficient (ADC) of different white-matter tracts in the first 4 days of life. A statistically significant correlation was found between gestational age and FA of the posterior limb of the internal capsule in VLBW infants (r = 0.495, P<0.01). Values of FA and ADC were measured in white-matter tracts of VLBW infants. FA of the pyramidal tracts measured in the first few days after birth is related to gestational age. (orig.)

Fractional anisotropy in white matter tracts of very-low-birth-weight infants

International Nuclear Information System (INIS)

Dudink, Jeroen; Conneman, Nikk; Goudoever, Johannes van; Govaert, Paul; Lequin, Maarten; Pul, Carola van; Buijs, Jan

2007-01-01

Advances in neonatal intensive care have not yet reduced the high incidence of neurodevelopmental disability among very-low-birth-weight (VLBW) infants. As neurological deficits are related to white-matter injury, early detection is important. Diffusion tensor imaging (DTI) could be an excellent tool for assessment of white-matter injury. To provide DTI fractional anisotropy (FA) reference values for white-matter tracts of VLBW infants for clinical use. We retrospectively analysed DTI images of 28 VLBW infants (26-32 weeks gestational age) without evidence of white-matter abnormalities on conventional MRI sequences, and normal developmental outcome (assessed at age 1-3 years). For DTI an echoplanar sequence with diffusion gradient (b = 1,000 s/mm 2 ) applied in 25 non-collinear directions was used. We measured FA and apparent diffusion coefficient (ADC) of different white-matter tracts in the first 4 days of life. A statistically significant correlation was found between gestational age and FA of the posterior limb of the internal capsule in VLBW infants (r = 0.495, P<0.01). Values of FA and ADC were measured in white-matter tracts of VLBW infants. FA of the pyramidal tracts measured in the first few days after birth is related to gestational age. (orig.)

Enhanced nutrition improves growth and increases blood adiponectin concentrations in very low birth weight infants

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Elin W. Blakstad

2016-12-01

Full Text Available Background: Adequate nutrient supply is essential for optimal postnatal growth in very low birth weight (VLBW, birth weight<1,500 g infants. Early growth may influence the risk of metabolic syndrome later in life. Objective: To evaluate growth and blood metabolic markers (adiponectin, leptin, and insulin-like growth factor-1 (IGF-1 in VLBW infants participating in a randomized nutritional intervention study. Design: Fifty VLBW infants were randomized to an enhanced nutrient supply or a standard nutrient supply. Thirty-seven infants were evaluated with growth measurements until 2 years corrected age (CA. Metabolic markers were measured at birth and 5 months CA. Results: Weight gain and head growth were different in the two groups from birth to 2 years CA (weight gain: pinteraction=0.006; head growth: pinteraction=0.002. The intervention group improved their growth z-scores after birth, whereas the control group had a pronounced decline, followed by an increase and caught up with the intervention group after discharge. At 5 months CA, adiponectin concentrations were higher in the intervention group and correlated with weight gain before term (r=0.35 and nutrient supply (0.35≤r≤0.45. Leptin concentrations correlated with weight gain after term and IGF-1 concentrations with length growth before and after term and head growth after term (0.36≤r≤0.53. Conclusion: Enhanced nutrient supply improved early postnatal growth and may have prevented rapid catch-up growth later in infancy. Adiponectin concentration at 5 months CA was higher in the intervention group and correlated positively with early weight gain and nutrient supply. Early nutrition and growth may affect metabolic markers in infancy.Clinical Trial Registration (ClinicalTrials.gov no.: NCT01103219

Impact of a standardized hand hygiene program on the incidence of nosocomial infection in very low birth weight infants.

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Capretti, Maria Grazia; Sandri, Fabrizio; Tridapalli, Elisabetta; Galletti, Silvia; Petracci, Elisabetta; Faldella, Giacomo

2008-08-01

This study examined the effects of a standardized hand hygiene program on the rate of nosocomial infection (NI) in very low birth weight (VLBW) infants (birth weight hand hygiene program was implemented using antimicrobial soap (4% chlorhexidine gluconate) and alcohol-based hand rubs. NI after 72 hours of life was detected in 16 of the 85 VLBW infants in the first period and in 5 of the 80 VLBW infants in the second period. The rate of central venous catheter colonization was significantly lower in the second period (5.8%) than in the first period (16.6%). In our NICU, the incidence of NI in VLBW infants was significantly reduced after the introduction of a standardized handwashing protocol. In our experience, a proper hand hygiene program can save approximately 10 NI episodes/year, at a cost of $10,000 per episode. Therefore, improving hand hygiene practice is a cost-effective program in the NICU.

Very low birth weight piglets show improved cognitive performance in the spatial cognitive holeboard task

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Alexandra eAntonides

2015-02-01

Full Text Available Low birth weight (LBW is common in humans and has been found to cause lasting cognitive and developmental deficits later in life. It is thought that the primary cause is intra-uterine growth restriction due to a shortage of oxygen and nutrients supply to the fetus. Pigs appear to be a good model animal to investigate long-term cognitive effects of LBW, as LBW is common in commercially farmed breeds of pigs. Moreover, pigs are developmentally similar to humans and can be trained to perform complex tasks. In this study, we trained ten very low birth weight (vLBW piglets and their ten normal birth weight (NBW siblings in a spatial cognitive holeboard task in order to investigate long-term cognitive effects of LBW. In this task, four out of sixteen holes contain a hidden food reward, which allows measuring working memory (short-term and reference memory (long-term in parallel. Piglets were trained for 46-54 trials during the acquisition phase, followed by a 20-trial reversal phase in which a different set of four holes was baited. Both groups acquired the task and improved their performance over time. A mixed model repeated measures ANOVA revealed that vLBW piglets showed a better reference memory performance than NBW piglets in both the acquisition and reversal phase. Additionally, the vLBW piglets fell back less in working memory scores than the NBW animals when switched to the reversal phase. These findings are contrary to findings in humans. Moreover, vLBW pigs had lower hair cortisol concentrations than NBW pigs in flank hair at 12 weeks of age. These results could indicate that restricted intra-uterine growth causes compensatory mechanisms to arise in early development that result in beneficial effects for vLBW piglets, increasing their low survival chances in early-life competition.

Very low birth weight piglets show improved cognitive performance in the spatial cognitive holeboard task.

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Antonides, Alexandra; Schoonderwoerd, Anne C; Nordquist, Rebecca E; van der Staay, Franz Josef

2015-01-01

Low birth weight (LBW) is common in humans and has been found to cause lasting cognitive and developmental deficits later in life. It is thought that the primary cause is intra-uterine growth restriction (IUGR) due to a shortage of oxygen and supply of nutrients to the fetus. Pigs appear to be a good model animal to investigate long-term cognitive effects of LBW, as LBW is common in commercially farmed breeds of pigs. Moreover, pigs are developmentally similar to humans and can be trained to perform complex tasks. In this study, we trained ten very low birth weight (vLBW) piglets and their ten normal birth weight (NBW) siblings in a spatial cognitive holeboard task in order to investigate long-term cognitive effects of LBW. In this task, four out of sixteen holes contain a hidden food reward, which allows measuring working memory (WM) (short-term memory) and reference memory (RM) (long-term memory) in parallel. Piglets were trained for 46-54 trials during the acquisition phase, followed by a 20-trial reversal phase in which a different set of four holes was baited. Both groups acquired the task and improved their performance over time. A mixed model repeated measures ANOVA revealed that vLBW piglets showed better RM performance than NBW piglets in both the acquisition and reversal phase. Additionally, WM scores in the vLBW were less disrupted than in the NBW animals when switched to the reversal phase. These findings are contrary to findings in humans. Moreover, vLBW pigs had lower hair cortisol concentrations (HCCs) than NBW pigs in flank hair at 12 weeks of age. These results could indicate that restricted intra-uterine growth causes compensatory mechanisms to arise in early development that result in beneficial effects for vLBW piglets, increasing their low survival chances in early-life competition.

A functional approach to cerebral visual impairments in very preterm/very-low-birth-weight children

NARCIS (Netherlands)

Geldof, C.J.A.; van Wassenaer-Leemhuis, A.G.; Dik, M.; Kok, J.H.; Oosterlaan, J.

2015-01-01

Background:Cerebral visual impairment (CVI) is a major cause of visual impairment, with very preterm birth/very low birth weight (VP/VLBW) being a major risk factor. There is no generally accepted definition of CVI. This study aims to investigate the usefulness of an empirically-based functional

A functional approach to cerebral visual impairments in very preterm/very-low-birth-weight children

NARCIS (Netherlands)

Geldof, Christiaan J. A.; van Wassenaer-Leemhuis, Aleid G.; Dik, Marjolein; Kok, Joke H.; Oosterlaan, Jaap

2015-01-01

Cerebral visual impairment (CVI) is a major cause of visual impairment, with very preterm birth/very low birth weight (VP/VLBW) being a major risk factor. There is no generally accepted definition of CVI. This study aims to investigate the usefulness of an empirically-based functional definition of

Oral Ibuprofen versus Intravenous Indomethacin for Closure of Patent Ductus Arteriosus in Very Low Birth Weight Infants

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Cheng Han Lee

2012-12-01

Conclusion: In infants with VLBW, oral ibuprofen is as effective as intravenous indomethacin for closure of PDA and is associated with significantly fewer cases of necrotizing enterocolitis among infants with birth body weights <1250 g and significantly lower rates of elevated creatinine levels among neonates with birth body weights ranging from 1000 to 1500 g.

Psychological and psychophysiological functioning of young adults born preterm: The Helsinki Study of Very Low Birth Weight Adults

OpenAIRE

Pyhälä, Riikka

2012-01-01

Improvements in neonatal intensive care during the last few decades have led to a remarkable improvement in the survival rates of preterm infants born with very low birth weight (< 1500 g; VLBW). However, VLBW may have a cost for the physical, psychosocial and cognitive development of the survivors. Nevertheless, there has been little research into the long-term consequences of VLBW that last till or emerge in adulthood. In addition, there have been relatively few studies on whether the adult...

Growth in VLBW infants fed predominantly fortified maternal and donor human milk diets: a retrospective cohort study

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Colaizy Tarah T

2012-08-01

Full Text Available Abstract Background To determine the effect of human milk, maternal and donor, on in-hospital growth of very low birthweight (VLBW infants. We performed a retrospective cohort study comparing in-hospital growth in VLBW infants by proportion of human milk diet, including subgroup analysis by maternal or donor milk type. Primary outcome was change in weight z-score from birth to hospital discharge. Methods Retrospective cohort study. Results 171 infants with median gestational age 27 weeks (IQR 25.4, 28.9 and median birthweight 899 g (IQR 724, 1064 were included. 97% of infants received human milk, 51% received > 75% of all enteral intake as human milk. 16% of infants were small-for-gestational age (SGA, th percentile at birth, and 34% of infants were SGA at discharge. Infants fed >75% human milk had a greater negative change in weight z-score from birth to discharge compared to infants receiving 75% human milk, there was no significant difference in change in weight z-score by milk type (donor −0.84, maternal −0.56, mixed −0.45, p = 0.54. Infants receiving >75% donor milk had higher rates of SGA status at discharge than those fed maternal or mixed milk (56% vs. 35% (maternal, 21% (mixed, p = 0.08. Conclusions VLBW infants can grow appropriately when fed predominantly fortified human milk. However, VLBW infants fed >75% human milk are at greater risk of poor growth than those fed less human milk. This risk may be highest in those fed predominantly donor human milk.

Development skills of children born premature with low and very low birth weight.

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Ribeiro, Camila da Costa; Pachelli, Mariane Regina de Oliveira; Amaral, Natalie Camillo de Oliveira; Lamônica, Dionísia Aparecida Cusin

2017-01-30

To compare the performance of children born premature with low birth weight (LBW) and very low birth-weight (VLBW) with that of children born at term, within the age range of one to three years, regarding child development in the gross motor, fine motor-adaptive, personal-social and language domains. This is a cross-sectional study in a cohort of 150 infants born premature (experimental group) and at term (control group) divided into eight groups with respect to weight (low birth weight: motor, fine motor-adaptive, personal-social and language domains. In this study, the preterm groups presented different performances, i.e., normative, average, and below average performances were observed within the same group.

Evaluation of very low birth weight (≤ 1,500 g) as a risk indicator for sensorineural hearing loss.

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Borkoski-Barreiro, Silvia A; Falcón-González, Juan C; Limiñana-Cañal, José M; Ramos-Macías, Angel

2013-01-01

Hearing plays an essential role in the acquisition, development and maintenance of the properties of the speech and language. Birth weight is an indicator of biological maturation of the newborn. Premature newborns with very low birth weight (VLBW<1,500 g) constitute a group with the highest risk of sensorineural hearing loss. Our objective was to ascertain the degree of hearing loss, sensorineural hearing loss and presence of the association to other risk factors for hearing loss in VLBW infants included in the Universal Hearing Loss Screening Programme at the University Mother-Child Hospital of Gran Canaria (Spain) in the 2007-2010 period. This was a retrospective study of 364 infants with VLBW, measured by transient evoked otoacoustic emissions and auditory brainstem response. There were 112 newborn (30.8%) referred for auditory brainstem response. A diagnosis of hearing loss was given to 22 newborns (2.2%), 14 had conductive hearing loss and 8, sensorineural hearing loss (SNHL), of which 2 had bilateral profound hearing loss. The VLBW newborn presented the association to another risk factor in more than a quarter of the sample studied. All those diagnosed with SNHL were premature. The percentage of VLBW newborns diagnosed with hearing loss is higher than expected in the general population. All those diagnosed with SNHL were premature and presented one or 2 hearing risk factors associated with VLBW. Copyright © 2013 Elsevier España, S.L. All rights reserved.

VitaminA, E, and D deficiencies in tunisian very low birth weight neonates: prevalence and risk factors.

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Fares, Samira; Sethom, Mohamed Marouane; Khouaja-Mokrani, Chahnez; Jabnoun, Sami; Feki, Moncef; Kaabachi, Naziha

2014-06-01

Preterm neonates are at high risk of vitamin deficiencies, which may expose them to increased morbidity and mortality. This study aimed to determine the prevalence and risk factors for vitamin A, E, and D deficiencies in Tunisian very low birth weight (VLBW) neonates. A total of 607 VLBW and 300 term neonates were included in the study. Plasma vitamins A and E were assessed by high performance liquid chromatography and vitamin D was assessed by radioimmunoassay. Prevalence of vitamin A, E, and D deficiencies were dramatically elevated in VLBW neonates and were significantly higher than term neonates (75.9% vs. 63.3%; 71.3% vs. 55.5%; and 65.2% vs. 40.4%, respectively). In VLBW neonates, the prevalence of vitamin deficiencies was significantly higher in lower classes of gestational age and birth weight. Vitamin E deficiency was associated with pre-eclampsia [odds ratio (OR) (95% confidence interval, 95% CI), 1.56 (1.01-2.44); p < 0.01] and gestational diabetes [4.01 (1.05-17.0); p < 0.01]. Vitamin D deficiency was associated with twin pregnancy [OR (95% CI), 2.66 (1.33-5.35); p < 0.01] and pre-eclampsia [2.89 (1.36-6.40); p < 0.01]. Vitamin A, E, and D deficiencies are very common in Tunisian VLBW neonates and are associated with pre-eclampsia. Improved nutritional and health support for pregnant women and high dose vitamins A, E, and D supplementation in VLBW neonates are strongly required in Tunisia. Copyright © 2013. Published by Elsevier B.V.

Early working memory and maternal communication in toddlers born very low birth weight.

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Lowe, Jean; Erickson, Sarah J; Maclean, Peggy; Duvall, Susanne W

2009-04-01

Early working memory is emerging as an important indicator of developmental outcome predicting later cognitive, behavioural and academic competencies. The current study compared early working memory in a sample of toddlers (18-22 months) born very low birth weight (VLBW; n = 40) and full term (n = 51) and the relationship between early working memory, mental developmental index (MDI), and maternal communication in both samples. Early working memory, measured by object permanence; Bayley mental developmental index; and maternal communication, coded during mother-toddler play interaction, were examined in 39 toddlers born VLBW and 41 toddlers born full term. Toddlers born VLBW were found to be 6.4 times less likely to demonstrate attainment of object permanence than were toddlers born full term, adjusting for age at testing. MDI and maternal communication were found to be positively associated with attainment of object permanence in the VLBW group only. The difference found in the early working memory performance of toddlers born VLBW, compared with those born full term, emphasizes the importance of assessing early working memory in at-risk populations, while the maternal communication finding highlights potential targets of intervention for improving working memory in toddlers born VLBW.

[Effect of extensively hydrolyzed formula on growth and development of infants with very/extremely low birth weight].

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Gu, Chun-Yan; Jiang, Hui-Fen; Wang, Jin-Xiu

2017-08-01

To study the effect of extensively hydrolyzed formula on the growth and development in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants. A total of 375 VLBW or ELBW infants were enrolled and divided into an observation group (187 infants) and a control group (188 infants) using a random number table. The infants in the observation group were given extensively hydrolyzed formula, and when the amount of extensively hydrolyzed formula reached 10 mL/time, it was changed to the standard formula for preterm infants. The infants in the control group were given standard formula for preterm infants. Both groups were fed for 4 consecutive weeks and were compared in terms of incidence rate of feeding intolerance, time to establish full enteral feeding, time to complete meconium excretion, number of spontaneous bowel movements, growth and development, motilin level at 4 and 10 days after feeding, and incidence rate of infection. Compared with the control group, the observation group had a lower rate of feeding intolerance (Pdevelopment, and reduce the incidence of infection in VLBW and ELBW infants.

Lower conditioning leisure-time physical activity in young adults born preterm at very low birth weight.

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Nina Kaseva

Full Text Available BACKGROUND: Adults born preterm at very low birth weight (VLBW, <1500 g have elevated levels of risk factors for cardiovascular diseases and type 2 diabetes. Preliminary observations suggest that this could partly be explained by lower rates of physical activity. The aim of this study was to assess physical activity in healthy young adults born preterm at very low birth weight compared with term-born controls. METHODOLOGY/PRINCIPAL FINDINGS: We studied 94 unimpaired young adults, aged 21-29 years, born at VLBW and 101 age-, sex-, and birth hospital-matched term-born controls from one regional center in Southern Finland. The participants completed a validated 30-item 12-month physical activity questionnaire and the NEO-Personality Inventory based on the Big Five taxonomy, the most commonly used classification of personality traits. Yearly frequency, total time, total volume and energy expenditure of conditioning and non-conditioning leisure-time physical activity (LTPA and commuting physical activity were compared between VLBW and term-born subjects. A subset of participants underwent dual-energy x-ray absorptiometry for body composition measurement. Data were analyzed by multiple linear regression. Compared with controls, VLBW participants had lower frequency [-38.5% (95% CI; -58.9, -7.7], total time [-47.4% (95% CI; -71.2, -4.1], total volume [-44.3% (95% CI; -65.8, -9.2] and energy expenditure [-55.9% (95% CI; -78.6, -9.4] of conditioning LTPA when adjusted for age, sex, body mass index, smoking, parental education and personality traits. Adjusting for lean body mass instead of body mass index attenuated the difference. There were no differences in non-conditioning LTPA or commuting physical activity. CONCLUSIONS/SIGNIFICANCE: Compared with term-born controls, unimpaired VLBW adults undertake less frequent LTPA with lower total time and volume of exercise resulting in lower energy expenditure. Differences in personality that exist between the

Personality of young adults born prematurely: the Helsinki study of very low birth weight adults.

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Pesonen, Anu-Katriina; Räikkönen, Katri; Heinonen, Kati; Andersson, Sture; Hovi, Petteri; Järvenpää, Anna-Liisa; Eriksson, Johan G; Kajantie, Eero

2008-06-01

Today, the first generations of very low birth weight (VLBW personality traits, associated with both psychopathological vulnerability and resilience. In this cohort study we compared personality traits among young adults (age range 18 to 27 years, mean 21.4, SD 2.19) with VLBW (n = 158) with those of term-born controls (n = 168) of same gender, age, and maternity hospital. The participants completed the Neo-Personality Inventory. Of the five main traits, the VLBW participants scored significantly higher in conscientiousness (MD .1, 95% CI .0 to .3; p personality profiles among the VLBW subjects (p assessment, parental education, individual school grade average, and maternal pre-eclampsia and smoking during pregnancy. Young adults born with VLBW showed markedly different personality traits compared with their controls. The VLBW group displayed less negative emotions, were more dutiful and cautious, and displayed more warmth in their social relationships than their term-born peers. We present two potential mechanisms underlying these findings. The first relates to parental influences and the other to evidence linking biological mechanisms associated with prematurity with personality characteristics in adulthood.

Influence of catch-up growth on abdominal fat distribution in very low birth weight children - cohort study.

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Alves, João Guilherme; Vasconcelos, Sarita Amorim; de Almeida, Tais Sá; Lages, Raquel; Just, Eduardo

2015-01-01

A rapid catch-up growth in very low birth weight has been associated both with a higher height growth and a higher risk to metabolic disturbances, including insulin resistance and its consequences. Abdominal fat distribution in early postnatal life may play a role in these outcomes and can help in addressing this neonatal dilemma. This study aimed to compare abdominal fat distribution among very low birth weight (VLBW) children with and without rapid catch-up growth. A cohort study followed 86 VLBW (children born in Brazil, during the first 3 years of life. Rapid catch-up growth was considered as an increased in length >2 Z score during the first year of life. Abdominal subcutaneous and preperitoneal fat thickness was determined by ultrasound. χ²-Test and Student's t-test were used to compare the groups. A total of 79 VLBW children completed the study, of whom 22 (27.8%) showed rapid catch-up growth. Abdominal subcutaneous and preperitoneal fat thickness showed no differences among children with or without rapid catch-up growth at 3.3 mm vs. 3.8 mm, respectively (p=0.79) and 4.0 mm vs. 4.0 mm (p=0.55), respectively. VLBW children with rapid catch-up growth were also taller. Rapid catch-up growth during the first year of life in VLBW children does not seem to change abdominal fat distribution until the third year of life.

Serum cortisol values, superior vena cava flow and illness severity scores in very low birth weight infants.

LENUS (Irish Health Repository)

Miletin, J

2012-02-01

OBJECTIVE: Recent evidence suggests that high cortisol concentrations are associated with increased morbidity and mortality in very low birth weight (VLBW) infants. Neonatal illness severity and mortality risk scores are reliable in predicting morbidity and mortality. The objectives were (i) to assess the correlation between serum cortisol levels and clinical assessment of multi-organ dysfunction\\/illness severity scores (CRIB II, SNAPPE-II and neonatal multiple organ dysfunction score (NEOMOD)) in first 24 h in VLBW infants and (ii) to assess the relationship between surrogates of end organ blood flow and serum cortisol levels. STUDY DESIGN: A prospective observational cohort study. Neonates with birth weight <1500 g were eligible for enrollment. Echocardiography evaluation of superior vena cava (SVC) flow was carried out in the first 24 h life. Cortisol levels were measured simultaneously and appropriate clinical scores were calculated. RESULT: A total of 54 VLBW neonates were enrolled following parental consent. Two patients were excluded because of congenital malformations. In 14 babies the cortisol value was not simultaneously obtained. The mean birth weight was 1.08 kg, mean gestational age was 27.8 weeks. There was a significant correlation between cortisol and NEOMOD score (P=0.006). There was no correlation between cortisol and CRIB II score (P=0.34), SVC flow (P=0.49) and mean arterial blood pressure respectively (P=0.35). CONCLUSION: There was no correlation between SVC flow and cortisol values or between cortisol and mean blood pressure values. There was a significant correlation between cortisol levels and neonatal organ dysfunction score evaluated suggesting that stressed VLBW infants do mount a cortisol response.

Meta-analysis of neurobehavioral outcomes in very preterm and/or very low birth weight children

NARCIS (Netherlands)

C.S.H. Aarnoudse-Moens (Cornelieke); N. Weisglas-Kuperus (Nynke); J.B. van Goudoever (Hans); J. Oosterlaan (Jaap)

2009-01-01

textabstractOBJECTIVE: Sequelae of academic underachievement, behavioral problems, and poor executive function (EF) have been extensively reported for very preterm (≤33 weeks' gestation) and/or very low birth weight (VLBW) (≤1500 g) children. Great variability in the published results, however,

Diurnal Cortisol Patterns and Dexamethasone Suppression Test Responses in Healthy Young Adults Born Preterm at Very Low Birth Weight.

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Nina Kaseva

Full Text Available Early life stress, such as painful and stressful procedures during neonatal intensive care after preterm birth, can permanently affect physiological, hormonal and neurobiological systems. This may contribute to altered programming of the hypothalamic-pituitary-adrenal axis (HPAA and provoke changes in HPAA function with long-term health impacts. Previous studies suggest a lower HPAA response to stress in young adults born preterm compared with controls born at term. We assessed whether these differences in HPAA stress responsiveness are reflected in everyday life HPAA functioning, i.e. in diurnal salivary cortisol patterns, and reactivity to a low-dose dexamethasone suppression test (DST, in unimpaired young adults born preterm at very low birth weight (VLBW; <1500 g.The participants were recruited from the Helsinki Study of Very Low Birth Weight Adults cohort study. At mean age 23.3 years (2.1 SD, 49 VLBW and 36 controls born at term participated in the study. For cortisol analyzes, saliva samples were collected on two consecutive days at 0, 15, 30 and 60 min after wake-up, at 12:00 h, 17:00 h and 22:00 h. After the last salivary sample of the first study day the participants were instructed to take a 0.5 mg dexamethasone tablet.With mixed-effects model no difference was seen in overall diurnal salivary cortisol between VLBW and control groups [13.9% (95% CI: -11.6, 47.0, P = 0.31]. Salivary cortisol increased similarly after awakening in both VLBW and control participants [mean difference -2.9% (29.2, 33.0, P = 0.85]. Also reactivity to the low-dose DST (awakening cortisol ratio day2/day1 was similar between VLBW and control groups [-1.1% (-53.5, 103.8, P = 0.97].Diurnal cortisol patterns and reactivity to a low-dose DST in young adulthood were not associated with preterm birth.

Neonatal treatment philosophy in Dutch and German NICUs: health-related quality of life in adulthood of VP/VLBW infants.

Science.gov (United States)

Breeman, Linda D; van der Pal, Sylvia; Verrips, Gijsbert H W; Baumann, Nicole; Bartmann, Peter; Wolke, Dieter

2017-04-01

Although survival after very preterm birth (VP)/very low birth weight (VLBW) has improved, a significant number of VP/VLBW individuals develop physical and cognitive problems during their life course that may affect their health-related quality of life (HRQoL). We compared HRQoL in VP/VLBW cohorts from two countries: The Netherlands (n = 314) versus Germany (n = 260) and examined whether different neonatal treatment and rates of disability affect HRQoL in adulthood. To analyse whether cohorts differed in adult HRQoL, linear regression analyses were performed for three HRQoL outcomes assessed with the Health Utilities Index 3 (HUI3), the London Handicap Scale (LHS), and the WHO Quality of Life instrument (WHOQOL-BREF). Stepwise hierarchical linear regression was used to test whether neonatal physical health and treatment, social environment, and intelligence (IQ) were related to VP/VLBW adults' HRQoL and cohort differences. Dutch VP/VLBW adults reported a significantly higher HRQoL on all three general HRQoL measures than German VP/VLBW adults (HUI3: .86 vs .83, p = .036; LHS: .93 vs. .90, p = .018; WHOQOL-BREF: 82.8 vs. 78.3, p life.

Intraventricular hemorrhage risk factors in very low birth weight newborns: a case-control study

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Laura Martins

2009-09-01

Full Text Available Objective: Identification of variables that affect the risk of severe intraventricular hemorrhage (IVH in very low birth weight (VLBW newborns. Methods: Analytic case-control study, in a population consisting of all VLBW newborns admitted to the Neonatal Intensive Care Unit of a maternity hospital, between January 2002 and December 2007. The authors considered as cases all VLBW newborns with severe IVH (grade ≥ 3, and control all VLBW newborns without IVH. Independent variables included obstetric, perinatal and neonatal diagnosis and therapy. Bivariate analysis and multivariate logistic regression analysis were performed. Rresults: During this period, of the 864 VLBW newborns admitted to the Neonatal Intensive Care Unit, 9.7% had severe IVH. With bivariate analysis an association between severe IVH, gestational age and birth weight was found. Prenatal care and pre-eclampsia were associated with a decrease in the incidence of severe IVH. Amnionitis, being outborn, vaginal delivery, male gender, intubation in the delivery room, surfactant, hyaline membrane disease, pneumothorax, necrotizing enterocolitis (NEC perforation and oscillatory high frequency ventilation were associated with an increased incidence of severe IVH. By multivariate logistic regression, the variables associated with increased risk of severe IVH were: pneumothorax (OR = 3.8; 95%CI = 1.7-8.3, NEC with perforation (OR = 8.8; 95%CI = 1.7-45.0, vaginal delivery (OR = 2.0; 95%CI = 1.0-4.1 and high frequency ventilation (OR = 4.8; 95%CI = 1.3-17.3. The following were protective of severe IVH: gestational age (OR = 0.61; 95%CI = 0.52-0.72, patent ductus arteriosus treatment with indomethacin (OR = 0.26; 95%CI = 0.11-0.6 and fertility treatment (OR = 0.24; 95%CI = 0.06-0.94. Cconclusion: These data outline the importance of improvement of pre and neonatal care to reduce severe IVH.

Relationship Between Perinatal and Neonatal Indices and Intelligence Quotient in Very Low Birth Weight Infants at the Age of 6 or 8 Years

OpenAIRE

Mu, Shu-Chi; Lin, Cheng-Hui; Chen, Yi-Ling; Chang, Chia-Han; Tsou, Kuo-Inn

2008-01-01

The majority of children born with very low birth weight (VLBW; < 1500 g) enter mainstream schools. They experience significant neurodevelopmental disabilities during childhood. The specific aims of our study were to evaluate the neonatal outcomes of VLBW infants and whether they would influence intelligence quotient (IQ), cognitive function and learning disabilities at the age of 6 or 8 years. Methods: We enrolled VLBW neonates who weighed less than 1500 g and who were delivered at Shin-K...

Extensive cardiopulmonary resuscitation for VLBW and ELBW infants: a systematic review and meta-analyses.

Science.gov (United States)

Shah, P S

2009-10-01

Studies of the outcomes of preterm infants after the receipt of extensive cardiopulmonary resuscitation (CPR) at birth or in the neonatal intensive care units (NICUs) have yielded varied results. A systematic review of the outcomes of very low birth weight (VLBW) and extremely low birth weight (ELBW) infants who received extensive resuscitation at birth or in the NICU was carried out. MEDLINE, EMBASE, CINAHL databases were searched for studies of extensive CPR in the delivery room (DR-CPR) and in NICU (NICU-CPR) that have reported neonatal or long-term outcomes. A total of 20 eligible studies were identified (11 of DR-CPR, 7 of NICU-CPR and 2 had combined data). DR-CPR was associated with an increased risk of mortality (odds ratio (OR) 2.83, 95% confidence interval (CI) 1.92, 4.16) and severe neurological injury (OR 2.27, 95% CI 1.40, 3.67) compared with infants who did not receive extensive CPR. NICU-CPR was associated with an increased risk of mortality (OR 55, 95% CI 15, 195) compared with infants who did not receive CPR; however, confidence limits were wide. The long-term outcome of survivors was reported in a limited number of studies. Extensive CPR at birth or in the NICU for VLBW or ELBW infants was associated with higher risk of mortality.

Growth in VLBW infants fed predominantly fortified maternal and donor human milk diets: a retrospective cohort study

Science.gov (United States)

2012-01-01

Background To determine the effect of human milk, maternal and donor, on in-hospital growth of very low birthweight (VLBW) infants. We performed a retrospective cohort study comparing in-hospital growth in VLBW infants by proportion of human milk diet, including subgroup analysis by maternal or donor milk type. Primary outcome was change in weight z-score from birth to hospital discharge. Methods Retrospective cohort study. Results 171 infants with median gestational age 27 weeks (IQR 25.4, 28.9) and median birthweight 899 g (IQR 724, 1064) were included. 97% of infants received human milk, 51% received > 75% of all enteral intake as human milk. 16% of infants were small-for-gestational age (SGA, 75% human milk had a greater negative change in weight z-score from birth to discharge compared to infants receiving human milk fortifier was related to human milk intake (p = 0.04). Among infants receiving > 75% human milk, there was no significant difference in change in weight z-score by milk type (donor −0.84, maternal −0.56, mixed −0.45, p = 0.54). Infants receiving >75% donor milk had higher rates of SGA status at discharge than those fed maternal or mixed milk (56% vs. 35% (maternal), 21% (mixed), p = 0.08). Conclusions VLBW infants can grow appropriately when fed predominantly fortified human milk. However, VLBW infants fed >75% human milk are at greater risk of poor growth than those fed less human milk. This risk may be highest in those fed predominantly donor human milk. PMID:22900590

Glycerin Suppositories Use in Very Low Birth Weight Infants.

Science.gov (United States)

Patel, Shalinkumar; Dereddy, Narendra; Talati, Ajay J; Gaston, Kan; Dhanireddy, Ramasubbareddy

2017-01-01

Objective  To study the characteristics of very low birth weight (VLBW) infants receiving glycerin suppositories (GS) and evaluate the association of GS use with outcomes. Study Design  This is a retrospective study of VLBW infants admitted to a level III neonatal intensive care unit. Infants with birth weight between 500 and 1,499 g were evaluated. We evaluated the frequency of GS use and compared the characteristics and outcomes of the GS group with the no-GS group. Multivariate analyses controlling for gestational age and small for gestational age status were performed to study the effect of GS on outcomes. Results  A total of 1,073 infants were included in the study. Out of those, 527 (49.1%) infants received GS. Incidence of necrotizing enterocolitis was not significantly different between the two groups, while days to reach full enteral feeds and length of hospital stay were significantly longer in the GS group. Conclusion  Frequent use of GS warrants further prospective studies to evaluate its safety and efficacy in view of our study showing association with longer time to reach full enteral feeds. We speculate that GS use could be a marker for gastrointestinal dysmotility and hence the association with unfavorable clinical outcomes. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Disparities in Perinatal Quality Outcomes for Very Low Birth Weight Infants in Neonatal Intensive Care

Science.gov (United States)

Lake, Eileen T; Staiger, Douglas; Horbar, Jeffrey; Kenny, Michael J; Patrick, Thelma; Rogowski, Jeannette A

2015-01-01

Objective To determine if hospital-level disparities in very low birth weight (VLBW) infant outcomes are explained by poorer hospital nursing characteristics. Data Sources Nurse survey and VLBW infant registry data. Study Design Retrospective study of 8,252 VLBW infants in 98 Vermont Oxford Network hospital neonatal intensive care units (NICUs) nationally. NICUs were classified into three groups based on their percent of infants of black race. Two nurse-sensitive perinatal quality standards were studied: nosocomial infection and breast milk. Data Collection Primary nurse survey (N = 5,773, 77 percent response rate). Principal Findings VLBW infants born in high-black concentration hospitals had higher rates of infection and discharge without breast milk than VLBW infants born in low-black concentration hospitals. Nurse understaffing was higher and practice environments were worse in high-black as compared to low-black hospitals. NICU nursing features accounted for one-third to one-half of the hospital-level health disparities. Conclusions Poorer nursing characteristics contribute to disparities in VLBW infant outcomes in two nurse-sensitive perinatal quality standards. Improvements in nursing have potential to improve the quality of care for seven out of ten black VLBW infants who are born in high-black hospitals in this country. PMID:25250882

Effects of a Birth Hospital's Neonatal Intensive Care Unit Level and Annual Volume of Very Low-Birth-Weight Infant Deliveries on Morbidity and Mortality.

Science.gov (United States)

Jensen, Erik A; Lorch, Scott A

2015-08-01

The annual volume of deliveries of very low-birth-weight (VLBW) infants has a greater effect on mortality risk than does neonatal intensive care unit (NICU) level. The differential effect of these hospital factors on morbidity among VLBW infants is uncertain. To assess the independent effects of a birth hospital's annual volume of VLBW infant deliveries and NICU level on the risk of several neonatal morbidities and morbidity-mortality composite outcomes that are predictive of future neurocognitive development. Retrospective, population-based cohort study (performed in 2014) of all VLBW infants without severe congenital anomalies delivered in all hospitals in California, Missouri, and Pennsylvania between January 1, 1999, and December 31, 2009 (N = 72,431). Risk-adjusted odds ratios and risk-adjusted probabilities were determined by logistic regression. The primary study outcomes were the individual composites of death or bronchopulmonary dysplasia, necrotizing enterocolitis, retinopathy of prematurity, and severe intraventricular hemorrhage. Among the 72,431 VLBW infants in the present study, birth at a hospital with 10 or less deliveries of VLBW infants per year was associated with the highest risk-adjusted probability of death (15.3% [95% CI, 14.4%-16.3%]), death or severe intraventricular hemorrhage (17.5% [95% CI, 16.5%-18.6%]), and death or necrotizing enterocolitis (19.3% [95% CI, 18.1%-20.4%]). These complications were also more common among infants born at hospitals with a level I or II NICU compared with infants delivered at hospitals with a level IIIB/C NICU. The risk-adjusted probability of death or retinopathy of prematurity was highest among infants born at hospitals with a level IIIB/C NICU and lowest among infants born at hospitals with a level IIIA NICU. When the effects of NICU level and annual volume of VLBW infant deliveries were evaluated simultaneously, the annual volume of deliveries was the stronger contributor to the risk of death, death or

Association of late-onset neonatal sepsis with late neurodevelopment in the first two years of life of preterm infants with very low birth weight

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Claudia Regina Hentges

2014-01-01

Full Text Available OBJECTIVE: To establish the influence of late-onset sepsis on neurodevelopment of preterm infants with very low birth weight (VLBW, according to the etiologic agent METHOD: This was a cohort of newborns with birth weight < 1,500 g and gestational age less than 32 weeks, admitted to the institutional intensive care unit (ICU with up to 48 hours of life, and followed-up at the outpatient follow-up clinic for preterm infants with VLBW until 2 years of corrected age. Exclusion criteria: death within the first 72 hours of life, congenital malformations and genetic syndromes, children with congenital infection by the human immunodeficiency virus (HIV, congenital infection (STORCH, presence of early-onset spesis and cases with more than one pathogen growth in blood cultures. Septic and non-septic infants were compared regarding neonatal outcomes and mortality. Neurodevelopment was assessed using the Bayley Scale (BSDI-II at 18 to 24 months of corrected age. RESULTS: 411 preterm infants with VLBW were eligible; the mean gestational age was 29 ± 2.2 weeks and mean birth weight was 1,041 ± 281grams. Late-onset sepsis occurred in 94 preterm infants with VLBW (22.8%. VLBW infants with Gram-positive infection showed motor deficit when compared to the non-septic group, 68.8% vs. 29.3%, respectively (OR 6; 1.6-21.8, p = 0.006; the cognitive development was similar between the groups. The overall mortality rate from infection was 26.7%; considering the pathogens, the rates were 18.7% for coagulase-negative Staphylococcus, 21.8% for Gram-positive bacteria, and 50% for Gram-negative bacteria and fungi. CONCLUSION: Neonatal sepsis has a significant influence on late neurodevelopment at 2 years of corrected age in preterm infants with VLBW, and Gram-positive infections are associated with motor deficit.

Association of late-onset neonatal sepsis with late neurodevelopment in the first two years of life of preterm infants with very low birth weight.

Science.gov (United States)

Hentges, Cláudia Regina; Silveira, Rita C; Procianoy, Renato Soibelmann; Carvalho, Clarissa Gutierrez; Filipouski, Gabriela Ribeiro; Fuentefria, Rubia Nascimento; Marquezotti, Fernanda; Terrazan, Ana Carolina

2014-01-01

To establish the influence of late-onset sepsis on neurodevelopment of preterm infants with very low birth weight (VLBW), according to the etiologic agent. This was a cohort of newborns with birth weight<1,500 g and gestational age less than 32 weeks, admitted to the institutional intensive care unit (ICU) with up to 48 hours of life, and followed-up at the outpatient follow-up clinic for preterm infants with VLBW until 2 years of corrected age. death within the first 72 hours of life, congenital malformations and genetic syndromes, children with congenital infection by the human immunodeficiency virus (HIV), congenital infection (STORCH), presence of early-onset sepsis and cases with more than one pathogen growth in blood cultures. Septic and non-septic infants were compared regarding neonatal outcomes and mortality. Neurodevelopment was assessed using the Bayley Scale (BSDI-II) at 18 to 24 months of corrected age. 411 preterm infants with VLBW were eligible; the mean gestational age was 29 ± 2.2 weeks and mean birth weight was 1,041 ± 281 grams. Late-onset sepsis occurred in 94 preterm infants with VLBW (22.8%). VLBW infants with Gram-positive infection showed motor deficit when compared to the non-septic group, 68.8% vs. 29.3%, respectively (OR 6; 1.6-21.8, p=0.006); the cognitive development was similar between the groups. The overall mortality rate from infection was 26.7%; considering the pathogens, the rates were 18.7% for coagulase-negative Staphylococcus, 21.8% for Gram-positive bacteria, and 50% for Gram-negative bacteria and fungi. Neonatal sepsis has a significant influence on late neurodevelopment at 2 years of corrected age in preterm infants with VLBW, and Gram-positive infections are associated with motor deficit. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Prevalence of and risk factors for cranial ultrasound abnormalities in very-low-birth-weight infants at Charlotte Maxeke Johannesburg Academic Hospital

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Azra Ghoor

2017-07-01

Full Text Available Background. Periventricular-intraventricular haemorrhage (IVH and cystic periventricular leukomalacia (cPVL contribute to neonatal mortality and morbidity. Low birth weight and gestational age are among the risk factors for IVH and cPVL. Objectives. To assess how many very low birth weight (VLBW infants had cranial ultrasound screening at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH and to determine the prevalence of cranial ultrasound abnormalities. To compare the characteristics and risk factors of those VLBW infants with cranial ultrasound abnormalities to those with normal cranial ultrasound findings. Methods. This was a retrospective case-controlled study of infants <1 500 g admitted to CMJAH from 1 January 2013 to 31 December 2015. Cases were identified as infants with IVH or cPVL. Controls were matched 1:2 based on birth weight and gender. Results. Only 55% (856/1 562 of VLBW infants had undergone cranial ultrasound screening. The final sample included 803 VLBW infants. IVH was identified in 26.7% of cases (n=215; 95% confidence interval (CI 23.8 - 29.9 and 0.9% had cPVL (n=8; 95% CI 0.5 - 1.9. A total of 197 cases were identified and matched with 394 controls. Antenatal care attendance was lower in the cases (71% v. 79%; p=0.039. Sepsis, ventilation, metabolic acidosis and patent ductus arteriosus were all significantly higher in the cases. The use of antenatal steroids was significantly higher in the grades I - II IVH/no-IVH group v. grades III - IV IVH group (44% v. 25%; p=0.017. Conclusion. The prevalence of IVH in our setting was consistent with that of developed countries. Improving antenatal care, infection control, and adequate early resuscitation could decrease the incidence of IVH and cPVL. All VLBW infants should undergo cranial ultrasound screening

Cerebral tissue oxygenation index and superior vena cava blood flow in the very low birth weight infant.

LENUS (Irish Health Repository)

Moran, M

2012-02-01

BACKGROUND: Superior vena cava (SVC) flow assesses blood flow from the upper body, including the brain. Near infrared spectroscopy (NIRS) provides information on brain perfusion and oxygenation. AIM: To assess the relationship between cerebral tissue oxygenation index (cTOI) and cardiac output measures in the very low birth weight (VLBW) infant in the first day of life. METHODS: A prospective observational cohort study. Neonates with birth weight less than 1500 g (VLBW) were eligible for enrollment. Newborns with congenital heart disease, major congenital malformations and greater than Papile grade1 Intraventricular Haemorrhage on day 1 of life were excluded. Echocardiographic evaluation of SVC flow was performed in the first 24 h of life. Low SVC flow states were defined as a flow less than 40 mL\\/kg\\/min. cTOI was measured using NIRO 200 Hamamatsu. RESULTS: Twenty-seven VLBW neonates had both echocardiography and NIRS performed. The median (range) gestation was 29\\/40 (25 + 3 to 31 + 5 weeks) and median birth weight was 1.2 kg (0.57-1.48 kg). The mean (SD) TOI was 68.1 (7.9)%. The mean (SD) SVC flow was 70.36(39.5) mLs\\/kg\\/min. The correlation coefficient of cerebral tissue oxygenation and SVC flow was r = 0.53, p-value 0.005. There was a poor correlation between right and left ventricular output and cTOI which is not surprising considering the influence of intra- and extracardiac shunts. CONCLUSION: There is a positive relationship between cerebral TOI values and SVC flow in the very low birth infant on day one of life.

Short- and Long-Term Outcomes in Very Low Birth Weight Infants with Admission Hypothermia.

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Hung-Yang Chang

Full Text Available Neonatal hypothermia remains a common problem and is related to elevated morbidities and mortality. However, the long-term neurodevelopmental effects of admission hypothermia are still unknown. This study attempted to determine the short-term and long-term consequences of admission hypothermia in VLBW preterm infants.This retrospective study measured the incidence and compared the outcomes of admission hypothermia in very low birth weight (VLBW preterm infants in a tertiary-level neonatal intensive care unit. Infants were divided into the following groups: normothermia (36.5-37.5°C, mild hypothermia (36.0-36.4°C, moderate hypothermia (32.0-35.9°C, and severe hypothermia (< 32°C. We compared the distribution, demographic variables, short-term outcomes, and neurodevelopmental outcomes at 24 months of corrected age among groups.We studied 341 infants: 79 with normothermia, 100 with mild hypothermia, 162 with moderate hypothermia, and 0 with severe hypothermia. Patients in the moderate hypothermia group had significantly lower gestational ages (28.1 wk vs. 29.7 wk, P < .02 and smaller birth weight (1004 g vs. 1187 g, P < .001 compared to patients in the normothermia group. Compared to normothermic infants, moderately hypothermic infants had significantly higher incidences of 1-min Apgar score < 7 (63.6% vs. 31.6%, P < .001, respiratory distress syndrome (RDS (58.0% vs. 39.2%, P = .006, and mortality (18.5% vs. 5.1%, P = .005. Moderate hypothermia did not affect neurodevelopmental outcomes at 2 years' corrected age. Mild hypothermia had no effect on short-term or long-term outcomes.Admission hypothermia was common in VLBW infants and correlated inversely with birth weight and gestational age. Although moderate hypothermia was associated with higher RDS and mortality rates, it may play a limited role among multifactorial causes of neurodevelopmental impairment.

Intraurethral knot in a very-low-birth-weight infant: radiological recognition, surgical management and prevention

International Nuclear Information System (INIS)

Lodha, Abhay; Ly, Linh; McNamara, Patrick J.; Brindle, Mary; Daneman, Alan

2005-01-01

We report a case where a knot developed in a urinary catheter and became lodged within the urethra of a very-low-birth-weight (VLBW) preterm infant. The catheter was removed with the assistance of a urologist. We recommend using caution when placing urinary catheters in VLBW infants and question the appropriateness of feeding tubes as catheters. Recognition on radiographs of malpositioned bladder catheters is vital to the care of these patients. All staff involved in the insertion, maintenance or removal of these catheters should be suitably trained to minimize the risk of knots and related complications. (orig.)

Respiratory severity score and extubation readiness in very low birth weight infants

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Maroun J. Mhanna

2017-12-01

Full Text Available Background: The respiratory severity score (RSS is a byproduct of mean airway pressure (MAP and fraction of inspired oxygen (FiO2. We sought to determine whether RSS could be used as a screening tool to predict extubation readiness in very low birth weight (VLBW infants. Methods: In a retrospective cohort study, medical records of all VLBW infants admitted to our unit (6/1/09–2/28/12 were reviewed for infants' demographics, prenatal characteristics, and medication use. Also, records were reviewed for unplanned vs. planned extubation, blood gas, ventilator parameters and signs of severe respiratory failure [RF, defined as partial pressure of carbon dioxide (pCO2 > 65, pH  50%, and MAP > 10 cm] on the day of extubation. Results: During the study period 31% (45/147 failed extubation. Overall, infants who failed extubation had a lower birth weight (BW and gestational age (GA, and on the day of extubation had a higher RSS and percentage of having one or more signs of severe RF. In a logistic regression model, adjusting for BW, GA, RSS and RF, RSS remained the only risk factor associated with extubation failure [adjusted OR 1.63 (95% CI: 1.10–2.40; p = 0.01]. RSS had a sensitivity of 0.86 (95% CI: 0.72–0.94 at a cutoff of 1.26 and a specificity of 0.88 (95% CI: 0.80–0.94 at a cutoff of 2.5. There was no difference in extubation failure between unplanned vs. planned extubation [41% (9/22 vs. 29% (36/125; p = 0.25]. Conclusion: An elevated RSS is associated with extubation failure. Successful unplanned extubation is common in VLBW infants. Key Words: very low birth weight, extubation, mechanical ventilation, respiratory severity score

Developmental outcome of very low birth weight infants in a developing country

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Ballot Daynia E

2012-02-01

Full Text Available Abstract Background Advances in neonatal care allow survival of extremely premature infants, who are at risk of handicap. Neurodevelopmental follow up of these infants is an essential part of ongoing evaluation of neonatal care. The neonatal care in resource limited developing countries is very different to that in first world settings. Follow up data from developing countries is essential; it is not appropriate to extrapolate data from units in developed countries. This study provides follow up data on a population of very low birth weight (VLBW infants in Johannesburg, South Africa. Methods The study sample included all VLBW infants born between 01/06/2006 and 28/02/2007 and discharged from the neonatal unit at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH. Bayley Scales of Infant and Toddler Development Version 111 (BSID 111 were done to assess development. Regression analysis was done to determine factors associated with poor outcome. Results 178 infants were discharged, 26 were not available for follow up, 9 of the remaining 152 (5.9% died before an assessment was done; 106 of the remaining 143 (74.1% had a BSID 111 assessment. These 106 patients form the study sample; mean birth weight and mean gestational age was 1182 grams (SD: 197.78 and 30.81 weeks (SD: 2.67 respectively. The BSID (111 was done at a median age of 16.48 months. The mean cognitive subscale was 88.6 (95% CI: 85.69 - 91.59, 9 (8.5% were Conclusion Although the neurodevelopmental outcome of this group of VLBW infants was within the normal range, with a low incidence of cerebral palsy, these results may reflect the low survival of babies with a birth weight below 900 grams. In addition, mean subscale scores were low and one third of the babies were identified as "at risk", indicating that this group of babies warrants long-term follow up into school going age.

Mothers of Very Low Birth Weight Children at School Age: Quality of Life Outcomes from the Newborn Lung Project Statewide Cohort Study

Science.gov (United States)

Witt, Whitney P.; Litzelman, Kristin; Spear, Hilary A.; Wisk, Lauren E.; Levin, Nataliya; McManus, Beth M.; Palta, Mari

2012-01-01

Purpose This study aimed to: (1) determine the health-related quality of life (HRQoL) in mothers of five year old very low birth weight (VLBW) and normal birth weight (NBW) children; (2) determine what extent stress mediates the relationship between case status and maternal HRQoL; and (3) examine the pre-pregnancy, pregnancy, birth, and child health-related factors in predicting maternal HRQoL among mothers of five year old VLBW children. Methods A telephone interview was administered to 297 mothers of VLBW children and 290 mothers of NBW children who were enrolled in the Newborn Lung Project Statewide Cohort Study. Results Mothers of VLBW children experienced worse physical and mental HRQoL than mothers of NBW children (52.8 versus 55.3 points, p<0.0001, and 48.9 versus 50.5 points, p=0.02, respectively). Adjusted analyses showed that maternal mental HRQoL was similar between cases and controls while physical HRQoL when children were age five was significantly different between cases and controls (Beta:−2.02, p=0.0006); this relationship was mediated by maternal stress. Among mothers of VLBW children, stress significantly contributed to adverse HRQoL outcomes when children were age five. Child behavior problems at age two were also associated with worse subsequent maternal mental HRQoL (Beta: −1.8 per SD, p=0.004), while each week of neonatal intensive care unit stay was associated with worse physical HRQoL (Beta: −0.26, p=0.02). Conclusions While caring for a VLBW child negatively impacts the HRQoL of mothers, this relationship was partially explained by maternal stress. Addressing maternal stress may be an important way to improve long-term HRQoL. PMID:22161725

Factors Affecting the Neonatal Intensive Care Unit Stay Duration in Very Low Birth Weight Premature Infants

OpenAIRE

Niknajad, Akram; Ghojazadeh, Morteza; Sattarzadeh, Niloufar; Bashar Hashemi, Fazileh; Dezham Khoy Shahgholi, Farid

2012-01-01

Introduction: Improved survival of very low birth weight (VLBW) premature infants requires urgent intensive care, professional nursing and medical care. On the other hand, long hospital stay period imposes emotional and economic burdens on the family and society. Therefore, it is necessary to clarify the most important factors affecting their hospitalization duration to lessen unwanted outcomes of premature birth and to eliminate or relieve the problems. Methods: In a descri...

Risk Factors for Neonatal Mortality Among Very Low Birth Weight Neonates

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Fatemeh Nayeri

2013-05-01

Full Text Available The objective of this study is to determine risk factors causing increase in very low birth way (VLBW neonatal mortality. The medical files of all neonates weighing ≤1500 g, born in Vali-e-Asr hospital (2001-2004 were studied. Two groups of neonates (living and dead were compared up to the time of hospital discharge or death. A total of 317 neonates were enrolled. A meaningful relationship existed between occurrence of death and low gestational age (P=0.02, low birth weight, lower than 1000 g (P=0.001, Apgar score <6 at 5th minutes (P=0.001, resuscitation at birth (P=0.001, respiratory distress syndrome (P=0.001 need for mechanical ventilation (P=0.001, neurological complications (P=0.001 and intraventricular hemorrhage (P=0.001. Regression analysis indicated that each 250 g weight increase up to 1250 g had protective effect, and reduced mortality rate. The causes of death of those neonates weighting over 1250 g should be sought in factors other than weight. Survival rate was calculated to be 80.4% for neonates weighing more than 1000 g. The most important high risk factors affecting mortality of neonates are: low birth weight, need for resuscitation at birth, need for ventilator use and intraventricular hemorrhage.

Implementation of an Automatic Stop Order and Initial Antibiotic Exposure in Very Low Birth Weight Infants.

Science.gov (United States)

Tolia, Veeral N; Desai, Sujata; Qin, Huanying; Rayburn, Polli D; Poon, Grace; Murthy, Karna; Ellsbury, Dan L; Chiruvolu, Arpitha

2017-01-01

Objective  To evaluate if an antibiotic automatic stop order (ASO) changed early antibiotic exposure (use in the first 7 days of life) or clinical outcomes in very low birth weight (VLBW) infants. Study Design  We compared birth characteristics, early antibiotic exposure, morbidity, and mortality data in VLBW infants (with birth weight  48 hours. Secondary outcomes included mortality, early mortality, early onset sepsis (EOS), and necrotizing enterocolitis. Results  Birth characteristics were similar between the two groups. We observed reduced median antibiotic exposure (pre-ASO: 6.5 DOT vs. Post-ASO: 4 DOT; p   48 hours (63.4 vs. 41.3%; p  < 0.001). There were no differences in mortality (12.1 vs 10.2%; p  = 0.44), early mortality, or other reported morbidities. EOS accounted for less than 10% of early antibiotic use. Conclusion  Early antibiotic exposure was reduced after the implementation of an ASO without changes in observed outcomes. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Profiling the preterm or VLBW born adolescent; implications of the Dutch POPS cohort follow-up studies

NARCIS (Netherlands)

Pal-de Bruin, K.M. van der; Pal, S.M. van der; Verloove-Vanhoricka, S.P.; Walther, F.J.

2015-01-01

In 1983, data of a unique nationwide cohort of 1338 very preterm (< 32 weeks of gestation) or VLBW (birth weight < 1500 g) infants in the Netherlands was collected and followed at several ages until they reached the age of 19 years. At 19 years of age a more extensive follow-up study was done,

Mineral balance studies in very low birth weight infants fed human milk

International Nuclear Information System (INIS)

Schanler, R.J.; Abrams, S.A.; Garza, C.

1988-01-01

Mineral homeostasis often is disrupted in the very low birth weight (VLBW) infant fed either human milk or commercial formula that contains insufficient quantities of available calcium (Ca) and phosphorus (P). Alterations in mineral homeostasis include abnormal patterns of serum (Ca and P concentrations and alkaline phosphatase activity) and urine (Ca and P) biochemical markers, low net Ca and P retentions in comparison with intrauterine estimates of mineral accretion, and decreased bone mineral content. A two-phase study was conducted in our laboratory to test for these alterations in mineral homeostasis. In phase 1, VLBW infants fed a preparation of fortified human milk (either human milk-derived fortifier I or II or cow milk-derived fortifier) or cow milk-based formula specially designed for VLBW infants were evaluated during their hospitalization. In phase 2, after hospitalization, these infants were evaluated during the first 6 months of life when fed either their mother's milk or routine formula exclusively. The bioavailability of Ca and P from the tested preparations varied widely. Although the fortification of human milk resulted in both an improved biochemical pattern and net retention of Ca and P, optimal intrauterine mineral accretion was not achieved in any group tested. Longitudinal assessments of bone mineralization, by single photon absorptiometry, demonstrated that human milk-fed former VLBW infants had reduced bone mineral content. These investigations suggest that former VLBW infants fed human milk exclusively may be at risk for Ca and P deficiencies

Preeclampsia and Retinopathy of Prematurity in Very-Low-Birth-Weight Infants: A Population-Based Study.

Science.gov (United States)

Huang, Hsin-Chung; Yang, Hwai-I; Chou, Hung-Chieh; Chen, Chien-Yi; Hsieh, Wu-Shiun; Tsou, Kuo-Inn; Tsao, Po-Nien

2015-01-01

Preeclampsia and retinopathy of prematurity (ROP) are associated with impaired angiogenesis. Previous studies on the relationship between preeclampsia and ROP have produced conflicting results. The goal of this study was to evaluate the association between maternal preeclampsia and ROP using a large population-based cohort of very-low-birth-weight (VLBW) infants from 21 neonatal departments registered in the database of the Premature Baby Foundation of Taiwan. Multivariable logistic regression analysis was used to estimate the adjusted odds ratios (OR) and 95% confidence intervals (CI) for preeclampsia with reference to ROP and severe ROP. A total of 5,718 VLBW infants (844 cases with maternal preeclampsia) were included for analysis. The overall incidences of mild and severe ROP were 36.0% and 12.2%, respectively. Univariable analysis showed lower GA and lower birth weight, vaginal delivery, non-SGA, RDS, PDA, sepsis, transfusion, and absence of maternal preeclampsia to be associated with mild and severe ROP development. However, OR (95% CI) adjusted for the variables that were significant according to univariable analysis showed the risks of developing any-stage ROP and severe ROP for maternal preeclampsia to be 1.00 (0.84-1.20) and 0.89 (0.63-1.25), respectively. The results remained unchanged in stratified analyses according to SGA status. Our data showed that maternal preeclampsia was not associated with the subsequent development of any stage or severe ROP in VLBW infants.

Preeclampsia and Retinopathy of Prematurity in Very-Low-Birth-Weight Infants: A Population-Based Study.

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Hsin-Chung Huang

Full Text Available Preeclampsia and retinopathy of prematurity (ROP are associated with impaired angiogenesis. Previous studies on the relationship between preeclampsia and ROP have produced conflicting results. The goal of this study was to evaluate the association between maternal preeclampsia and ROP using a large population-based cohort of very-low-birth-weight (VLBW infants from 21 neonatal departments registered in the database of the Premature Baby Foundation of Taiwan. Multivariable logistic regression analysis was used to estimate the adjusted odds ratios (OR and 95% confidence intervals (CI for preeclampsia with reference to ROP and severe ROP. A total of 5,718 VLBW infants (844 cases with maternal preeclampsia were included for analysis. The overall incidences of mild and severe ROP were 36.0% and 12.2%, respectively. Univariable analysis showed lower GA and lower birth weight, vaginal delivery, non-SGA, RDS, PDA, sepsis, transfusion, and absence of maternal preeclampsia to be associated with mild and severe ROP development. However, OR (95% CI adjusted for the variables that were significant according to univariable analysis showed the risks of developing any-stage ROP and severe ROP for maternal preeclampsia to be 1.00 (0.84-1.20 and 0.89 (0.63-1.25, respectively. The results remained unchanged in stratified analyses according to SGA status. Our data showed that maternal preeclampsia was not associated with the subsequent development of any stage or severe ROP in VLBW infants.

A retrospective comparison of VLBW outcomes before and after implementing new delivery room guidelines at a regional tertiary care center.

Science.gov (United States)

Wlodaver, A; Blunt, M; Satnes, K; Escobedo, M; Hallford, G; Szyld, E

2016-03-01

To evaluate the impact of implemented protocol changes on delivery room interventions and very low birth weight (VLBW) health outcomes. Retrospective study comparing birth characteristics, interventions and health outcomes of VLBW infants born in a tertiary care center before (calendar years 2008 to 2009) and after (calendar years 2012 to 2013) implementing new protocols using Chi-square analyses. Four hundred and nine were born before and 303 after changes were implemented. Postimplementation infants had more use of antenatal steroids (P=0.02), gestational age ⩽24 weeks (P=0.03) and birth weights between 501 and 750 g (P=0.04) and less oxygen administration (P=0.002), face mask ventilation (P=0.0001), surfactant use (P=0.0001), chest compressions (P=0.0001), intubation (P=0.002), epinephrine use (P=0.011), hypothermia (P=0.0001) and discharges home on supplemental oxygen (P=0.05). Changes creating a new delivery team, adopting new delivery practice guidelines and updating delivery room equipment resulted in positive outcomes for delivery room practices and patient outcomes.

[Factors influencing the prognosis of patent ductus arteriosus in very low birth weight infants].

Science.gov (United States)

Wang, Chen-Hong; Shi, Li-Ping; Ma, Xiao-Lu; Luo, Fang; Chen, Zheng; Lin, Hui-Jia; DU, Li-Zhong

2016-08-01

To investigate the factors influencing the prognosis of patent ductus arteriosus (PDA) in very low birth weight (VLBW) infants. A total of 194 VLBW infants who were admitted from January 2012 to December 2014 were enrolled as study subjects. According to cardiac ultrasound findings and treatment outcome, these infants were divided into non-PDA group, spontaneous closure group, pharmaceutical closure group, and surgical closure group. Their clinical and echocardiographic characteristics were analyzed. The spontaneous closure rate of PDA was 58.7%. The spontaneous closure group showed significantly higher gestational age, birth weight, and proportion of small-for-gestational-age infants than the pharmaceutical and surgical closure groups (Pclosure groups had a significantly higher incidence rate of neonatal respiratory distress syndrome and a significantly higher proportion of infants who were given pulmonary surfactant (PS) than the spontaneous closure group (Pclosure group had a significantly smaller ductus arteriosus diameter than the pharmaceutical and surgical closure groups (Pductus arteriosus diameter at 48 hours were significantly associated with the prognosis of PDA. The major transductal flow pattern in the spontaneous closure group was closing pattern, while in the pharmaceutical and surgical closure groups, the main flow patterns were pulmonary hypertension and growing patterns within 48 hours and growing pattern on days 4 and 7. The VLBW infants have a high spontaneous closure rate of PDA. A decreased closure rate of PDA is associated with the lower gestational age and the application of PS. PDA with a large ductus arteriosus diameter and a growing or pulsatile flow pattern cannot easily achieve spontaneous closure.

Continuous Positive Airway Pressure versus Mechanical Ventilation on the Fist Day of Life in Very Low-Birth-Weight Infants

Science.gov (United States)

Flannery, Dustin D.; O’Donnell, Elizabeth; Kornhauser, Mike; Dysart, Kevin; Greenspan, Jay; Aghai, Zubair H.

2017-01-01

Objective The objective of this study was to determine differences in the incidence of bronchopulmonary dysplasia (BPD) or death in very low-birth-weight (VLBW) infants managed successfully on continuous positive airway pressure (CPAP) versus mechanical ventilation on the first day of life (DOL). Study Design This is a retrospective analysis of the Alere neonatal database for infants born between January 2009 and December 2014, weighing ≤ 1,500 g. Baseline demographics, clinical characteristics, and outcomes were compared between the two groups. Multivariate regression analysis was performed to control the variables that differ in bivariate analysis. Results In this study, 4,629 infants (birth weight 1,034 ± 290 g, gestational age 28.1 ± 2.5 weeks) met the inclusion criteria. The successful use of early CPAP was associated with a significant reduction in BPD or death (p CPAP on the first DOL in VLBW infants is associated with a reduced risk of BPD or death. PMID:27057767

Do the early development of gestures and receptive and expressive language predict language skills at 5;0 in prematurely born very-low-birth-weight children?

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Stolt, S; Lind, A; Matomäki, J; Haataja, L; Lapinleimu, H; Lehtonen, L

2016-01-01

It is unclear what the predictive value of very early development of gestures and language is on later language ability in prematurely born very-low-birth-weight (VLBW; birth weight ≤1500g) children. The aim of the present study was to analyse the predictive value of early gestures and a receptive lexicon measured between the ages of 0;9 and 1;3, as well as the predictive value of receptive and expressive language ability at 2;0 for language skills at 5;0 in VLBW children. The subjects were 29 VLBW children and 28 full-term children whose language development has been followed intensively between the ages of 0;9 and 2;0 using the Finnish version of the MacArthur Developmental Inventory and the Reynell Developmental Language Scales (RDLS III). At 5;0, five selected verbal subtests of the Nepsy II test and the Boston Naming Test (BNT) were used to assess children's language skills. For the first time in VLBW children, the development of gestures measured between the ages of 0;9 and 1;3 was shown to correlate significantly and positively with language skills at 5;0. In addition, both receptive and expressive language ability measured at 2;0 correlated significantly and positively with later language skills in both groups. Moreover, according to the hierarchical regression analysis, the receptive language score of the RDLS III at 2;0 was a clear and significant predictor for language skills at 5;0 in both groups. The findings particularly underline the role of early receptive language as a significant predictor for later language ability in VLBW children. The results provide evidence for a continuity between early language development and later language skills. After reading this article, readers will understand the associations between the very early (≤2 years of age) development of gestures and language (i.e. early receptive lexicon, expressive lexicon at 2;0, receptive and expressive language ability at 2;0) and the language skills at 5;0 in prematurely born

Racial disparities in health-related quality of life in a cohort of very-low-birth-weight 2- and 3-year-olds with and without asthma.

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McManus, Beth Marie; Robert, Stephanie; Albanese, Aggie; Sadek-Badawi, Mona; Palta, Mari

2012-07-01

Children born very low birth weight (VLBW) are at risk for low health-related quality of life (HRQoL), compared with normal-birth-weight peers, and racial disparities may compound the difference. Asthma is the most pervasive health problem among VLBW children and is also more common among black than white children, partly due to unfavourable environmental exposures. This study explores racial disparities in HRQoL among VLBW children and examines whether potential disparities can be explained by asthma and neighbourhood disadvantage. The study population was the Newborn Lung Project, a cohort of infants (n=660) born VLBW in 2003-2004 in Wisconsin, USA, who were followed up at age 2-3. Multilevel linear regression models were used to examine the contributions of asthma, neighbourhood disadvantage, and other child and family socio-demographic covariates, to racial disparities in HRQoL at age 2-3. A child's HRQoL was measured using the Paediatric Quality of Life Inventory 4.0. VLBW, black, non-Hispanic children, on average, score nearly 4 points lower (p0.05). The authors found no evidence that the relationship between asthma and HRQoL differs by race. The interaction between neighbourhood disadvantage and asthma is statistically significant, with further examination suggesting that racial disparities are particularly pronounced in the most advantaged neighbourhoods. The authors found that the black disadvantage in HRQoL among 2-3-year-old VLBW children likely stems from a high prevalence of asthma. Neighbourhood attributes did not further explain the disparity, as the racial difference was particularly pronounced in advantaged neighbourhoods.

Born Too Soon: What Can We Expect? Nature of Home Literacy Experiences for Children with Very Low Birth Weight

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Ragusa, G.

2009-01-01

This study documents the home literacy experiences of children born with very low birth weight (VLBW). The study's design was modelled after Purcell-Gates' study of social domains mediated by print as home literacy experiences. A design combining purposeful sampling, semi-structured data collection and descriptive case study analysis was employed…

Epidemiological factors involved in the development of bronchopulmonary dysplasia in very low birth-weight preterm infants.

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Lardón-Fernández, Marita; Uberos, José; Molina-Oya, Manuel; Narbona-López, Eduardo

2017-02-01

In spite of the advances made in perinatal medicine, the incidence of bronchopulmonary dysplasia (BPD) has not decreased and the aetiopathogenesis of the "new" BPD is still a matter for debate. The objectives of the present study were to analyse the epidemiological factors and morbidity associated with the development of BPD in a cohort of very low birth-weight (VLBW) preterm infants. This retrospective observational study included all the preterm infants with birth weight ≤1500 g who were admitted to a tertiary-level hospital NICU from 2008 to 2011. A neurological follow-up was also carried out during the first two years of life. A total of 140 VLBW infants were analyzed: 28.4% presented oxygen dependence at 28 days, and 17.2% at 36 weeks adjusted gestational age. Predictive factors for the development of BPD were gestational age, birth weight, number of days of parenteral nutrition, number of days to achieve full enteral feeding, number of transfusions, duration of respiratory support and insulin administration, vasoactive drugs, diuretics, sedoanalgesia and postnatal corticosteroids. The neonatal morbidity associated with the development of BPD was late neonatal sepsis, patent ductus arteriosus, retinopathy of prematurity (ROP) and intraventricular hemorrhage. Non-significant associations with neurodevelopmental impairment were observed. Predictive factors for the development of BPD were respiratory support, feeding and different types of medication. Moreover, patients with BPD had a higher associated morbidity than those who did not develop BPD.

Thrombocytopenia in the first 24 hours after birth and incidence of patent ductus arteriosus.

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Sallmon, Hannes; Weber, Sven C; Hüning, Britta; Stein, Anja; Horn, Peter A; Metze, Boris C; Dame, Christof; Bührer, Christoph; Felderhoff-Müser, Ursula; Hansmann, Georg; Koehne, Petra

2012-09-01

Experimental studies suggest that platelet-triggered ductal sealing is critically involved in definite ductus arteriosus closure. Whether thrombocytopenia contributes to persistently patent ductus arteriosus (PDA) in humans is controversial. This was a retrospective study of 1350 very low birth weight (VLBW; gender, and sepsis on PDA was determined by receiver operating characteristic curve, odds ratio, and regression analyses. Platelet numbers within the first 24 hours after birth did not differ between VLBW/ELBW infants with and without spontaneous ductal closure. Platelet numbers were not associated with subsequent PDA treatment. Low platelet counts were not related to failure of pharma-cologic PDA treatment and the need for subsequent surgical ligation. Lower gestational age or birth weight, male gender, and sepsis were linked to the presence of PDA in VLBW infants on day of life 4 to 5. Thrombocytopenia in the first 24 hours after birth was not associated with PDA in this largest VLBW/ELBW infant cohort studied to date. Impaired platelet function, due to immaturity and critical illness, rather than platelet number, might play a role in ductus arteriosus patency.

Growth and development of very low birth weight infants aged 18-24 months at Queen Sirikit National Institute of Child Health.

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Sangtawesin, Varaporn; Singarj, Yupayao; Kanjanapattanakul, Wiboon

2011-08-01

The number of very low birth weight (VLBW) births is increasing worldwide. Despite better care in recent years, they have a high incidence of delayed growth and development. There are no previous studies regarding the growth and development of these infants at Queen Sirikit National Institute of Child Health (QSNICH). To study growth and developmental outcome of VLBW infants, aged 18-24 months who were discharged from QSNICH. VLBW infants who were discharged from QSNICH during the year 2007 were recruited in the study. Patients with chromosomal abnormalities, major congenital anomalies, definite congenital infections and positive maternal anti-HIV tests were excluded. At the corrected age of 18-24 months, the parents were called upon to bring their infants for complete physical examination and developmental evaluation on 2 occasions, two months apart. There were 111 cases of VLBW infants who were discharged from QSNICH during the year 2007. Fifty-four patients were eligible for the present study. Thirty cases (55.56%) were contacted for the first examination. During this examination, there were 3 cases (10%) with low head circumference, 1 case (3.33%) with poor weight gain, 5 cases (16.67%) with visual defect, 1 case (3.33%) with moderately severe hearing loss, 1 case (3.33%) with cerebral palsy and 7 cases (23.33%) with delayed development. Twenty-one cases could be recalled for a second evaluation. Two of the 5 cases had delayed language development. There were no cases with hydrocephalous, blindness or profound hearing loss. VLBW infants at QSNICH had much better survival during recent years. Most of these survivors had normal growth and development. Those with delayed growth and development need aggressive intervention and long-term follow-up for enhancement of quality of their lives.

Effect of Environmental Factors on Low Weight in Non-Premature Births: A Time Series Analysis.

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Díaz, Julio; Arroyo, Virginia; Ortiz, Cristina; Carmona, Rocío; Linares, Cristina

2016-01-01

Exposure to pollutants during pregnancy has been related to adverse birth outcomes. LBW can give rise to lifelong impairments. Prematurity is the leading cause of LBW, yet few studies have attempted to analyse how environmental factors can influence LBW in infants who are not premature. This study therefore sought to analyse the influence of air pollution, noise levels and temperature on LBW in non-premature births in Madrid during the period 2001-2009. Ecological time-series study to assess the impact of PM2.5, NO2 and O3 concentrations, noise levels, and temperatures on LBW among non-premature infants across the period 2001-2009. Our analysis extended to infants having birth weights of 1,500 g to 2,500 g (VLBW) and less than 1,500 g (ELBW). Environmental variables were lagged until 37 weeks with respect to the date of birth, and cross-correlation functions were used to identify explaining lags. Results were quantified using Poisson regression models. Across the study period 298,705 births were registered in Madrid, 3,290 of which had LBW; of this latter total, 1,492 were non-premature. PM2.5 was the only pollutant to show an association with the three variables of LBW in non-premature births. This association occurred at around the third month of gestation for LBW and VLBW (LBW: lag 23 and VLBW: lag 25), and at around the eighth month of gestation for ELBW (lag 6). Leqd was linked to LBW at lag zero. The RR of PM2.5 on LBW was 1.01 (1.00 1.03). The RR of Leqd on LBW was 1.09 (0.99 1.19)(p<0.1). The results obtained indicate that PM2.5 had influence on LBW. The adoption of measures aimed at reducing the number of vehicles would serve to lower pregnant women's exposure. In the case of noise should be limited the exposure to high levels during the final weeks of pregnancy.

Neonatal Nutrition Predicts Energy Balance in Young Adults Born Preterm at Very Low Birth Weight

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Hanna-Maria Matinolli

2017-11-01

Full Text Available Epidemiological studies and animal models suggest that early postnatal nutrition and growth can influence adult health. However, few human studies have objective recordings of early nutrient intake. We studied whether nutrient intake and growth during the first 9 weeks after preterm birth with very low birth weight (VLBW, <1500 g predict total energy intake, resting energy expenditure (REE, physical activity and food preferences in young adulthood. We collected daily nutritional intakes and weights during the initial hospital stay from hospital records for 127 unimpaired VLBW participants. At an average age 22.5 years, they completed a three-day food record and a physical activity questionnaire and underwent measurements of body composition (dual X-ray absorptiometry; n = 115 with adequate data and REE (n = 92 with adequate data. We used linear regression and path analysis to investigate associations between neonatal nutrient intake and adult outcomes. Higher energy, protein and fat intakes during the first three weeks of life predicted lower relative (=per unit lean body mass energy intake and relative REE in adulthood, independent of other pre- and neonatal factors. In path analysis, total effects of early nutrition and growth on relative energy intake were mostly explained by direct effects of early life nutrition. A path mediated by early growth reached statistical significance only for protein intake. There were no associations of neonatal intakes with physical activity or food preferences in adulthood. As a conclusion, higher intake of energy and nutrients during first three weeks of life of VLBW infants predicts energy balance after 20 years. This association is partly mediated through postnatal growth.

Risk Factors Associated with Very Low Birth Weight in a Large Urban Area, Stratified by Adequacy of Prenatal Care.

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Xaverius, Pamela; Alman, Cameron; Holtz, Lori; Yarber, Laura

2016-03-01

This study examined risk and protective factors associated with very low birth weight (VLBW) for babies born to women receiving adequate or inadequate prenatal care. Birth records from St. Louis City and County from 2000 to 2009 were used (n = 152,590). Data was categorized across risk factors and stratified by adequacy of prenatal care (PNC). Multivariate logistic regression and population attributable risk (PAR) was used to explore risk factors for VLBW infants. Women receiving inadequate prenatal care had a higher prevalence of delivering a VLBW infant than those receiving adequate PNC (4.11 vs. 1.44 %, p < .0001). The distribution of risk factors differed between adequate and inadequate PNC regarding Black race (36.4 vs. 79.0 %, p < .0001), age under 20 (13.0 vs. 33.6 %, p < .0001), <13 years of education (35.9 vs. 77.9 %, p < .0001), Medicaid status (35.7 vs. 74.9, p < .0001), primiparity (41.6 vs. 31.4 %, p < .0001), smoking (9.7 vs. 24.5 %, p < .0001), and diabetes (4.0 vs. 2.4 %, p < .0001), respectively. Black race, advanced maternal age, primiparity and gestational hypertension were significant predictors of VLBW, regardless of adequate or inadequate PNC. Among women with inadequate PNC, Medicaid was protective against (aOR 0.671, 95 % CI 0.563-0.803; PAR -32.6 %) and smoking a risk factor for (aOR 1.23, 95 % CI 1.01, 1.49; PAR 40.1 %) VLBW. When prematurity was added to the adjusted models, the largest PAR shifts to education (44.3 %) among women with inadequate PNC. Community actions around broader issues of racism and social determinants of health are needed to prevent VLBW in a large urban area.

Health-related quality of life of mothers of very low birth weight children at the age of five: results from the Newborn Lung Project Statewide Cohort Study.

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Witt, Whitney P; Litzelman, Kristin; Spear, Hilary A; Wisk, Lauren E; Levin, Nataliya; McManus, Beth M; Palta, Mari

2012-11-01

This study aimed to determine the health-related quality of life (HRQoL) in mothers of 5-year-old very low birth weight (VLBW) and normal birth weight (NBW) children, with a focus on the role of stress. This cohort study is ancillary to the Newborn Lung Project. A telephone interview collected information on symptoms of stress and HRQoL from 297 mothers of VLBW children and 290 mothers of NBW children who were enrolled in the Newborn Lung Project Statewide Cohort Study. Staged multiple regression analyses were used to evaluate the relationship between caregiver status and maternal HRQoL and the role stress played in this relationship. Additional multiple regression analyses were also used to evaluate the correlates of poor maternal HRQoL among VLBW mothers. Mothers of VLBW children experienced worse physical and mental HRQoL than mothers of NBW children. Adjusted analyses showed that physical HRQoL was significantly different between these mothers (β: -1.87, P = 0.001); this relationship was attenuated by maternal stress. Among the mothers of VLBW children, stress significantly contributed to adverse HRQoL outcomes when children were aged five. Child behavior problems at the age of two were also associated with worse subsequent maternal mental HRQoL (β: -0.18, P = 0.004), while each week of neonatal intensive care unit stay was associated with worse physical HRQoL (β: -0.26, P = 0.02). Caring for a VLBW child is negatively associated with the HRQoL of mothers; this relationship might be, in part, explained by maternal stress. Addressing maternal stress may be an important way to improve long-term HRQoL.

Early relations between language development and the quality of mother-child interaction in very-low-birth-weight children.

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Stolt, S; Korja, R; Matomäki, J; Lapinleimu, H; Haataja, L; Lehtonen, L

2014-05-01

It is not clearly understood how the quality of early mother-child interaction influences language development in very-low-birth-weight children (VLBW). We aim to analyze associations between early language and the quality of mother-child interaction, and, the predictive value of the features of early mother-child interaction on language development at 24 months of corrected age in VLBW children. A longitudinal prospective follow-up study design was used. The participants were 28 VLBW children and 34 full-term controls. Language development was measured using different methods at 6, 12 and at 24 months of age. The quality of mother-child interaction was assessed using PC-ERA method at 6 and at 12 months of age. Associations between the features of early interaction and language development were different in the groups of VLBW and full-term children. There were no significant correlations between the features of mother-child interaction and language skills when measured at the same age in the VLBW group. Significant longitudinal correlations were detected in the VLBW group especially if the quality of early interactions was measured at six months and language skills at 2 years of age. However, when the predictive value of the features of early interactions for later poor language performance was analyzed separately, the features of early interaction predicted language skills in the VLBW group only weakly. The biological factors may influence on the language development more in the VLBW children than in the full-term children. The results also underline the role of maternal and dyadic factors in early interactions. Copyright © 2014 Elsevier Ltd. All rights reserved.

Long-term cognitive outcome of very low birth-weight Saudi preterm infants at the corrected age of 24-36 months.

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Sobaih, Badr H

2018-04-01

To assess infants' cognitive function at the corrected age of 24-36 months, and to identify factors associated with adverse outcome and examine the correlation between Bayley Infants Neurodevelopmental Screener (BINS) score and Gesell Schedule of Child Development (GSCD). Methods: This retrospective study was performed on Saudi very low birth-weight (VLBW)  infants born   in King Khalid University Hospital, Riyadh, Saudi Arabia between 1997 and 2014 by the use of BINS as screening test and GSCD as definitive test. Results: Of 561 enrolled infants, 367 (65.4%) continued to follow-up. Three-hundred and fifteen infants (85.6%) had a normal cognitive function. In addition to lower birth weight (beta = -0.003) (p less than 0.001), male gender (OR =3.9) (p=0.001)and cerebral palsy (OR =33.9) (p less than 0.001) were the strongest factors associated with poor cognitive outcome. Approximately 75.4% of infants with normal BINS score had normal cognitive function and 7.6% of total infants had sever cognitive impairment. Conclusion: The majority of VLBW infants in our center have  normal cognitive function at the corrected age of 24-36 months. Male gender, lower birth weight, and cerebral palsy are major predictors of poor outcome. The BINS scores were correlated with GSCD as a valid predictor for future developmental outcome.

Changes in quality of life into adulthood after very preterm birth and/or very low birth weight in the Netherlands

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2013-01-01

Background It is important to know the impact of Very Preterm (VP) birth or Very Low Birth Weight (VLBW). The purpose of this study is to evaluate changes in Health-Related Quality of Life (HRQoL) of adults born VP or with a VLBW, between age 19 and age 28. Methods The 1983 nationwide Dutch Project On Preterm and Small for gestational age infants (POPS) cohort of 1338 VP (gestational age LHS) and the WHOQoL-BREF. Multiple imputation was applied to correct for missing data and non-response. Results The mean HUI3 and LHS scores did not change significantly from age 19 to age 28. However, after multiple imputation, a significant, though not clinically relevant, increase of 0.02 on the overall HUI3 score was found. The mean HRQoL score measured with the HUI3 increased from 0.83 at age 19 to 0.85 at age 28. The lowest score on the WHOQoL was the psychological domain (74.4). Conclusions Overall, no important changes in HRQoL between age 19 and age 28 were found in the POPS cohort. Psychological and emotional problems stand out, from which recommendation for interventions could be derived. PMID:23531081

Early Caffeine Prophylaxis and Risk of Failure of Initial Continuous Positive Airway Pressure in Very Low Birth Weight Infants.

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Patel, Ravi M; Zimmerman, Kanecia; Carlton, David P; Clark, Reese; Benjamin, Daniel K; Smith, P Brian

2017-11-01

To test the hypothesis that early caffeine treatment on the day of birth, compared with later treatment in very low birth weight (VLBW, caffeine in the first week of life. We used multivariable conditional logistic regression to compare the risk of CPAP failure, defined as invasive mechanical ventilation or surfactant therapy on DOL 1-6, by timing of caffeine treatment as either early (initiation on DOL 0) or routine (initiation on DOL 1-6). We identified 11 133 infants; 4528 (41%) received early caffeine and 6605 (59%) received routine caffeine. Median gestational age was lower in the early caffeine group, 29 weeks (25th, 75th percentiles; 28, 30) vs the routine caffeine group, 30 weeks (29, 31); P caffeine groups: 22% vs 21%; adjusted OR = 1.05 (95% CI: 0.93, 1.18). Early caffeine treatment on the day of birth was not associated with a decreased risk of CPAP failure in the first week of life for VLBW infants initially treated with CPAP. Copyright © 2017 Elsevier Inc. All rights reserved.

Bubble nasal CPAP, early surfactant treatment, and rapid extubation are associated with decreased incidence of bronchopulmonary dysplasia in very-low-birth-weight newborns: efficacy and safety considerations.

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Friedman, Charles A; Menchaca, Robert C; Baker, Mary C; Rivas, Clarissa K; Laberge, Raymond N; Rios, Enrique H; Haider, Syed H; Romero, Edgar J; Eason, Elizabeth B; Fraley, J Kennard; Woldesenbet, Mesfin

2013-07-01

Current literature has been inconsistent in demonstrating that minimizing the duration of mechanical ventilation in very-low-birth-weight (VLBW) newborns reduces lung damage. To determine if introduction of bubble nasal CPAP (bnCPAP), early surfactant treatment, and rapid extubation (combined bnCPAP strategy) in our community-based neonatal ICU reduced bronchopulmonary dysplasia (BPD). This was a 7-year retrospective,single-institution review of respiratory outcomes in 633 VLBW babies before and after introduction of the combined bnCPAP strategy. Coincident changes in newborn care were taken into account with a logistic regression model. The average percentage of VLBW newborns with BPD decreased to 25.8% from 35.4% (P = .02), reaching a minimum in the last post-bnCPAP year of22.1% (P = .02). When other coincident changes in newborn care during the study years were taken into account, VLBW babies in the post-bnCPAP years had a 43% lower chance of developing BPD(P = .003, odds ratio 0.43, 95% CI 0.25– 0.75). Decreases occurred in mechanical ventilation and the percentage of infants discharged on diuretics and on supplemental oxygen. Among the subset of extremely-low-birth-weight newborns, improved respiratory outcomes in the post-bnCPAP years,as compared to outcomes in the pre-bnCPAP years, included an increase in the percentage alive and off mechanical ventilation at 1 week postnatal age (P < .001), a more rapid extubation rate(P < .03), a decrease in the median days on mechanical ventilation (P = .002), and a decrease in the percentage with BPD plus died (P = .01). Post-bnCPAP extremely-low-birth-weight babies had a statistically significant decrease in retinopathy of prematurity, an increase in low-grade intraventricular hemorrhage, and a decrease in ductal ligations. A combined BnCPAP strategy may contribute to a reduction of BPD, after adjusting for concurrent treatments.

Plasma Levels of Dimethylarginines in Preterm Very Low Birth Weight Neonates: Its Relation with Perinatal Factors and Short-Term Outcome

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Rob M. Moonen

2014-12-01

Full Text Available Endogenously produced inhibitors of nitric oxide (NO synthase, in particular asymmetric dimethylarginine (ADMA, are currently considered of importance in various disease states characterized by reduced NO availability. We investigated the association between plasma levels of ADMA, symmetric dimethylarginine (SDMA, l-arginine, and citrulline and perinatal factors and outcome in 130 preterm (gestational age ≤30 weeks very low birth weight (VLBW, <1500 g infants. Plasma samples were collected 6–12 h after birth. We did not find significant correlations between ADMA, SDMA, l-arginine, and citrulline levels and gestational age or birth weight. However, the arginine:ADMA ratio (AAR, a better indicator of NO availability than either arginine or ADMA separately was positively correlated with gestational age. ADMA and arginine levels were not significantly different between males and females but males showed a negative correlation between ADMA levels and gestational age. Perinatal factors such as preeclampsia, chrorioamnionitis, prolonged rupture of membranes, or form of delivery did not significantly alter dimethylarginine levels or AAR. In contrast, the AAR was significantly reduced in the infants with respiratory distress, mechanical ventilation, and systemic hypotension Therefore, our data suggest that altered NO availability may play a role in the respiratory and cardiovascular adaptation in preterm VLBW infants.

RISK FACTORS FOR THE EARLY NEONATAL MORTALITY IN NEWBORNS WITH VERY LOW AND EXTREMELY LOW BIRTH WEIGHT

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О. V. Lebedeva

2014-01-01

Full Text Available Objective: Our aim was to assess the association of perinatal factors with the early neonatal mortality in newborns with very low (VLBW and extremely low birth weight (ELBW.Methods: The statistical data was carried out, that is analysis of 17 perinatal factors of 28 newborns with an ELBW with gestation of 23–27 weeks and 18 newborns with a VLBW with gestation of 28–32 weeks, who died in the first 7 days of life. The comparison group consisted of 25 newborns with an ELBW and 56 children with a VLBW with gestation of 25–27 and 28–32 weeks, respectively, who survived the early neonatal period. The association of risk factors with the early neonatal mortality was assessed by means of a multiple-factor logistic regression analysis. A critical p error level was set equal to 0.05. Results: In newborns with a VLBW the increased risk of the early neonatal mortality depended on a gestation term (OR 4.40, 95% CI 1.56–11.71; р = 0.002 and emergency Caesarean section (OR 7.48, 95% CI 1.28–43.74; р = 0.008. A vaginal birth increased the survival chance (OR 0.12, 95% CI 0.01–0.86; р = 0.032. Newborns with an ELBW had the following factors of the increased risk of the early neonatal mortality: gestational age (OR 2.86, 95% CI 1.06–7.73; р = 0.038, Apgar score at the 5th minute (OR 1.91, 95% CI 0.99–3.69; р = 0.050 and presence of chorioamnionitis (OR 5.45, 95% CI 1.0–29.53; p = 0.048. An elective Caesarean section increased the survival chance (OR 0.02, 95% CI 0.001–0.44; p = 0.048. Conclusion: Summarizing the obtained data, we can conclude that besides a gestational age the risk of early neonatal mortality in newborns with a VLBW may be increased due to the emergency Caesarean section, with an ELBW — due to a low Apgar score at the 5th minute and the presence of mother's chorioamnionitis. A vaginal birth in newborns with a VLBW and an elective Caesarean section in children with an ELBW increase survival chances.

Visual search and attention in five-year-old very preterm/very low birth weight children.

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Geldof, Christiaan J A; de Kieviet, Jorrit F; Dik, Marjolein; Kok, Joke H; van Wassenaer-Leemhuis, Aleid G; Oosterlaan, Jaap

2013-12-01

This study aimed to establish visual search performance and attention functioning in very preterm/very low birth weight (VP/VLBW) children using novel and well established measures, and to study their contribution to intellectual functioning. Visual search and attention network efficiency were assessed in 108 VP/VLBW children and 72 age matched term controls at 5.5 years corrected age. Visual search performance was investigated with a newly developed paradigm manipulating stimulus density and stimulus organization. Attention functioning was studied using the Attention Network Test (ANT). Intellectual functioning was measured by a short form of the Wechsler Preschool and Primary Scale of Intelligence. Data were analyzed using ANOVAs and multiple regression analyses. Visual search was less efficient in VP/VLBW children as compared to term controls, as indicated by increased search time (0.31 SD, p = .04) and increased error rate (0.36 SD, p = .02). In addition, VP/VLBW children demonstrated poorer executive attention as indicated by lower accuracy for the executive attention measure of the ANT (0.61 SD, p attention measures (0.13 SD, p = .42). Visual search time and error rate, and executive attention, collectively, accounted for 14% explained variance in full scale IQ (R(2) = .14, p attention. Visual attention dysfunctions contributed to intelligence, suggesting the opportunity to improve intellectual functioning by using interventions programs that may enhance attention capacities. © 2013.

Parenteral lipid administration to very-low-birth-weight infants-early introduction of lipids and use of new lipid emulsions: a systematic review and meta-analysis

NARCIS (Netherlands)

Vlaardingerbroek, Hester; Veldhorst, Margriet A. B.; Spronk, Sandra; van den Akker, Chris H. P.; van Goudoever, Johannes B.

2012-01-01

Background: The use of intravenous lipid emulsions in preterm infants has been limited by concerns regarding impaired lipid tolerance. As a result, the time of initiation of parenteral lipid infusion to very-low-birth-weight (VLBW) infants varies widely among different neonatal intensive care units.

Maternal Cytomegalovirus-Specific Immune Responses and Symptomatic Postnatal Cytomegalovirus Transmission in Very Low-Birth-Weight Preterm Infants

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Ehlinger, Elizabeth P.; Webster, Emily M.; Kang, Helen H.; Cangialose, Aislyn; Simmons, Adam C.; Barbas, Kimberly H.; Burchett, Sandra K.; Gregory, Mary L.; Puopolo, Karen P.

2011-01-01

Introduction. Transmission of cytomegalovirus (CMV) via breast milk can lead to severe acute illness in very low-birth-weight (VLBW) preterm infants. Although the majority of CMV-seropositive women shed CMV in milk, symptomatic postnatal infection of VLBW infants occurs infrequently, suggesting that virologic or immunologic factors in milk may be associated with the risk and severity of postnatal CMV infection. Methods. We investigated the magnitude of CMV-specific cellular and humoral immune responses in milk of 30 seropositive mothers of VLWB preterm infants and assessed their relationship to milk CMV load and symptomatic CMV transmission. Results. Milk immunoglobulin G (IgG) avidity was inversely correlated to milk CMV load (r = −0.47; P = .009). However, milk CMV load and CMV-specific cellular and humoral immune responses were similar in mothers of VLBW infants with and those without symptomatic postnatal CMV infection. Conclusions. Similar immunologic parameters in milk of CMV-seropositive mothers of VLBW infants with and without symptomatic postnatal CMV infection indicate that screening milk by these parameters may not predict disease risk. However, the inverse correlation between milk CMV IgG avidity and CMV load may suggest that enhancement of maternal CMV-specific IgG responses could aid in reduction of CMV shedding into breast milk. PMID:21984738

Mother-preterm infant interactions at three months of corrected age: influence of maternal depression, anxiety and neonatal birth weight

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Erica eNeri

2015-09-01

Full Text Available Maternal depression and anxiety represent risk factors for the quality of early mother-preterm infant interactions, especially in the case of preterm birth. Despite the presence of many studies on this topic, the comorbidity of depressive and anxious symptoms has not been sufficiently investigated, as well as their relationship with the severity of prematurity and the quality of early interactions. The Aim of this study was to evaluate the quality of early mother-infant interactions and the prevalence of maternal depression and anxiety comparing dyads of Extremely Low Birth Weight-ELBW and Very Low Birth Weight-VLBW preterm infants with full-term ones. 77 preterm infants (32 ELBW; 45 VLBW and 120 full term (FT infants and their mothers were recruited. At 3 months of corrected age, 5 minutes of mother-infant interactions were recorded and later coded through the Global Ratings Scales. Mothers completed the Edinburgh Postnatal Depression Scale and Penn State Worry Questionnaire. Infant levels of development were assessed through the Griffiths Mental Development Scales. A relation emerged among the severity of prematurity, depression, anxiety, and the quality of interactions. When compared with the FT group, the ELBW interactions were characterized by high maternal intrusiveness and low remoteness, while the VLBW dyads showed high levels of maternal sensitivity and infant communication. Depression was related to maternal remoteness and negative affective state, anxiety to low sensitivity, while infant interactive behaviours were impaired only in case of comorbidity. ELBW’s mothers showed the highest prevalence of depressive and anxious symptoms; moreover, only in FT dyads, low maternal sensitivity, negative affective state and minor infant communication were associated to the presence of anxious symptoms. The results confirmed the impact of prematurity on mother–infant interactions and on maternal affective state. Early diagnosis help to plan

Risk for late-onset blood-culture proven sepsis in very-low-birth weight infants born small for gestational age: a large multicenter study from the German Neonatal Network.

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Tröger, Birte; Göpel, Wolfgang; Faust, Kirstin; Müller, Thilo; Jorch, Gerhard; Felderhoff-Müser, Ursula; Gortner, Ludwig; Heitmann, Friedhelm; Hoehn, Thomas; Kribs, Angela; Laux, Reinhard; Roll, Claudia; Emeis, Michael; Mögel, Michael; Siegel, Jens; Vochem, Matthias; von der Wense, Axel; Wieg, Christian; Herting, Egbert; Härtel, Christoph

2014-03-01

It was the aim of this study to assess whether very-low-birth-weight (VLBW) infants born small for gestational age (SGA; birth weight less than 10th percentile) are at increased risk for late-onset sepsis. This was a prospective, multicenter study of the German Neonatal Network including VLBW infants from 23 to risk with coagulase-negative staphylococci in our SGA cohort. In a multivariate logistic regression analysis, higher gestational age [per week; odds ratio (OR): 0.75, 95% confidence interval (CI): 0.72-0.78, PGerman descendance (OR: 0.76, 95% CI: 0.63-0.91, P = 0.003) and prophylaxis with glycopeptide antibiotics (OR: 0.64, 95% CI: 0.47-0.87, P = 0.005) were shown to be protective against late-onset sepsis. In contrast, longer duration of parenteral nutrition (per day; OR: 1.016, 95% CI: 1.011-1.021, P risk factors (OR: 1.31, 95% CI: 1.02-1.68, P= 0.03). SGA contributes to the risk of late-onset sepsis in VLBW infants. Future studies are needed to investigate the underlying pathophysiology to guide individualized preventive measures in this vulnerable subgroup.

Long term follow-up of health-related quality of life in young adults born very preterm or with a very low birth weight

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Verrips, Gijsbert; Brouwer, Leonoor; Vogels, Ton; Taal, Erik; Drossaert, Constance H.C.; Feeny, David; Verheijden, Marieke; Verloove-Vanhorick, Pauline

2012-01-01

Background The purpose was, first, to evaluate changes in health-related quality of life (HRQL) in a cohort of very low birth weight (VLBW; <1500 g.) or very preterm (< 32 weeks of gestation) children between ages 14 and 19, and second, to identify correlates of HRQL at age 19. Methods HRQL was

An Open-label Randomized Controlled Trial to Compare Weight Gain of Very Low Birth Weight Babies with or without Addition of Coconut Oil to Breast Milk.

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Arun, Sumitha; Kumar, Manish; Paul, Thomas; Thomas, Nihal; Mathai, Sarah; Rebekah, Grace; Thomas, Niranjan

2018-03-23

Nutritional guidelines involving the feeding of very low birth weight babies (VLBW) recommend addition of Human Milk Fortifiers to breast milk. Owing to financial constraints, it is a practice in low- and middle-income countries (LMIC) to add coconut oil to aid better weight gain. There are inadequate data on improvement of growth parameters with oral coconut oil supplementation of breast milk. In this randomized controlled trial, we measured growth parameters and body composition of 60 babies who received either breast milk with coconut oil or breast milk alone. Randomization was stratified according to intrauterine growth appropriate for gestational age (n = 30) and small for gestational age (n = 30). There was no difference in weight gain between the two groups. The weight gain velocity was 15 ± 3.6 and 14.4 ± 3.4 g/kg/day (p value = 0.49) in the breast milk alone and in the breast milk with coconut oil group, respectively. There was no difference in increase in head circumference and length. Triceps skinfold thickness (n = 56) was similar in both groups, but subscapular skinfold thickness was significantly more in the coconut oil group. Total body fat percentage did not differ between the groups (25.2 ± 4.3 vs. 25.5 ± 4.3%, p = 0.79). Oral supplementation of coconut oil along with breast milk did not increase growth parameters or result in change in body composition in very low birth weight (VLBW) babies.

Neurodevelopmental outcomes of infants with very low birth weights are associated with the severity of their extra-uterine growth retardation

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Han-Chun Chien

2018-04-01

Full Text Available Background: For infants with very low birth weights (VLBW, their neurodevelopmental outcomes are thought to be associated with extra-uterine growth retardation (EUGR. In this study, based on a single institute, we analyzed the association between different levels or severity of EUGR of VLBW infants and their neurodevelopmental outcomes later at a corrected age of 24 months. Methods: This is a hospital-based retrospective cohort study. The severity of EUGR was classified into three categories according to the z-score of discharge weight: z < −2.0, <−2.5, and <−3.0. The outcomes were assessed using the Bayley Scales of Infant Development-II (BSID-II at a corrected age of 24 months. We then estimated the association of EUGR with low mental developmental index (MDI or low psychomotor developmental index (PDI. Multiple logistic regression and stratified analyses were used to adjust for the possible confounding factors. Results: In total, 224 VLBW infants were enrolled in this study from 1997 to 2006. In the univariate analysis, EUGR for weight at discharge from hospital was associated with MDI <85 at the corrected age of 24 months, and this association was related to the severity of EUGR (z < −2.5, OR: 1.92 (1.04–3.53; z < −3.0, OR: 2.83 (1.26–6.36. In addition, the relationship was not confounded by gender nor small for gestational age. The stratified analysis against hemodynamic significant patent ductus arteriosus also revealed that EUGR was an independent predictor for neurodevelopmental outcomes. Conclusion: In VLBW preterm infants, EUGR was significantly associated with low MDI scores assessed at a corrected age of 24 months. Early evaluation and recognition of EUGR should be emphasized when caring for preterm infants. Key Words: EUGR, VLBW, neurodevelopment

Outcomes of very low birth weight infants in a newborn tertiary center in Turkey, 1997-2000.

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Atasay, Begüm; Günlemez, Ayla; Unal, Sevim; Arsan, Saadet

2003-01-01

Our purpose was to determine mortality and morbidity rates and selected outcome variables for infants weighing less than 1500 g, who were admitted to the neonatal intensive care unit of our hospital from 1997 to 2000. The ultimate goal of the study was to define a model for developing a regional database. Information on all very low birth weight (VLBW) admissions to a tertiary level neonatal intensive care unit (NICU) in Ankara between January 1997 and December 2000 was prospectively collected by three neonatologists using a standard manual of operation and definitions. The data consisted of patient information including sociodemographic characteristics; antenatal history; mode of delivery; APGAR scores; need for resuscitation; admission illness severity (Clinical Risk Index for Babies-CRIB) and therapeutic intensity (Neonatal Therapeutic Intensity Scoring System-NTISS); selected NICU parameters and procedures such as respiratory support, surfactant therapy, and postnatal corticosteroid therapy; and selected patient outcomes such as intraventricular hemorrhage, septicemia, necrotizing enterecolitis, retinopathy of prematurity, and chronic lung disease. The number of VLBW admissions to the NICU was 133, with 51 (28.6%) referrals from other maternity centers. The mean birth weight and gestational age of the infants were 1175 +/- 252 g and 30.3 +/- 2.9 weeks, respectively. One hundred and seventeen of 133 cases (88.7%) received at least one antenatal care visit. The median CRIB and NTISS scores were 4.5 and 31, respectively. Antenatal steroids had been given to 74 (55.6%) infants. Surfactant treatment and respiratory support were given to 33 (24.8%) and 73 (54.8%) infants, respectively. Among selected outcomes, chronic lung disease (CLD), threshold retinopathy of prematurity (ROP), severe intraventricular hemorrhage (IVH > or = grade III), nosocomial infection and necrotizing enterocolitis (NEC) were encountered in 14 (12.6%), 9 (8.1%), 3 (2.2%), 34 (25.5%) and 35 (26

Pattern of growth of very low birth weight preterm infants, assessed using the WHO Growth Standards, is associated with neurodevelopment.

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Nash, Andrea; Dunn, Michael; Asztalos, Elizabeth; Corey, Mary; Mulvihill-Jory, Bridget; O'Connor, Deborah L

2011-08-01

Several Canadian professional organizations recently recommended that the growth of preterm infants be monitored using the World Health Organization Growth Standards (WHO-GS) after hospital discharge. The WHO-GS are a prescriptive set of growth charts that describe how term infants should grow under ideal environmental conditions. Whether preterm infants following this pattern of growth have better outcomes than infants that do not has yet to be evaluated. Our aim was to determine whether the pattern of growth of very low birth weight (VLBW) infants during the first 2 years, assessed using the WHO-GS or the traditional Centers for Disease Control and Prevention reference growth charts (CDC-RGC), is associated with neurodevelopment. Pattern of weight, length, and head circumference gain of appropriate-for-gestation VLBW preterm infants (n = 289) from birth to 18-24 months corrected age was classified, using the WHO-GS and CDC-RGC, as sustained (change in Z-score ≤1 SD), decelerated (decline >1 SD), or accelerated (incline >1 SD). Development was assessed using the Bayley Scales of Infant and Toddler Development (BSID)-III at 18-24 months corrected age. Using the WHO-GS, children with a decelerated pattern of weight gain had lower cognitive (10 points), language (6 points), and motor (4 points) scores than infants with sustained weight gain (p growth.

Efficacy and safety of rectal ibuprofen for patent ductus arteriosus closure in very low birth weight preterm infants.

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Demir, Nihat; Peker, Erdal; Ece, İbrahim; Balahoroğlu, Ragıp; Tuncer, Oğuz

2017-09-01

To compare rectal ibuprofen with oral ibuprofen for the closure of hemodynamically significant patent ductus arteriosus (hsPDA) in very low birth weight (VLBW) preterm infants. In a prospective, randomized study, 72 VLBW infants who had hsPDA received either rectal or oral ibuprofen. The plasma concentration of ibuprofen and renal functions were determined in both groups by the high-performance liquid chromatography (HPLC) method and cystatin-C (cys-C), respectively. The hsPDA closure rate of the group that received rectal ibuprofen was similar to oral ibuprofen (86.1% versus 83.3%) after the first course of the treatment (p = 0.745). A statistically significant difference was identified between the mean plasma cys-C levels before and after treatment in both the rectal and oral ibuprofen groups (p = 0.004 and p 0.05 for all values). Rectal ibuprofen is as effective as oral ibuprofen for hsPDA closure in VLBW infants. The rise in the cys-C level with rectal and oral treatment shows that patients with borderline renal function should be evaluated and followed closely.

Perinatal risk factors for pneumothorax and morbidity and mortality in very low birth weight infants.

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García-Muñoz Rodrigo, Fermín; Urquía Martí, Lourdes; Galán Henríquez, Gloria; Rivero Rodríguez, Sonia; Tejera Carreño, Patricia; Molo Amorós, Silvia; Cabrera Vega, Pedro; Rodríguez Ramón, Fernando

2017-11-01

To determine the perinatal risk factors for pneumothorax in Very-Low-Birth-Weight (VLBW) infants and the associated morbidity and mortality in this population. Retrospective analysis of data collected prospectively from a cohort of VLBW neonates assisted in our Unit (2006-2013). We included all consecutive in-born patients with ≤ 1500 g, without severe congenital anomalies. Perinatal history, demographics, interventions and clinical outcomes were collected. Associations were evaluated by logistic regression analysis. During the study period, 803 VLBW infants were assisted in our Unit, of whom 763 were inborn. Ten patients (1.2%) died in delivery room, and 18 (2.2%) with major congenital anomalies were excluded. Finally, 735 (91.5%) neonates were included in the study. Seventeen (2.3%) developed pneumothorax during the first week of life [median (IQR): 2 (1-2) days]. After correcting for GA and other confounders, prolonged rupture of membranes [aOR =1.002 (95% CI 1.000-1.003); p = 0.040] and surfactant administration [aOR = 6.281 (95% CI 1.688-23.373); p = 0.006] were the independent risk factors associated with pneumothorax. Patients with pneumothorax had lower probabilities of survival without major brain damage (MBD): aOR = 0.283 (95% CI = 0.095-0.879); p = 0.029. Pneumothorax in VLBW seems to be related to perinatal inflammation and surfactant administration, and it is significantly associated with a reduction in the probabilities of survival without MBD.

Deficits in vision and visual attention associated with motor performance of very preterm/very low birth weight children.

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Geldof, Christiaan J A; van Hus, Janeline W P; Jeukens-Visser, Martine; Nollet, Frans; Kok, Joke H; Oosterlaan, Jaap; van Wassenaer-Leemhuis, Aleid G

2016-01-01

To extend understanding of impaired motor functioning of very preterm (VP)/very low birth weight (VLBW) children by investigating its relationship with visual attention, visual and visual-motor functioning. Motor functioning (Movement Assessment Battery for Children, MABC-2; Manual Dexterity, Aiming & Catching, and Balance component), as well as visual attention (attention network and visual search tests), vision (oculomotor, visual sensory and perceptive functioning), visual-motor integration (Beery Visual Motor Integration), and neurological status (Touwen examination) were comprehensively assessed in a sample of 106 5.5-year-old VP/VLBW children. Stepwise linear regression analyses were conducted to investigate multivariate associations between deficits in visual attention, oculomotor, visual sensory, perceptive and visual-motor integration functioning, abnormal neurological status, neonatal risk factors, and MABC-2 scores. Abnormal MABC-2 Total or component scores occurred in 23-36% of VP/VLBW children. Visual and visual-motor functioning accounted for 9-11% of variance in MABC-2 Total, Manual Dexterity and Balance scores. Visual perceptive deficits only were associated with Aiming & Catching. Abnormal neurological status accounted for an additional 19-30% of variance in MABC-2 Total, Manual Dexterity and Balance scores, and 5% of variance in Aiming & Catching, and neonatal risk factors for 3-6% of variance in MABC-2 Total, Manual Dexterity and Balance scores. Motor functioning is weakly associated with visual and visual-motor integration deficits and moderately associated with abnormal neurological status, indicating that motor performance reflects long term vulnerability following very preterm birth, and that visual deficits are of minor importance in understanding motor functioning of VP/VLBW children. Copyright © 2016 Elsevier Ltd. All rights reserved.

Arsenic in drinking water and adverse birth outcomes in Ohio.

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Almberg, Kirsten S; Turyk, Mary E; Jones, Rachael M; Rankin, Kristin; Freels, Sally; Graber, Judith M; Stayner, Leslie T

2017-08-01

Arsenic in drinking water has been associated with adverse reproductive outcomes in areas with high levels of naturally occurring arsenic. Less is known about the reproductive effects of arsenic at lower levels. This research examined the association between low-level arsenic in drinking water and small for gestational age (SGA), term low birth weight (term LBW), very low birth weight (VLBW), preterm birth (PTB), and very preterm birth (VPTB) in the state of Ohio. Exposure was defined as the mean annual arsenic concentration in drinking water in each county in Ohio from 2006 to 2008 using Safe Drinking Water Information System data. Birth outcomes were ascertained from the birth certificate records of 428,804 births in Ohio from the same time period. Multivariable generalized estimating equation logistic regression models were used to assess the relationship between arsenic and each birth outcome separately. Sensitivity analyses were performed to examine the roles of private well use and prenatal care utilization in these associations. Arsenic in drinking water was associated with increased odds of VLBW (AOR 1.14 per µg/L increase; 95% CI 1.04, 1.24) and PTB (AOR 1.10; 95% CI 1.06, 1.15) among singleton births in counties where water was positively associated with VLBW and PTB in a population where nearly all (>99%) of the population was exposed under the current maximum contaminant level of 10µg/L. Current regulatory standards may not be protective against reproductive effects of prenatal exposure to arsenic. Copyright © 2017 Elsevier Inc. All rights reserved.

Factors associated with inter-institutional variations in sepsis rates of very-low-birth-weight infants in 34 Malaysian neonatal intensive care units.

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Boo, Nem-Yun; Cheah, Irene Guat-Sim

2016-03-01

This study aimed to determine whether patient loads, infant status on admission and treatment interventions were significantly associated with inter-institutional variations in sepsis rates in very-low-birth-weight (VLBW) infants in the Malaysian National Neonatal Registry (MNNR). This was a retrospective study of 3,880 VLBW (≤ 1,500 g) infants admitted to 34 neonatal intensive care units (NICUs) in the MNNR. Sepsis was diagnosed in symptomatic infants with positive blood culture. Sepsis developed in 623 (16.1%) infants; 61 (9.8%) had early-onset sepsis (EOS) and 562 (90.2%) had late-onset sepsis (LOS). The median EOS rate of all NICUs was 1.0% (interquartile range [IQR] 0%, 2.0%). Compared with NICUs reporting no EOS (n = 14), NICUs reporting EOS (n = 20) had significantly higher patient loads (total live births, admissions, VLBW infants, outborns); more mothers with a history of abortions, and antenatal steroids and intrapartum antibiotic use; more infants requiring resuscitation procedures at birth; higher rates of surfactant therapy, pneumonia and insertion of central venous catheters. The median LOS rate of all NICUs was 14.5% (IQR 7.8%, 19.2%). Compared with NICUs with LOS rates below the first quartile (n = 8), those above the third quartile (n = 8) used less intrapartum antibiotics, and had significantly bigger and more mature infants, more outborns, as well as a higher number of sick infants requiring ventilator support and total parenteral nutrition. Patient loads, resuscitation at birth, status of infants on admission and treatment interventions were significantly associated with inter-institutional variations in sepsis. Copyright: © Singapore Medical Association.

Screening for autism in preterm children with extremely low and very low birth weight

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Dudova, Iva; Kasparova, Martina; Markova, Daniela; Zemankova, Jana; Beranova, Stepanka; Urbanek, Tomas; Hrdlicka, Michal

2014-01-01

Background Studies of children with very low birth weight (VLBW, 1,000–1,500 g) and extremely low birth weight (ELBW, less than 1,000 g) indicate that this population seems to be at increased risk of autism spectrum disorder (ASD). Methods Parents of 101 VLBW and ELBW children (age 2 years, corrected for prematurity) agreed to participate in the study and signed informed consents; however, parents of only 75 children (44 boys, 31 girls) completed the screening questionnaires. The screening battery included the Modified Checklist for Autism in Toddlers (M-CHAT), Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (CSBS-DP-ITC), and the Infant/Toddler Sensory Profile (ITSP). Children with disabilities were excluded. All children who screened positive on any of the screening tools were subsequently invited for a detailed assessment. Results Thirty-two children (42.7%) screened positive on at least one of the screening questionnaires. The screening tool with the most positive results was the CSBS-DP-ITC (26 positive screens), followed by the M-CHAT (19 positive screens) and the ITSP (11 positive screens). Of the 32 children who tested positive, 19 participated in the detailed follow-up assessment. A diagnosis of ASD was confirmed in eight of the 19 children. ASD prevalence, calculated from those 19 children and those with negative screening results (43 children), yielded a prevalence of 12.9% in the sample. The difference in frequency of positive screens between the tests was significant (P=0.011). In pair comparisons, ITSP was found to be significantly less positive than CSBS-DP-ITC (P=0.032). No significant differences were found between the M-CHAT and CSBS-DP-ITC or between the M-CHAT and ITSP. Conclusion The results strongly support the hypothesis of an increased prevalence of autism in children with a birth weight less than 1,500 g. PMID:24627633

The relationship between multiple developmental difficulties in very low birth weight children at 3½ years of age and the need for learning support at 5 years of age

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Verkerk, Gijs; Jeukens-Visser, Martine; van Wassenaer-Leemhuis, Aleid; Kok, Joke; Nollet, Frans

2014-01-01

This study investigated whether multiple developmental difficulties are more frequent in very low birth weight (VLBW) children than in those born full term. The association between multiple developmental difficulties assessed at 3½ years of age and educational provision for the child at 5½ years was

Oral versus intravenous paracetamol: which is better in closure of patent ductus arteriosus in very low birth weight infants?

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Sancak, Selim; Gokmen Yildirim, Tulin; Topcuoglu, Sevilay; Yavuz, Taner; Karatekin, Guner; Ovali, Fahri

2016-01-01

To compare the efficacy of oral and intravenous paracetamol for closure of hemodynamically significant patent ductus arteriosus (HSPDA) in very low birth weight (VLBW) preterm infants. Eighteen VLBW infants with HSPDA treated with either intravenous (n = 10) or oral (n = 8) paracetamol at 60 mg/kg/d for three consecutive days were analysed retrospectively. Ductal closure rate and evaluation of liver function tests were the major outcomes. After two courses of treatment, HSPDA closure rate was higher in oral paracetamol group than that in the intravenous paracetamol group (88% versus 70%), but it was not statistically significant (p = 0.588). Liver function tests were normal after the treatment. Although it was not statistically significant, the cumulative closure rates were higher in oral paracetamol group than those in the intravenous group. Larger trials are needed to confirm these data.

Diminished growth and lower adiposity in hyperglycemic very low birth weight neonates at 4 months corrected age.

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Scheurer, J M; Gray, H L; Demerath, E W; Rao, R; Ramel, S E

2016-02-01

Characterize the relationship between neonatal hyperglycemia and growth and body composition at 4 months corrected age (CA) in very low birth weight (VLBW) preterm infants. A prospective study of VLBW appropriate-for-gestation infants (N=53). All blood glucose measurements in the first 14 days and nutritional intake and illness markers until discharge were recorded. Standard anthropometrics and body composition via air displacement plethysmography were measured near term CA and 4 months CA. Relationships between hyperglycemia and anthropometrics and body composition were examined using multivariate linear regression. Infants with >5 days of hyperglycemia were lighter (5345 vs 6455 g, P⩽0.001), shorter (57.9 vs 60.9 cm, P⩽0.01), had smaller occipital-frontal head circumference (39.4 vs 42.0 cm, P⩽0.05) and were leaner (percent body fat 15.0 vs 23.8, P⩽0.01) at 4 months CA than those who did not have hyperglycemia, including after correcting for nutritional and illness factors. Neonatal hyperglycemia in VLBW infants is associated with decreased body size and lower adiposity at 4 months CA independent of nutritional deficit, insulin use and illness. Downregulation of the growth hormone axis may be responsible. These changes may influence long-term growth and cognitive development.

Survival and morbidity of very low birth weight infant in a South American neonatal network.

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Fernández, Rocío; D'Apremont, Ivonne; Domínguez, Angélica; Tapia, José L

2014-10-01

To analyze survival and relevant morbidity by gestational age (GA) in very low birth weight (VLBW) infants (Neonatal Network (Red Neonatal Neocosur) between January 2001 and December 2011. Data on 8234 VLBW with a GA between 24+0 and 31+6 weeks were analyzed. Overall mortality was 26% (95% CI: 25.0-26.9), including 2.6% of deaths in the delivery room. Fact sheets for survival and morbidity for each week of gestation were developed based on collected data. Survival at discharge increased from 29% at 24 weeks of GA to 91% at 31 weeks of GA (p neonatal morbidity was inversely related to GA (p hemorrhage, and 4.6% periventricular leukomalacia. Among survivors, 47.3% had none of these five conditions. A tool for use in a clinical setting was developed based on updated regional data for establishing week-to-week survival and morbidity of newborn infants born between 24+0 and 31+6 weeks of GA. This information could be used to make decisions related to perinatal care and for counseling parents.

Review of interventional procedures in the very low birth-weight infant (<1.5 kg): complications, lessons learned and current practice

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Laffan, Eoghan E. [Children' s Hospital of Eastern Ontario, Department of Diagnostic Imaging, Ottawa, ON (Canada); McNamara, Patrick J.; Whyte, Hilary; L' Herault, Johanne [The Hospital for Sick Children, Division of Neonatology, Toronto, ON (Canada); Amaral, Joao; Temple, Michael; John, Philip; Connolly, Bairbre L. [The Hospital for Sick Children, The Image-Guided Therapy Unit, Toronto, ON (Canada)

2009-08-15

Interventional radiology (IR) procedures in very low birth-weight (VLBW) infants (<1.5 kg) are challenging due to size, immaturity, comorbidities and lack of devices of suitable size. Infants are moved from the neonatal intensive care unit to the IR suite, further exposing them to risk. Our purpose was to review our experience of interventional procedures in VLBW infants, specifically complications and potential risks. VLBW infants referred for image-guided therapy between 1998 and 2005 were identified and medical records reviewed. ''Complications'' were divided into: major or minor, periprocedural or postprocedural, and intervention-/device-related, patient-related or equipment-related. Transport risk index of physiological stability (TRIPS) scores were calculated. A total of 116 infants (68 male, 48 female) underwent 176 procedures (159 vascular access-related and 17 nonvascular). Of 158 complications identified, 116 were major and 42 were minor. Major complications included hypothermia (n=33), line manipulations/removals (n=25), bleeding (n=12), thrombosis (n=4), cardiac arrest (n=3), tamponade (n=2), and multiorgan failure (n=1). Of the complications, 119 were categorized as intervention-/device-related, 32 patient-related and 7 equipment-related. There were no significant differences between pre- and postprocedural TRIPS scores. Successful completion of IR procedures in the VLBW infant is possible, but complications still occur in these fragile infants. (orig.)

Recombinant Activated Factor VIIa (rFVIIa) Treatment in Very-Low-Birth-Weight (VLBW) Premature Infants with Acute Pulmonary Hemorrhage: A Single-Center, Retrospective Study.

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Cosar, Hese; Isik, Halil; Cakır, Salih Cagrı; Yar, Nese; Goksen, Bulent; Tokbay, Hakan; Kertmen, Hasan; Erdoğan, Nihal; Durak, Ikbal

2017-02-01

We aimed to evaluate the efficacy of intravenous administration of recombinant activated factor VIIa (rFVIIa) for acute pulmonary hemorrhage treatment in very-low-birth-weight (VLBW) premature infants. This study was carried out retrospectively in premature infants with pulmonary hemorrhage that were ≤30 weeks gestational age or hemorrhage who were hospitalized in our neonatal intensive care unit between 01 January 2013 and 31 December 2015 were evaluated. Group 1 (n = 21) received rFVIIa support within the first 30 min of pulmonary hemorrhage plus conventional treatment, while Group 2 (n = 21) received conventional treatment only. The number of patients whose pulmonary hemorrhage was stopped within the first 2 h was significantly higher in Group 1 than Group 2 (n = 14 vs n = 4; p = 0.002). After pulmonary hemorrhage, hemoglobin values of Group 1 were higher than Group 2 (11.12 ± 1.06 vs 10.14 ± 1.59 g/dL; p = 0.024). Erythrocyte suspension (1.43 ± 4.51 vs 5.71 ± 7.46 mL/kg; p = 0.030) and fresh frozen plasma use (5.71 ± 8.10 vs 19.52 ± 12.44 mL/kg; p hemorrhage after 72 h, overall mortality, mortality from pulmonary hemorrhage, surfactant use, intubation time, hospitalization duration, intraventricular hemorrhage (IVH), severe IVH, patent ductus arteriosus rates, or short-term complication rates. rFVIIa administration was observed to be effective in stopping pulmonary hemorrhage, reducing blood product requirement, and improving coagulation test parameters. Prospective studies are needed to evaluate the efficacy, reliability, and long-term results of rFVIIa in the prevention and treatment of pulmonary hemorrhage in premature infants.

Respiratory morbidity in very preterm and very low birth weight infants: the first 2 years of life

Directory of Open Access Journals (Sweden)

Mariana Ferreira

2014-06-01

Full Text Available Respiratory morbidity in the first two years of life, including recurrent symptoms and frequent hospitalizations, is a common problem in very preterm and very low birth weight (VLBW infants. We conducted a retrospective cohort study aiming to describe the respiratory morbidity at 2 years of corrected age for very preterm and VLBW infants and to identify potential risk factors for its development in a Portuguese based population born in a tertiary referral center between 2009 and 2011. Data were collected from patient’s clinical files and using a standardized questionnaire-based clinical interview for parents. A total 59 children were included. Thirteen (22.0% had recurrent respiratory symptoms and 12 (20.3% were using chronic respiratory medication. Health care utilization for respiratory causes was frequent (57.6%, particularly emergency department attendance (50.8%. Twenty seven (45.8% had additional outpatient visits for respiratory causes and hospital admission was necessary for 8 (13.6% patients. Factors associated with increased recurrent respiratory symptoms included maternal hypertensive disorders during pregnancy, umbilical artery flow disturbances, being small for gestational age, bronchopulmonary dysplasia, retinopathy of prematurity, intraventricular hemorrhage and a weight percentile below 3 at 6, 12 and 24 months of corrected age. Premature rupture of membranes was negatively associated with respiratory morbidity. Respiratory morbidity at 2 years of age is a common problem in very preterm and VLBW children from our population. Several perinatal and developmental risk factors were identified for respiratory morbidity. Further studies are needed to clarify the importance of these factors, as they can lead to changes in healthcare guidelines.

Survival of the very-low-birth-weight infants after cardiopulmonary resuscitation in neonatal intensive care unit.

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Kostelanetz, Anna S; Dhanireddy, Ramasubbareddy

2004-05-01

To assess whether advances in neonatal care in the last decade have altered the outcome of very-low-birth-weight (VLBW) infants after cardiopulmonary resuscitation (CPR) in the neonatal intensive care unit (NICU). Medical records of all VLBW infants (n=283, body weight (BW)=1066+/-281 g, gestational age (GA)=28.3+/-2.9 weeks) admitted to the NICU between 1999 and 2002 were reviewed. In all, 29 (10.25%) infants received CPR in the NICU. Only one of these infants survived. After adjusting for GA, the clinical variables significantly associated with the need for CPR in the NICU were (adjusted odds ratio; 95% CI): pulmonary hemorrhage (7.89; 3.06 to 20.28), pulmonary air leak syndrome (23.90; 7.58 to 75.4), and delivery by Cesarian section (0.26; 0.1 to 0.66). The results were similar when the data were reanalyzed matching the 28 infants in the CPR group with 28 infants of identical GA in the non-CPR group. Survival rate for the infants who require CPR in the NICU remains extremely poor. This poor outcome needs to be discussed with parents and the option of the "do not resuscitate" (DNR) order may be appropriate for these infants, especially for those infants with multiple organ failure unresponsive to therapy.

Teamwork in the NICU setting and its association with healthcare-associated infections in very low birth weight infants

Science.gov (United States)

Profit, Jochen; Sharek, Paul J.; Kan, Peiyi; Rigdon, Joseph; Desai, Manisha; Nisbet, Courtney C.; Tawfik, Daniel S.; Thomas, Eric J.; Lee, Henry C.; Sexton, J. Bryan

2018-01-01

Background and Objective Teamwork may affect clinical care in the neonatal intensive care unit (NICU) setting. The objective of this study was to assess teamwork climate across NICUs and to test scale level and item level associations with healthcare-associated infection (HAI) rates in very low birth weight (VLBW) infants. Methods Cross-sectional study of the association between HAI rates, defined as any bacterial or fungal infection during the birth hospitalization, among 6663 VLBW infants cared for in 44 NICUs between 2010 and 2012. NICU HAI rates were correlated with teamwork climate ratings obtained in 2011 from 2073 of 3294 eligible (response rate 63%) NICU health professionals. The relation between HAI rates and NICU teamwork climate was assessed using logistic regression models including NICU as a random effect. Results Across NICUs, 36 to 100% (mean 66%) of respondents reported good teamwork. HAI rates were significantly and independently associated with teamwork climate (OR [95% CI] 0.82 [0.73-0.92], p = 0.005), such that the odds of an infant contracting a HAI decreased by 18% with each 10% rise in NICU respondents reporting good teamwork. Conclusion Improving teamwork may be an important element in infection control efforts. PMID:28395366

Efficacy of Probiotics Versus Placebo in the Prevention of Necrotizing Enterocolitis in Preterm Very Low Birth Weight Infants: A Double-blind Randomized Controlled Trial

International Nuclear Information System (INIS)

Chowdhury, T.; Ali, M.M.; Hossain, M. M.

2016-01-01

Objective: To evaluate the efficacy of orally administered probiotics in preventing necrotizing enterocolitis (NEC) in preterm very low birth weight (VLBW) infants. Study Design: Arandomized double blind controlled trial. Place and Duration of Study: The Paediatrics Department of Sylhet M.A.G. Osmani Medical College Hospital, Sylhet Bangladesh, from July 2012 to June 2015. Methodology: Preterm (28 - 33 weeks gestation) VLBW (birth weight 1000 - 1499 g) neonates were enrolled. The study group was fed with probiotics once daily with breast milk from first feeding, and the control group with only breast milk without the addition of probiotics. Both the groups received other standard care. The primary outcome was the development of NEC (stage II and III), categorized by modified Bell's classification. Result: In 108 neonates, development of NEC was significantly lower in the study group than that of control group [1 (1.9 percent) vs. 6 (11.5 percent); p=0.044]. Age of achievement of full oral feeding was significantly earlier in the study group than that in the control group (14.88 ±3.15 and 18.80 ±4.32 days; p < 0.001). Duration of hospital stay was significantly short in the study group compared to the control group (15.82 ±2.94 days vs. 19.57 ±4.26 days; p < 0.001). Conclusion: Probiotic supplementation reduces the frequency of necrotising enterocolitis in preterm neonates with very low birth weight. It is also associated with faster achievement of full oral feeding and short duration of hospital stay. (author)

A Multidisciplinary Quality Improvement Approach Increases Breastmilk Availability at Discharge from the Neonatal Intensive Care Unit for the Very-Low-Birth-Weight Infant.

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Bixby, Christine; Baker-Fox, Cindy; Deming, Crystal; Dhar, Vijay; Steele, Caroline

2016-03-01

Mothers of very-low-birth-weight (VLBW) infants often struggle to establish and maintain a milk supply. Children's Hospital of Orange County (CHOC Children's) data from 2005 to 2011 showed that while the total percentage of all neonatal intensive care unit (NICU) babies being discharged on breastmilk had remained stable, the percentage of VLBW babies with breastmilk at discharge had declined. This information resulted in a quality improvement initiative to remove barriers and implement programs shown to have the greatest impact on initiating and sustaining lactation in this patient subset. The objective of this initiative was to increase breastmilk availability at discharge for the VLBW population. A multidisciplinary program was initiated, which included NICU parent and staff education, clarification of roles, and improved access to pumping supplies. Physicians and nurses completed online education. An algorithm defining roles in lactation support was developed, and a resource team of trained bedside nurses was formed. Lactation consultant time was then refocused on the VLBW population. In addition, "Lactation Support" was added to the physician daily documentation to bring the topic to daily bedside rounds. Twice weekly lactation rounds between the lactation consultant and neonatologist addressed lactation concerns for each dyad. To address pumping issues, the loaner pump program was enhanced. To assess the effectiveness of the initiative, breastmilk availability at discharge for the VLBW population at CHOC Children's was compared from baseline (2011) to the end of June 2015. VLBW breastmilk availability at discharge upon project initiation was 58.7% and increased by 36% to a final rate of 80% by 2013--a rate sustained through the first 6 months of 2015. The results of this initiative suggest that a multidisciplinary approach, including education, changes in workflow, and redefinition of roles, is effective in improving breastmilk rates at discharge in the VLBW

The human milk project: a quality improvement initiative to increase human milk consumption in very low birth weight infants.

Science.gov (United States)

Ward, Laura; Auer, Christine; Smith, Carrie; Schoettker, Pamela J; Pruett, Raymond; Shah, Nilesh Y; Kotagal, Uma R

2012-08-01

Human milk has well-established health benefits for preterm infants. We conducted a multidisciplinary quality improvement effort aimed at providing at least 500 mL of human milk/kg in the first 14 days of life to very low birth weight (VLBW) (milk program, and twice-daily physician evaluation of infants' ability to tolerate feedings. The number of infants receiving at least 500 mL of human milk/kg in their first 14 days of life increased from 50% to 80% within 11 months of implementation, and this increase has been sustained for 4 years. Infants who met the feeding goal because they received donor milk increased each year. Since September 2007, infants have received, on average, 1,111 mL of human milk/kg. Approximately 4% of infants did not receive any human milk. Respiratory instability was the most frequent physiological reason given by clinicians for not initiating or advancing feedings in the first 14 days of life. Our quality improvement initiative resulted in a higher consumption of human milk in VLBW infants in the first 14 days of life. Other clinicians can use these described quality improvement methods and techniques to improve their VLBW babies' consumption of human milk.

[Effect of early nutrition on growth parameters and psychomotor development of children of very low birth weight].

Science.gov (United States)

Kocourková, I; Sobotková, D; Pilarová, M; Dittrichová, J; Vondrácek, J; Stranák, Z

2004-12-01

The aim of the study was to evaluate influence of early nutrition on growth parameters and psychomotor development of children with very low birth weight (VLBW). A prospective clinical study. Institute for Care of Mother and Child, Prague. Thirty nine children of birth weight 1,000-1,499 were followed up to one year of their corrected age in a prospective study. The group was divided in two groups according to type of nutrition: 17 children (group A) were fed with milk of own mother - "preterm milk", 22 children (group B) were orally fed with mature milk from the Bank of mother milk - "term milk", which was fortified with BMF preparation (Nutricia, Netherlands). Both groups were comparable in basic anthropometric parameters (weight, lenght, circumference of head and thotax) and in psychosocial characteristics of their mothers. Growths parameters were monitored in weekly intervals for approximatelly eight weeks. In the period between 11th and 15th month of corrected age, the children were evaluated by a clinical psychologist on a blind basis in mental a motor development by using Bayley Scales of Infant Development (BSID-II). Statistical analysis was performed by chi-square test and t-test. No statistically significant differences between the two groups in evaluating the growth parameters were observed. The psychological examination demonstrated statistically significant differences in the motor development. The psychomotor developmental index (PVI) proved to be 84.4 +/- 14.6 in the group A and 94.3 +/- 12.5 in the group B (t-test = 2.28, pdevelopment between the two groups. The mean mentel developmental index (MVI) was 98.2 +/- 10.2 in the A group and 101.0 +/- 13.3 in the group B. Result of the study indicate favorable effect of fortification of breast milk in VLBW newborns, especially in view of the observed favorable influence of fortfication on motor development of the children.

Effects of underwater bubble CPAP on very-low-birth-weight preterm newborns in the delivery room and after transport to the neonatal intensive care unit.

Science.gov (United States)

Abelenda, Vera Lucia Barros; Valente, Tania Cristina Oliveira; Marinho, Cirlene Lima; Lopes, Agnaldo José

2018-01-01

The development of less invasive ventilatory strategies in very-low-birth-weight (VLBW) preterm newborns has been a growing concern in recent decades. This study aimed to measure differences in the clinical progression of preterm newborns using two distinct periods in a university hospital: before and after using underwater bubble continuous positive airway pressure (ubCPAP). This is a retrospective study of VLBW preterm newborns with gestational ages less than or equal to 32 weeks admitted to the neonatal intensive care unit. The time series was divided into two groups: a pre-CPAP group ( n = 45) and a post-CPAP group ( n = 40). The post-CPAP group had fewer resuscitations, required fewer surfactant doses, spent fewer days on mechanical ventilation, and demonstrated less of a need for fraction of inspired oxygen > 30%. UbCPAP is an easy to use, minimally invasive, and effective ventilatory strategy for VLBW preterm newborns that can be used in environments with limited resources. Thus, adopting this simple strategy as part of a service organization and health policy can positively impact outcomes.

Sequential hand hygiene promotion contributes to a reduced nosocomial bloodstream infection rate among very low-birth weight infants: an interrupted time series over a 10-year period.

Science.gov (United States)

Helder, Onno K; Brug, Johannes; van Goudoever, Johannes B; Looman, Caspar W N; Reiss, Irwin K M; Kornelisse, René F

2014-07-01

Sustained high compliance with hand hygiene (HH) is needed to reduce nosocomial bloodstream infections (NBSIs). However, over time, a wash out effect often occurs. We studied the long-term effect of sequential HH-promoting interventions. An observational study with an interrupted time series analysis of the occurrence of NBSI was performed in very low-birth weight (VLBW) infants. Interventions consisted of an education program, gain-framed screen saver messages, and an infection prevention week with an introduction on consistent glove use. A total of 1,964 VLBW infants admitted between January 1, 2002, and December 31, 2011, were studied. The proportion of infants with ≥1 NBSI decreased from 47.6%-21.2% (P Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Servo-control for maintaining abdominal skin temperature at 36C in low birth weight infants.

Science.gov (United States)

Sinclair, J C

2002-01-01

Randomized trials have shown that the neonatal mortality rate of low birth-weight babies can be reduced by keeping them warm. For low birth-weight babies nursed in incubators, warm conditions may be achieved either by heating the air to a desired temperature, or by servo-controlling the baby's body temperature at a desired set-point. In low birth weight infants, to determine the effect on death and other important clinical outcomes of targeting body temperature rather than air temperature as the end-point of control of incubator heating. Standard search strategy of the Cochrane Neonatal Review Group. Searches were made of the Cochrane Controlled Trials Register (CCTR) (Cochrane Library, Issue 4, 2001) and MEDLINE, 1966 to November 2001. Randomized or quasi-randomized trials which test the effects of having the heat output of the incubator servo-controlled from body temperature compared with setting a constant incubator air temperature. Trial methodologic quality was systematically assessed. Outcome measures included death, timing of death, cause of death, and other clinical outcomes. Categorical outcomes were analyzed using relative risk and risk difference. Meta-analysis assumed a fixed effect model. Two eligible trials were found. In total, they included 283 babies and 112 deaths. Compared to setting a constant incubator air temperature of 31.8C, servo-control of abdominal skin temperature at 36C reduces the neonatal death rate among low birth weight infants: relative risk 0.72 (95% CI 0.54, 0.97); risk difference -12.7% (95% CI -1.6, -23.9). This effect is even greater among VLBW infants. During at least the first week after birth, low birth weight babies should be provided with a carefully regulated thermal environment that is near the thermoneutral point. For LBW babies in incubators, this can be achieved by adjusting incubator temperature to maintain an anterior abdominal skin temperature of at least 36C, using either servo-control or frequent manual

Cerebral metabolite differences in adolescents with low birth weight: assessment with in vivo proton MR spectroscopy

International Nuclear Information System (INIS)

Bathen, Tone F.; Gribbestad, Ingrid S.; Sjoebakk, Torill E.; Skranes, Jon; Brubakk, Ann-Mari; Martinussen, Marit; Vik, Torstein; Myhr, Gunnar E.; Axelson, David

2006-01-01

Children with very low birth weight (VLBW) have a significantly increased risk of later neurodevelopmental problems, while infants born small for gestational age (SGA) at term are also at some risk of developing neurological impairment. To investigate possible brain metabolite differences in adolescents with VLBW, SGA at term and controls by proton in vivo magnetic resonance spectroscopy (MRS) at 1.5 T. MR spectra were acquired from volumes localized in the left frontal lobe, containing mainly white matter (54 subjects). Peak areas of N-acetyl aspartate (NAA), choline (Cho) and creatine (Cr) were determined, and the peak area ratio of NAA to Cr, total Cho to Cr, or NAA to Cho calculated. Probabilistic neural network (PNN) analysis was performed utilizing the chemical shift region containing resonances from NAA, Cho and Cr as inputs. No significant difference in the peak area ratios could be found using the Kruskal-Wallis test. By application of PNN, a correct classification of 52 of the 54 adolescents with a sensitivity and specificity exceeding 93% for all groups was achieved. Small, yet systematic, differences in brain metabolite distribution among the groups were confirmed by PNN analysis. (orig.)

Cerebral metabolite differences in adolescents with low birth weight: assessment with in vivo proton MR spectroscopy

Energy Technology Data Exchange (ETDEWEB)

Bathen, Tone F.; Gribbestad, Ingrid S. [Norwegian University of Science and Technology, Department of Circulation and Medical Imaging, Trondheim (Norway); Sjoebakk, Torill E. [Department of Neuroscience, Norwegian University of Science and Technology, Trondheim (Norway); Skranes, Jon; Brubakk, Ann-Mari; Martinussen, Marit [St. Olavs Hospital HF, Department of Laboratory Medicine, Children' s and Women' s Health, Norwegian University of Science and Technology, Trondheim (Norway); Vik, Torstein [Norwegian University of Science and Technology, Department of Public Health and General Practise, Trondheim (Norway); Myhr, Gunnar E. [St. Olavs University Hospital, Department of Radiology, Trondheim (Norway); Axelson, David [MRi Consulting, Ontario (Canada)

2006-08-15

Children with very low birth weight (VLBW) have a significantly increased risk of later neurodevelopmental problems, while infants born small for gestational age (SGA) at term are also at some risk of developing neurological impairment. To investigate possible brain metabolite differences in adolescents with VLBW, SGA at term and controls by proton in vivo magnetic resonance spectroscopy (MRS) at 1.5 T. MR spectra were acquired from volumes localized in the left frontal lobe, containing mainly white matter (54 subjects). Peak areas of N-acetyl aspartate (NAA), choline (Cho) and creatine (Cr) were determined, and the peak area ratio of NAA to Cr, total Cho to Cr, or NAA to Cho calculated. Probabilistic neural network (PNN) analysis was performed utilizing the chemical shift region containing resonances from NAA, Cho and Cr as inputs. No significant difference in the peak area ratios could be found using the Kruskal-Wallis test. By application of PNN, a correct classification of 52 of the 54 adolescents with a sensitivity and specificity exceeding 93% for all groups was achieved. Small, yet systematic, differences in brain metabolite distribution among the groups were confirmed by PNN analysis. (orig.)

Laboratory-confirmed bloodstrean infeccion in very low birth weigth neonates

Directory of Open Access Journals (Sweden)

Juliana Ferreira da Silva Rios Alvim

2014-04-01

Full Text Available Backgound and Objectives: Premature newborns are exposed to multiple risk factors for late-onset sepsis: the immaturity of defense systems, low birth weight and low gestational age, use of invasive devices. Purpose to assess the occurrence and etiology of late-onset sepsis (ICSLC in premature infants with birth weight less than 1500 g (VLBW admitted to the Neonatal Intensive Care Unit (NICU of a philanthropic reference in Belo Horizonte – Minas Gerais. Methodology: Cross-sectional study. We evaluated data from epidemiological surveillance system (SACIH® and tokens active search of Hospital Infection Control Committee (HICC of the institution, for January 2010 to December 2012. Results: were recorded in 1850 Health Associated Infection (HAI, these 1481 were of bloodstream infection (BSI, representing 80% of HAIs. Of ICS, 559 (37.7% were early-onset and 922 (62.3% late-onset. The density incidence of infections was 30.7 / 1.000patients-day. Were registered LCBI 256 patients, totaling 355 infections. Of these patients, 16 had LCBI more of a microbiological agent. 99 patients (38.6% had more than one LCBI. Birth-weight average 985g and gestational age (GA average of 28 weeks. Most frequent agents were Coagulase-Negative Staphylococcus 49.9% (n = 117, Klebsiella sp 17% (n = 60, Candida sp 12.4% (n = 44. The lethality rate associated with LCBI in VLBW was 6.8% (n = 23. Conclusion: Despite the technological advances in fetal medicine and increase the survival of VLBW infants, the late onset sepsis presents itself at high rates and high incidence, which represents a major cause of morbidity and mortality for these newborns. KEYWORDS: Sepsis. Premature. Newborn. Infection control.

Differential ethnic associations between maternal flexibility and play sophistication in toddlers born very low birth weight

Science.gov (United States)

Erickson, Sarah J.; Montague, Erica Q.; Maclean, Peggy C.; Bancroft, Mary E.; Lowe, Jean R.

2013-01-01

Children born very low birth weight (development of self-regulation and effective functional skills, and play serves as an important avenue of early intervention. The current study investigated associations between maternal flexibility and toddler play sophistication in Caucasian, Spanish speaking Hispanic, English speaking Hispanic, and Native American toddlers (18-22 months adjusted age) in a cross-sectional cohort of 73 toddlers born VLBW and their mothers. We found that the association between maternal flexibility and toddler play sophistication differed by ethnicity (F(3,65) = 3.34, p = .02). In particular, Spanish speaking Hispanic dyads evidenced a significant positive association between maternal flexibility and play sophistication of medium effect size. Results for Native Americans were parallel to those of Spanish speaking Hispanic dyads: the relationship between flexibility and play sophistication was positive and of small-medium effect size. Findings indicate that for Caucasians and English speaking Hispanics, flexibility evidenced a non-significant (negative and small effect size) association with toddler play sophistication. Significant follow-up contrasts revealed that the associations for Caucasian and English speaking Hispanic dyads were significantly different from those of the other two ethnic groups. Results remained unchanged after adjusting for the amount of maternal language, an index of maternal engagement and stimulation; and after adjusting for birth weight, gestational age, gender, test age, cognitive ability, as well maternal age, education, and income. Our results provide preliminary evidence that ethnicity and acculturation may mediate the association between maternal interactive behavior such as flexibility and toddler developmental outcomes, as indexed by play sophistication. Addressing these association differences is particularly important in children born VLBW because interventions targeting parent interaction strategies such as

Teamwork in the NICU Setting and Its Association with Health Care-Associated Infections in Very Low-Birth-Weight Infants.

Science.gov (United States)

Profit, Jochen; Sharek, Paul J; Kan, Peiyi; Rigdon, Joseph; Desai, Manisha; Nisbet, Courtney C; Tawfik, Daniel S; Thomas, Eric J; Lee, Henry C; Sexton, J Bryan

2017-08-01

Background and Objective  Teamwork may affect clinical care in the neonatal intensive care unit (NICU) setting. The objective of this study was to assess teamwork climate across NICUs and to test scale-level and item-level associations with health care-associated infection (HAI) rates in very low-birth-weight (VLBW) infants. Methods  Cross-sectional study of the association between HAI rates, defined as any bacterial or fungal infection during the birth hospitalization, among 6,663 VLBW infants cared for in 44 NICUs between 2010 and 2012. NICU HAI rates were correlated with teamwork climate ratings obtained in 2011 from 2,073 of 3,294 eligible NICU health professionals (response rate 63%). The relation between HAI rates and NICU teamwork climate was assessed using logistic regression models including NICU as a random effect. Results  Across NICUs, 36 to 100% (mean 66%) of respondents reported good teamwork. HAI rates were significantly and independently associated with teamwork climate (odds ratio, 0.82; 95% confidence interval, 0.73-0.92, p  = 0.005), such that the odds of an infant contracting a HAI decreased by 18% with each 10% rise in NICU respondents reporting good teamwork. Conclusion  Improving teamwork may be an important element in infection control efforts. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Association of Maternal Preeclampsia With Infant Risk of Premature Birth and Retinopathy of Prematurity.

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Shulman, Julia P; Weng, Cindy; Wilkes, Jacob; Greene, Tom; Hartnett, M Elizabeth

2017-09-01

Studies report conflicting associations between preeclampsia and retinopathy of prematurity (ROP). This study provides explanations for the discrepancies to clarify the relationship between preeclampsia and ROP. To evaluate the association of maternal preeclampsia and risk of ROP among infants in an unrestricted birth cohort and a restricted subcohort of preterm, very low birth weight (P-VLBW) infants. A retrospective review of 290 992 live births within the Intermountain Healthcare System in Utah from January 1, 2001, through December 31, 2010, was performed. Generalized estimating equations for logistic regressions with covariate adjustment were applied to relate ROP to preeclampsia among the full cohort and in a subcohort of P-VLBW infants born at younger than 31 weeks' gestation and weighing less than 1500 g. The occurrence of ROP was related to maternal preeclampsia in the full cohort and in a subcohort of P-VLBW infants. In the full cohort, 51% of the infants were male and the mean (SD) gestational age was 38.38 (1.87) weeks. In the P-VLBW cohort, 55% were male and the mean (SD) gestational age was 26.87 (2.40) weeks. In the full cohort, preeclampsia was associated with an increased risk of all ROP (adjusted odds ratio [aOR], 2.46; 95% CI, 2.17-2.79; P prematurity, because prematurity is an outcome of preeclampsia.

Antibiotic Therapy for Very Low Birth Weigh Newborns in NICU

OpenAIRE

Seyyed-Abolfazl Afjeh; Mohammad-Kazem Sabzehei; Seyyed-Ali-Reza Fahimzad; Farideh Shiva; Ahmad-Reza Shamshiri; Fatemeh Esmaili

2016-01-01

Background Prolonged empiric antibiotics therapy in neonates results in several adverse consequences including widespread antibiotic resistance, late onset sepsis (LOS), necrotizing enterocolitis (NEC), prolonged hospital course (HC) and increase in mortality rates. Objectives To assess the risk factors and the outcome of prolonged empiric antibiotic therapy in very low birth weight (VLBW) newborns. ...

Birth weight and stuttering: Evidence from three birth cohorts.

Science.gov (United States)

McAllister, Jan; Collier, Jacqueline

2014-03-01

Previous studies have produced conflicting results with regard to the association between birth weight and developmental stuttering. This study sought to determine whether birth weight was associated with childhood and/or adolescent stuttering in three British birth cohort samples. Logistic regression analyses were carried out on data from the Millenium Cohort Study (MCS), British Cohort Study (BCS70) and National Child Development Study (NCDS), whose initial cohorts comprised over 56,000 individuals. The outcome variables were parent-reported stuttering in childhood or in adolescence; the predictors, based on prior research, were birth weight, sex, multiple birth status, vocabulary score and mother's level of education. Birth weight was analysed both as a categorical variable (low birth weight, stuttering during childhood (age 3, 5 and 7 and MCS, BCS70 and NCDS, respectively) or at age 16, when developmental stuttering is likely to be persistent. None of the multivariate analyses revealed an association between birth weight and parent-reported stuttering. Sex was a significant predictor of stuttering in all the analyses, with males 1.6-3.6 times more likely than females to stutter. Our results suggest that birth weight is not a clinically useful predictor of childhood or persistent stuttering. Copyright © 2013 Elsevier Inc. All rights reserved.

A Randomized Trial Comparing Efficacy of Bubble and Ventilator Derived Nasal CPAP in Very Low Birth Weight Neonates with Respiratory Distress.

Science.gov (United States)

Agarwal, Sheetal; Maria, Arti; Roy, Mahesh K; Verma, Ankit

2016-09-01

Continuous Positive Airway Pressure (CPAP) has an established role in the care of Very Low Birth Weight (VLBW) babies with respiratory distress. Bubble CPAP (BCPAP) is a cheap alternative for countries where resources are limited. However, data comparing efficacy of BCPAP with conventional ventilator derived (VCPAP) is limited. To compare CPAP failure rates between BCPAP and VCPAP among VLBW, with moderate respiratory distress. Secondary objectives were to compare the rates of Intraventricular Haemorrhage (IVH), pulmonary air leaks and deaths between the two groups and determine the predictors of CPAP failure. VLBW babies with moderate respiratory distress (Silverman Anderson score 4-7), born or admitted in Neonatal Intensive Care Unit (NICU) within 28 days of life were randomized to receive either BCPAP (n=34) or VCPAP (n=34). CPAP failure rate in both the groups was compared. The baseline characteristics were similar in both the groups. Five out of 34 (14.70%) babies in BCPAP group and 11 out of 34 (32.35%) in VCPAP failed CPAP (p=0.08). IVH (BCPAP group 24% and VCPAP group 9%, p= 0.10) and mortality (BCPAP group 6% and VCPAP group 9%, p=0.642) were comparable in both the groups. Factors such as gestational age CPAP failure in our study. The CPAP failure rates in VLBW babies with moderate respiratory distress were found to be similar whether bubble CPAP or ventilator CPAP was used. There was no difference in complication rates of IVH or mortality with either method of CPAP.

Birth weight and perinatal mortality: A comparison of "optimal" birth weight in seven western European countries

NARCIS (Netherlands)

Graafmans, W.C.; Richardus, J.H.; Borsboom, G.J.J.M.; Bakketeig, L.; Langhoff-Roos, J.; Bergsjø, P.; Macfarlane, A.; Verloove-Vanhorick, P.; Mackenbach, J.; Aelvoet, W.; Alderdice, F.; Amelink, M.; Bakoula, C.; Blondel, B.; Bødker, B.; Bolumar, F.; Davidson, L.; Gissler, M.; Hartikainen, A.L.; Holt, J.; Kaminski, M.; Leidinger, J.; Lekea, V.; Lindmark, G.; Masuy-Stroobant, G.; Pal, K. van der; Penney, G.; Purificação Araújo, M. Da; Rantakallio, P.; Rebagliato, M.

2002-01-01

Background. Previous studies have suggested that a population's entire birth weight distribution may be shifted towards higher or lower birth weights, and that optimal birth weight may be lower in populations with a lower average birth weight. We evaluated this hypothesis for seven western European

Early neurodevelopment in very low birth weight infants with mild intraventricular hemorrhage or those without intraventricular hemorrhage

Directory of Open Access Journals (Sweden)

Il Rak Choi

2012-11-01

Full Text Available &lt;B&gt;Purpose:&lt;/B&gt; This study aimed to assess early development in very low birth weight (VLBW infants with mild intraventricular hemorrhage (IVH or those without IVH and to identify the perinatal morbidities affecting early neurodevelopmental outcome. &lt;B&gt;Methods:&lt;/B&gt; Bayley Scales of Infant Development-II was used for assessing neurological development in 49 infants with a birth weight &lt;1,500 g and with low grade IVH (?#167;rade II or those without IVH at a corrected age of 12 months. &lt;B&gt;Results:&lt;/B&gt; Among the 49 infants, 19 infants (38.8% showed normal development and 14 (28.6% showed abnormal mental and psychomotor development. Infants with abnormal mental development (n=14 were mostly male and had a longer hospitalization, a higher prevalence of patent ductus arteriosus (PDA and bronchopulmonary dysplasia (BPD, and were under more frequent postnatal systemic steroid treatment compared with infants with normal mental development (n=35, P&lt;0.05. Infants with abnormal psychomotor development (n=29 had a longer hospitalization and more associated PDA compared to infants with normal psychomotor development (n=20, P&lt;0.05. Infants with abnormal mental and psychomotor development were mostly male and had a longer hospitalization and a higher prevalence of PDA and BPD compared to infants with normal mental and psychomotor development (n=19, P&lt;0.05. Using multiple logistic regression analysis, a longer duration of hospitalization and male gender were found to be significant risk factors. &lt;B&gt;Conclusion:&lt;/B&gt; Approximately 62% of VLBW infants with low grade IVH or those without IVH had impaired early development.

White matter alterations and their associations with motor function in young adults born preterm with very low birth weight

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Ingrid Marie Husby Hollund

2018-01-01

Full Text Available Very low birth weight (VLBW: ≤1500 g individuals have an increased risk of white matter alterations and neurodevelopmental problems, including fine and gross motor problems. In this hospital-based follow-up study, the main aim was to examine white matter microstructure and its relationship to fine and gross motor function in 31 VLBW young adults without cerebral palsy compared with 31 term-born controls, at mean age 22.6 ± 0.7 years. The participants were examined with tests of fine and gross motor function (Trail Making Test-5: TMT-5, Grooved Pegboard, Triangle from Movement Assessment Battery for Children-2: MABC-2 and High-level Mobility Assessment Tool: HiMAT and diffusion tensor imaging (DTI. Probabilistic tractography of motor pathways of the corticospinal tract (CST and corpus callosum (CC was performed. Fractional anisotropy (FA was calculated in non-crossing (capsula interna in CST, body of CC and crossing (centrum semiovale fibre regions along the tracts and examined for group differences. Associations between motor test scores and FA in the CST and CC were investigated with linear regression. Tract-based spatial statistics (TBSS was used to examine group differences in DTI metrics in all major white matter tracts. The VLBW group had lower scores on all motor tests compared with controls, however, only statistically significant for TMT-5. Based on tractography, FA in the VLBW group was lower in non-crossing fibre regions and higher in crossing fibre regions of the CST compared with controls. Within the VLBW group, poorer fine motor function was associated with higher FA in crossing fibre regions of the CST, and poorer bimanual coordination was additionally associated with lower FA in crossing fibre regions of the CC. Poorer gross motor function was associated with lower FA in crossing fibre regions of the CST and CC. There were no associations between motor function and FA in non-crossing fibre regions of the CST and CC within

White matter alterations and their associations with motor function in young adults born preterm with very low birth weight.

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Hollund, Ingrid Marie Husby; Olsen, Alexander; Skranes, Jon; Brubakk, Ann-Mari; Håberg, Asta K; Eikenes, Live; Evensen, Kari Anne I

2018-01-01

Very low birth weight (VLBW: ≤ 1500 g) individuals have an increased risk of white matter alterations and neurodevelopmental problems, including fine and gross motor problems. In this hospital-based follow-up study, the main aim was to examine white matter microstructure and its relationship to fine and gross motor function in 31 VLBW young adults without cerebral palsy compared with 31 term-born controls, at mean age 22.6 ± 0.7 years. The participants were examined with tests of fine and gross motor function (Trail Making Test-5: TMT-5, Grooved Pegboard, Triangle from Movement Assessment Battery for Children-2: MABC-2 and High-level Mobility Assessment Tool: HiMAT) and diffusion tensor imaging (DTI). Probabilistic tractography of motor pathways of the corticospinal tract (CST) and corpus callosum (CC) was performed. Fractional anisotropy (FA) was calculated in non-crossing (capsula interna in CST, body of CC) and crossing (centrum semiovale) fibre regions along the tracts and examined for group differences. Associations between motor test scores and FA in the CST and CC were investigated with linear regression. Tract-based spatial statistics (TBSS) was used to examine group differences in DTI metrics in all major white matter tracts. The VLBW group had lower scores on all motor tests compared with controls, however, only statistically significant for TMT-5. Based on tractography, FA in the VLBW group was lower in non-crossing fibre regions and higher in crossing fibre regions of the CST compared with controls. Within the VLBW group, poorer fine motor function was associated with higher FA in crossing fibre regions of the CST, and poorer bimanual coordination was additionally associated with lower FA in crossing fibre regions of the CC. Poorer gross motor function was associated with lower FA in crossing fibre regions of the CST and CC. There were no associations between motor function and FA in non-crossing fibre regions of the CST and CC within the VLBW

Post discharge formula fortification of maternal human milk of very low birth weight preterm infants: an introduction of a feeding protocol in a University Hospital

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Abeer El Sakka

2016-10-01

Full Text Available The objective of this study is to determine the growth parameters and nutritional biochemical markers and complications of fortification of human milk by post discharge formula of preterm very low birth weight newborns (VLBW. Fifty preterm infants less than 37 weeks with weight less than 1500 g were enrolled in the study. They received parental nutrition and feeding according to our protocol. When enteral feeding reached 100 cc/kg/day, infants were randomized into two groups: group I, Cases, n=25, where post discharge formula (PDF was used for fortification, group II, Controls, n=25 with no fortification. Infants of both groups were given 50% of required enteral feeding as premature formula. This protocol was used until infants’ weight reached 1800 g. Daily weight, weekly length and head circumference were recorded. Hemoglobin, albumin (Alb, electrolytes, blood urea nitrogen (BUN and clinical complications were documented. Human milk fortification with PDF resulted in better growth with increase in weight 16.8 and 13.78 g/kg/day (P=0.0430, length 0.76 and 0.58 cm/week (P=0.0027, and head circumference of 0.59 and 0.5 cm/week (P=0.0217 in cases and controls respectively. Duration of hospital stay was less in cases (22.76 versus 28.52 days in Controls, P=0.02. No significant changes were found in serum electrolytes, BUN, or Alb between both groups. Hemoglobin was significantly higher in Cases, P=0.04. There were no significant clinical complications. Our feeding protocol of fortification of human milk with PDF in preterm very low birth weight newborns resulted in better growth and decrease in length of hospital stay. The use of PDF could be an alternative option for fortification of mothers’ milk for preterm VLBW infants in developing countries with low resources.

Birth weight ratio as an alternative to birth weight percentile to express infant weight in research and clinical practice: a nationwide cohort study

NARCIS (Netherlands)

Voskamp, Bart Jan; Kazemier, Brenda M.; Schuit, Ewoud; Mol, Ben Willem J.; Buimer, Maarten; Pajkrt, Eva; Ganzevoort, Wessel

2014-01-01

Objective. To compare birth weight ratio and birth weight percentile to express infant weight when assessing pregnancy outcome. Study Design. We performed a national cohort study. Birth weight ratio was calculated as the observed birth weight divided by the median birth weight for gestational age.

Pulmonary outcome in former preterm, very low birth weight children with bronchopulmonary dysplasia: a case-control follow-up at school age.

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Vom Hove, Maike; Prenzel, Freerk; Uhlig, Holm H; Robel-Tillig, Eva

2014-01-01

To assess and compare long-term pulmonary outcomes in former preterm-born, very low birth weight (VLBW) children with and without bronchopulmonary dysplasia (BPD) born in the surfactant era. Pulmonary function tests (ie, spirometry, body plethysmography, and gas transfer testing) were performed in children with a history of VLBW and BPD (n = 28) and compared with a matched preterm-born VLBW control group (n = 28). Medical history was evaluated by questionnaire. At time of follow-up (mean age, 9.5 years), respiratory symptoms (36% vs 8%) and receipt of asthma medication (21% vs 0%) were significantly more frequent in the preterm-born children with previous BPD than in those with no history of BPD. The children with a history of BPD had significantly lower values for forced expiratory volume in 1 second (z-score -1.27 vs -0.4; P = .008), forced vital capacity (z-score -1.39 vs -0.71 z-score; P = .022), and forced expiratory flow rate at 50% of forced vital capacity (z-score -2.21 vs -1.04; P = .048) compared with the preterm control group. Preterm-born children with a history of BPD are significantly more likely to have lung function abnormalities, such as airway obstruction and respiratory symptoms, at school age compared with preterm-born children without BPD. Copyright © 2014 Mosby, Inc. All rights reserved.

Screening for autism in preterm children with extremely low and very low birth weight

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Dudova I

2014-02-01

Full Text Available Iva Dudova,1 Martina Kasparova,2 Daniela Markova,3 Jana Zemankova,4 Stepanka Beranova,1 Tomas Urbanek,5 Michal Hrdlicka1 1Department of Child Psychiatry, Charles University Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic; 2Department of Pediatrics, Charles University Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic; 3Department of Pediatrics and Adolescent Medicine, Charles University First Faculty of Medicine and General University Hospital, Prague, Czech Republic; 4Department of Pediatrics, Charles University Faculty of Medicine and University Hospital, Hradec Kralove, Czech Republic; 5Institute of Psychology, Academy of Sciences, Brno, Czech Republic Background: Studies of children with very low birth weight (VLBW, 1,000–1,500 g and extremely low birth weight (ELBW, less than 1,000 g indicate that this population seems to be at increased risk of autism spectrum disorder (ASD. Methods: Parents of 101 VLBW and ELBW children (age 2 years, corrected for prematurity agreed to participate in the study and signed informed consents; however, parents of only 75 children (44 boys, 31 girls completed the screening questionnaires. The screening battery included the Modified Checklist for Autism in Toddlers (M-CHAT, Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (CSBS-DP-ITC, and the Infant/Toddler Sensory Profile (ITSP. Children with disabilities were excluded. All children who screened positive on any of the screening tools were subsequently invited for a detailed assessment. Results: Thirty-two children (42.7% screened positive on at least one of the screening questionnaires. The screening tool with the most positive results was the CSBS-DP-ITC (26 positive screens, followed by the M-CHAT (19 positive screens and the ITSP (11 positive screens. Of the 32 children who tested positive, 19 participated in the detailed follow-up assessment. A

Social causes of low birth weight.

OpenAIRE

Kogan, M D

1995-01-01

The manifest importance of reducing the incidence of low birth weight is most obvious for the first year of life: low birth weight is the single most important factor affecting infant morbidity and mortality. However, there is growing evidence that the adverse consequences of low birth weight continue throughout the life cycle. This review deals primarily with social causes of low birth weight.

Correlates of Low Birth Weight

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Ankur Barua MD, PhD

2014-12-01

Full Text Available Background. Low birth weight is the single most important factor that determines the chances of child survival. A recent annual estimation indicated that nearly 8 million infants are born with low birth weight in India. The infant mortality rate is about 20 times greater for all low birth weight babies. Methods. A matched case–control study was conducted on 130 low birth weight babies and 130 controls for 12 months (from August 1, 2007, to July 31, 2008 at the Central Referral Hospital, Tadong, East District of Sikkim, India. Data were analyzed using the Statistical Package for Social Sciences, version 10.0 for Windows. Chi-square test and multiple logistic regression were applied. A P value less than .05 was considered as significant. Results. In the first phase of this study, 711 newborn babies, borne by 680 mothers, were screened at the Central Referral Hospital of Sikkim during the 1-year study period, and the proportion of low birth weight babies was determined to be 130 (18.3%. Conclusion. Multiple logistic regression analysis, conducted in the second phase, revealed that low or middle socioeconomic status, maternal underweight, twin pregnancy, previous history of delivery of low birth weight babies, smoking and consumption of alcohol during pregnancy, and congenital anomalies had independent significant association with low birth weight in this study population.

The occurrence of high-risk factors for hearing loss in very-low-birth-weight neonates: a retrospective exploratory study of targeted hearing screening.

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Kanji, Amisha; Khoza-Shangase, Katijah

2012-12-01

The current study aimed at determining the type and frequency of high-risk factors for hearing loss in a group of very-low-birth-weight (VLBW) neonates in a tertiary hospital in South Africa with the objective of collating evidence that could be used in arguing for or against revisiting targeted hearing screening in developing countries. Furthermore, the study aimed at investigating the relationship between the identified high-risk factors and hearing screening results. In a retrospective data review design, data were collated from files from the VLBW project; this included hearing screening records, as well as records from participant medical and audiology files. Records of 86 neonates with birth weights ranging between 680 g and 1500 g were reviewed. Findings indicated that neonatal jaundice, exposure to human immunodeficiency virus (HIV), mechanical or assisted ventilation, and neonatal intensive care unit stay greater than 48 hours were the most frequently occurring high-risk factors for hearing loss in the current sample. These factors are consistent with those listed in the high-risk register of the Health Professions Council of South Africa for the South African context. Findings confirm the complexity of risk factors, and the influence that a variety of factors such as poor follow-up or return rate might have on the implementation of early hearing detection and intervention. The importance of establishing context-specific risk factors for effective implementation of targeted screening protocols where niversal newborn hearing screening is not yet a reality was highlighted by the current study.

Temporal trends in pregnancy weight gain and birth weight in Bavaria 2000–2007: slightly decreasing birth weight with increasing weight gain in pregnancy

OpenAIRE

Schiessl, Barbara; Beyerlein, Andreas; Lack, Nicholas; Kries, Rüdiger von

2009-01-01

Aims: To assess temporal trends in birth weight and pregnancy weight gain in Bavaria from 2000 to 2007. Methods: Data on 695,707 mother and infant pairs (singleton term births) were available from a compulsory reporting system for quality assurance, including information on birth weight, maternal weight at delivery and at booking, maternal smoking, age, and further anthropometric and lifestyle factors. Pregnancy weight gain was defined as: weight prior to delivery minus weight at first booki...

Association of BPD and IVH with early neutrophil and white counts in VLBW neonates with gestational age <32 weeks

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Palta, Mari; Sadek-Badawi, Mona; Carlton, David P

2008-01-01

Objectives To investigate associations between early low neutrophil count from routine blood samples, white blood count (WBC), pregnancy complications and neonatal outcomes for very low birth weight infants (VLBW ≤1500g) with gestational age <32 weeks. Patients and Methods Information was abstracted on all infants admitted to level III NICUs in Wisconsin 2003-2004. 1002 (78%) had differential and corrected total white counts within 2 ½ hours of birth. Data analyses included frequency tables, binary logistic, ordinal logistc and ordinary regression. Results Low neutrophil count (<1000/μL) was strongly associated with low WBC, pregnancy complications and antenatal steroids. Low neutrophil count predicted bronchopulmonary dysplasia severity level (BPD) (OR: 1.7, 95% CI: 1.1-2.7) and intraventricular hemorrhage (IVH) grade (OR: 2.2, 95% CI: 1.3-3.8). Conclusions Early neutrophil counts may have multiple causes interfering with their routine use as an inflammatory marker. Nonetheless, low neutrophil count has consistent independent associations with outcomes. PMID:18563166

Increasing illness severity in very low birth weight infants over a 9-year period

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Locke Robert G

2006-02-01

Full Text Available Abstract Background Recent reports have documented a leveling-off of survival rates in preterm infants through the 1990's. The objective of this study was to determine temporal changes in illness severity in very low birth weight (VLBW infants in relationship to the outcomes of death and/or severe IVH. Methods Cohort study of 1414 VLBW infants cared for in a single level III neonatal intensive care unit in Delaware from 1993–2002. Infants were divided into consecutive 3-year cohorts. Illness severity was measured by two objective methods: the Score for Neonatal Acute Physiology (SNAP, based on data from the 1st day of life, and total thyroxine (T4, measured on the 5th day of life. Death before hospital discharge and severe intraventricular hemorrhage (IVH were investigated in the study sample in relation to illness severity. The fetal death rate was also investigated. Statistical analyses included both univariate and multivariate analysis. Results Illness severity, as measured by SNAP and T4, increased steadily over the 9-year study period with an associated increase in severe IVH and the combined outcome of death and/or severe IVH. During the final 3 years of the study, the observed increase in illness severity accounted for 86% (95% CI 57–116% of the variability in the increase in death and/or severe IVH. The fetal death rate dropped from 7.8/1000 (1993–1996 to 5.3/1000 (1999–2002, p = .01 over the course of the study. Conclusion These data demonstrate a progressive increase in illness in VLBW infants over time, associated with an increase in death and/or severe IVH. We speculate that the observed decrease in fetal death, and the increase in neonatal illness, mortality and/or severe IVH over time represent a shift of severely compromised patients that now survive the fetal time period and are presented for care in the neonatal unit.

Long-term follow-up of mental health, health-related quality of life and associations with motor skills in young adults born preterm with very low birth weight.

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Husby, Ingrid Marie; Stray, Kaia Mølbach-Thellefsen; Olsen, Alexander; Lydersen, Stian; Indredavik, Marit Sæbø; Brubakk, Ann-Mari; Skranes, Jon; Evensen, Kari Anne I

2016-04-07

Being born with very low birth weight (VLBW: ≤ 1,500 g) is related to long-term disability and neurodevelopmental problems, possibly affecting mental health and health-related quality of life (HRQoL). However, studies in young adulthood yield mixed findings. The aim of this study was to examine mental health and HRQoL at 23 years, including changes from 20 to 23 years and associations with motor skills in VLBW young adults compared with controls. In a geographically based follow-up study, 35 VLBW and 37 term-born young adults were assessed at 23 years by using Achenbach Adult Self-Report (ASR), Short Form 36 Health Survey (SF-36), Beck Depression Inventory (BDI) and various motor tests. The ASR and SF-36 were also used at 20 years. Longitudinal changes in ASR and SF-36 from 20 to 23 years were analysed by linear mixed models and associations with motor skills at 23 years by linear regression. At 23 years, total ASR score was 38.6 (SD: 21.7) in the VLBW group compared with 29.0 (SD: 18.6) in the control group (p = 0.048). VLBW participants had higher scores for attention problems, internalizing problems and critical items, and they reported to drink less alcohol than controls. BDI total score did not differ between groups. On SF-36, VLBW participants reported significantly poorer physical and social functioning, more role-limitations due to physical and emotional problems, more bodily pain and lower physical and mental component summaries than controls. In the VLBW group, total ASR score increased by 9.0 (95 % CI: 3.3 to 14.7) points from 20 to 23 years (p = 0.009 vs controls), physical and mental component summaries of SF-36 decreased by 2.9 (95 % CI: -4.8 to -1.1) and 4.4 (95 % CI: -7.1 to -1.7) points, respectively (p = 0.012 and p = 0.022 vs controls). Among VLBW participants, more mental health problems and lower physical and mental HRQoL were associated with poorer motor skills at 23 years. VLBW young adults reported poorer and declining

Analysis of birth weights of a rural hospital

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Ashtekar Shyam

2010-01-01

Full Text Available Background: Low birth weight remains a major reason behind childhood malnutrition. The NFHS findings show no dent in this problem. Objective: This study was undertaken to explore change in birth weights in a period from 1989 to 2007 and any associations thereof. Materials and Methods: All birth records of a private rural hospital spanning two decades (1989-2007 were analyzed for birth weight, age of mother, gender, birth order of the baby, proportion of pre-term babies and low birth weight babies. Results: No change was observed in the average birth weights (average 2.71 kg over the period. Although the birth weight shows some expected variance with the age of mother, it was found to have no relation with the baby′s birth order and gender. The low birth weight proportion is about 24% and shows little difference before and after the series midpoint of year 1998. Conclusion: The birth weights have hardly changed in this population in the two decades.

Analysis of Birth Weights of a Rural Hospital

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Ashtekar, Shyam V; Kulkarni, Madhav B; Sadavarte, Vaishali S; Ashtekar, Ratna S

2010-01-01

Background: Low birth weight remains a major reason behind childhood malnutrition. The NFHS findings show no dent in this problem. Objective: This study was undertaken to explore change in birth weights in a period from 1989 to 2007 and any associations thereof. Materials and Methods: All birth records of a private rural hospital spanning two decades (1989-2007) were analyzed for birth weight, age of mother, gender, birth order of the baby, proportion of pre-term babies and low birth weight babies. Results: No change was observed in the average birth weights (average 2.71 kg) over the period. Although the birth weight shows some expected variance with the age of mother, it was found to have no relation with the baby’s birth order and gender. The low birth weight proportion is about 24% and shows little difference before and after the series midpoint of year 1998. Conclusion: The birth weights have hardly changed in this population in the two decades. PMID:20922101

Maternal and infant characteristics associated with human milk feeding in very low birth weight infants.

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Sisk, Paula M; Lovelady, Cheryl A; Dillard, Robert G; Gruber, Kenneth J; O'Shea, T Michael

2009-11-01

This study identified maternal and infant characteristics predicting human milk (HM) feeding in very low birth weight (VLBW) infants whose mothers (n = 184) participated in a study of lactation counseling and initiated milk expression. Data were collected prospectively, by maternal interview and medical record review. During hospitalization, 159 (86%) infants received at least 50% HM proportion of feedings in the first 2 weeks of life, and 114 (62%) received some HM until the day of hospital discharge. Analysis showed plan to breastfeed was the strongest predictor of initiation and duration of HM feeding. Greater than 12 years of education, respiratory distress syndrome, Apgar score >6, and female gender were significant predictors, and no perinatal hypertensive disorder, white race, and mechanical ventilation were marginal predictors of HM feeding. Women with a high-risk pregnancy should be provided education about the benefits of breastfeeding for infants who are likely to be born prematurely.

Preterm Birth and Low Birth Weight Following Icsi- Pregnancies

OpenAIRE

Aygül Demirol; Süleyman Güven; Timur Gürgan

2006-01-01

OBJECTIVE: To report preterm birth and low birth weight rate of intracytoplasmic sperm injection (ICSI) related pregnancies and to compare our data with literature findings. STUDY DESIGN: Three-hundred and eighty-nine pregnancies following controlled ovarian hyperstimulation and intracytoplasmic sperm injection were retrospectively evaluated. Patients’ characteristics including age, gestational age at delivery and birth weight were noted from special clinic files. Women with early pregnanc...

Analysis of the association between necrotizing enterocolitis and transfusion of red blood cell in very low birth weight preterm infants

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Seon-Yeong Bak

2013-03-01

Full Text Available Purpose: To investigate the association between necrotizing enterocolitis (NEC and red blood cell transfusions in very low birth weight (VLBW preterm infants. Methods: We studied were 180 VLBW preterm infants who were admitted to the neonatal intensive care unit of CHA Gangnam Hospital from January of 2006 to December of 2009. The subjects were divided into 2 groups: an NEC group (greater than stage II on the modified Bell’s criteria and a control group (less than stage II on the modified Bell’s critieria. We defined red blood cell transfusion before NEC diagnosis as the frequency of transfusion until NEC diagnosis (mean day at NEC diagnosis, day 18 in the NEC group and the frequency of transfusion until 18 days after birth in the control group. Results: Of the 180 subjects, 18 (10% belonged to the NEC group, and 14 (78% of these 18 patients had a history of transfusion before NEC diagnosis. The NEC group received 3.1±2.9 transfusions, and the control group received 1.0±1.1 transfusions before the NEC diagnosis (P =0.005. In a multivariate logistic regression corrected for gestational age, Apgar score at 1 minute, the presence of respiratory distress syndrome, patent ductus arteriosus, premature rupture of membrane, disseminated intravascular coagulopathy and death were confounding factors. The risk of NEC increased 1.63 times (95% confidence interval, 1.145 to 2.305; P =0.007 with transfusion before the NEC diagnosis. Conclusion: The risk for NEC increased significantly with increased transfusion frequency before the NEC diagnosis.

Birth weight in a large series of triplets

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van Beijsterveldt Catharina EM

2011-04-01

Full Text Available Abstract Background Triplets are often born premature and with a low birth weight. Because the incidence of triplet births is rare, there are relatively few studies describing triplet birth weight characteristics. Earlier studies are often characterized by small sample sizes and lack information on important background variables such as zygosity. The objective of this study is to examine factors associated with birth weight in a large, population-based sample of triplets registered with the Netherlands Twin Register (NTR. Methods In a sample of 1230 triplets from 410 families, the effects of assisted reproductive techniques, zygosity, birth order, gestational age, sex, maternal smoking and alcohol consumption during pregnancy on birth weight were assessed. The resemblance among triplets for birth weight was estimated as a function of zygosity. Birth weight discordance within families was studied by the pair-wise difference between triplets, expressed as a percentage of the birth weight of the heaviest child. We compare data from triplets registered with the NTR with data from population records, which include live births, stillbirths and children that have deceased within days after birth. Results There was no effect of assisted reproductive techniques on triplet birth weight. At gestational age 24 to 40 weeks triplets gained on average 130 grams per week; boys weighed 110 grams more than girls and triplets of smoking mothers weighted 104 grams less than children of non-smoking mothers. Monozygotic triplets had lower birth weights than di- and trizygotic triplets and birth weight discordance was smaller in monozygotic triplets than in di- and trizygotic triplets. The correlation in birth weight among monozygotic and dizygotic triplets was 0.42 and 0.32, respectively. In nearly two-thirds of the families, the heaviest and the lightest triplet had a birth weight discordance over 15%. The NTR sample is representative for the Dutch triplet

Amino acid-based formula as a rescue strategy in feeding very-low-birth-weight infants with intrauterine growth restriction.

Science.gov (United States)

Raimondi, Francesco; Spera, Anna Maria; Sellitto, Maria; Landolfo, Francesca; Capasso, Letizia

2012-05-01

Very-low-birth-weight (VLBW) neonates may develop severe intolerance to standard preterm formula especially if they are associated with intrauterine growth restriction (IUGR). We tested the hypothesis that these infants may tolerate an elemental, amino acid-based formula as a rescue feeding strategy. In a prospective, case-control pilot study, we enrolled VLBW IUGR infants enterally fed with standard preterm formula (SPF) at daily increments of 16 mL/kg. If gastric residuals accounted for >70% of milk feed in the previous 24 hours, then feedings were temporarily withheld and then resumed with amino acid formula (AAF) increased at the same speed. Cases on AAF were compared to controls on SPF and with cases themselves while on SPF. Primary outcome was the time to reach full enteral feedings. Secondary outcomes were time on parenteral nutrition, time on central venous catheter, and formula tolerability based on the amount of gastric residual volume. Sixty-four infants (22 cases) were enrolled. Although during the total duration of nutrition, cases had worse primary and secondary outcomes, when on AAF, cases were comparable to controls in time to full enteral feeding (14.4 vs 14 days), time on parenteral nutrition, and time on central venous catheter. Cases on AAF and controls had similar gastric residual volumes. At day 3 after AAF introduction, cases had a significantly reduced number (%) of gastric residual volume >5 mL/kg over total number of feedings (5.6 vs 1.5%; P Growth at 12 months of corrected age was also comparable. In our population of VLBW IUGR newborns with severe feeding intolerance, a short course on AAF was a safe and effective means of nutritional rescue.

How Neighborhood Disadvantage Reduces Birth Weight

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Emily Moiduddin

2008-06-01

Full Text Available In this analysis we connect structural neighborhood conditions to birth outcomes through their intermediate effects on mothers’ perceptions of neighborhood danger and their tendency to abuse substances during pregnancy. We hypothesize that neighborhood poverty and racial/ethnic concentration combine to produce environments that mothers perceive as unsafe, thereby increasing the likelihood of negative coping behaviors (substance abuse. We expect these behaviors, in turn, to produce lower birth weights. Using data from the Fragile Families and Child Wellbeing Study, a survey of a cohort of children born between 1998 and 2000 and their mothers in large cities in the United States, we find little evidence to suggest that neighborhood circumstances have strong, direct effects on birth weight. Living in a neighborhood with more foreigners had a positive effect on birth weight. To the extent that neighborhood conditions influence birth weight, the effect mainly occurs through an association with perceived neighborhood danger and subsequent negative coping behaviors. Poverty and racial/ethnic concentration increase a mother’s sense that her neighborhood is unsafe. The perception of an unsafe neighborhood, in turn, associates with a greater likelihood of smoking cigarettes and using illegal drugs, and these behaviors have strong and significant effects in reducing birth weight. However, demographic characteristics, rather than perceived danger or substance abuse, mediate the influence of neighborhood characteristics on birth weight.

Effects of infants' birth order, maternal age, and socio-economic status on birth weight.

Science.gov (United States)

Ghaemmaghami, Seyed J; Nikniaz, Leila; Mahdavi, Reza; Nikniaz, Zeinab; Razmifard, Farzad; Afsharnia, Farzaneh

2013-09-01

To determine the effects of infants' birth order, maternal age, and socioeconomic status (SES) on birth weight. This cross-sectional study included a sample of 858 mothers recruited over a 6-month period in 2010, in a defined population of 9 urban health centers, and who were admitted for their infants' first vaccination. Maternal clinical data, demographic data, and infants' birth weight were obtained from the interview and maternal hospital files. Multiple regression and analysis of variance were used for data analysis. First and fourth births had lower birth weights compared with second and third births in all maternal ages in controlling parity, birth weight increases with maternal age up to the early 24, and then tends to level off. Male gender, maternal age 20-24 years, second and third births had a significant positive effect on birth weight. Lower family economic status and higher educational attainment were significantly associated with lower birth weight. For women in the 15-19 and 40-44 years age groups, the second birth order was associated with the most undesirable effect on birth weight. Accessibility of health care services, parity, maternal age, and socioeconomic factors are strongly associated with infants' birth weight.

Poor birth weight recovery among low birth weight/preterm infants following hospital discharge in Kampala, Uganda

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Namiiro Flavia B

2012-01-01

Full Text Available Abstract Background Healthy infants typically regain their birth weight by 21 days of age; however, failure to do so may be due to medical, nutritional or environmental factors. Globally, the incidence of low birth weight deliveries is high, but few studies have assessed the postnatal weight changes in this category of infants, especially in Africa. The aim was to determine what proportion of LBW infants had not regained their birth weight by 21 days of age after discharge from the Special Care Unit of Mulago hospital, Kampala. Methods A cross sectional study was conducted assessing weight recovery of 235 LBW infants attending the Kangaroo Clinic in the Special Care Unit of Mulago Hospital between January and April 2010. Infants aged 21 days with a documented birth weight and whose mothers gave consent to participate were included in the study. Baseline information was collected on demographic characteristics, history on pregnancy, delivery and postnatal outcome through interviews. Pertinent infant information like gestation age, diagnosis and management was obtained from the medical records and summarized in the case report forms. Results Of the 235 LBW infants, 113 (48.1% had not regained their birth weight by 21 days. Duration of hospitalization for more than 7 days (AOR: 4.2; 95% CI: 2.3 - 7.6; p value Conclusion Failure to regain birth weight among LBW infants by 21 days of age is a common problem in Mulago Hospital occurring in almost half of the neonates attending the Kangaroo clinic. Currently, the burden of morbidity in this group of high-risk infants is undetected and unaddressed in many developing countries. Measures for consideration to improve care of these infants would include; discharge after regaining birth weight and use of total parenteral nutrition. However, due to the pressure of space, keeping the baby and mother is not feasible at the moment hence the need for a strong community system to boost care of the infant. Close

Association of Timing of Weight Gain in Pregnancy With Infant Birth Weight.

Science.gov (United States)

Retnakaran, Ravi; Wen, Shi Wu; Tan, Hongzhuan; Zhou, Shujin; Ye, Chang; Shen, Minxue; Smith, Graeme N; Walker, Mark C

2018-02-01

Gestational weight gain is a determinant of infant birth weight, but it is unclear whether its timing in pregnancy may hold implications in this regard. Previous studies have yielded conflicting findings on the association of maternal weight gain in early pregnancy with birth weight. However, as these studies have typically recruited women during the first trimester, they are inherently limited by a reliance on self-reported pregravid weight. To evaluate the associations of directly measured maternal pregravid weight and the timing of subsequent weight gain across pregnancy with infant birth weight. In this prospective, preconception, observational cohort study, 1164 newly married women in Liuyang, China, underwent pregravid evaluation at a median of 19.9 weeks before a singleton pregnancy during which they underwent serial weight measurements. The study was conducted from February 1, 2009, to November 4, 2015. Data analysis was performed between September 1, 2016, and May 6, 2017. Maternal weight gain was calculated for the following 10 gestational intervals: from pregravid to less than 14, 14 to 18, 19 to 23, 24 to 28, 29 to 30, 31 to 32, 33 to 34, 35 to 36, 37 to 38, and 39 to 40 weeks. Associations of pregravid weight and weight gain within each of the 10 gestational intervals with the outcome of infant birth weight. The mean (SD) age of the 1164 women included in the study was 25.3 (3.1) years. Pregravid weight was consistently associated with infant birth weight. However, among the 10 gestational intervals, only weight gain from pregravid to 14 weeks and from 14 to 18 weeks was associated with birth weight. Birth weight increased by 13.6 g/kg (95% CI, 3.2-24.1 g/kg) of maternal weight gain from pregravid to 14 weeks and by 26.1 g/kg (95% CI, 3.8-48.4 g/kg) of maternal weight gain from 14 to 18 weeks. Maternal weight only in the first half of gestation is a determinant of infant birth weight. Before pregnancy and early gestation may be a critical window for

Gestational weight gain among minority adolescents predicts term birth weight.

Science.gov (United States)

Ekambaram, Maheswari; Irigoyen, Matilde; DeFreitas, Johelin; Rajbhandari, Sharina; Geaney, Jessica Lynn; Braitman, Leonard Edward

2018-03-07

In adolescents, there is limited evidence on the independent and additive effect of prepregnancy body mass index (BMI) and gestational weight gain on infant birth weight. Data also show that this effect may vary by race. We sought to examine the impact of maternal prepregnancy BMI and gestational weight gain on birth weight and risk of large for gestational age (LGA) in term newborns of minority adolescent mothers. This was a retrospective cohort study of 411 singleton live term infants born to mothers ≤ 18 years. Data were abstracted from electronic medical records. Gestational weight gain was related to infant birth weight (ρ = 0.36, P gain, gestational age and Hispanic ethnicity were independent predictors of birth weight, controlling for maternal age, BMI, parity, tobacco/drug use and preeclampsia. The probability of having an LGA infant increased with weight gain [adjusted odds ratio (aOR) 1.14, 95% confidence interval (CI) 1.07-1.21] but not with BMI. Mothers who gained weight in excess of 2009 Institute of Medicine (IOM) recommendations had a greater risk of having an LGA infant compared to those who gained within recommendations (aOR 5.7, 95% CI 1.6-19.5). Minority adolescents with greater gestational weight gain had infants with higher birth weight and greater risk of LGA; BMI was not associated with either outcome. Further studies are needed to examine the applicability of the 2009 BMI-specific IOM gestational weight gain recommendations to adolescents in minority populations.

Evaluation of factors affecting birth weight and preterm birth in southern Turkey

International Nuclear Information System (INIS)

Araz, N. C.

2013-01-01

Objective: To identify factors affecting birth weight and pre-term birth, and to find associations with electromagnetic devices such as television, computer and mobile phones. Methods: The study was conducted in Turkey at Gazintep University, Faculty of Medicine Outpatient Clinic at the Paediatric Ward. It comprised 500 patients who presented at the clinic from May to December 2009. All participants were administered a questionnaire regarding their pregnancy history. SPSS 13 was used for statistical analysis. Results: In the study, 90 (19%) patients had pre-term birth , and 64 (12.9%) had low birth weight rate Birth weight was positively correlated with maternal age and baseline maternal weight (r= 0.115, p= 0.010; r= 0.168, p=0.000, respectively). Pre-term birth and birth weight less than 2500g were more common in mothers with a history of disease during pregnancy (p=0.046 and p=0.008, respectively). The habit of watching television and using mobile phones and computer by mothers did not demonstrate any relationship with birth weight. Mothers who used mobile phones or computers during pregnancy had more deliveries before 37 weeks (p=0.018, p=0.034; respectively). Similarly, pregnancy duration was shorter in mothers who used either mobile phone or computers during pregnancy (p=0.005, p=0.048, respectively). Conclusion: Mobile phones and computers may have an effect on pre-term birth. (author)

Regression Equations for Birth Weight Estimation using ...

African Journals Online (AJOL)

In this study, Birth Weight has been estimated from anthropometric measurements of hand and foot. Linear regression equations were formed from each of the measured variables. These simple equations can be used to estimate Birth Weight of new born babies, in order to identify those with low birth weight and referred to ...

Pulmonary diseases of the infants weighing under 1500 grams at birth: clinical and radiographic findings

International Nuclear Information System (INIS)

Kim, Ok Hwa; Park, Jeong Mi; Bahk, Yong Whee

1990-01-01

Since the introduction of the intensive perinatal care, the survival rate of the infants weighing less than 1500 gm at birth has improved substantially. However, pulmonary diseases remain to be the major causes of the high mortality of these low birthweight infants. In order to systematically assess an epidemiologic distribution of the pulmonary diseases in these very low weight prematures, we have analyzed the chest x-rays of 102 infants weighing less than 1500 gm. These consisted of 30 with extreme low birth weight (ELBW) weighing less than 1000 gm and 72 with very low birth weight (VLBW) weighing 1001 - 1500 gm. The survival rate of ELBW and VLBW was 10% and 49%, respectively. Seventy of 102 infants had abnormal findings in the chest x-ray. Forty-eight had idiopathic respiratory distress syndrome (IRDS), 8 immature lung, 6 Wilson-Mikity syndrome, 4 pneumonia, 2 pulmonary hemorrhage, 1 congenital heart disease, and 1 suspicious Pierre-Robin syndrome. Seven out of 48 infants with IRDS had persistent ductus arteriosus, and in only 2(30%) of 7 cases were alive. Endotracheal intubation and assisted ventilation application for the treatment of IRDS resulted in pulmonary interstitial emphysema in 4 infants and pneumothorax and / or pneumomediastinum in 4 infants. Displacement of endotracheal intubation showed lobar and / or unilateral lung atelectasis in 8 infants and a case of accidental dislodgement of intubation tube into the esophagus resulted in air esophagogram and worsened lung aeration. In spite of the development of many sophisticated methods of diagnostic radiology, the chest x-ray was still the most valuable yet simple way of evaluating the pulmonary problems in these extreme and very low birth weight prematures

Disease Human - MDC_LowBirthWeight

Data.gov (United States)

NSGIC Local Govt | GIS Inventory — Polygon feature class based on Zip Code boundaries showing the percentage of babies born in Miami-Dade County in 2006 with low birth weights. Low birth weight is...

Randomized trial of BCG vaccination at birth to low-birth-weight children

DEFF Research Database (Denmark)

Aaby, Peter; Roth, Adam Anders Edvin; Ravn, Henrik

2011-01-01

Observational studies have suggested that BCG may have nonspecific beneficial effects on survival. Low-birth-weight (LBW) children are not given BCG at birth in Guinea-Bissau; we conducted a randomized trial of BCG at birth (early BCG) vs delayed BCG.......Observational studies have suggested that BCG may have nonspecific beneficial effects on survival. Low-birth-weight (LBW) children are not given BCG at birth in Guinea-Bissau; we conducted a randomized trial of BCG at birth (early BCG) vs delayed BCG....

[Chinese neonatal birth weight curve for different gestational age].

Science.gov (United States)

Zhu, Li; Zhang, Rong; Zhang, Shulian; Shi, Wenjing; Yan, Weili; Wang, Xiaoli; Lyu, Qin; Liu, Ling; Zhou, Qin; Qiu, Quanfang; Li, Xiaoying; He, Haiying; Wang, Jimei; Li, Ruichun; Lu, Jiarong; Yin, Zhaoqing; Su, Ping; Lin, Xinzhu; Guo, Fang; Zhang, Hui; Li, Shujun; Xin, Hua; Han, Yanqing; Wang, Hongyun; Chen, Dongmei; Li, Zhankui; Wang, Huiqin; Qiu, Yinping; Liu, Huayan; Yang, Jie; Yang, Xiaoli; Li, Mingxia; Li, Wenjing; Han, Shuping; Cao, Bei; Yi, Bin; Zhang, Yihui; Chen, Chao

2015-02-01

Since 1986, the reference of birth weight for gestational age has not been updated. The aim of this study was to set up Chinese neonatal network to investigate the current situation of birth weight in China, especially preterm birth weight, to develop the new reference for birth weight for gestational age and birth weight curve. A nationwide neonatology network was established in China. This survey was carried out in 63 hospitals of 23 provinces, municipalities and autonomous regions. We continuously collected the information of live births in participating hospitals during the study period of 2011-2014. Data describing birth weight and gestational age were collected prospectively. Newborn's birth weight was measured by electronic scale within 2 hours after birth when baby was undressed. The evaluation of gestational age was based on the combination of mother's last menstrual period, ultrasound in first trimester and gestational age estimation by gestational age scoring system. the growth curve was drawn by using LMSP method, which was conducted in GAMLSS 1.9-4 software package in R software 2.11.1. A total of 159 334 newborn infants were enrolled in this study. There were 84 447 male and 74 907 female. The mean birth weight was (3 232 ± 555) g, the mean birth weight of male newborn was (3 271 ± 576) g, the mean weight of female newborn was (3 188 ± 528) g. The test of the variables' distribution suggested that the distribution of gestational age and birth weight did not fit the normal distribution, the optimal distribution for them was BCT distribution. The Q-Q plot test and worm plot test suggested that this curve fitted the distribution optimally. The male and female neonatal birth weight curve was developed using the same method. Using GAMLSS method to establish nationwide neonatal birth weight curve, and the first time to update the birth weight reference in recent 28 years.

Assessing the value of customized birth weight percentiles.

Science.gov (United States)

Hutcheon, Jennifer A; Walker, Mark; Platt, Robert W

2011-02-15

Customized birth weight percentiles are weight-for-gestational-age percentiles that account for the influence of maternal characteristics on fetal growth. Although intuitively appealing, the incremental value they provide in the identification of intrauterine growth restriction (IUGR) over conventional birth weight percentiles is controversial. The objective of this study was to assess the value of customized birth weight percentiles in a simulated cohort of 100,000 infants aged 37 weeks whose IUGR status was known. A cohort of infants with a range of healthy birth weights was first simulated on the basis of the distributions of maternal/fetal characteristics observed in births at the Royal Victoria Hospital in Montreal, Canada, between 2000 and 2006. The occurrence of IUGR was re-created by reducing the observed birth weights of a small percentage of these infants. The value of customized percentiles was assessed by calculating true and false positive rates. Customizing birth weight percentiles for maternal characteristics added very little information to the identification of IUGR beyond that obtained from conventional weight-for-gestational-age percentiles (true positive rates of 61.8% and 61.1%, respectively, and false positive rates of 7.9% and 8.5%, respectively). For the process of customization to be worthwhile, maternal characteristics in the customization model were shown through simulation to require an unrealistically strong association with birth weight.

BIRTH WEIGHT : A COMMUNITY PERSPECTIVE

Directory of Open Access Journals (Sweden)

J P SRIVASTAVA

2003-06-01

Full Text Available India has a dubious distinction of belonging to the top bracket of countries with a very high under-5 Mortality Rate (U5MR of above 96/1000 live births. The U5MR considered the single most significant basic indicator of health status of a community, is proportional to the Infant Mortality Rate (IMR which in turn is contributed to directly and indirectly by the incidence of low Birth Weight (LB W.About 25 million LB W are born each year consisting 17% of all live births,nearly 95% of them in developing countries. About 26% of newborns are LBW in India, and indeed over 16% in those countries with very high U5MR.Both preterm and small-for-dates almost equally make up this category of vulnerable infants predisposed to asphyxia, feeding problems, anemia and growth failure. Considering the close relationship of birth weight with perinatal and infant morbidity as well as mortality, it is crucial to identify the liigh risk groups of low birth weight babies as early as possible.Unfortunately, in a community where 80% of newborns never get to have their weight measured, this itself is a tall order. In our society, the cry of the newborn is greeted with anxious queries about the sex of the baby and not his well­being and potential for healthy survival. The basic concept of the importance of birth weight is missing even among educated families. Indeed, it is as if the weighing machine has no place in the requirements at childbirth. In the absence of this basic facility, field workers and TBAs must report to other means to identify babies at risk. Mid-arm circumference, thigh circumference, foot length, and skin-fold thickness etc. are measurements that have been correlated satisfactorily with the baby’s weight. Simple tools like coloured strips have been developed and these show promise of applicability in field situation for identification of LB W by TBAs for early referral.

BIRTH WEIGHT : A COMMUNITY PERSPECTIVE

Directory of Open Access Journals (Sweden)

J P SRIVASTAVA

2003-06-01

Full Text Available India has a dubious distinction of belonging to the top bracket of countries with a very high under-5 Mortality Rate (U5MR of above 96/1000 live births. The U5MR considered the single most significant basic indicator of health status of a community, is proportional to the Infant Mortality Rate (IMR which in turn is contributed to directly and indirectly by the incidence of low Birth Weight (LB W.About 25 million LB W are born each year consisting 17% of all live births,nearly 95% of them in developing countries. About 26% of newborns are LBW in India, and indeed over 16% in those countries with very high U5MR.Both preterm and small-for-dates almost equally make up this category of vulnerable infants predisposed to asphyxia, feeding problems, anemia and growth failure.Considering the close relationship of birth weight with perinatal and infant morbidity as well as mortality, it is crucial to identify the liigh risk groups of low birth weight babies as early as possible.Unfortunately, in a community where 80% of newborns never get to have their weight measured, this itself is a tall order. In our society, the cry of the newborn is greeted with anxious queries about the sex of the baby and not his well­being and potential for healthy survival. The basic concept of the importance of birth weight is missing even among educated families. Indeed, it is as if the weighing machine has no place in the requirements at childbirth. In the absence of this basic facility, field workers and TBAs must report to other means to identify babies at risk. Mid-arm circumference, thigh circumference, foot length, and skin-fold thickness etc. are measurements that have been correlated satisfactorily with the baby’s weight. Simple tools like coloured strips have been developed and these show promise of applicability in field situation for identification of LB W by TBAs for early referral.

Definition of intertwin birth weight discordance.

Science.gov (United States)

Breathnach, Fionnuala M; McAuliffe, Fionnuala M; Geary, Michael; Daly, Sean; Higgins, John R; Dornan, James; Morrison, John J; Burke, Gerard; Higgins, Shane; Dicker, Patrick; Manning, Fiona; Mahony, Rhona; Malone, Fergal D

2011-07-01

To establish the level of birth weight discordance at which perinatal morbidity increases in monochorionic and dichorionic twin pregnancy. This prospective multicenter cohort study included 1,028 unselected twin pairs recruited over a 2-year period. Participants underwent two weekly ultrasonographic surveillance from 24 weeks of gestation with surveillance of monochorionic twins two-weekly from 16 weeks. Analysis using Cox proportional hazards compared a composite measure of perinatal morbidity (including any of the following: mortality, respiratory distress syndrome, hypoxic-ischemic encephalopathy, periventricular leukomalacia, necrotizing enterocolitis, or sepsis) at different degrees of birth weight discordance with adjustment for chorionicity, gestational age, twin-twin transfusion syndrome, birth order, gender, and growth restriction. Perinatal outcome data were recorded for 977 patients (100%) who continued the study with both fetuses alive beyond 24 weeks, including 14 cases of twin-twin transfusion syndrome. Adjusting for gestation at delivery, twin order, gender, and growth restriction, perinatal mortality, individual morbidity, and composite perinatal morbidity were all seen to increase with birth weight discordance exceeding 18% for dichorionic pairs (hazard ratio 2.2, 95% confidence interval [CI] 1.6-2.9, Pbirth weights were appropriate for gestational age. : The threshold for birth weight discordance established by this prospective study is 18% both for dichorionic twin pairs and for monochorionic twins without twin-twin transfusion syndrome. This threshold is considerably lower than that defined by many retrospective series as pathologic. We suggest that an anticipated difference of 18% in birth weight should prompt more intensive fetal monitoring.

Epigenetic Consequences of Low Birth-Weight and Preterm Birth in Adult Twins

DEFF Research Database (Denmark)

Tan, Qihua

2018-01-01

could be detrimental to health later in life. Current epigenetic studies using genome-wide DNA methylation profiling have discovered molecular evidence confirming that, as important early life events, both low birth-weight and premature birth can result in long-lasting epigenetic consequences...... that impact health at adult ages. Results from our epigenome-wide association studies indicate that the two moderately correlated traits of adverse pregnancy outcome could be linked to increased susceptibility to different health problems with low birth-weight more relevant to metabolic disorders, while......Adverse birth outcomes including low birth-weight and preterm birth are associated with long-term morbidity and health consequences at adult ages. Molecular mechanisms including epigenetic modification may have been involved in the adaptation to the stressful condition in peridelivery period which...

Impact of police-reported intimate partner violence during pregnancy on birth outcomes.

Science.gov (United States)

Lipsky, Sherry; Holt, Victoria L; Easterling, Thomas R; Critchlow, Cathy W

2003-09-01

To examine the relationship of police-reported intimate partner violence during pregnancy and adverse birth outcomes. We conducted a population-based, retrospective, cohort study in Seattle, Washington, using Seattle police data and Washington State birth certificate files from January 1995 through September 1999. Exposed subjects were women with an intimate partner violence incident reported to police during pregnancy and who subsequently had a singleton live birth or fetal death registered in the state of Washington. Unexposed subjects were randomly selected Seattle residents with a singleton live birth or fetal death in the same time period and who did not report an incident. The main outcome measures were low birth weight (LBW less than 2500 g), very LBW (VLBW less than 1500 g), preterm birth (20-36 weeks' gestation), very preterm birth (20-31 weeks), and neonatal death (before discharge). Women reporting any partner violence during pregnancy were significantly more likely to have a LBW infant (adjusted odds ratio [aOR] 1.70; 95% confidence interval [CI] 1.20, 2.40), a VLBW infant (aOR 2.54; 95% CI 1.32, 4.91), a preterm birth (aOR 1.61; 95% CI 1.14, 2.28), a very preterm birth (aOR 3.71; 95% CI 1.80, 7.63), and a neonatal death (aOR 3.49; 95% CI 1.43, 8.50). Police-reported partner violence during pregnancy is significantly associated with an increased risk of adverse birth outcomes. There is a critical need to identify pregnancy among women with reported incidents and to provide women health and social service information and referrals, particularly referrals to high-risk pregnancy programs.

A Study Of Risk Factors For Low Birth Weight

Directory of Open Access Journals (Sweden)

Deswal B S

1999-01-01

Full Text Available Research question: What is the extent of low weight babies born in hospitals and its association with some maternal factors? Objectives: 1. To find an overall prevalence of low birth weight babies amongst hospital births in Meerut city. 2. To identify and quantify the effects of some risk factors for low birth weight. Setting: District women Hospital of Meerut city of western U.P. Study Design: Hospital based matched case-control study. Sample size: 491 low birth weight babies as ‘cases’ and an equal number of babies of normal birth weight in ‘control’ group matched for maternal age, sex of baby, birth order and institution of delivery. Study variables: Socio-economic Status: maternal biological factors including obstetric history: antenatal factors: nutritional factors: history of abortion: toxaemia of pregnancy etc. Results: Overall proportion of low birth weight babies was found to be 21.8% amongst hospital live births and 30.9% born to mothers aged below 30 years of age. Low maternal weight, under nutrition, lack of antenatal care, short inter-pregnancy interval, toxacmia of pregnancy were independent factors increasing the risk of low birth weight significantly. Conclusions: The study suggested that a substantial proportion of low birth weight babies can be averted by improving maternal nutritional status including anemic condition, birth spacing and proper antenatal care.

[Perinatal health: low birth weight and social class].

Science.gov (United States)

da Silva, A A; Barbieri, M A; Bettiol, H; Dal Bó, C M; Mucillo, G; Gomes, U A

1991-04-01

A survey was carried out in Ribeirão Preto, S. Paulo State, Brazil, between June 1978 and May 1979 with a view to studying the prevalence of low birth weight and its occurrence among different social classes. Data were collected from 8,878 singleton live births in eight maternity hospitals, accounting for 98% of all births in the area. Social classes were determinated by the use of a model proposed by Singer and modified for epidemiological purposes by Barros. Out of the 8,878 births, 660 (7.5%) were of low birth weight. The prevalence of deficient weight at birth (between 2,500 and 2,999 grams) was of 21.1%. Analysis indicated that 50.6% of children with low birth weight were at term and the majority of them suffered form intrauterine growth retardation. The prevalence of low birth weight according to social class was seen to be lower in the bourgeoisie classes (ranging from 2.8% to 3.9%) and higher in working classes (from 7% up to 9.5%). Low birth weight (defined as less than or equal to 2,500 grams) was used for purposes of comparison with other previous surveys. The percentage was lower in this study (8.3%) than that found in the Interamerican Investigation of Mortality in Childhood (8.7%), carried out in 1968-70. No statistically significant differences in the percentage of low birth weight were found in the case of Ribeirão Preto when these two surveys were compared.

The influence of maternal body composition on birth weight.

LENUS (Irish Health Repository)

Farah, Nadine

2012-02-01

OBJECTIVE: To identify the maternal body composition parameters that independently influence birth weight. STUDY DESIGN: A longitudinal prospective observational study in a large university teaching hospital. One hundred and eighty-four non-diabetic caucasian women with a singleton pregnancy were studied. In early pregnancy maternal weight and height were measured digitally in a standardised way and the body mass index (BMI) was calculated. At 28 and 37 weeks\\' gestation maternal body composition was assessed using segmental multifrequency bioelectrical impedance analysis. At delivery the baby was weighed and the clinical details were recorded. RESULTS: Of the women studied, 29.2% were overweight and 34.8% were obese. Birth weight did not correlate with maternal weight or BMI in early pregnancy. Birth weight correlated with gestational weight gain (GWG) before the third trimester (r=0.163, p=0.027), but not with GWG in the third trimester. Birth weight correlated with maternal fat-free mass, and not fat mass at 28 and 37 weeks gestation. Birth weight did not correlate with increases in maternal fat and fat-free masses between 28 and 37 weeks. CONCLUSIONS: Contrary to previous reports, we found that early pregnancy maternal BMI in a non-diabetic population does not influence birth weight. Interestingly, it was the GWG before the third trimester and not the GWG in the third trimester that influenced birth weight. Our findings have implications for the design of future intervention studies aimed at optimising gestational weight gain and birth weight. CONDENSATION: Maternal fat-free mass and gestational weight gain both influence birth weight.

Prepregnancy body mass index, gestational weight gain, and birth weight in the BRISA cohort.

Science.gov (United States)

Lima, Raina Jansen Cutrim Propp; Batista, Rosângela Fernandes Lucena; Ribeiro, Marizélia Rodrigues Costa; Ribeiro, Cecília Cláudia Costa; Simões, Vanda Maria Ferreira; Lima Neto, Pedro Martins; Silva, Antônio Augusto Moura da; Bettiol, Heloisa

2018-01-01

OBJECTIVE To analyze the effects of maternal pre-pregnancy body mass index and weight gain during pregnancy on the baby's birth weight. METHODS We conducted a cross-sectional study with 5,024 mothers and their newborns using a Brazilian birth cohort study. In the proposed model, estimated by structural equation modeling, we tested socioeconomic status, age, marital status, pre-pregnancy body mass index, smoking habit and alcohol consumption during pregnancy, hypertension and gestational diabetes, gestational weight gain, and type of delivery as determinants of the baby's birth weight. RESULTS For a gain of 4 kg/m2 (1 Standard Deviation [SD]) in pre-pregnancy body mass index, there was a 0.126 SD increase in birth weight, corresponding to 68 grams (p gestational weight gain represented a 0.280 SD increase in newborn weight, correponding to 151.2 grams (p weight was direct (standardized coefficient [SC] = 0.202; p weight gain during pregnancy (SC = -0.070, p weight gain during pregnany on birth weight was predominantly direct (SC = 0.269, p gained less weight during pregnancy (p gestational weight gain on the increase in birth weight was greater than that of pre-pregnancy body mass index.

birth-weight infants

African Journals Online (AJOL)

including the CRIB (Clinical Risk Index for Babies) score, in a local ... these babies for expensive tertiary care. Subjects. ... patient numbers, the tendency is simply to increase the ... included birth weight, gestational age, 5-minute Apgar score ...

Birth weight recovery among very low birth weight infants surviving ...

African Journals Online (AJOL)

A multiple linear regression showed a negative association between ZSW at discharge and number of days nil per os without parenteral nutrition (PN). Antenatal steroids were associated with poor GV. There were no factors associated with regaining birth weight after 21 days on multiple logistic regression. Conclusion.

Coffee Consumption During Pregnancy and Birth Weight

DEFF Research Database (Denmark)

Bech, Bodil Hammer; Frydenberg, Morten; Henriksen, Tine Brink

2015-01-01

weight and whether it was modified by the mothers' smoking habits. Methods: In the Danish National Birth Cohort, coffee intake and smoking during pregnancy were recorded prospectively in 89,539 pregnancies that ended with live born singletons. Information on birth weight was obtained from the Danish......Background: A previous randomized trial demonstrated an association between coffee intake and birth weight in smokers only. This could be a chance finding or because smoking interferes with caffeine metabolism. This study assessed the association between coffee intake during pregnancy and birth....../cup/day). Compared to non-coffee drinkers, intake of eight or more cups of coffee per day was associated with an adjusted birth weight difference of −65 g [95% confidence interval (CI) −92 to −39] for non-smokers and −79 g [95% CI −124 to −34] for women smoking more than 10 cigarettes per day. Women drinking eight...

Pacemaker therapy in low-birth-weight infants.

Science.gov (United States)

Fuchigami, Tai; Nishioka, Masahiko; Akashige, Toru; Shimabukuro, Atsuya; Nagata, Nobuhiro

2018-02-01

Infants born with complete atrioventricular block (CAVB) and fetal bradycardia are frequently born with low birth weight. Three low-birth-weight CAVB infants underwent temporary pacemaker implantation, followed by permanent single-chamber pacemaker implantation at median body weights of 1.7 and 3.2 kg, respectively. All infants caught up with their growth curves and had >3 years of estimated residual battery life. This two-stage strategy was successful in facilitating permanent pacemaker implantation in low-birth-weight babies. Placement of single-chamber pacemaker on the apex of the left ventricle appears to be associated with longer battery lifespan. © 2018 Wiley Periodicals, Inc.

Birth weight in a large series of triplets

NARCIS (Netherlands)

Ponsen-Lamb, D.J.; Middeldorp, C.M.; van Beijsterveldt, C.E.M.; Vink, J.M.; Haak, M.C.; Boomsma, D.I.

2011-01-01

Background: Triplets are often born premature and with a low birth weight. Because the incidence of triplet births is rare, there are relatively few studies describing triplet birth weight characteristics. Earlier studies are often characterized by small sample sizes and lack information on

Birth weight in a large series of triplets

NARCIS (Netherlands)

Lamb, Diane J.; Middeldorp, Christel M.; van Beijsterveldt, Catharina E. M.; Vink, Jacqueline M.; Haak, Monique C.; Boomsma, Dorret I.

2011-01-01

Triplets are often born premature and with a low birth weight. Because the incidence of triplet births is rare, there are relatively few studies describing triplet birth weight characteristics. Earlier studies are often characterized by small sample sizes and lack information on important background

Increasing low birth weight rates: deliveries in a tertiary hospital in istanbul.

Science.gov (United States)

Akin, Yasemin; Cömert, Serdar; Turan, Cem; Unal, Orhan; Piçak, Abdülkadir; Ger, Lale; Telatar, Berrin

2010-09-01

Prevalence of low birth weight deliveries may vary across different environments. The necessity of determination of regional data prompted this study. Information of all deliveries from January 2004 to December 2008 was obtained from delivery registry records retrospectively. Initial data including birth weight, vital status, sex, maternal age and mode of delivery were recorded using medical files. The frequency of low birth weight, very low birth weight, extremely low birth weight and stillbirth deliveries were determined. Among 19,533 total births, there were 450 (23.04 per 1000) stillbirths. Low birth weight rate was 10.61%. A significant increase in yearly distribution of low birth weight deliveries was observed (Pbirth weight and extremely low birth weight delivery rates were 3.14% and 1.58% respectively. Among 2073 low birth weight infants, 333 (16.06%) were stillbirths. The stillbirth delivery rate and the birth of a female infant among low birth weight deliveries were significantly higher than infants with birth weight ≥2500g (Pbirth weight and maternal age. The rate of cesarean section among low birth weight infants was 49.4%. High low birth weight and stillbirth rates, as well as the increase in low birth weight deliveries over the past five years in this study are striking. For reduction of increased low birth weight rates, appropriate intervention methods should be initiated.

Effect of Smoking Cessation on Gestational and Postpartum Weight Gain and Neonatal Birth Weight

DEFF Research Database (Denmark)

Rode, Line; Kjærgaard, Hanne; Damm, Peter

2013-01-01

To examine the association among smoking cessation, gestational and postpartum weight gain, and neonatal birth weight.......To examine the association among smoking cessation, gestational and postpartum weight gain, and neonatal birth weight....

Trends and racial differences in birth weight and related survival.

Science.gov (United States)

Alexander, G R; Tompkins, M E; Allen, M C; Hulsey, T C

1999-06-01

In the past two decades, infant mortality rates in the United States declined in African-American and White populations. Despite this, racial disparities in infant mortality rates have increased and rates of low birth weight deliveries have shown little change. In this study, we examine temporal changes in birth weight distributions, birth weight specific neonatal mortality, and the birth weight threshold for an adverse risk of survival within both racial groups in order to explore the mechanisms for the disparities in infant mortality rates. Single live births born to South Carolina resident mothers between 1975 and 1994 and considered White or African-American based on the mother's report of maternal race on the birth certificate were selected for investigation. We define the birth weight threshold for adverse survival odds as the birth weight at which 50% or more of infants in the population died within the first month of life. Despite significant increases in very low birth weight percentages, neonatal mortality rates markedly declined. Birth weight specific neonatal mortality decreased for both races, although greater reductions accrued to White low birth weight infants. By the end of the study period, the birth weight at which over 50% of newborns died within the first month of life was 696 g for Whites and 673 g for African-Americans. The ongoing decline in neonatal mortality is mainly due to reductions in birth weight specific neonatal mortality, probably related to high-risk obstetric and neonatal care. Technological developments in these areas may have differentially benefited Whites, resulting in an increasing racial disparity in mortality rates. Moreover, the relatively greater and increasing mortality risk from postmaturity and macrosomia in infants of African-America mothers may further exacerbate the racial gap in infant mortality.

Bedside detection of low systemic flow in the very low birth weight infant on day 1 of life.

LENUS (Irish Health Repository)

Miletin, J

2012-02-01

We aimed to assess the relationship between the clinical and biochemical parameters of perfusion and superior vena cava (SVC) flow in a prospective observational cohort study of very low birth weight (VLBW) infants. Newborns with congenital heart disease were excluded. Echocardiographic evaluation of SVC flow was performed in the first 24 h of life. Capillary refill time (forehead, sternum and toe), mean blood pressure, urine output and serum lactate concentration were also measured simultaneously. Thirty-eight VLBW infants were examined. Eight patients (21%) had SVC flow less than 40 ml\\/kg\\/min. There was a poor correlation between the capillary refill time (in all sites), mean blood pressure, urine output and SVC flow. The correlation coefficient for the serum lactate concentration was r = -0.28, p = 0.15. The median serum lactate concentration was 3.5 (range 2.8-8.5) vs. 2.7 (range 1.2-6.9) mmol\\/l (p = 0.01) in low flow versus normal flow states. A serum lactate concentration of >2.8 was 100% sensitive and 60% specific for detecting a low flow state. Combining a capillary refill time of >4 s with a serum lactate concentration of >4 mmol\\/l had a specificity of 97% for detecting a low SVC flow state. Serum lactate concentrations are higher in low SVC flow states. A capillary refill time of >4 s combined with serum lactate concentrations >4 mmol\\/l increased the specificity and positive and negative predictive values of detecting a low SVC flow state.

Maternal pre-pregnancy body mass index, gestational weight gain influence birth weight.

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Zhao, R; Xu, L; Wu, M L; Huang, S H; Cao, X J

2018-02-01

Evidence suggests that pre-pregnancy body mass index and gestational weight gain have impact on pregnancy and birth weight, yet whether maternal gestational weight gain has a differential effect on the rates of adverse birth weight among women with different pre-pregnancy body mass index categories are unknown. We selected 1617 children matched with their mothers as study subjects. The subjects were divided into three categories: weight gain below the American Institute of Medicine guidelines, weight gain within the American Institute of Medicine guidelines and weight gain above the American Institute of Medicine guidelines. The prevalence of pre-pregnancy underweight and overweight/obese women was 16.3% and 12.3%. And nearly 15.2% of the women had gestational weight gain below American Institute of Medicine guideline, 52.1% of the women had gestational weight gain above American Institute of Medicine guideline. Maternal overweight and obese was associated with increased risk for macrosomia and large-for-gestational age. Women had gestational weight gain below American Institute of Medicine guideline were more likely to have low birth weight and small-for-gestational age than women who had gestational weight gain within American Institute of Medicine guideline. Furthermore, the risks for macrosomia and large-for-gestational age were increased in women with above American Institute of Medicine guideline. And for women with a normal weight before pregnancy, gestational weight gain above the American Institute of Medicine guidelines were associated with higher rates of macrosomia and large-for-gestational age, compared with the women of similar pre-pregnancy weight category but with gestational weight gain within the American Institute of Medicine guidelines. Women with abnormal pre-pregnancy body mass index and gestational weight gain are at risk for adverse birth weight outcomes. Moreover, gestational weight gain has a differential effect on the rates of adverse

Association between maternal weight gain and birth weight

DEFF Research Database (Denmark)

Rode, Line; Hegaard, Hanne K; Kjaergaard, Hanne

2007-01-01

To investigate the association between maternal weight gain and birth weight less than 3,000 g and greater than or equal to 4,000 g in underweight (body mass index [BMI] less than 19.8 kg/m(2)), normal weight (BMI 19.8-26.0 kg/m(2)), overweight (BMI 26.1-29.0 kg/m(2)), and obese (BMI greater than...

Low birth weight is not associated with thyroid autoimmunity

DEFF Research Database (Denmark)

Brix, Thomas Heiberg; Hansen, Pia Skov; Rudbeck, Annette Beck

2006-01-01

CONTEXT: Low birth weight has been proposed as a risk factor for the development of antibodies toward thyroid peroxidase (TPOAb) and thyroglobulin (TgAb) in adult life. However, the association could also be due to genetic or environmental factors affecting both birth weight and the development...... of thyroid autoantibodies. The effect of these confounders can be minimized through investigation of twin pairs. OBJECTIVE AND DESIGN: To examine the impact of low birth weight on the development of thyroid autoimmunity, we studied whether within-twin-cohort and within-twin-pair differences in birth weight......, gestational age, TSH, and smoking) did not change the findings of nonsignificant regression coefficients. CONCLUSION: Low birth weight per se has no evident role in the etiology of thyroid autoimmunity....

Birth Weight and Intelligence in Young Adulthood and Midlife.

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Flensborg-Madsen, Trine; Mortensen, Erik Lykke

2017-06-01

We examined the associations between birth weight and intelligence at 3 different adult ages. The Copenhagen Perinatal Cohort is comprised of children born in Copenhagen from 1959 to 1961. Information on birth weight and ≥1 tests of intelligence was available for 4696 members of the cohort. Intelligence was assessed at a mean age of 19 years with the Børge Priens Prøve test, at age 28 years with the Wechsler Adult Intelligence Scale, and at age 50 years with the Intelligenz-Struktur-Test 2000 R. Birth weight was significantly associated with intelligence at all 3 follow-up assessments, with intelligence scores increasing across 4 birth weight categories and declining for the highest birth weight category. The adjusted differences between those in the 5 IQ points at all 3 follow-up assessments, corresponding to one-third of a SD. The association was stable from young adulthood into midlife,and not weaker at age 50 years. Adjustment for potential confounding factors, including infant socioeconomic status and gestational age, did not dilute the associations, and associations with intelligence were evident across the normal birth weight range and so were not accounted for by low birth weight only. The association between birth weight and intelligence is stable from young adulthood into midlife. These long-term cognitive consequences may imply that even small shifts in the distribution of birth size, in normal-sized infants as well, may have a large impact at the population level. Copyright © 2017 by the American Academy of Pediatrics.

Residential proximity to major roads and placenta/birth weight ratio.

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Yorifuji, Takashi; Naruse, Hiroo; Kashima, Saori; Murakoshi, Takeshi; Tsuda, Toshihide; Doi, Hiroyuki; Kawachi, Ichiro

2012-01-01

Exposure to air pollution has been demonstrated to increase the risk of preterm birth and low birth weight. We examined whether proximity to major roads (as a marker of exposure to air pollution) is associated with increased placenta/birth weight ratio (as a biomarker of the placental transport function). Data on parental characteristics and birth outcomes were extracted from the database maintained by a major hospital in Shizuoka Prefecture, Japan. We restricted the analysis to mothers who delivered liveborn single births from 1997 to 2008 (n = 14,189). Using geocoded residential information, each birth was classified according to proximity to major roads. We examined the association between proximity to major roads and the placenta/birth weight ratio, using multiple linear regression. Proximity to major roads was associated with higher placenta/birth weight ratio. After adjusting for potential confounders, living within 200 m of a major road increased the ratio by 0.48% (95% CI = 0.15 to 0. 80). In addition, proximity to major roads was associated with lower placenta weight and birth weight. These observed associations were stronger among participants living closer to major roads. Exposure to traffic-related air pollution is associated with higher placenta/birth weight ratio. Impaired placental oxygen and nutrient transport function might be a mechanism for explaining the observed association between air pollution and low birth weight as well as preterm birth. Copyright © 2011 Elsevier B.V. All rights reserved.

Prepregnancy body mass index, gestational weight gain, and birth weight in the BRISA cohort

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Raina Jansen Cutrim Propp Lima

2018-05-01

Full Text Available ABSTRACT OBJECTIVE To analyze the effects of maternal pre-pregnancy body mass index and weight gain during pregnancy on the baby's birth weight. METHODS We conducted a cross-sectional study with 5,024 mothers and their newborns using a Brazilian birth cohort study. In the proposed model, estimated by structural equation modeling, we tested socioeconomic status, age, marital status, pre-pregnancy body mass index, smoking habit and alcohol consumption during pregnancy, hypertension and gestational diabetes, gestational weight gain, and type of delivery as determinants of the baby's birth weight. RESULTS For a gain of 4 kg/m2 (1 Standard Deviation [SD] in pre-pregnancy body mass index, there was a 0.126 SD increase in birth weight, corresponding to 68 grams (p < 0.001. A 6 kg increase (1 SD in gestational weight gain represented a 0.280 SD increase in newborn weight, correponding to 151.2 grams (p < 0.001. The positive effect of pre-pregnancy body mass index on birth weight was direct (standardized coefficient [SC] = 0.202; p < 0.001, but the negative indirect effect was small (SC = -0.076, p < 0.001 and partially mediated by the lower weight gain during pregnancy (SC = -0.070, p < 0.001. The positive effect of weight gain during pregnany on birth weight was predominantly direct (SC = 0.269, p < 0.001, with a small indirect effect of cesarean delivery (SC = 0.011; p < 0.001. Women with a higher pre-pregnancy body mass index gained less weight during pregnancy (p < 0.001. CONCLUSIONS The effect of gestational weight gain on the increase in birth weight was greater than that of pre-pregnancy body mass index.

Impaired kidney growth in low-birth-weight children

DEFF Research Database (Denmark)

Schmidt, Ida M; Chellakooty, Marla; Boisen, Kirsten A

2005-01-01

BACKGROUND: Low birth weight is an important risk factor for hypertension and unfavorable prognoses of a number of renal diseases. It is also associated with reduced kidney size and nephron number. A differentiation between the effects of low birth weight versus being born premature or small...... for gestational age has, however, not been addressed. METHODS: The influence of weight for gestational age (percentage deviation from expected mean), gestational age, birth weight, and early diet on kidney growth was studied in 178 children born pre- or postmature and/or small or large for gestational age......, comparing them to 717 mature children, birth weight appropriate for gestational age. Kidney size was determined by bilateral ultrasonography measuring length, width and depth, using the equation of an ellipsoid for volume calculation. The examinations were performed at 0, 3, and 18 months of age together...

Malaria has no effect on birth weight in Rwanda

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Karema Corine

2009-08-01

Full Text Available Abstract Background Malaria has a negative effect on pregnancy outcome, causing low birth weight, premature birth and stillbirths, particularly in areas with high malaria transmission. In Rwanda, malaria transmission intensity ranges from high to nil, probably associated with variable altitudes. Overall, the incidence decreased over the last six years (2002–2007. Therefore, the impact of malaria on birth outcomes is also expected to vary over time and space. Methods Obstetric indicators (birth weight and pregnancy outcome and malaria incidence were compared and analyzed to their association over time (2002–2007 and space. Birth data from 12,526 deliveries were collected from maternity registers of 11 different primary health centers located in different malaria endemic areas. Malaria data for the same communities were collected from the National Malaria Control Programme. Associations were sought with mixed effects models and logistic regression. Results In all health centres, a significant increase of birth weight over the years was observed (p Conclusion In Rwanda, birth weight and pregnancy outcome are not directly influenced by malaria, which is in contrast to many other studied areas. Although malaria incidence overall has declined and mean birth weight increased over the studied period, no direct association was found between the two. Socio-economic factors and improved nutrition could be responsible for birth weight changes in recent years.

Low birth weight in the United States.

Science.gov (United States)

Goldenberg, Robert L; Culhane, Jennifer F

2007-02-01

Pregnancy outcomes in the United States and other developed countries are considerably better than those in many developing countries. However, adverse pregnancy outcomes are generally more common in the United States than in other developed countries. Low-birth-weight infants, born after a preterm birth or secondary to intrauterine growth restriction, account for much of the increased morbidity, mortality, and cost. Wide disparities exist in both preterm birth and growth restriction among different population groups. Poor and black women, for example, have twice the preterm birth rate and higher rates of growth restriction than do most other women. Low birth weight in general is thought to place the infant at greater risk of later adult chronic medical conditions, such as diabetes, hypertension, and heart disease. Of interest, maternal thinness is a strong predictor of both preterm birth and fetal growth restriction. However, in the United States, several nutritional interventions, including high-protein diets, caloric supplementation, calcium and iron supplementation, and various other vitamin and mineral supplementations, have not generally reduced preterm birth or growth restriction. Bacterial intrauterine infections play an important role in the etiology of the earliest preterm births, but, at least to date, antibiotic treatment either before labor for risk factors such as bacterial vaginosis or during preterm labor have not consistently reduced the preterm birth rate. Most interventions have failed to reduce preterm birth or growth restriction. The substantial improvement in newborn survival in the United States over the past several decades is mostly due to better access to improved neonatal care for low-birth-weight infants.

Gestational Weight Gain and its Relation with Birth Weight of the Newborn.

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Thapa, Meena; Paneru, Rupa

2017-01-01

Gestational weight gain is an important predictor of the health of the newborn. It is affected by body mass index of the women. This study was conducted to find out gestational weight gain according to Institute of Medicine 2009 recommendation and relationship of newborn birth weight to body mass index and gestational weight gain of the women. It was cross sectional, hospital based study. The women, who attended at term pregnancy for delivery and having recorded first trimester body weight, were included in the study. Their body mass index was calculated and they were stratified into 4 groups according to body mass index. The gestational weight gain was calculated by subtracting first trimester body weight from body weight at the time of admission for delivery. All the women were followed till delivery. The newborn birth weight was taken immediately after delivery. A total of 227 women were enrolled in the study. More than half of the women had normal body mass index. There were 84 (37%) overweight and obese women. Mean gestational weight gain was 10.21 kg, and mean weight of the newborn was 3.05 kg. There were equal number of women who had adequate weight gain and less weight gain according to recommendation. Excess weight gain was seen in 34 (15%) women. Women of higher body mass index and women who had gain more weight during pregnancy had larger newborns. Body mass index and gestational weight gain of the women were important predictors of birth weight of the newborn. There is a positive correlation between gestational weight gain of the women and birth weight of the newborn.

Cerebral MRI of very low birth weight children at 6 years of age compared with the findings at 1 year

International Nuclear Information System (INIS)

Skranes, J.S.; Nilsen, G.; Smevik, O.; Vik, T.; Brubakk, A.M.

1998-01-01

Background. We have previously reported the results of cerebral MRI examinations in an unselected year cohort of very low birth weight (VLBW) infants at one year of corrected age. Twenty-one (78 %) of 27 infants had abnormal myelination, mainly in the central occipital white matter (COWM) and in the centrum semiovale (CS), seen on T2-weighted images. Twelve infants had irregular and dilated lateral ventricles. We speculated whether these findings indicated perinatal periventricular leukomalacia (PVL). Only two infants had completely normal MRI at age 1 year. Objective. To determine whether the abnormal myelination seen at 1 year of age, was still present, either as delayed myelination or as gliosis caused by perinatal PVL. Materials and methods. In the present study, we report the results of follow-up cerebral MRI in 20 of these infants at 6 years of age. Results. Most of the children with MRI deviations at 1 year still had abnormalities at 6 years. Abnormal myelination in the central occipital white matter combined with abnormalities in the CS or with ventricular dilatation at age 1 year, presented as gliosis in 12 of 13 children at 6 years of age. Abnormalities solely in the COWM at age 1 year had normalised in two of five children and persisted as delayed myelination in three at age 6 years. Gliotic changes in periventricular white matter were found in 12 of 20 children (60 %). Areas most affected were the CS (11 children) and the COWM (9 children). Delayed myelination in COWM was found in six children (30 %), combined with gliosis in CS in three children. Twelve infants had ventricular dilatation both at 1 and 6 years of age. Conclusions. The MRI correlates of PVL, i. e. gliosis and ventricular dilatation, are common findings on cerebral MRI at 6 years of age in VLBW infants. (orig.)

CALF CIRCUMFERENCE AT BIRTH: A SCREENING METHOD FOR DETECTION OF LOW BIRTH WEIGHT

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Sandip Kumar

2012-12-01

Full Text Available Background: Low Birth Weight (LBW babies run a higher risk of morbidity and mortality in the perinatal period. However, in our country where almost 70-80% births take place at home and peripheral hospitals, taking accurate weight is a problem due to unavailability of weighing scale and trained personnel. Hence there is a constant search for newer methods to detect LBW babies so that early interventions can be instituted. Various authors have used different surrogate anthropometric measurements from different parts of our country. In the present study, an attempt was made to validate the feasibility of using calf circumference as a predictor of LBW babies that can be used by a trained or untrained person. Objectives: To study various anthropometric measurements including calf circumference in newborns and to correlate various measurements with birth weight. Methods: The present study was conducted in the department of Social & Preventive Medicine, MLB Medical College, Jhansi (UP for a period of one year. The study included 1100 consecutively delivered neonates in the maternity ward of MLB Medical College Hospital, Jhansi (UP. The birth weight (Wt, crown heel length (CHL, crown rump length (CRL, head circumference (HC, chest circumference (CC, mid arm circumference (MAC, thigh circumference (TC and calf circumference (CC by standard techniques. All the measurements were taken by a single person throughout the study period with in 24 hours of delivery. Standard statistical methods were adopted for determination of critical limit, sensitivity, specificity and correlation coefficient of different anthropometric measurements in relation to birth weight. Results: Analysis of data indicates that out of 1100 newborns, 55.64% were low birth weight. The percentage of newborns > 2500gm was 44.36. Overall average birth weight was 2348 ± 505gm. Out of 1100 newborns, 608 (55.27% were males and 492 (44.73% were females. Average birth weight for males was 2412

References of birth weights for gestational age and sex from a large cohort of singleton births in cameroon.

Science.gov (United States)

Kemfang Ngowa, Jean Dupont; Domkam, Irénée; Ngassam, Anny; Nguefack-Tsague, Georges; Dobgima Pisoh, Walter; Noa, Cyrille; Kasia, Jean Marie

2014-01-01

Objective. To establish the percentile charts of birth weights for gestational age and sex within the Cameroonian population. Methods. A review of medical records of infants born between January 2007 and December 2011 at the maternities of two hospitals in Cameroon, Central Africa. Multiple pregnancies, births of HIV infected women, stillbirths, and births with major fetal malformations were excluded. The smooth curves of birth weight for gestational age and sex were created using the Gamlss package under R.3.0.1 software. Results. The birth weights of 12837 live birth singleton infants born to HIV negative women between 28 and 42 weeks of gestation were analyzed to construct the birth weight curves for gestational age and sex. The smoothed percentile curves of birth weights for gestational age and sex of Cameroonian infants have demonstrated an increasing slope until 40 weeks and then a plateau. There was a varied difference of distribution in birth weights for gestational age between Cameroonian, Botswanan, American, and French infants. Conclusion. We established the reference curves of birth weights for gestational age and sex for Cameroonians. The difference in birth weight curves noted between Cameroonian, Botswanan, American, and French infants suggests the importance of establishing the regional birth weight norms.

References of Birth Weights for Gestational Age and Sex from a Large Cohort of Singleton Births in Cameroon

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Jean Dupont Kemfang Ngowa

2014-01-01

Full Text Available Objective. To establish the percentile charts of birth weights for gestational age and sex within the Cameroonian population. Methods. A review of medical records of infants born between January 2007 and December 2011 at the maternities of two hospitals in Cameroon, Central Africa. Multiple pregnancies, births of HIV infected women, stillbirths, and births with major fetal malformations were excluded. The smooth curves of birth weight for gestational age and sex were created using the Gamlss package under R.3.0.1 software. Results. The birth weights of 12837 live birth singleton infants born to HIV negative women between 28 and 42 weeks of gestation were analyzed to construct the birth weight curves for gestational age and sex. The smoothed percentile curves of birth weights for gestational age and sex of Cameroonian infants have demonstrated an increasing slope until 40 weeks and then a plateau. There was a varied difference of distribution in birth weights for gestational age between Cameroonian, Botswanan, American, and French infants. Conclusion. We established the reference curves of birth weights for gestational age and sex for Cameroonians. The difference in birth weight curves noted between Cameroonian, Botswanan, American, and French infants suggests the importance of establishing the regional birth weight norms.

Influence of birth order, birth weight, colostrum and serum immunoglobulin G on neonatal piglet survival.

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Cabrera, Rafael A; Lin, Xi; Campbell, Joy M; Moeser, Adam J; Odle, Jack

2012-12-23

Intake of colostrum after birth is essential to stimulate intestinal growth and function, and to provide systemic immunological protection via absorption of Immunoglobulin G (IgG). The birth order and weight of 745 piglets (from 75 litters) were recorded during a one-week period of farrowing. Only pigs weighing greater than 0.68 kg birth weight were chosen for the trial. Sow colostrum was collected during parturition, and piglets were bled between 48 and 72 hours post-birth. Piglet serum IgG and colostral IgG concentrations were determined by radial immunodiffusion. Sow parity had a significant (P birth order accounted for another 4% of the variation observed in piglet serum IgG concentration (P birth weight had no detectable effect. Piglet serum IgG concentration had both a linear (P Birth order had no detectable effect on survival, but birth weight had a positive linear effect (P birth had a 68% survival rate, and those weighing 1.6 kg (n = 158) had an 89% survival. We found that the combination of sow colostrum IgG concentration and birth order can account for 10% of the variation of piglet serum IgG concentration and that piglets with less than 1,000 mg/dl IgG serum concentration and weight of 0.9 kg at birth had low survival rate when compared to their larger siblings. The effective management of colostrum uptake in neonatal piglets in the first 24 hrs post-birth may potentially improve survival from birth to weaning.

A National Census of Birth Weight in Purebred Dogs in Italy

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Debora Groppetti

2017-05-01

Full Text Available Despite increasing professionalism in dog breeding, the physiological range of birth weight in this species remains unclear. Low birth weight can predispose to neonatal mortality and growth deficiencies in humans. To date, the influence of the morphotype on birth weight has never been studied in dogs. For this purpose, an Italian census of birth weight was collected from 3293 purebred pups based on maternal morphotype, size, body weight and breed, as well as on litter size and sex of pups. Multivariate analysis outcomes showed that birth weight (p < 0.001 and litter size (p < 0.05 increased with maternal size and body weight. Birth weight was also influenced by the maternal head and body shape, with brachycephalic and brachymorph dogs showing the heaviest and the lightest pups, respectively (p < 0.001. Birth weight decreased with litter size (p < 0.001, and male pups were heavier than females (p < 0.001. These results suggest that canine morphotype, not only maternal size and body weight, can affect birth weight and litter size with possible practical implications in neonatal assistance.

Low birth weight in relation to maternal age and multiple ...

African Journals Online (AJOL)

Vihar

Objectives: To determine the relationship between Low Birth Weight (LBW), maternal age and multiple ... mothers. Low socio-economic status is the underlying ... rate of low birth weight infants. ... Table 3: Distribution of Age against Birth weight.

Influence of environmental factors on birth weight variability of ...

African Journals Online (AJOL)

Administrator

2011-05-30

May 30, 2011 ... significant (P < 0.05). Type of birth also had effect on the body weight of lambs at birth in both Pirot and ... Key words: Environmental factors, birth weight variability, indigenous sheep. ... breeding plans to improve production.

Maternal pesticide use and birth weight in the agricultural health study.

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Sathyanarayana, Sheela; Basso, Olga; Karr, Catherine J; Lozano, Paula; Alavanja, Michael; Sandler, Dale P; Hoppin, Jane A

2010-04-01

Studies examining the association between maternal pesticide exposure and low birth weight yield conflicting results. The authors examined the association between maternal pesticide use and birth weight among women in the Agricultural Health Study, a large study of pesticide applicators and their spouses in Iowa and North Carolina. The authors evaluated self-reported pesticide use of 27 individual pesticides in relation to birth weight among 2246 farm women whose most recent singleton birth occurred within 5 years of enrollment (1993-1997). The authors used linear regression models adjusted for site, preterm birth, medical parity, maternal body mass index, height, and smoking. The results showed that mean infant birth weight was 3586 g (+/- 546 g), and 3% of the infants were low birth weight (birth weight. Ever use of the pesticide carbaryl was associated with decreased birth weight (-82 g, 95% confidence interval [CI] = -132, -31). This study thus provides limited evidence about pesticide use as a modulator of birth weight. Overall, the authors observed no associations between birth weight and pesticide-related activities during early pregnancy; however, the authors have no data on temporal specificity of individual pesticide exposures prior to or during pregnancy and therefore cannot draw conclusions related to these exposure windows. Given the widespread exposure to pesticide products, additional evaluation of maternal pregnancy exposures at specific time windows and subsequent birth outcomes is warranted.

Low Birth Weight And Maternal Risk Factors

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Secma Nigam

2003-06-01

Full Text Available Objectives : To study tile socio-economic and maternal risk factors associated with low birth weight babies and to measure the strength of association. Study Design : Hospital based case-control study. Setting : Shri Sayajirao General Hospital, Vadodara. Sample size : 312 cases and 312 controls. Participants : Cases Mothers who delivered single, live baby less than 2500 gms i.e. low birth weight. Controls:- Mothers who delivered single live baby more than 2500 gms. Study Variable : Maternal age, literacy, anaemia, outcome of last pregnancy. Statistical Analysis : Chi-square test and odd’s ratio. Result : Among cases, 14.5% mothers had age less titan 20 yrs as compared to 7.3% mothers in control group. 68.6% mothers amongst cases were illiterate against 46.5% mothers in control group. 53.8% mothers had haemoglobin level 10gm% or less amongst cases and no statistically significant difference was found between low birth weight and outcome of last pregnancy Conclusion : The maternal risk factors associated with low birth weight in mothers attending S.S.G. hospital age maternal anaemia (OR 2.66, illiteracy (OR 2.51, maternal age less than 20 yrs. (OR 2.OS. No association was found between low birth rate and outcome of last pregnancy

Relationship between birth order and birth weight of the pig

OpenAIRE

Charneca, Rui; Freitas, Amadeu; Nunes, José; Le Dividich, Jean

2013-01-01

The objective of this study was to determine whether birth weight of the pig is related to its birth order. The study involved 292 sows from 2 genotypes (Large White x Landrace crossbred (LL), n= 247 and Alentejano (AL), n=45) of mixed parity and their piglets. Most sows farrowed naturally. Each piglet was identified, weighed (± 1g) (mummies excepted) and its birth order (BO) recorded within 2 min of birth. A total of 3418 LL and 375 AL piglets were born of which 43 and 7 were mummified, a...

Physical activity during pregnancy and infant's birth weight: results from the 3D Birth Cohort.

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Bisson, Michèle; Croteau, Jordie; Guinhouya, Benjamin C; Bujold, Emmanuel; Audibert, François; Fraser, William D; Marc, Isabelle

2017-01-01

To evaluate the association between maternal physical activity and infant's birth weight or risk of inappropriate weight for gestational age (GA), and whether this association differs by infant's sex, maternal body mass index (BMI) or pregnancy complications in a prospective cohort study. 1913 pregnant women from the 3D Birth Cohort (Québec, Canada) completed the Pregnancy Physical Activity Questionnaire at each trimester. Energy expenditure (metabolic equivalent of task (MET)*hours/week) for total activity, sports and exercise and vigorous intensity activities was calculated. The associations with birth weight and risk of inappropriate weight for GA were evaluated by regression modelling. Interactions were tested with infant's sex, maternal prepregnancy BMI, gestational diabetes, hypertensive disorders and prematurity. Each 1 MET/hours/week increase in sports and exercise in the first trimester was associated with a 2.5 g reduction in infant's birth weight (95% CI -4.8 to -0.3) but was not associated with the risk of small weight for GA. In contrast, although not significant, a 17% reduction in the risk of large weight for GA was observed with increasing sports and exercise. Furthermore, in women with subsequent pre-eclampsia (but not normotensive or hypertensive women), each 1 MET/hours/week increment spent in any vigorous exercise in the first trimester reduced the infant's birth weight by 19.8 g (95% CI -35.2 to -4.3). Pregnant women with higher sports and exercise levels in the first trimester delivered infants with a lower birth weight. The risk of reducing infant's birth weight with vigorous exercise in women who develop pre-eclampsia later in pregnancy requires evaluation.

The role of serum and urinary urea in the evaluation of enteral protein intake in adequate and small-for-gestational-age very low birth weight infants

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Silvana Darcie

Full Text Available CONTEXT AND OBJECTIVE: Very low birth weight (VLBW infants have special nutritional needs. There is a current tendency to individualize their protein needs. The objective of this study was to determine the suitability of serum and urinary urea as indicators for protein intake in adequate-for-gestational-age (AGA and small-for-gestational-age (SGA VLBW infants. DESIGN AND SETTING: Prospective study in the nursery attached to the Maternity Ward of the "Prof. Pedro de Alcântara" Children's Institute, Hospital das Clínicas, Department of Pediatrics, Faculdade de Medicina da Universidade de São Paulo, Brazil. METHODS: Seventy-two VLBW infants (mean protein intake = 3.7 mg/kg/day were enrolled in a prospective cohort study in two groups: AGA (n = 34 and SGA (n = 38. Blood samples, six-hour urine (6hUr collections and urine sample tests (STUr were obtained for urea and creatinine assays at three and five weeks of life. Statistical analysis: Student's t test, Pearson correlation and linear regression (p < 0.05. RESULTS: There were no differences between groups for serum urea, 6hUr and STUr, or between two assessments within each group. Serum urea correlated with 6hUr in both AGA and SGA, and to STUr in SGA; 6hUr correlated with STUr in both AGA and SGA. There was no correlation between protein intake and serum or urine urea. CONCLUSIONS: Serum and urinary urea did not reflect protein intake when mean intakes of 3.7 g/kg/day were used. Sample tests of urinary urea can be as reliable as urea from urine collected over longer periods.

Birth weight discordance and perinatal mortality among triplets

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Egić Amira

2005-01-01

Full Text Available INTRODUCTION. The incidence of multiple births has increased in the last decade. Perinatal mortality in triplets is significantly greater than in twin and singleton births. OBJECTIVE. The objective of this study was to describe the extent of birth weight discordance among triplets and to identify its association with an increased risk of perinatal mortality. METHOD A retrospective analysis of triplet births, for the period 1993-2003, was conducted at the Gynaecological-Obstetric Clinic "Narodni Front" in Belgrade. Birth weight discordance was defined as the difference in birth weight between the largest and the smallest triplet's weight of more than 20%. RESULTS. The rate of triplets has increased by almost 75% between the first (7.7% and the last (29.6% 5-year period of the last decade. Triplets are becoming more common because of the frequent use of assisted reproductive technology as a treatment for infertility. In the period 1993-2003, there were a total of 40 triplet live births (24 weeks and greater with incidence of 0.06%. There was no clear association between maternal age, parity, method of conception, birth gestational age, and disorders complicating pregnancy with birth discordance more than 20%. Regarding birth weight groups, statistical significance occurred only in the <999 grams group for discordant and in the 2000-2499 grams group for concordant triplets. Overall, the perinatal mortality rate in the group was 10.8%, the foetal mortality rate was 1.7% (2/120, and the neonatal (0-28 days mortality rate was 9.1% (11/120. An odds ratio of 95% confidence interval shows 3 times greater risk for adverse perinatal outcome in the discordant group. However, the difference was not significant. CONCLUSION. Increasing birth weight discordance may increase the risk of adverse perinatal outcome. Triplet pregnancies, being high risk, require intensive antenatal care in order to prevent preterm delivery and ultrasound in order to diagnose foetal

Parental socioeconomic status and birth weight distribution of ...

African Journals Online (AJOL)

owner

2013-03-17

Mar 17, 2013 ... The low birth weight rate was ... identified maternal educational level4 and parental occu- pation5 as significant determinants of birth weight. There however, has not been sufficient evaluation of effects of ..... children in Ilesa.

KIR and HLA-C: Immunogenetic regulation of human birth weight

Directory of Open Access Journals (Sweden)

Lydia E. Farrell

2014-12-01

Full Text Available Pregnancies resulting in very small or very large babies are at higher risk of obstetric complications with increased morbidity for both mother and baby. Using data from the Medical Birth Registry of Norway we have shown how human birth weight is still subject to stabilizing selection. Particular combinations of maternal/fetal immune genes have been implicated in pregnancies resulting in a low birth weight baby (<5th birth weight centile. More specifically, an inhibitory maternal KIRAA genotype with a paternally derived fetal HLA-C2 ligand. At the other end of the birth weight spectrum the presence of an activating maternal KIR2DS1 gene is associated with increased birth weight in linear or logistic regression analyses of all pregnancies >5th centile (p=0.005, OR=2.65. Thus, inhibitory maternal KIR combined with fetal HLA-C2 is more frequently associated with low birth weight, whereas activating maternal KIR with fetal HLA-C2 ligand is associated with increasing birth weight. Our findings using the MoBa cohort have replicated the association of KIR and HLA-C seen in poor placentation, and confirm the importance of maternal/fetal immune gene interactions in determining the outcome of pregnancy.

Maternal Determinants of Birth Weight in Northern Ghana.

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Abdulai Abubakari

Full Text Available Weight at birth is usually considered as an indicator of the health status of a given society. As a result this study was designed to investigate the association between birth weight and maternal factors such as gestational weight gain, pre-pregnancy BMI and socio-economic status in Northern Ghana.The study was a facility-based cross-sectional survey conducted in two districts in the Northern region of Ghana. These districts were purposively sampled to represent a mix of urban, peri-urban and rural population. The current study included 419 mother-infant pairs who delivered at term (37-42 weeks. Mother's height, pre-pregnancy weight and weight changes were generated from the antenatal records. Questionnaires were administered to establish socio-economic and demographic information of respondents. Maternal factors associated with birth weight were examined using multiple and univariate regressions.The mothers were generally well nourished before conception (Underweight 3.82%, Normal 57.76%, Overweight 25.06% and Obesity 13.37% but approximately half of them could not gain adequate weight according to Institute of Medicine recommendations (Low weight gain 49.64%, Adequate weight gain 42.96% and Excessive weight gain 7.40%. Infants whose mothers had excess weight gain were 431g (95% CI 18-444 heavier compared to those whose mothers gained normal weight, while those whose mothers gained less were 479g (95% CI -682- (-276 lighter. Infants of mothers who were overweight and obese before conception were 246g (95% CI 87-405 and 595g (95% CI 375-815 respectively heavier than those of normal mothers, whereas those whose mothers were underweight were 305g (95% CI -565 -(-44 lighter. The mean birth weight observed was 2.98 ± 0.68 kg.Our findings show that pre-pregnancy body mass index and weight gain during pregnancy influence birth weight. Therefore, emphasis should be placed on counseling and assisting pregnant women to stay within the recommended weight

biostatistical analysis of birth weight and head circumference

African Journals Online (AJOL)

URCHMAN

hypothesis that birth weight is independent of head circumference; birth weight is ... small head size called Microcephaly or very slow growth rate may indicate that .... Decision is to reject H0 if the F distribution with K degrees of freedom in the ...

Birth weight, breast cancer and the potential mediating hormonal environment.

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Radek Bukowski

Full Text Available Previous studies have shown that woman's risk of breast cancer in later life is associated with her infants birth weights. The objective of this study was to determine if this association is independent of breast cancer risk factors, mother's own birth weight and to evaluate association between infants birth weight and hormonal environment during pregnancy. Independent association would have implications for understanding the mechanism, but also for prediction and prevention of breast cancer.Risk of breast cancer in relation to a first infant's birth weight, mother's own birth weight and breast cancer risk factors were evaluated in a prospective cohort of 410 women in the Framingham Study. Serum concentrations of estriol (E3, anti-estrogen alpha-fetoprotein (AFP, and pregnancy-associated plasma protein-A (PAPP-A were measured in 23,824 pregnant women from a separate prospective cohort, the FASTER trial. During follow-up (median, 14 years 31 women (7.6% were diagnosed with breast cancer. Women with large birth weight infants (in the top quintile had a higher breast cancer risk compared to other women (hazard ratio (HR, 2.5; 95% confidence interval (CI, 1.2-5.2; P = 0.012. The finding was not affected by adjustment for birth weight of the mother and traditional breast cancer risk factors (adjusted HR, 2.5; 95% CI, 1.2-5.6; P = 0.021. An infant's birth weight had a strong positive relationship with the mother's serum E3/AFP ratio and PAPP-A concentration during pregnancy. Adjustment for breast cancer risk factors did not have a material effect on these relationships.Giving birth to an infant with high birth weight was associated with increased breast cancer risk in later life, independently of mother's own birth weight and breast cancer risk factors and was also associated with a hormonal environment during pregnancy favoring future breast cancer development and progression.

A randomized pilot study comparing the role of PEEP, O2 flow, and high-flow air for weaning of ventilatory support in very low birth weight infants

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Chang-Yo Yang

2018-04-01

Full Text Available Background: There is a lack of evidence to guide step-wise weaning of positive pressure respiratory support for premature infants. This study sought to compare the efficacy of three weaning protocols we designed to facilitate weaning of very low birth weight (VLBW, less than 1500 g preterm infants from nasal continuous positive airway pressure (NCPAP support. Methods: This was a prospective, randomized, controlled trial of VLBW preterm infants who received positive pressure ventilatory support in our neonatal intensive care unit (NICU from April 2008 through March 2009. When these infants were weaned to CPAP as their last step of respiratory support, they would be randomly assigned to one of the following three groups as their further weaning methods (M: (M1 CPAP group, (M2 O2 flow group, and (M3 air flow group. The time period they needed to wean off any kind of respiratory support, as well as the likelihood of developing relevant prematurity related morbidities, were compared among patients using different weaning modalities. Results: 181 patients were enrolled in the study. Their gestational age (GA and birth weight (BW were 29.1 ± 2.5, 28.7 ± 2.4, 28.7 ± 2.4 (mean ± SD weeks and 1142 ± 232, 1099 ± 234, 1083 ± 219 g, in M1, M2 and M3, respectively. The time (period needed to wean off support was 16.0 ± 10.0 days (M1, 11.6 ± 6.4 days (M2, and 15.0 ± 8.9 days (M3, respectively (p = .033. Incidence of retinopathy of prematurity (ROP and bronchopulmonary dysplasia (BPD were both significantly higher in the O2 flow group (p = .048. Conclusions: Although using low oxygen flow significantly shortens CPAP weaning time, it may increase risks of BPD and ROP, both known to be related to oxygen toxicity. Unless the infant has BPD and is O2-dependent, clinicians should consider using air flow or just splinting with no support at all when weaning NCPAP. Key Words: weaning, nasal continuous positive airway pressure, very

Updated birth weight centiles for England and Wales.

Science.gov (United States)

Norris, Tom; Seaton, Sarah E; Manktelow, Brad N; Baker, Philip N; Kurinczuk, Jennifer J; Field, David; Draper, Elizabeth S; Smith, Lucy K

2017-12-07

Construct updated birth weight-for-gestational age centile charts for use in the UK and compare these to the currently used UK-WHO charts. Secondary analysis of national birth data. Centiles were constructed using 1 269 403 singleton births occurring in England and Wales in 2013-2014 as part of the MBRRACE-UK national perinatal surveillance programme. These were then validated using 642 737 singleton births occurring in England and Wales in 2015. Sex-specific birth weight-for-gestational age centiles. Centiles were created using the lambda-mu-sigma method via the GAMLSS package in R. This method transforms the skewed birth weight distribution to approximate a normal distribution, allowing any birth weight centile to be produced. The new centiles performed well in the validation sample, with the observed and expected proportion of births below a given centile in agreement. Overall, driven by the predominance of term births, the UK-WHO charts classify a smaller proportion of infants as below a given centile. For example, the UK-WHO estimates classified only 1.32% (8035/606 430) of term infants born in 2015 as below the second centile, compared with 1.97% (11 975/606 430) using the new MBRRACE-UK centiles. At the earliest gestational ages, however, the opposite is observed, with the UK-WHO classifying a larger proportion of infants as below a given centile, particularly at the lower end of the birthweight distribution. We have constructed and validated updated birth weight-for-gestational age centiles using a contemporary sample of births occurring in England and Wales. The benefits of these updated centiles will be first to assist the national surveillance of perinatal mortality programme by improving the identification of the proportion of stillbirths and neonatal deaths affected by intrauterine growth restriction and, second, to aid clinicians by more accurately identifying babies who require increased monitoring in the period immediately following birth. �

Epigenetic signature of birth weight discordance in adult twins

DEFF Research Database (Denmark)

Tan, Qihua; Nielsen, Morten Frost Munk; Heijmans, Bastiaan T

2014-01-01

between birth weight and adult life health while controlling for not only genetics but also postnatal rearing environment. We performed an epigenome-wide profiling on blood samples from 150 pairs of adult monozygotic twins discordant for birth weight to look for molecular evidence of epigenetic signatures...... profiling did not reveal epigenetic signatures of birth weight discordance although some sites displayed age-dependent intra-pair differential methylation in the extremely discordant twin pairs....

Young adults with very low birth weight: leaving the parental home and sexual relationships--Helsinki Study of Very Low Birth Weight Adults.

Science.gov (United States)

Kajantie, Eero; Hovi, Petteri; Räikkönen, Katri; Pesonen, Anu-Katriina; Heinonen, Kati; Järvenpää, Anna-Liisa; Eriksson, Johan G; Strang-Karlsson, Sonja; Andersson, Sture

2008-07-01

Although most children and adults who are born very preterm live healthy lives, they have, on average, lower cognitive scores, more internalizing behaviors, and deficits in social skills. This could well affect their transition to adulthood. We studied the tempo of first leaving the parental home and starting cohabitation with an intimate partner and sexual experience of young adults with very low birth weight (Adults, 162 very low birth weight individuals and 188 individuals who were born at term (mean age: 22.3 years [range: 18.5-27.1]) and did not have any major disability filled out a questionnaire. For analysis of their ages at events which had not occurred in all subjects, we used survival analysis (Cox regression), adjusted for gender, current height, parents' ages at the birth, maternal smoking during pregnancy, parental educational attainment, number of siblings, and parental divorce/death. During their late teens and early adulthood, these very low birth weight adults were less likely to leave the parental home and to start cohabiting with an intimate partner. In gender-stratified analyses, these hazard ratios were similar between genders, but the latter was statistically significant for women only. These very low birth weight adults were also less likely to experience sexual intercourse. This relationship was statistically significant for women but not for men; however, very low birth weight women and men both reported a smaller lifetime number of sex partners than did control subjects. Healthy young adults with very low birth weight show a delay in leaving the parental home and starting sexual activity and partnerships.

Ophthalmic, Hearing, Speaking and School Readiness Outcomes in Low Birth Weight and Normal Birth Weight Primary School Children in Mashhad-Iran

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Ashraf Mohammadzadeh

2011-01-01

Full Text Available Low Birth weight infants are at risk of many problems. Therefore their outcome must evaluate in different ages especially in school age. In this study we determined prevalence of ophthalmic, hearing, speaking and school readiness problems in children who were born low birth weight and compared them with normal birth weight children. In a cross-sectional and retrospective study, all Primary School children referred to special educational organization center for screening before entrance to school were elected in Mashhad, Iran. In this study 2400 children enrolled to study and were checked for ophthalmic, hearing, speaking and school readiness problems by valid instrument. Data were analyzed by SPSS 11.5. This study showed that 8.3% of our population had birth weight less than 2500 gram. Visual impairment in LBW (Low Birth Weight and NBW (Normal Birth Weight was 8.29% vs. 5.74% and there was statistically significant difference between them (P=0.015. Hearing problem in LBW and NBW was 2.1% vs. 1.3 and it was not statistically significant. Speaking problem in LBW and NBW was 2.6% vs. 2.2% and it was not statistically significant. School readiness problem in LBW and NBW was 12.4% vs. 5.8% and it was statistically significant (P<0.001. According to the results, neurological problems in our society is more than other society and pay attention to this problem is critical. We believe that in our country, it is necessary to provide a program to routinely evaluate LBW children.

Association between maternal weight gain and birth weight

DEFF Research Database (Denmark)

Rode, Line; Hegaard, Hanne K; Kjaergaard, Hanne

2007-01-01

To investigate the association between maternal weight gain and birth weight less than 3,000 g and greater than or equal to 4,000 g in underweight (body mass index [BMI] less than 19.8 kg/m(2)), normal weight (BMI 19.8-26.0 kg/m(2)), overweight (BMI 26.1-29.0 kg/m(2)), and obese (BMI greater than...... 29.0 kg/m(2)) women, with emphasis on the use of the American Institute of Medicine (IOM) recommendations in Denmark....

Fosfluconazole for Antifungal Prophylaxis in Very Low Birth Weight Infants

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Daijiro Takahashi

2009-01-01

Full Text Available We conducted a retrospective case series study to evaluate the safety of fosfluconazole prophylaxis for preventing invasive fungal infection in VLBW infants with a central vascular access. Fosfluconazole was administered intravenously at a dose of 6 mg/kg everyday during which time a central venous catheter was placed. A total of 23 infants met the criteria for enrollment in our study. No cases of fungal infection were detected during the central venous catheter placement in the group. None of the infants had an elevated β-D-glucan, and all of them were still alive at discharge. Regarding the liver and renal function, no statistically significant differences were observed before and at the end of fosfluconazole prophylaxis. The results of this study demonstrate that fosfluconazole prophylaxis in preventing invasive fungal infection was well tolerated by VLBW infants. This is a first report to describe antifungal prophylaxis using fosfluconazole for VLBW infants.

Birth weight curves tailored to maternal world region.

Science.gov (United States)

Ray, Joel G; Sgro, Michael; Mamdani, Muhammad M; Glazier, Richard H; Bocking, Alan; Hilliard, Robert; Urquia, Marcelo L

2012-02-01

Newborns of certain immigrant mothers are smaller at birth than those of domestically born mothers. Contemporary, population-derived percentile curves for these newborns are lacking, as are estimates of their risk of being misclassified as too small or too large using conventional rather than tailored birth weight curves. We completed a population-based study of 766 688 singleton live births in Ontario from 2002 to 2007. Smoothed birth weight percentile curves were generated for males and females, categorized by maternal world region of birth: Canada (63.5%), Europe/Western nations (7.6%), Africa/Caribbean (4.9%), Middle East/North Africa (3.4%), Latin America (3.4%), East Asia/Pacific (8.1%), and South Asia (9.2%). We determined the likelihood of misclassifying an infant as small for gestational age (≤ 10th percentile for weight) or as large for gestational age (≥ 90th percentile for weight) on a Canadian-born maternal curve versus one specific to maternal world region of origin. Significantly lower birth weights were seen at gestation-specific 10th, 50th, and 90th percentiles among term infants born to mothers from each world region, with the exception of Europe/Western nations, compared with those for infants of Canadian-born mothers. For example, for South Asian babies born at 40 weeks' gestation, the absolute difference at the 10th percentile was 198 g (95% CI 183 to 212) for males and 170 g (95% CI 161 to 179) for females. Controlling for maternal age and parity, South Asian males had an odds ratio of 2.60 (95% CI 2.53 to 2.68) of being misclassified as small for gestational age, equivalent to approximately 116 in 1000 newborns; for South Asian females the OR was 2.41 (95% CI 2.34 to 2.48), equivalent to approximately 106 per 1000 newborns. Large for gestational age would be missed in approximately 61 per 1000 male and 57 per 1000 female South Asian newborns if conventional rather than ethnicity-specific birth weight curves were used. Birth weight curves

Effect of prenatal irradiation on total litter birth weight

International Nuclear Information System (INIS)

Angleton, G.M.; Lee, A.C.

1981-01-01

Total litter weight at birth was used as a response variable to study the effects of in utero irradiations on birth weight. Analyses were performed in such a manner as to allow for variations in litter size and environmental temperatures. No effects due to irradiation were noted for exposures given 8 days postcoitus (dpc) and 55 dpc. However, for exposures given 28 dpc, a 5% decrement in birth weight was found for an 80 rad dose

The role of lifestyle in preventing low birth weight.

Science.gov (United States)

Chomitz, V R; Cheung, L W; Lieberman, E

1995-01-01

Lifestyle behaviors such as cigarette smoking, weight gain during pregnancy, and use of other drugs play an important role in determining fetal growth. The relationship between lifestyle risk factors and low birth weight is complex and is affected by psychosocial, economic, and biological factors. Cigarette smoking is the largest known risk factor for low birth weight. Approximately 20% of all low birth weight could be avoided if women did not smoke during pregnancy. Reducing heavy use of alcohol and other drugs during pregnancy could also reduce the rate of low birth weight births. Pregnancy and the prospect of pregnancy provide an important window of opportunity to improve women's health and the health of children. The adoption before or during pregnancy of more healthful lifestyle behaviors, such as ceasing to smoke, eating an adequate diet and gaining enough weight during pregnancy, and ceasing heavy drug use, can positively affect the long-term health of women and the health of their infants. Detrimental lifestyles can be modified, but successful modification will require large-scale societal changes. In the United States, these societal changes should include a focus on preventive health, family-centered workplace policies, and changes in social norms.

Weight at birth and subsequent fecundability: a prospective cohort study.

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Cathrine Wildenschild

Full Text Available To examine the association between a woman's birth weight and her subsequent fecundability.In this prospective cohort study, we included 2,773 Danish pregnancy planners enrolled in the internet-based cohort study "Snart-Gravid", conducted during 2007-2012. Participants were 18-40 years old at study entry, attempting to conceive, and were not receiving fertility treatment. Data on weight at birth were obtained from the Danish Medical Birth Registry and categorized as <2,500 grams, 2,500-2,999 grams, 3,000-3,999 grams, and ≥ 4,000 grams. In additional analyses, birth weight was categorized according to z-scores for each gestational week at birth. Time-to-pregnancy measured in cycles was used to compute fecundability ratios (FR and 95% confidence intervals (CI, using a proportional probabilities regression model.Relative to women with a birth weight of 3,000-3,999 grams, FRs adjusted for gestational age, year of birth, and maternal socio-demographic and medical factors were 0.99 (95% CI: 0.73;1.34, 0.99 (95% CI: 0.87;1.12, and 1.08 (95% CI: 0.94;1.24 for birth weight <2,500 grams, 2,500-2,999 grams, and ≥ 4,000 grams, respectively. Estimates remained unchanged after further adjustment for markers of the participant's mother's fecundability. We obtained similar results when we restricted to women who were born at term, and to women who had attempted to conceive for a maximum of 6 cycles before study entry. Results remained similar when we estimated FRs according to z-scores of birth weight.Our results indicate that birth weight appears not to be an important determinant of fecundability.

Maternal risk factors associated with low birth weight

International Nuclear Information System (INIS)

Khan, N.; Jamal, M.

2003-01-01

Objective: To determine the association of socio-demographic, maternal, medical and obstetric risk factors with low birth weight. Results: The mean weight of cases was 2.08 kg as compared to 3.1 in controls. Forty-sixty percent of cases were preterm. The factors like maternal malnutrition, young age of the mothers, poverty, close birth spacing, hypertension and antenatal per vagamin (p/v) bleeding during pregnancy have independent effect in causing low birth weight (LBW). Conclusion: Maternal bio social, medical and obstetric factors have strong association with LBW. To overcome this problem, special attention is required to strengthen the mother and child health care services in the community. (author)

Neonatal Brain Pathology Predicts Adverse Attention and Processing Speed Outcomes in Very Preterm and/or Very Low Birth Weight Children

Science.gov (United States)

Murray, Andrea L; Scratch, Shannon E; Thompson, Deanne K; Inder, Terrie E; Doyle, Lex W; Anderson, Jacqueline F. I.; Anderson, Peter J

2014-01-01

Objective This study aimed to examine attention and processing speed outcomes in very preterm (VPT; deep gray matter, and cerebellar abnormalities. Attention and processing speed were assessed at 7 years using standardized neuropsychological tests. Group differences were tested in attention and processing speed, and the relationships between these cognitive domains and brain abnormalities at birth were investigated. Results At 7 years of age, the VPT/VLBW group performed significantly poorer than term controls on all attention and processing speed outcomes. Associations between adverse attention and processing speed performances at 7 years and higher neonatal brain abnormality scores were found; in particular, white matter and deep gray matter abnormalities were reasonable predictors of long-term cognitive outcomes. Conclusion Attention and processing speed are significant areas of concern in VPT/VLBW children. This is the first study to show that adverse attention and processing speed outcomes at 7 years are associated with neonatal brain pathology. PMID:24708047

The Effect of Birth Weight on Academic Performance: Instrumental Variable Analysis.

Science.gov (United States)

Lin, Shi Lin; Leung, Gabriel Matthew; Schooling, C Mary

2017-05-01

Observationally, lower birth weight is usually associated with poorer academic performance; whether this association is causal or the result of confounding is unknown. To investigate this question, we obtained an effect estimate, which can have a causal interpretation under specific assumptions, of birth weight on educational attainment using instrumental variable analysis based on single nucleotide polymorphisms determining birth weight combined with results from the Social Science Genetic Association Consortium study of 126,559 Caucasians. We similarly obtained an estimate of the effect of birth weight on academic performance in 4,067 adolescents from Hong Kong's (Chinese) Children of 1997 birth cohort (1997-2016), using twin status as an instrumental variable. Birth weight was not associated with years of schooling (per 100-g increase in birth weight, -0.006 years, 95% confidence interval (CI): -0.02, 0.01) or college completion (odds ratio = 1.00, 95% CI: 0.96, 1.03). Birth weight was also unrelated to academic performance in adolescents (per 100-g increase in birth weight, -0.004 grade, 95% CI: -0.04, 0.04) using instrumental variable analysis, although conventional regression gave a small positive association (0.02 higher grade, 95% CI: 0.01, 0.03). Observed associations of birth weight with academic performance may not be causal, suggesting that interventions should focus on the contextual factors generating this correlation. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Cord Blood Lysophosphatidylcholine 16: 1 is Positively Associated with Birth Weight

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Yong-Ping Lu

2018-01-01

Full Text Available Background/Aims: Impaired birth outcomes, like low birth weight, have consistently been associated with increased disease susceptibility to hypertension in later life. Alterations in the maternal or fetal metabolism might impact on fetal growth and influence birth outcomes. Discerning associations between the maternal and fetal metabolome and surrogate parameters of fetal growth could give new insight into the complex relationship between intrauterine conditions, birth outcomes, and later life disease susceptibility. Methods: Using flow injection tandem mass spectrometry, targeted metabolomics was performed in serum samples obtained from 226 mother/child pairs at delivery. Associations between neonatal birth weight and concentrations of 163 maternal and fetal metabolites were analyzed. Results: After FDR adjustment using the Benjamini-Hochberg procedure lysophosphatidylcholines (LPC 14: 0, 16: 1, and 18: 1 were strongly positively correlated with birth weight. In a stepwise linear regression model corrected for established confounding factors of birth weight, LPC 16: 1 showed the strongest independent association with birth weight (CI: 93.63 - 168.94; P = 6.94×10-11 . The association with birth weight was stronger than classical confounding factors such as offspring sex (CI: -258.81- -61.32; P = 0.002 and maternal smoking during pregnancy (CI: -298.74 - -29.51; P = 0.017. Conclusions: After correction for multiple testing and adjustment for potential confounders, LPC 16: 1 showed a very strong and independent association with birth weight. The underlying molecular mechanisms linking fetal LPCs with birth weight need to be addressed in future studies.

Obesity, gestational weight gain and preterm birth: a study within the Danish National Birth Cohort

DEFF Research Database (Denmark)

Nøhr, Ellen Aagaard; Bech, Bodil Hammer; Vaeth, Michael

2007-01-01

The aim of the present study was to assess the impact of obesity and gestational weight gain on the risk of subtypes of preterm birth, because little is known about these associations. The study included 62 167 women within the Danish National Birth Cohort for whom self-reported information about...... prepregnancy body mass index (BMI) and gestational weight gain was available. Information about spontaneous preterm birth with or without preterm premature rupture of membranes (PPROM) and about induced preterm deliveries was obtained from national registers. Cox regression analyses were used to examine...... associations of prepregnancy BMI and gestational weight gain with subtypes of preterm birth. The crude risks of PPROM and of induced preterm deliveries were higher in obese women (BMI > or = 30) than in normal-weight women (18.5 gestation, when obese...

Low birth weight: risk factors in irbid, jordan

International Nuclear Information System (INIS)

Tal, Y.S.A.; Bataineh, H.A.

2006-01-01

The aim of this study was to estimate the birth weight distribution and prevalence of low birth weights (LBW) in Irbid, Jordan, and to determine some of the contributing risk factors. A cross-sectional design was used to study women who delivered in Prince Rashed Hospital (PRH). Respondents were 2256 mothers ranging in age from 15-45 years. Anthropometric measurements and interviews were used to determine the risk factors. The birth weights and anthropometric measurements of all babies born alive in PRH during the period were collected. Post-delivery weight and other measurements of respondents were also collected. The mean birth weight of the newborns in the study was 2812 g. Twenty-two percent of the newborns weighed between 700 and 2499 g. About 39% of respondents had urinary tract infection while 29% suffered from anemia, and 10% had bleeding during pregnancy. All anthropometric measurements were significantly associated with LBW. Mothers who were younger in age at their first delivery, had low post-delivery weight, and bled during pregnancy, were more likely to have LBW babies. There is also a need to discourage early pregnancies and to encourage utilization of mother and child health services, and treat concomitant illnesses during pregnancy. (author)

Intrapartum prediction of birth weight using maternal anthropometric ...

African Journals Online (AJOL)

This prospective study was conducted at Federal Medical Centre, Owo, Nigeria, between April 1st and 31st of July, 2013 to predict birth weight in labour using four clinical methods and ultrasound scan independently and comparatively to determine which is closest to the actual birth weight. The four clinical methods are ...

Fetal size monitoring and birth-weight prediction: a new population-based approach.

Science.gov (United States)

Gjessing, H K; Grøttum, P; Økland, I; Eik-Nes, S H

2017-04-01

To develop a complete, population-based system for ultrasound-based fetal size monitoring and birth-weight prediction for use in the second and third trimesters of pregnancy. Using 31 516 ultrasound examinations from a population-based Norwegian clinical database, we constructed fetal size charts for biparietal diameter, femur length and abdominal circumference from 24 to 42 weeks' gestation. A reference curve of median birth weight for gestational age was estimated using 45 037 birth weights. We determined how individual deviations from the expected ultrasound measures predicted individual percentage deviations from expected birth weight. The predictive quality was assessed by explained variance of birth weight and receiver-operating characteristics curves for prediction of small-for-gestational age. A curve for intrauterine estimated fetal weight was constructed. Charts were smoothed using the gamlss non-linear regression method. The population-based approach, using bias-free ultrasound gestational age, produces stable estimates of size-for-age and weight-for-age curves in the range 24-42 weeks' gestation. There is a close correspondence between percentage deviations and percentiles of birth weight by gestational age, making it easy to convert between the two. The variance of birth weight that can be 'explained' by ultrasound increases from 8% at 20 weeks up to 67% around term. Intrauterine estimated fetal weight is 0-106 g higher than median birth weight in the preterm period. The new population-based birth-weight prediction model provides a simple summary measure, the 'percentage birth-weight deviation', to be used for fetal size monitoring throughout the third trimester. Predictive quality of the model can be measured directly from the population data. The model computes both median observed birth weight and intrauterine estimated fetal weight. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2016 ISUOG. Published by John

Contribution of low Birth –Weight and Very Low Birth Weight Infants ...

African Journals Online (AJOL)

Objective: To determine the association between low and very low birth weight infants and perinatal mortality at the University of Nigeria Teaching Hospital, Enugu. Methods: A retrospective study of the hospital records in the labour ward and the Newborn Special Care Unit (N.B.S.C.U), of the UNTH was carried out for the ...

[Hypothermia risk factors in the very low weight newborn and associated morbidity and mortality in a neonatal care unit].

Science.gov (United States)

García-Muñoz Rodrigo, F; Rivero Rodríguez, S; Siles Quesada, C

2014-03-01

Heat loss in the newborn after delivery could interfere with post-natal adaptation due to metabolic and hemodynamic instability. Associated perinatal factors and their relationship with morbidity and mortality during the neonatal period have not been systematically studied in our unit. To determine the temperature of very low birth weight (VLBW) infants on admission to our NICU, and to determine the associated perinatal variables, and the association of temperature with morbidity and mortality. Infants born in our maternity from January 2006 to November 2012, with birth weights (BW) 401 g to 1,499 g and/or less than 30 weeks gestational age, were included. A multivariate analysis was performed using the perinatal variables and the temperature on admission, as well as a logistic regression between these and the morbidity-mortality variables, in order to detect any independent associations. A total of 635 infants were included, with a mean (± SD) birth weight and gestational age of 1,137.6 ± 257.6g, and 29.5 ± 2.0 weeks, respectively. The mean admission temperature was 35.8 ± 0.6°C (range: 33.0-37.8°C). The proportion of infants with a temperature < 36°C was 44.4%. Independently associated perinatal variables were chorioamnionitis, birth weight, vaginal delivery, and advanced cardiopulmonary resuscitation (CPR). Admission hypothermia was associated with severe intraventricular haemorrhage (IVH) (grades 3 and 4) (OR: 0.377; 95% CI: 0.221-0.643; P<.001), and mortality (OR: 0.329; 95% CI: 0.208-0.519; P=.012). Hypothermia on admission is frequent among our VLBW infants. Birth weight, vaginal delivery, and advanced CPR were the principal variables associated with hypothermia. A low temperature on admission was related to an increased risk of IVH and mortality. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Low birth weight infants and Calmette-Guérin bacillus vaccination at birth

DEFF Research Database (Denmark)

Roth, Adam Anders Edvin; Jensen, Henrik; Garly, May-Lill

2004-01-01

In developing countries, low birth weight (LBW) children are often not vaccinated with Calmette-Guérin bacillus (BCG) at birth. Recent studies have suggested that BCG may have a nonspecific beneficial effect on infant mortality. We evaluated the consequences of not vaccinating LBW children at birth...

Changes in birth weight between 2002 and 2012 in Guangzhou, China.

Directory of Open Access Journals (Sweden)

Yong Guo

Full Text Available Recent surveillance data suggest that mean birth weight has begun to decline in several developed countries. The aim of this study is to examine the changes in birth weight among singleton live births from 2002 to 2012 in Guangzhou, one of the most rapidly developed cities in China.We used data from the Guangzhou Perinatal Health Care and Delivery Surveillance System for 34108 and 54575 singleton live births with 28-41 weeks of gestation, who were born to local mothers, in 2002 and 2012, respectively. The trends in birth weight, small (SGA and large (LGA for gestational age and gestational length were explored in the overall population and gestational age subgroups.The mean birth weight decreased from 3162 g in 2002 to 3137 g in 2012 (crude mean difference, -25 g; 95% CI, -30 to -19. The adjusted change in mean birth weight appeared to be slight (-6 g from 2002 to 2012 after controlling for maternal age, gestational age, educational level, parity, newborn's gender and delivery mode. The percentages of SGA and LGA in 2012 were 0.6% and 1.5% lower than those in 2002, respectively. The mean gestational age dropped from 39.2 weeks in 2002 to 38.9 weeks in 2012. In the stratified analysis, we observed the changes in birth weight differed among gestational age groups. The mean birth weight decreased among very preterm births (28-31 weeks, while remained relatively stable among other gestational age subcategories.Among local population in Guangzhou from 2002 to 2012, birth weight appeared to slightly decrease. The percentage of SGA and LGA also simultaneously dropped, indicating that newborns might gain a healthier weight for gestational age.

Brothers and reduction of the birth weight of later-born siblings

DEFF Research Database (Denmark)

Nielsen, Henriette Svarre; Mortensen, Laust; Nygaard, Ulrikka

2008-01-01

It has been speculated whether maternal immune responses against male-specific minor histocompatibility (H-Y) antigens affect pregnancies negatively. This study explores, on a population level, whether previous births of boys compared with girls are associated with a decrease in birth weight...... of later-born siblings. The population was identified in the Danish Birth Registry and consisted of all Danish women who gave birth to their first-born singleton from 1980 to 1998. The women were followed until 2004, and their subsequent births were recorded. A total of 545,839 second- to fourth......-born children were identified. The authors used linear regression to analyze the association between sex of preceding children and birth weight of subsequent siblings. Brothers compared with sisters reduced the birth weight of later-born siblings. One or two brothers, respectively, reduced the mean birth weight...

Newborn birth weight in normal pregnancy in rural Telangana

Directory of Open Access Journals (Sweden)

Basanta M Hota

2017-01-01

Conclusion: Abnormal birth weight leads to many complications, both immediate and remote. However, to predict and manage such complications, one must know the average newborn birth weight. This study is the first of its kind in rural Telangana.

Post-discharge body weight and neurodevelopmental outcomes among very low birth weight infants in Taiwan: A nationwide cohort study

Science.gov (United States)

Hsu, Chung-Ting; Chen, Chao-Huei; Wang, Teh-Ming; Hsu, Ya-Chi

2018-01-01

Background Premature infants are at high risk for developmental delay and cognitive dysfunction. Besides medical conditions, growth restriction is regarded as an important risk factor for cognitive and neurodevelopmental dysfunction throughout childhood and adolescence and even into adulthood. In this study, we analyzed the relationship between post-discharge body weight and psychomotor development using a nationwide dataset. Materials and methods This was a nationwide cohort study conducted in Taiwan. Total of 1791 premature infants born between 2007 and 2011 with a birth weight of less than 1500 g were enrolled into this multi-center study. The data were obtained from the Taiwan Premature Infant Developmental Collaborative Study Group. The growth and neurodevelopmental evaluations were performed at corrected ages of 6, 12 and 24 months. Post-discharge failure to thrive was defined as a body weight below the 3rd percentile of the standard growth curve for Taiwanese children by the corrected age. Results The prevalence of failure to thrive was 15.8%, 16.9%, and 12.0% at corrected ages of 6, 12, and 24 months, respectively. At corrected ages of 24 months, 12.9% had low Mental Developmental Index (MDI) scores (MDIneurodevelopmental impairment. Post-discharge failure to thrive was significantly associated with poor neurodevelopmental outcomes. After controlling for potential confounding factors (small for gestational age, extra-uterine growth retardation at discharge, cerebral palsy, gender, mild intraventricular hemorrhage, persistent pulmonary hypertension of newborn, respiratory distress syndrome, chronic lung disease, hemodynamic significant patent ductus arteriosus, necrotizing enterocolitis, surfactant use and indomethacin use), post-discharge failure to thrive remained a risk factor. Conclusion This observational study observed the association between lower body weight at corrected age of 6, 12, and 24 months and poor neurodevelopmental outcomes among VLBW

Post-discharge body weight and neurodevelopmental outcomes among very low birth weight infants in Taiwan: A nationwide cohort study.

Directory of Open Access Journals (Sweden)

Chung-Ting Hsu

Full Text Available Premature infants are at high risk for developmental delay and cognitive dysfunction. Besides medical conditions, growth restriction is regarded as an important risk factor for cognitive and neurodevelopmental dysfunction throughout childhood and adolescence and even into adulthood. In this study, we analyzed the relationship between post-discharge body weight and psychomotor development using a nationwide dataset.This was a nationwide cohort study conducted in Taiwan. Total of 1791 premature infants born between 2007 and 2011 with a birth weight of less than 1500 g were enrolled into this multi-center study. The data were obtained from the Taiwan Premature Infant Developmental Collaborative Study Group. The growth and neurodevelopmental evaluations were performed at corrected ages of 6, 12 and 24 months. Post-discharge failure to thrive was defined as a body weight below the 3rd percentile of the standard growth curve for Taiwanese children by the corrected age.The prevalence of failure to thrive was 15.8%, 16.9%, and 12.0% at corrected ages of 6, 12, and 24 months, respectively. At corrected ages of 24 months, 12.9% had low Mental Developmental Index (MDI scores (MDI<70, 17.8% had low Psychomotor Developmental Index (PDI scores (PDI<70, 12.7% had cerebral palsy, and 29.5% had neurodevelopmental impairment. Post-discharge failure to thrive was significantly associated with poor neurodevelopmental outcomes. After controlling for potential confounding factors (small for gestational age, extra-uterine growth retardation at discharge, cerebral palsy, gender, mild intraventricular hemorrhage, persistent pulmonary hypertension of newborn, respiratory distress syndrome, chronic lung disease, hemodynamic significant patent ductus arteriosus, necrotizing enterocolitis, surfactant use and indomethacin use, post-discharge failure to thrive remained a risk factor.This observational study observed the association between lower body weight at corrected age

Influence of birth order, birth weight, colostrum and serum immunoglobulin G on neonatal piglet survival

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Cabrera Rafael A

2012-12-01

Full Text Available Abstract Background Intake of colostrum after birth is essential to stimulate intestinal growth and function, and to provide systemic immunological protection via absorption of Immunoglobulin G (IgG. The birth order and weight of 745 piglets (from 75 litters were recorded during a one-week period of farrowing. Only pigs weighing greater than 0.68 kg birth weight were chosen for the trial. Sow colostrum was collected during parturition, and piglets were bled between 48 and 72 hours post-birth. Piglet serum IgG and colostral IgG concentrations were determined by radial immunodiffusion. Results Sow parity had a significant (P Conclusion We found that the combination of sow colostrum IgG concentration and birth order can account for 10% of the variation of piglet serum IgG concentration and that piglets with less than 1,000 mg/dl IgG serum concentration and weight of 0.9 kg at birth had low survival rate when compared to their larger siblings. The effective management of colostrum uptake in neonatal piglets in the first 24 hrs post-birth may potentially improve survival from birth to weaning.

Increasing Low Birth Weight Rates: Deliveries in a Tertiary Hospital in Istanbul

OpenAIRE

Berrin Telatar; Orhan Ünal; Abdülkadir Piçak; Lale Ger; Serdar Cömert; Cem Turan; Yasemin Akin

2010-01-01

Objective:Prevalence of low birth weight deliveries may vary across different environments. The necessity of determination of regional data prompted this study. Methods:Information of all deliveries from January 2004 to December 2008 was obtained from delivery registry records retrospectively. Initial data including birth weight, vital status, sex, maternal age and mode of delivery were recorded using medical files. The frequency of low birth weight, very low birth weight, extremely low birth...

Birth weight centiles by gestational age for twins born in south India.

Science.gov (United States)

Premkumar, Prasanna; Antonisamy, Belavendra; Mathews, Jiji; Benjamin, Santhosh; Regi, Annie; Jose, Ruby; Kuruvilla, Anil; Mathai, Mathews

2016-03-24

Birth weight centile curves are commonly used as a screening tool and to assess the position of a newborn on a given reference distribution. Birth weight of twins are known to be less than those of comparable singletons and twin-specific birth weight centile curves are recommended for use. In this study, we aim to construct gestational age specific birth weight centile curves for twins born in south India. The study was conducted at the Christian Medical College, Vellore, south India. The birth records of all consecutive pregnancies resulting in twin births between 1991 and 2005 were reviewed. Only live twin births between 24 and 42 weeks of gestation were included. Birth weight centiles for gestational age were obtained using the methodology of generalized additive models for location, scale and shape (GAMLSS). Centiles curves were obtained separately for monochorionic and dichorionic twins. Of 1530 twin pregnancies delivered during the study period (1991-2005), 1304 were included in the analysis. The median gestational age at birth was 36 weeks (1st quartile 34, 3rd quartile 38 weeks). Smoothed percentile curves for birth weight by gestational age increased progressively till 38 weeks and levels off thereafter. Compared with dichorionic twins, monochorionic twins had lower birth weight for gestational age from after 27 weeks. We provide centile values of birth weight at 24 to 42 completed weeks of gestation for twins born in south India. These charts could be used both in routine clinical assessments and epidemiological studies.

Does culture medium influence offspring birth weight?

Science.gov (United States)

Carrasco, Beatriz; Boada, Montserrat; Rodríguez, Ignacio; Coroleu, Buenaventura; Barri, Pedro N; Veiga, Anna

2013-11-01

To determine whether the type of medium used to culture human embryos in vitro influences neonatal birth weight after IVF/intracytoplasmic sperm injection (ICSI). A prospective study and a retrospective study. Private assisted reproduction center. The prospective study included 449 IVF/ICSI cycles from August to December 2008. The retrospective analysis was performed for 2,518 IVF/ICSI cycles from October 2006 to December 2010. In the prospective study, patients were randomized for embryo culture in Cook or Vitrolife medium. The retrospective study was performed with three different culture media (MediCult, Cook, and Vitrolife). Mean birth weight, adjusted for gestational age and gender (z score) of newborns. In the prospective study, the average z score was -0.19 ± 0.85 in Cook and 0.08 ± 1.40 in Vitrolife. In the retrospective study, the z scores obtained in each group were as follows: Cook, -0.14 ± 0.96; MediCult, 0.06 ± 1.13; and Vitrolife, 0.03 ± 1.05. No significant differences were observed regarding the birth weight of children born in the different groups in both studies. The results do not show any relationship between the medium used for in vitro culture and mean birth weight adjusted for gestational age and gender of singletons born after IVF/ICSI. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Placental weight and birth weight to placental weight ratio in monochorionic and dichorionic growth-restricted and non-growth-restricted twins

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Mariângela Alves Souza

Full Text Available OBJECTIVE: The aim of the present study was to compare the placental weight and birth weight/placental weight ratio for intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins. METHODS: This was a retrospective analysis of placentas from twin pregnancies. Placental weight and the birth weight/placental weight ratio were compared in intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins. The association between cord insertion type and placental lesions in intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins was also investigated. RESULTS: A total of 105 monochorionic (intrauterine growth restriction=40; non-intrauterine growth restriction=65 and 219 dichorionic (intrauterine growth restriction=57; non-intrauterine growth restriction=162 placentas were analyzed. A significantly lower placental weight was observed in intrauterine growth-restricted monochorionic (p=0.022 and dichorionic (p<0.001 twins compared to non-intrauterine growth-restricted twins. There was no difference in the birth weight/placental weight ratio between the intrauterine growth restriction and non-intrauterine growth restriction groups for either monochorionic (p=0.36 or dichorionic (p=0.68 twins. Placental weight and the birth weight/placental weight ratio were not associated with cord insertion type or with placental lesions. CONCLUSION: Low placental weight, and consequently reduced functional mass, appears to be involved in fetal growth restriction in monochorionic and dichorionic twins. The mechanism by which low placental weight influences the birth weight/placental weight ratio in intrauterine growth-restricted monochorionic and dichorionic twins needs to be determined in larger prospective studies.

Birth weight and risk of adiposity among adult Inuit in Greenland.

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Pernille Falberg Rønn

Full Text Available OBJECTIVE: The Inuit population in Greenland has undergone rapid socioeconomic and nutritional changes simultaneously with an increasing prevalence of obesity. Therefore, the objective was to examine fetal programming as part of the aetiology of obesity among Inuit in Greenland by investigating the association between birth weight and measures of body composition and fat distribution in adulthood. METHODS: The study was based on cross-sectional data from a total of 1,473 adults aged 18-61 years in two population-based surveys conducted in Greenland between 1999-2001 and 2005-2010. Information on birth weight was collected from birth records. Adiposity was assessed by anthropometry, fat mass index (FMI, fat-free mass index (FFMI, and visceral (VAT and subcutaneous adipose tissue (SAT estimated by ultrasound. The associations to birth weight were analyzed using linear regression models and quadratic splines. Analyses were stratified by sex, and adjusted for age, birthplace, ancestry and family history of obesity. RESULTS: Spline analyses showed linear relations between birth weight and adult adiposity. In multiple regression analyses, birth weight was positively associated with BMI, waist circumference, FMI, FFMI and SAT with generally weaker associations among women compared to men. Birth weight was only associated with VAT after additional adjustment for waist circumference and appeared to be specific and inverse for men only. CONCLUSIONS: Higher birth weight among Inuit was associated with adiposity in adulthood. More studies are needed to explore a potential inverse association between birth size and VAT.

The NOFLO trial: low-flow nasal prongs therapy in weaning nasal continuous positive airway pressure in preterm infants.

LENUS (Irish Health Repository)

O'Donnell, Sinéad M

2013-07-01

To determine if low-flow nasal prongs therapy with room air, compared with no treatment, facilitates weaning from nasal continuous positive airway pressure (NCPAP) in very low birth weight (VLBW, birth weight <1500 g) infants.

Maternal pre-pregnancy BMI, gestational weight gain, and infant birth weight: A within-family analysis in the United States.

Science.gov (United States)

Yan, Ji

2015-07-01

In the United States, the high prevalence of unhealthy preconception body weight and inappropriate gestational weight gain among pregnant women is an important public health concern. However, the relationship among pre-pregnancy BMI, gestational weight gain, and newborn birth weight has not been well established. This study uses a very large dataset of sibling births and a within-family design to thoroughly address this issue. The baseline analysis controlling for mother fixed effects indicates maternal preconception overweight, preconception obesity, and excessive gestational weight gain significantly increase the risk of having a high birth weight baby, respectively, by 1.3, 3 and 3.9 percentage points, while underweight before pregnancy and inadequate gestational weight gain increase the low birth weight incidence by 1.4 and 2 percentage points. The benchmark results are robust in a variety of sensitivity checks. Since poor birth outcomes especially high birth weight and low birth weight have lasting adverse impacts on one's health, education, and socio-economic outcomes later in life, the findings of this research suggest promoting healthy weight among women before pregnancy and preventing inappropriate weight gain during pregnancy can generate significant intergenerational benefits. Copyright © 2015 Elsevier B.V. All rights reserved.

Maternal occupation during pregnancy, birth weight, and length of gestation: combined analysis of 13 European birth cohorts

NARCIS (Netherlands)

Casas, Maribel; Cordier, Sylvaine; Martínez, David; Barros, Henrique; Bonde, Jens Peter; Burdorf, Alex; Costet, Nathalie; dos Santos, Ana Cristina; Danileviciute, Asta; Eggesbø, Merete; Fernandez, Mariana; Fevotte, Joelle; García, Ana M.; Gražuleviciene, Regina; Hallner, Eva; Hanke, Wojciech; Kogevinas, Manolis; Kull, Inger; Stemann Larsen, Pernille; Melaki, Vasiliki; Monfort, Christine; Nordby, Karl-Christian; Nybo Andersen, Anne-Marie; Patelarou, Evridiki; Polanska, Kinga; Richiardi, Lorenzo; Santa Marina, Loreto; Snijder, Claudia; Tardón, Adonina; van Eijsden, Manon; Vrijkotte, Tanja G. M.; Zugna, Daniela; Nieuwenhuijsen, Mark; Vrijheid, Martine

2015-01-01

We assessed whether maternal employment during pregnancy - overall and in selected occupational sectors - is associated with birth weight, small for gestational age (SGA), term low birth weight (LBW), length of gestation, and preterm delivery in a population-based birth cohort design. We used data

Birth weight, breast cancer and the potential mediating hormonal environment.

LENUS (Irish Health Repository)

Bukowski, Radek

2012-01-01

Previous studies have shown that woman\\'s risk of breast cancer in later life is associated with her infants birth weights. The objective of this study was to determine if this association is independent of breast cancer risk factors, mother\\'s own birth weight and to evaluate association between infants birth weight and hormonal environment during pregnancy. Independent association would have implications for understanding the mechanism, but also for prediction and prevention of breast cancer.

Birth weight and intelligence in young adulthood and midlife

DEFF Research Database (Denmark)

Flensborg-Madsen, Trine; Mortensen, Erik Lykke

2017-01-01

of the cohort. Intelligence was assessed at a mean age of 19 years with the Børge Priens Prøve test, at age 28 years with the Wechsler Adult Intelligence Scale, and at age 50 years with the Intelligenz-Struktur-Test 2000 R. RESULTS: Birth weight was significantly associated with intelligence at all 3 follow......OBJECTIVES: We examined the associations between birth weight and intelligence at 3 different adult ages. METHODS: The Copenhagen Perinatal Cohort is comprised of children born in Copenhagen from 1959 to 1961. Information on birth weight and ≥1 tests of intelligence was available for 4696 members...

Birth Weight in Type 1 Diabetic Pregnancy

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Jacquemyn Yves

2010-01-01

Full Text Available Our aim was to investigate whether birth weight in mothers with diabetes mellitus type 1 is higher as compared to nondiabetic controls. Methods. A retrospective study was performed using an existing database covering the region of Flanders, Belgium. Data included the presence of diabetes type 1, hypertension, parity, maternal age, the use artificial reproductive technology, fetal- neonatal death, congenital anomalies, admission to a neonatal intensive care unit, and delivery by Caesarean section or vaginally. Results. In the period studied, 354 women with diabetes type 1 gave birth and were compared with 177.471 controls. Women with type 1 diabetes more often had a maternal age of over 35 years (16.7% versus 12.0%, P=.008, OR 1.46; 95% CI 1.09–1.95. They more frequently suffered hypertension in pregnancy (19.5% versus 4.7%, P<.0001, OR 4.91; 95% CI 3.73–6.44. Perinatal death was significantly higher in the diabetes mellitus group (3.05% versus 0.73%, P<.0001, OR 4.28; 95% CI 2.22–8.01. Caesarean section was performed almost 5 times as frequently in the diabetes versus the control group (OR 4.57; 95% CI 3.70–5.65. Birth weight was significantly higher in diabetic pregnant women from 33 until 38 weeks included, but those reaching 39 weeks and later were not different with control groups. Conclusion. In Belgium, diabetic pregnancy still carries a high risk for fetal and maternal complications; in general birth weight is significantly higher but for those reaching term there is no significant difference in birth weight.

Associations between birth weight and colon and rectal cancer risk in adulthood

DEFF Research Database (Denmark)

Smith, Natalie R; Jensen, Britt W; Zimmermann, Esther

2016-01-01

BACKGROUND: Birth weight has inconsistent associations with colorectal cancer, possibly due to different anatomic features of the colon versus the rectum. The aim of this study was to investigate the association between birth weight and colon and rectal cancers separately. METHODS: 193,306 children....... No significant sex differences were observed; therefore combined results are presented. Birth weight was positively associated with colon cancers with a HR of 1.14 (95% CI, 1.04-1.26) per kilogram of birth weight. For rectal cancer a significant association was not observed for birth weights below 3.5kg. Above 3...

Ramadan during pregnancy and birth weight of newborns.

Science.gov (United States)

Savitri, Ary I; Amelia, Dwirani; Painter, Rebecca C; Baharuddin, Mohammad; Roseboom, Tessa J; Grobbee, Diederick E; Uiterwaal, Cuno S P M

2018-01-01

Previous studies suggest that Ramadan exposure during pregnancy might affect the health of women and their babies, particularly through the effect of fasting. This study aimed to evaluate the association between Ramadan exposure and fasting during pregnancy on the birth weight of newborns. This study concerned 1351 pregnant women from a prospective cohort in Jakarta, Indonesia. Ramadan exposure was based on the actual overlap between Ramadan and pregnancy. Women's fasting behaviour was recorded among 139 women who came for antenatal care between 10 July 2013 and 7 August 2013, and those who had fasted for at least 1 d ( n 110) were classified as exposed to Ramadan fasting. Furthermore, a 24 h dietary recall was performed and repeated 1 month later. Birth weight of newborns who were exposed to Ramadan during pregnancy did not significantly differ from those who were not, both in the total and trimester-specific analysis. Maternal fasting did not seem to affect the birth weight of newborns (-72 (95 % CI -258, 114) g; P = 0·44), although there was a non-significant trend towards lower birth weight with fasting in the second and third trimester. Women who fasted had significantly lower total energy, macronutrient and water intake as compared with women who did not. Women's intake was also lower during Ramadan (regardless of their fasting behaviour) as compared with 1 month later. Lifestyle changes that occur with Ramadan and fasting during pregnancy are associated with lower reported energy intake. We cannot conclude on the effect of fasting on birth weight due to low statistical power.

Association between alcohol abuse during pregnancy and birth weight.

Science.gov (United States)

Silva, Ivelissa da; Quevedo, Luciana de Avila; Silva, Ricardo Azevedo da; Oliveira, Sandro Schreiber de; Pinheiro, Ricardo Tavares

2011-10-01

To assess the association between alcohol abuse during gestation and low birth weight. Cross-sectional, population-based nested study from a cohort of 957 pregnant women who received prenatal assistance through Sistema Único de Saúde (National Health System) in the city of Pelotas, Southern Brazil, and delivered their babies between September 2007 and September 2008. The mothers were interviewed at two distinct moments: prenatal and postpartum periods. In order to verify alcohol abuse, the CAGE (Cut down, Annoyed by criticism, Guilty and Eye-opener) scale was used. Bivariate analyses were carried out, as well as multiple logistic regression adjusted by the variables prematurity and alcohol abuse. The level of significance that was adopted was 95%. Of the women who participated in the study, 2.1% abused alcohol during pregnancy and, among these, 26.3% had low birth weight children. There was an association between alcohol abuse and low birth weight (palcohol abuse during pregnancy is associated with low birth weight.

Patterns of birth weight at a community level

African Journals Online (AJOL)

user

identified a one-year live birth cohort of 8,273 in Jimma, Illubabor and Keffa ... METHODS: This was a community-based longitudinal study, which attempts to ... RESULTS: The results of the study found an estimated low birth weight rate ... mothers' experience of previous child deaths. ... births occur at home. ..... assessment.

The effect of environmental tobacco smoke during pregnancy on birth weight.

Science.gov (United States)

Hegaard, Hanne K; Kjaergaard, Hanne; Møller, Lars F; Wachmann, Henrik; Ottesen, Bent

2006-01-01

This study explores whether pregnant nonsmokers' exposure to environmental tobacco smoke (ETS) affects the average birth weight at term. The population studied consists of pregnant nonsmokers participating in a study called Smoke-free Newborn Study. The participants (n = 1612) answered a questionnaire during 12th to 16th gestational week about their exposure to ETS at home and outside the home. Pregnant nonsmokers exposed to ETS both at home and outside the home gave birth to children with a birth weight of 78.9 g (95% CI -143.7 to -14.1) (P=0.02) lower than the weight of children born to women unexposed to ETS. There was no significant reduction in birth weight among women exposed to ETS at home only or outside the home only. A nonsignificant dose-response association was seen between increasing daily exposure to ETS and reduction in birth weight. Nonsmoking pregnant women who were exposed to ETS at home as well as outside the home gave birth to children with a 79 g reduction in birth weight compared to children of unexposed women. The fact that exposure to ETS has an effect on the birth weight is regarded as essential. The authors recommend that pregnant women should not be exposed to passive smoking, and that it should be considered whether workplace legislation should be instituted in order to protect pregnant women against the adverse effects of passive smoking.

Antibiotic Therapy for Very Low Birth Weigh Newborns in NICU

Science.gov (United States)

Afjeh, Seyyed-Abolfazl; Sabzehei, Mohammad-Kazem; Fahimzad, Seyyed-Ali-Reza; Shiva, Farideh; Shamshiri, Ahmad-Reza; Esmaili, Fatemeh

2016-01-01

Background Prolonged empiric antibiotics therapy in neonates results in several adverse consequences including widespread antibiotic resistance, late onset sepsis (LOS), necrotizing enterocolitis (NEC), prolonged hospital course (HC) and increase in mortality rates. Objectives To assess the risk factors and the outcome of prolonged empiric antibiotic therapy in very low birth weight (VLBW) newborns. Materials and Methods Prospective study in VLBW neonates admitted to NICU and survived > 2 W, from July 2011 - June 2012. All relevant perinatal and postnatal data including duration of antibiotics therapy (Group I 2W) and outcome up to the time of discharge or death were documented and compared. Results Out of 145 newborns included in the study, 62 were in group I, and 83 in Group II. Average duration of antibiotic therapy was 14 days (range 3 - 62 days); duration in Group I and Group II was 10 ± 2.3 vs 25.5 ± 10.5 days. Hospital stay was 22.3 ± 11.5 vs 44.3 ± 14.7 days, respectively. Multiple regression analysis revealed following risk factors as significant for prolonged empiric antibiotic therapy: VLBW especially stage II, 12 (8.3%) newborns died. Infant mortality alone and with LOS/NEC was higher in group II as compared to group I (P < 0.002 and < 0.001 respectively). Conclusions Prolonged empiric antibiotic therapy caused increasing rates of LOS, NEC, HC and infant mortality. PMID:27307961

Validity of recalled v. recorded birth weight: a systematic review and meta-analysis.

Science.gov (United States)

Shenkin, S D; Zhang, M G; Der, G; Mathur, S; Mina, T H; Reynolds, R M

2017-04-01

Low birth weight is associated with adverse health outcomes. If birth weight records are not available, studies may use recalled birth weight. It is unclear whether this is reliable. We performed a systematic review and meta-analysis of studies comparing recalled with recorded birth weights. We followed the Meta-Analyses of Observational Studies in Epidemiology (MOOSE) statement and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched MEDLINE, EMBASE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) to May 2015. We included studies that reported recalled birth weight and recorded birth weight. We excluded studies investigating a clinical population. Two reviewers independently reviewed citations, extracted data, assessed risk of bias. Data were pooled in a random effects meta-analysis for correlation and mean difference. In total, 40 studies were eligible for qualitative synthesis (n=78,997 births from 78,196 parents). Agreement between recalled and recorded birth weight was high: pooled estimate of correlation in 23 samples from 19 studies (n=7406) was 0.90 [95% confidence interval (CI) 0.87-0.93]. The difference between recalled and recorded birth weight in 29 samples from 26 studies (n=29,293) was small [range -86-129 g; random effects estimate 1.4 g (95% CI -4.0-6.9 g)]. Studies were heterogeneous, with no evidence for an effect of time since birth, person reporting, recall bias, or birth order. In post-hoc subgroup analysis, recall was higher than recorded birth weight by 80 g (95% CI 57-103 g) in low and middle income countries. In conclusion, there is high agreement between recalled and recorded birth weight. If birth weight is recalled, it is suitable for use in epidemiological studies, at least in high income countries.

Birth weight in Kohkilooyeh and Boyer Ahmad province, 1999

Directory of Open Access Journals (Sweden)

Goshtasbi Nasab A

2001-10-01

Full Text Available The newborn's weight at birth is an important measure for newborn's health in all communities. Among developed countries, 70 percent of low birth weight (LBW newborns are preterm. The corresponding figure for undeveloped countries is only 30 percent, there are also evidence of intra-uterine growth retardation among these countries. Among effective factors on LBW, maternal related factors have important role in promotion and improvement of infants and mother's health. This study is a descriptive-analytic one and was conducted cross-sectionally through a questionnair. The study population determined by simple random sampling from newborns under coverage of urban health centers in Kohgiloye and Boyerahmad province. Necessary data collected from existing medical and health records filed in the health centers. Among 285 newborns, 88.4 percent considered with normal weight, 4 percent with IBW and 11.6 percent with more than normal weight. 7.4 percent of cases were immature. 85.3 percent of the mothers in study population were in immune range of age for pregnancy and 7.6 percent of them were illiterate. Except the sex of newborn (P=0.0008 and gestational age at birth (P<0.001 none of the variables demonstrated a significant statistical relation with the birth weight. The results of this study confirm other research's findings and reveal that with improving material factors such as mother's age, employment and literacy, the factors which are effective on birth weight, will be dependent on physiological factors such as sex of newborn and gestational age at birth.

Race, Ethnicity, Concentrated Poverty, and Low Birth Weight Disparities

OpenAIRE

Sims, Mario; Sims, Tammy L.; Bruce, Marino A.

2008-01-01

This study examines the extent to which the relationship between area socioeconomic position (SEP) and low birth weight (LBW) varies by race and ethnicity. A cross-sectional, secondary data analysis was performed with 1992-1994 Vital Statistics and 1990 U.S. Census data for selected metropolitan areas. Low birth weight (< 2500 grams) rates were calculated for non-Hispanic Black, Latino, and non-Hispanic White live singleton births. Concentrated poverty was defined as poor persons living in ne...

Attitudes of mothers and staff towards treatment and possible ...

African Journals Online (AJOL)

Subjects. Mothers of very low-birth-weight (VLBW) babies and children with multiple disabilities; paediatricians (including registrars) and nurses working in these units. Outcome measures. The preferences for developmental outcomes were compared between four groups: nurses, paediatricians, mothers of VLBW infants, ...

Ambient air pollution exposure and full-term birth weight in California

Directory of Open Access Journals (Sweden)

Sadd James L

2010-07-01

Full Text Available Abstract Background Studies have identified relationships between air pollution and birth weight, but have been inconsistent in identifying individual pollutants inversely associated with birth weight or elucidating susceptibility of the fetus by trimester of exposure. We examined effects of prenatal ambient pollution exposure on average birth weight and risk of low birth weight in full-term births. Methods We estimated average ambient air pollutant concentrations throughout pregnancy in the neighborhoods of women who delivered term singleton live births between 1996 and 2006 in California. We adjusted effect estimates of air pollutants on birth weight for infant characteristics, maternal characteristics, neighborhood socioeconomic factors, and year and season of birth. Results 3,545,177 singleton births had monitoring for at least one air pollutant within a 10 km radius of the tract or ZIP Code of the mother's residence. In multivariate models, pollutants were associated with decreased birth weight; -5.4 grams (95% confidence interval -6.8 g, -4.1 g per ppm carbon monoxide, -9.0 g (-9.6 g, -8.4 g per pphm nitrogen dioxide, -5.7 g (-6.6 g, -4.9 g per pphm ozone, -7.7 g (-7.9 g, -6.6 g per 10 μg/m3 particulate matter under 10 μm, -12.8 g (-14.3 g, -11.3 g per 10 μg/m3 particulate matter under 2.5 μm, and -9.3 g (-10.7 g, -7.9 g per 10 μg/m3 of coarse particulate matter. With the exception of carbon monoxide, estimates were largely unchanged after controlling for co-pollutants. Effect estimates for the third trimester largely reflect the results seen from full pregnancy exposure estimates; greater variation in results is seen in effect estimates specific to the first and second trimesters. Conclusions This study indicates that maternal exposure to ambient air pollution results in modestly lower infant birth weight. A small decline in birth weight is unlikely to have clinical relevance for individual infants, and there is debate about whether

Early nasal continuous positive airway pressure versus INSURE in VLBW neonates

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Ana Saianda

2010-09-01

Full Text Available Background: Evidence suggests the INSURE strategy (INtubate-SURfactant administration and Extubate to nasal continuous positive airway pressure [nCPAP] is superior to mechanical ventilation (MV with rescue surfactant for the management of respiratory distress syndrome (RDS in very low birth weight (VLBW neonates. There is limited data, however, to assess whether INSURE is superior to nCPAP alone. We aimed to compare these two strategies regarding early and late outcomes. Methods: Retrospective cohort study from Jan/2002 to Aug/2008. We included VLBW neonateswith gestational age (GA ≤ 30 weeks registered in the Vermont Oxford Network that used either nCPAP alone (nCPAP group, N = 40, or with INSURE (INSURE group, N = 56. We assessed early (RDS, need for rescue surfactant, and CPAP failure with MV and late outcomes (chronic lung disease of prematurity (CLD, mortality, and composite outcome of mortality and/or CLD. Results: Neonates in the INSURE group had lower mean GA, while other baseline variables were comparable. The proportion of RDS was significantly superior in the nCPAP group (53% vs. 30%; adjusted OR [95% CI] – 0.2 [0.1-0.6]. Therapeutic surfactant was administered to all cases with RDS in the nCPAP group, but to none from the INSURE group. MV was more frequently required in the nCPAP group (11/ 40, 28% vs. 9/ 56, 12%; p = 0.04. No statistically significant differences were found in either of the late outcomes. Conclusion: The use of nCPAP alone in VLBW neonates with GA ≤ 30 weeks may be associated with slightly poorer early outcomes than the INSURE strategy, but there were no significant differences in CLD or mortality. Resumo: Introdução: Pretende-se determinar se a utilização do método INSURE em recém-nascidos de muito baixo peso, com idade gestacional (IG ≤ 30 semanas se associa a menor morbilidade e mortalidade quando comparado com uso de nCPAP isolado. Métodos: Estudo de

Early weight changes after birth and serum high-molecular-weight adiponectin level in preterm infants.

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Yoshida, Tomohide; Nagasaki, Hiraku; Asato, Yoshihide; Ohta, Takao

2011-12-01

Extra-uterine growth retardation (EUGR) is associated with an increased risk for cardiometabolic diseases later in life. The aim of the present study was to examine the relationship between early weight change after birth in preterm infants and adiponectin (adn) multimeric complexes. Subjects included 28 preterm infants born between weeks 24 and 33 of gestation. Serum adn multimeric complexes and the anthropometric parameters were measured in preterm infants at birth and at corrected term. Bodyweight (BW) decreased during the first week of life, with birthweight restored at approximately 19 days after birth. Nineteen of the subjects had EUGR at corrected term. Total (T)-adn, high-molecular-weight (H)-adn, and the ratio of H-adn to T-adn (H/T-adn) were significantly elevated at corrected term than at birth. Postmenstrual age, birthweight, birth length and lowest BW after birth were positively correlated with H-adn and H/T-adn. Weight reduction after birth was negatively correlated with H-adn. Age to restore birthweight was negatively correlated with T-adn, H-adn and H/T-adn. Stepwise multiple regression analysis indicated age to restore birthweight as the major predictor of T-adn and H-adn. Early weight changes after birth may alter serum adn level in preterm infants at corrected term. The appropriate nutritional support in the early postnatal period could reduce the prevalence of EUGR and the future risk for cardiometabolic diseases. © 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.

Declines in Birth weight and Fetal Growth Independent of Gestational Length

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Morisaki, Naho; Esplin, M. Sean; Varner, Michael W.; Henry, Erick; Oken, Emily

2014-01-01

Objective Birth weight is decreasing in the US and elsewhere, even among term singletons, although trends in most maternal characteristics should contribute to increased birth weight. Some studies have attributed this decline to the simultaneous decrease in gestational length. Methods Using data from Intermountain Healthcare, where a successful initiative reduced the number of early term (37–38 week) elective deliveries, we examined trends in birth weight, small-for-gestational-age (SGA), and large-for-gestational-age (LGA) among 219,694 singleton infants born July 2000 to December 2008 at 37–41 weeks gestation. Results Over the 8.5 years, births through scheduled deliveries at 37–38 weeks decreased (9.4% to 4.4%), but overall scheduled deliveries increased (29% to 34%) and mean gestational age at birth (39.1 weeks) did not change. Mean birth weight (3410g to 3383g) and LGA (9.0% to 7.4%) both decreased, whereas SGA increased (7.5% to 8.2%). In multivariable analyses adjusting for maternal and infant characteristics, birth weight decreased (36g; 95% CI: 31, 42), especially among infants born at 37–38 weeks (40g; 30, 49) or that had medical indications for urgent deliveries (48g; 34, 63). Odds of LGA decreased (0.84; 0.80, 0.88) and odds of SGA increased (1.14; 1.08, 1.20). Conclusion Even in a population where gestation length did not change, birth weight and fetal growth declined. Decrease in not only gestational length but in fetal growth as well is likely to be contributing to the widely observed recent decrease in birth weight. PMID:23262927

Neonatal and Infant Mortality in Korea, Japan, and the U.S.: Effect of Birth Weight Distribution and Birth Weight-Specific Mortality Rates

OpenAIRE

Kim, Do-Hyun; Jeon, Jihyun; Park, Chang Gi; Sriram, Sudhir; Lee, Kwang-sun

2016-01-01

Difference in crude neonatal and infant mortality rates (NMR and IMR) among different countries is due to the differences in its two determinants: birth weight distribution (BWD) and birth weight-specific mortality rates (BW-SMRs). We aimed to determine impact of BWD and BW-SMRs on differences in crude NMR and IMR among Korea, Japan, and the U.S. Our study used the live birth data of the period 2009 through 2010. Crude NMR/IMR are the lowest in Japan, 1.1/2.1, compared to 1.8/3.2, in Korea, a...

Birth Weight does not Associate with Gestational Physical Activity ...

African Journals Online (AJOL)

Exercise during pregnancy has been a subject of debate and whether gestational physical activity profile affects birth weight is an important issue as birth weight is an indicator of fetal, neo-natal and post-natal mortality. This study was carried at three hospitals in Enugu, Eastern Nigeria to determine the difference between ...

Incidence And Potential Risk Factors Of Low Birth Weight Among ...

African Journals Online (AJOL)

Incidence And Potential Risk Factors Of Low Birth Weight Among Full Term Deliveries. ... (LBW) is a reliable indicator in monitoring and evaluating the success of maternal and child ... Key words: Low birth weight- incidence- associated factors.

Correlation of periodontitis during pregnancy and incidence of low birth weight babies

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Prashanthi Reddy

2012-01-01

After delivery, gestational age (in weeks and birth weight of baby (in kg were collected from hospital records. Infants were placed into following categories by gestational age (WHO and by birth weight preterm-3,900 gm. Results: Based on the findings of the study, a significant correlation was observed between periodontitis and low birth weight and preterm low birth weight (p<_0.001 and a significant relation was observed between periodontitis and gestational age (p < 0.001. Conclusion: Periodontitis was considered a risk indicator for reduced gestational age and birth weight. Multicentric trials will greatly help to establish the independent role of periodontal disease and their relationship in terms of pregnancy outcomes.

Factors associated with low birth weight in Nepal using multiple imputation

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Usha Singh

2017-02-01

Full Text Available Abstract Background Survey data from low income countries on birth weight usually pose a persistent problem. The studies conducted on birth weight have acknowledged missing data on birth weight, but they are not included in the analysis. Furthermore, other missing data presented on determinants of birth weight are not addressed. Thus, this study tries to identify determinants that are associated with low birth weight (LBW using multiple imputation to handle missing data on birth weight and its determinants. Methods The child dataset from Nepal Demographic and Health Survey (NDHS, 2011 was utilized in this study. A total of 5,240 children were born between 2006 and 2011, out of which 87% had at least one measured variable missing and 21% had no recorded birth weight. All the analyses were carried out in R version 3.1.3. Transform-then impute method was applied to check for interaction between explanatory variables and imputed missing data. Survey package was applied to each imputed dataset to account for survey design and sampling method. Survey logistic regression was applied to identify the determinants associated with LBW. Results The prevalence of LBW was 15.4% after imputation. Women with the highest autonomy on their own health compared to those with health decisions involving husband or others (adjusted odds ratio (OR 1.87, 95% confidence interval (95% CI = 1.31, 2.67, and husband and women together (adjusted OR 1.57, 95% CI = 1.05, 2.35 were less likely to give birth to LBW infants. Mothers using highly polluting cooking fuels (adjusted OR 1.49, 95% CI = 1.03, 2.22 were more likely to give birth to LBW infants than mothers using non-polluting cooking fuels. Conclusion The findings of this study suggested that obtaining the prevalence of LBW from only the sample of measured birth weight and ignoring missing data results in underestimation.

Neonatal birth weight and related factors in south of Iran, Jahrom

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Fatemeh Emamghorashi

2008-12-01

Full Text Available Objective: This study aimed to determinate the relationship between neonatal birth weight and related factors in Jahrom, Iran. Materials and methods: All women delivering in two hospitals, in which obstetric services were presented, entered the study. In this cross sectional study, 2311 women were enrolled prospectively in a 12- month period during 2006-7. Data were collected during first three post partum days from the following sources: maternal hospital files and charts, interview with the mothers, measurement of anthropometric indices of fathers and the infants. Percentile distribution of birth weight for classified gestational age was calculated.Results: Results showed significant correlation between neonatal birth weight with neonatal gender, maternal age, weight, education and working status. There was no relation between neonatal weight with paternal weight, maternal education and living in urban or rural areas.Conclusion: Neonatal birth weight is affected by neonatal gender, maternal age and weight; education and job.

[The effect of birth weight on the early postnatal vitality of piglets].

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Hoy, S; Lutter, C; Wähner, M; Puppe, B

1994-10-01

Investigations with 1248 newborn piglets in 7 farms showed a high significant influence of birth weight on parameters of early postnatal vitality. The duration between birth and first standing up was by two times, the time between birth and first udder contact by 3.5 times and the duration between birth and first colostrum intake was by 4 times longer in piglets with a low birth weight ( 2200 g). The drop in rectal temperature up to 30 minutes after birth reached 4.5 Kelvin in lightweight piglets, whereas their litter mates with a high body weight at birth had a value of 0.85 K (p vitality of newborn piglets and has a high prognostic value in relation to the risk of losses and the live weight development of neonates.

Dietary patterns in pregnancy and birth weight

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Natália de Lima Pereira Coelho

2015-01-01

Full Text Available OBJECTIVE To analyze if dietary patterns during the third gestational trimester are associated with birth weight.METHODS Longitudinal study conducted in the cities of Petropolis and Queimados, Rio de Janeiro (RJ, Southeastern Brazil, between 2007 and 2008. We analyzed data from the first and second follow-up wave of a prospective cohort. Food consumption of 1,298 pregnant women was assessed using a semi-quantitative questionnaire about food frequency. Dietary patterns were obtained by exploratory factor analysis, using the Varimax rotation method. We also applied the multivariate linear regression model to estimate the association between food consumption patterns and birth weight.RESULTS Four patterns of consumption – which explain 36.4% of the variability – were identified and divided as follows: (1 prudent pattern (milk, yogurt, cheese, fruit and fresh-fruit juice, cracker, and chicken/beef/fish/liver, which explained 14.9% of the consumption; (2 traditional pattern, consisting of beans, rice, vegetables, breads, butter/margarine and sugar, which explained 8.8% of the variation in consumption; (3 Western pattern (potato/cassava/yams, macaroni, flour/farofa/grits, pizza/hamburger/deep fried pastries, soft drinks/cool drinks and pork/sausages/egg, which accounts for 6.9% of the variance; and (4 snack pattern (sandwich cookie, salty snacks, chocolate, and chocolate drink mix, which explains 5.7% of the consumption variability. The snack dietary pattern was positively associated with birth weight (β = 56.64; p = 0.04 in pregnant adolescents.CONCLUSIONS For pregnant adolescents, the greater the adherence to snack pattern during pregnancy, the greater the baby’s birth weight.

Dietary patterns in pregnancy and birth weight.

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Coelho, Natália de Lima Pereira; Cunha, Diana Barbosa; Esteves, Ana Paula Pereira; Lacerda, Elisa Maria de Aquino; Theme Filha, Mariza Miranda

2015-01-01

OBJECTIVE To analyze if dietary patterns during the third gestational trimester are associated with birth weight.METHODS Longitudinal study conducted in the cities of Petropolis and Queimados, Rio de Janeiro (RJ), Southeastern Brazil, between 2007 and 2008. We analyzed data from the first and second follow-up wave of a prospective cohort. Food consumption of 1,298 pregnant women was assessed using a semi-quantitative questionnaire about food frequency. Dietary patterns were obtained by exploratory factor analysis, using the Varimax rotation method. We also applied the multivariate linear regression model to estimate the association between food consumption patterns and birth weight.RESULTS Four patterns of consumption - which explain 36.4% of the variability - were identified and divided as follows: (1) prudent pattern (milk, yogurt, cheese, fruit and fresh-fruit juice, cracker, and chicken/beef/fish/liver), which explained 14.9% of the consumption; (2) traditional pattern, consisting of beans, rice, vegetables, breads, butter/margarine and sugar, which explained 8.8% of the variation in consumption; (3) Western pattern (potato/cassava/yams, macaroni, flour/farofa/grits, pizza/hamburger/deep fried pastries, soft drinks/cool drinks and pork/sausages/egg), which accounts for 6.9% of the variance; and (4) snack pattern (sandwich cookie, salty snacks, chocolate, and chocolate drink mix), which explains 5.7% of the consumption variability. The snack dietary pattern was positively associated with birth weight (β = 56.64; p = 0.04) in pregnant adolescents.CONCLUSIONS For pregnant adolescents, the greater the adherence to snack pattern during pregnancy, the greater the baby's birth weight.

Is Biology Destiny? Birth Weight and Differential Parental Treatment

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Hsin, Amy

2016-01-01

Time diaries of sibling pairs from the PSID-CDS are used to determine whether maternal time investments compensate for or reinforce birth-weight differences among children. The findings demonstrate that the direction and degree of differential treatment vary by mother's education. Less-educated mothers devote more total time and more educationally oriented time to heavier-birth-weight children, whereas better-educated mothers devote more total and more educationally oriented time to lower-birth-weight children. The compensating effects observed among highly educated mothers are substantially larger than the reinforcing effects among the least-educated mothers. The findings show that families redistribute resources in ways that both compensate for and exacerbate early-life disadvantages. PMID:22865101

DENGUE DURING PREGNANCY: ASSOCIATION WITH LOW BIRTH WEIGHT AND PREMATURITY

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Christiane Fernandes RIBEIRO

2016-01-01

Full Text Available The aim of this study was to evaluate the effects of dengue virus infection during pregnancy and its correlation with low birth weight, prematurity, and asphyxia. A non-concurrent cohort study reveals the association of dengue during pregnancy with prematurity and low birth weight, when birth occurred during the maternal-fetal viremia period (p = 0.016 and p < 0.0001, respectively.

Relationship between periodontal disease and preterm low birth weight: systematic review.

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Teshome, Amare; Yitayeh, Asmare

2016-01-01

Periodontal disease is a neglected bacterial infection that causes destruction of the periodontium in pregnant women. Yet its impact on the occurrence of adverse pregnancy outcomes has not systematically evaluated and there is no clear statement on the relationship between periodontal disease and preterm low birth weight. The objective of this study was to summarize the evidence on the impact of periodontal disease on preterm low birth weight. We searched the following data bases from January 2005 to December 2015: CINAHL (cumulative index to nursing and allied health literature), MEDLINE, AMED, EMBASE (excerpta medica database), Cochrane library and Google scholar. Only case-control studies with full text in English were eligible. Critical appraisal of the identified articles was done by two authors independently to provide the possible relevance of the papers for inclusion in the review process. The selected Case control studies were critically appraised with 12 items structured checklist adapted from national institute of health (NIH). Odds ratio (OR) or risk ratios (RR) were extracted from the selected studies. The two reviewers who selected the appropriate studies also extracted the data and evaluated the risk of bias. Of 229 articles, ten studies with a total of 2423 participants with a mean age ranged from 13 to 49 years were met the inclusion criteria. The studies focused on preterm birth, low birth weight and /or preterm low birth weight and periodontitis. Of the selected studies, 9 implied an association between periodontal disease and increased risk of preterm birth, low birth weight and /or preterm low birth weight outcome (ORs ranging from 2.04 to 4.19) and only one study found no evidence of association. Periodontal disease may be one of the possible risk factor for preterm low birth weight infant. However, more precise studies with randomized clinical trial with sufficient follow-up period must be done to confirm the association.

Delayed Prenatal Care and the Risk of Low Birth Weight Delivery.

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Hueston, William J.; Gilbert, Gregory E.; Davis, Lucy; Sturgill, Vanessa

2003-01-01

Assessed whether the timing of prenatal care related to low birth weight delivery, adjusting for sociodemographic and behavioral risk factors. Data on births to white and African American women showed no benefits for early initiation of prenatal care in reducing the risk of low birth weight.(SM)

SAJCH 449 NEW.indd

African Journals Online (AJOL)

made it possible to save very low-birth-weight (VLBW; <1 500 g) and extremely .... premature babies regardless of birth weight, even with a 50% chance of being handicapped if the child .... of adolescent children. J Pediatr 2000;137:701-. 706.

Effect of marital distance on birth weight and length of offspring

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Kozieł Sławomir

2017-09-01

Full Text Available Marital distance (MD, the geographical distance between birthplaces of spouses, is considered an agent favouring occurrence of heterosis and can be used as a measure of its level. Heterosis itself is a phenomenon of hybrid vigour and seems to be an important factor regulating human growth and development. The main aim of the study is to examine potential effects of MD on birth weight and length of offspring, controlling for socioeconomic status (SES, mother’s age and birth order. Birth weight (2562 boys and 2572 girls and length (2526 boys, 2542 girls of children born in Ostrowiec Swietokrzyski (Poland in 1980, 1983, 1985 and 1988 were recorded during cross-sectional surveys carried out between 1994-1999. Data regarding the socio-demographic variables of families were provided by the parents. Analysis of covariance showed that MD significantly affected both birth weight and length, allowing for sex, birth order, mother’s age and SES of family. For both sexes, a greater marital distance was associated with a higher birth weight and a longer birth length. Our results support the hypothesis that a greater geographical distance between the birth places of parents may contribute to the heterosis effects in offspring. Better birth outcomes may be one of the manifestations of these effects.

The Effect of an Increased Minimum Wage on Infant Mortality and Birth Weight.

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Komro, Kelli A; Livingston, Melvin D; Markowitz, Sara; Wagenaar, Alexander C

2016-08-01

To investigate the effects of state minimum wage laws on low birth weight and infant mortality in the United States. We estimated the effects of state-level minimum wage laws using a difference-in-differences approach on rates of low birth weight (minimum wage above the federal level was associated with a 1% to 2% decrease in low birth weight births and a 4% decrease in postneonatal mortality. If all states in 2014 had increased their minimum wages by 1 dollar, there would likely have been 2790 fewer low birth weight births and 518 fewer postneonatal deaths for the year.

[Relationship between air pollution exposure during pregnancy and birth weight of term singleton live-birth newborns].

Science.gov (United States)

Guo, L Q; Zhang, Q; Zhao, D D; Wang, L L; Chen, Y; Mi, B B; Dang, S N; Yan, H

2017-10-10

Objective: This study explored the association between air pollution exposure and birth weight by using the multilevel linear model, after controlling related meteorological factors and individual differences of both mothers and babies. Methods: Women of childbearing age who were pregnant in Xi'an from 2010 to 2013, were selected as objects of this study. Multistage random sampling method was used to select 4 631 subjects followed by a self-designed questionnaire survey. Data related to quality of air and meteorology were gathered from routine monitoring system. Gestational age and date of birth, together with the average levels of air pollution were calculated for each trimester on each mother, and then the impact of air pollution on birth weight was assessed. A multilevel linear model was employed to investigate the association between the levels of exposure to air pollution by birth weight. Confounding factors were under control. We established three models in this study: Model 1 which involving the variable of air pollution exposure. Model 2 was adjusted for variables in Model 1 plus some other individual differences of both mother and baby. Model 3 was adjusted for variables in Model 2 plus meteorological factors. Results: There were significant differences seen in birth weight within the subgroups of gender, gestational age, mother's reproductive age, maternal education, residential areas and family incomes ( P 0.05). Data from Model 3 indicated that a decrease of 13.3 g(10.9 g in Model 2) and 6.6 g (5.9 g in Model 2) in birth weight that were associated with an increase of 10 μg/m(3) in the average level of NO(2) and PM(10) during the second trimester; A decrease of 13.7 g (9.8 g in Model 2) in birth weight was associated with an increase of 10 μg/m(3) in the average level of NO(2) during the third trimester. Conclusion: After controlling for meteorological factors, the levels of exposure to NO(2) and PM(10) during the second trimester and NO(2) during the

Influence of pre-pregnancy leisure time physical activity on gestational and postpartum weight gain and birth weight

DEFF Research Database (Denmark)

Hegaard, Hanne Kristine; Rode, Line; Katballe, Malene Kjær

2017-01-01

In order to examine the association between pre-pregnancy leisure time physical activities and gestational weight gain, postpartum weight gain and birth weight, we analysed prospectively collected data from 1827 women with singleton term pregnancies. Women were categorised in groups of sedentary...... risk of having a gestational weight gain above Institute of Medicine (IOM) recommendations with an odds ratio of 2.60 (1.32-5.15) compared to light exercisers. However, birth weight and one year postpartum weight was similar for all four groups. Thus, although competitive athletes gain more weight than...... recommended during pregnancy, this may not affect birth weight or postpartum weight. Impact statement: What is already known on this subject: Previous studies have found that increased pre-pregnancy physical activity is associated with lower gestational weight gain during the last trimester, but showed...

Errors in registered birth weight and its implications for mortality statistics

OpenAIRE

Anand, D; Pharoah, P

2000-01-01

BACKGROUND—Birth weight mortality statistics are important for examining trends and monitoring the outcomes of neonatal care.
AIM—To determine the effects of errors in the registered birth weight on birth weight specific mortality.
METHODS—All twins born in England and Wales during 1993-95 comprise the denominator population. For those twins that died, the Office for National Statistics (ONS) provided copies of the death certificates. From the information on the death cer...

Effect of birth order on neonatal morbidity and mortality among very low birthweight twins: a population based study

Science.gov (United States)

Shinwell, E; Blickstein, I; Lusky, A; Reichman, B

2004-01-01

Objective: To study the effect of birth order on the risk for respiratory distress syndrome (RDS), chronic lung disease (CLD), adverse neurological findings, and death in very low birthweight (VLBW; < 1500 g) twins. Methods: A population based study of VLBW infants from the Israel National VLBW Infant Database. The sample included all complete sets of VLBW twin pairs admitted to all 28 neonatal intensive care units between 1995 and 1999. Outcome variables were compared by birth order and stratified by mode of delivery and gestational age, using General Estimating Equation models, with results expressed as odds ratio (OR) with 95% confidence interval (CI). Results: Second twins were at increased risk for RDS (OR 1.51, 95% CI 1.29 to 1.76), CLD (OR 1.36, 95% CI 1.11 to 1.66), and death (OR 1.24, 95% CI 1.02 to 1.51) but not for adverse neurological findings (OR 1.20, 95% CI 0.91 to 1.60). Mode of delivery did not significantly influence outcome. The odds ratio for RDS in the second twin was inversely related to gestational age, and the increased risk for RDS and CLD was found in both vaginal and caesarean deliveries. Conclusions: VLBW second twins are at increased risk for acute and chronic lung disease and neonatal mortality, irrespective of mode of delivery. PMID:14977899

Birth weight and cognitive development in adolescence: causal relationship or social selection?

Science.gov (United States)

Gorman, Bridget K

2002-01-01

Using data from the National Longitudinal Survey of Adolescent Health (Add Health), I investigate the relationship between birth weight and cognitive development among adolescents aged 12-17. Initial OLS regression models reveal a significant, positive relationship between low birth weight and verbal ability. Controlling for demographic, socioeconomic, and other adolescent characteristics modifies, but does not eliminate, this relationship. Additional models that stratify the sample by parental education illustrate the greater importance of other family and adolescent characteristics for cognitive development in adolescence, and a diminished role of birth weight. In the final section of the paper, fixed effects models of non-twin full siblings indicate no significant association between birth weight and verbal ability, suggesting that traditional cross-sectional models overstate the influence of birth weight for cognitive development in adolescence.

Maternal immigrant status and high birth weight: implications for childhood obesity.

Science.gov (United States)

El-Sayed, Abdulrahman M; Galea, Sandro

2011-01-01

Childhood obesity, a growing epidemic, is associated with greater risk of several chronic diseases in adulthood. Children of immigrant mothers are at higher risk for obesity than children of non-immigrant mothers. High birth weight is the most important neonatal predictor of childhood obesity in the general population. To understand the etiology of obesity in children of immigrant mothers, we assessed the relation between maternal immigrant status and risk for high birth weight. Data about all births in Michigan (N = 786,868) between 2000-2005 were collected. We used bivariate chi-square tests and multivariate logistic regression models to assess the relation between maternal immigrant status and risk for neonatal high birth weight. The prevalence of high birth weight among non-immigrant mothers was 10.6%; the prevalence among immigrant mothers was 8.0% (P maternal age, education, marital status, parity, and tobacco use, children of immigrant mothers had lower odds (odds ratio = 0.69, 95% confidence interval = 0.67-0.70) of high birth weight compared to those of non-immigrant mothers. Although maternal immigrant status has been shown to be associated with greater childhood obesity, surprisingly, children of immigrant mothers have lower risk of high birth weight than children of non-immigrant mothers. This suggests that factors in early childhood, potentially cultural or behavioral factors, may play a disproportionately important role in the etiology of childhood obesity in children of immigrant vs non-immigrant mothers.

Prenatal Secondhand Smoke Exposure and Infant Birth Weight in China

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Adolfo Correa

2012-09-01

Full Text Available Epidemiologic evidence provides some support for a causal association between maternal secondhand smoke (SHS exposure during pregnancy and reduction in infant birth weight. The purpose of this cross-sectional study is to examine the magnitude of this association in China, where both prevalence and dose of SHS exposure are thought to be higher than in U.S. populations. Women who gave birth in Beijing and Changchun September 2000–November 2001 were interviewed to quantify self-reported prenatal SHS exposure. Their medical records were reviewed for data on pregnancy complications and birth outcomes. Non-smoking women who delivered term babies (≥37 weeks gestation were included in the study (N = 2,770. Nearly a quarter of the women (24% reported daily SHS exposure, 47% reported no prenatal exposure, and 75% denied any SHS exposure from the husband smoking at home. Overall, no deficit in mean birth weight was observed with exposure from all sources of SHS combined (+11 grams, 95% CI: +2, +21. Infants had higher mean birth weights among the exposed than the unexposed for all measures of SHS exposure. Future studies on SHS exposure and infant birth weight in China should emphasize more objective measures of exposure to quantify and account for any exposure misclassification.

Relationship between Maternal Serum Copper Level and Birth Weight Neonate

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Mirzarahimi M

2012-01-01

Full Text Available Background and Objectives: Low birth weight (LBW is a major public health problem. LBW is associated with increased neonatal morbidity and mortality. There is no consensus in the literature as to whether maternal copper nutrition is associated with pregnancy outcome or fetal growth. Methods: This case-control study was carried out at Alavi Hospital in Ardabil between August 2008 and August 2009. 56 women who had delivered low-birth- weight infants (<2500gr were taken as the case group, and from the mothers who had delivered normal birth weight infants (≥2500gr, 56 were selected at random as the control group. Venous blood samples were obtained from the mothers. Serum zinc level was determined by the Atomic Absorption Spectrophotometer method.Results: Mean of birth weight in infants, maternal age, body mass index in mothers and socioeconomic or demographic factors did not differ between cases and control groups. Maternal copper concentration (μg/dl differed between Cases and Controls; 231.75±38.12μg/dl vs. 204.42±31.30μg/dl respectively. There is a significant difference (p<0.001 in the serum copper concentration between the two groups.Conclusion: There is a negative relation between low infant birth weight and maternal copper concentration.

Stress in parents of very low birth weight preterm infants hospitalized in neonatal intensive care units. A multicenter study.

Science.gov (United States)

Wormald, Francisca; Tapia, José L; Torres, Gabriela; Cánepa, Paula; González, María Aurelia; Rodríguez, Diana; Escobar, Marisol; Reyes, Bernardita; Capelli, Carola; Menéndez, Laura; Delgado, Patricia; Treuer, Sergio; Ramírez, Rodrigo; Borja, Norma; Domínguez, Angélica

2015-08-01

The birth of a premature baby is a stressful event for parents. The objective of this study was to determine early stress in parents of very low birth weight infants (VLBWIs) hospitalized in 12 neonatal intensive care units from a South American Neonatal Network, to identify associated factors, and to compare the level of parental stress in public versus private healthcare facilities. Cross-sectional study in mothers/fathers of VLBWIs (500 to 1500 g). Early parental stress was measured using the Parental Stressor Scale, with a score from 1 (low stress) to 5 (high stress). The sociodemographic characteristics of parents and newborn infants were collected and associated with levels of parental stress. The study included 273 fathers/mothers of a total of 218 VLBW preterm infants. The survey was administered at 5.9 ± 2.0 days of life. The average total parental stress was 3.1 ± 0.8, and the highest score was obtained for the parental role subscale (3.6). A lower education level, unemployment, not having held the newborn infant, and respiratory support requirement were associated with higher parental stress levels. Stress was higher among mothers than fathers, and at public facilities versus private ones. Among parents of VLBWIs, a moderate early parental stress was observed. Parental role alteration was the most relevant factor. Parental stress was higher among mothers and at public healthcare facilities. A greater sensitization, further research and interventions in this area are required.

The use of nasal CPAP at the Charlotte Maxeke Johannesburg ...

African Journals Online (AJOL)

The incidence of HMD is related to the degree of prematurity of the lungs, and ... the determinants of survival in very low birth weight (VLBW) neonates (birth weight <1 500 ..... able to treat a large number of neonates with HMD. This effectively.

Sub-optimal birth weight in newborns of a high socioeconomic status population

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Conceição Aparecida de Mattos Segre

2008-09-01

Full Text Available Objective: To compare sub-optimal birth weight (2,500 to 2,999 g term newborns to appropriate for gestational age (birth weight ≥ 3,000 g term newborns, regarding maternal data and newborn morbidity and mortality. Methods: Single term newborns, appropriate for gestational age from a high socioeconomic population (n = 1,242 with birth weight ranging from 2,500 to 2,999 g (Group I were compared to 4,907 newborns with birth weight ≥ than 3,000 g (Group II. Maternal and newborn characteristics were compared between the groups. The Mann-Whitney test, χ2 test and multivariate analysis were used. The significance level adopted was p < 0.05. Rresults: The frequency of sub-optimal birth weight newborns in the population studied was 20.2%. There was a significant association between sub-optimal birth weight and maternal weight before pregnancy and body mass index, maternal weight gain, height, smoking habit and hypertension. Newborns’ 1-minute Apgar score, neonatal hypoglycemia, jaundice, transient tachypnea, congenital pneumonia and hospital stay were significantly different between the groups (p < 0.05. A significant relationship could not be established with the 5-minute Apgar score and pulmonary hypertension in both groups. Neonatal mortality did not differ between the groups. Cconclusions: Socioeconomic status was not a risk factor for sub-optimal birth weight in the studied population. Genetic and environmental factors were associated to sub-optimal weight and neonatal diseases. According to these data, this group of newborns should receive special attention from the health team.

Elevated plasma urokinase receptor predicts low birth weight in maternal malaria

DEFF Research Database (Denmark)

Ostrowski, S R; Shulman, C E; Peshu, N

2007-01-01

-suPAR and gestational age were the only independent predictors of birth weight in multivariate linear regression adjusted for maternal-suPAR, HIV-1 infection, age, BMI, haemoglobin, peripheral parasitaemia, parity and gestational age; 1 ng/mL higher maternal-suPAR predicted -56 g (95% CI -100 to -12, P = 0.016) reduced...... birth weight. Cord-suPAR could not predict birth weight after adjusting for gestational age. Future studies are warranted to investigate whether the maternal suPAR level is increased earlier in pregnancy in women with active placental malaria infection and whether early maternal suPAR measurements can...... predict birth weight. If so, measurements of maternal suPAR early in pregnancy might then potentially identify women with increased needs for antenatal care and intervention....

INFLUENCE OF SOME NON GENETIC FACTORS ON BIRTH WEIGHT OF TEDDY GOAT KIDS

OpenAIRE

Asad Ullah Hyder, Pervez Akhtar and Khalid Zafar Gondal1

2002-01-01

Data on birth weight of Teddy goats maintained at the Livestock Production Research Institute, Bahadurnagar, were collected. A total of 1666 kidding records spread over a period of 25 years were available. Overall least square mean for birth weight was 1.44 ± 0.06 kg. The variation in birth weight due year and season of birth was significant. The winter born kids were heavier (1.46 ± 0.06 kg) than summer born kids (1.42 ± 0.06 kg). Least square mean for birth weight of male kids was 1.49 ± 0....

Does prenatal exposure to vitamin D-fortified margarine and milk alter birth weight?

DEFF Research Database (Denmark)

Jensen, Camilla B; Berentzen, Tina L; Gamborg, Michael

2014-01-01

The present study examined whether exposure to vitamin D from fortified margarine and milk during prenatal life influenced mean birth weight and the risk of high or low birth weight. The study was based on the Danish vitamin D fortification programme, which was a societal intervention with mandat......The present study examined whether exposure to vitamin D from fortified margarine and milk during prenatal life influenced mean birth weight and the risk of high or low birth weight. The study was based on the Danish vitamin D fortification programme, which was a societal intervention...... the initiation and termination of vitamin D fortification programmes. In total, four sets of analyses were performed. Information on birth weight was available in the Copenhagen School Health Record Register for all school children in Copenhagen. The mean birth weight was lower among the exposed than non...

Metabolomic profiling in blood from umbilical cords of low birth weight newborns

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Ivorra Carmen

2012-07-01

Full Text Available Abstract Background Low birth weight has been linked to an increased risk to develop obesity, type 2 diabetes, and hypertension in adult life, although the mechanisms underlying the association are not well understood. The objective was to determine whether the metabolomic profile of plasma from umbilical cord differs between low and normal birth weight newborns. Methods Fifty healthy pregnant women and their infants were selected. The eligibility criteria were being born at term and having a normal pregnancy. Pairs were grouped according to their birth weight: low birth weight (LBW, birth weight th percentile, n = 20 and control (control, birth weight between the 75th-90th percentiles, n = 30. Nuclear Magnetic Resonance (NMR was used to generate metabolic fingerprints of umbilical cord plasma samples. Simultaneously, the metabolomic profiles of the mothers were analysed. The resulting data were subjected to chemometric, principal component and partial least squares discriminant analyses. Results Umbilical cord plasma from LBW and control newborns displayed a clearly differentiated metabolic profile. Seven metabolites were identified that discriminate the LBW from the control group. LBW newborns had lower levels of choline, proline, glutamine, alanine and glucose than did the control newborns, while plasma levels of phenylalanine and citrulline were higher in LBW newborns (p Conclusions Low birth weight newborns display a differential metabolomic profile than those of normal birth weight, a finding not present in the mothers. The meaning and the potential utility of the findings as biomarkers of risk need to be addressed in future studies.

Validity of recalled v. recorded birth weight: a systematic review and meta-analysis

OpenAIRE

Shenkin, S.D.; Zhang, M.G.; Der, G.; Mathur, S.; Mina, T.H.; Reynolds, R.M.

2017-01-01

Low birth weight is associated with adverse health outcomes. If birth weight records are not available, studies may use recalled birth weight. It is unclear whether this is reliable. We performed a systematic review and meta-analysis of studies comparing recalled with recorded birth weights. We followed the Meta-Analyses of Observational Studies in Epidemiology (MOOSE) statement and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched MEDLINE, EM...

Factors predisposing to low birth weight in Jimma Hospital South ...

African Journals Online (AJOL)

Background: Low birth weight continues to remain a major public health problem in Ethiopia in contrast to what is observed in many developing countries. Objectives: To assess some of the predisposing factors to low birth weight among deliveries in Jimma hospital. Design: Cross-sectional case referent study.

Gestational age, birth weight, and the risk of hyperkinetic disorder

DEFF Research Database (Denmark)

Linnet, Karen M; Wisborg, Kirsten; Agerbo, Esben

2006-01-01

AIMS: To study the association between gestational age and birth weight and the risk of clinically verified hyperkinetic disorder. METHODS: Nested case-control study of 834 cases and 20 100 controls with incidence density sampling. RESULTS: Compared with children born at term, children born...... with gestational ages of 34-36 completed weeks had a 70% increased risk of hyperkinetic disorder (rate ratio (RR) 1.7, 95% confidence interval (CI) 1.2 to 2.5). Children with gestational ages below 34 completed weeks had an almost threefold increased risk (RR 2.7, 95% CI 1.8 to 4.1). Children born at term...... with birth weights of 1500-2499 g had a 90% increased risk of hyperkinetic disorder (RR 1.9, 95% CI 1.2 to 2.9), and children with birth weights of 2500-2999 g had a 50% increased risk (RR 1.5, 95% CI 1.2 to 1.8) compared with children born at term with birth weights above 2999 g. The results were adjusted...

Nutritional intake and weight z-scores in very low birth weight infants in Peru.

Science.gov (United States)

Proaño, Alvaro; Aragón, Romina Elena; Rivera, Fabiola; Zegarra, Jaime

2016-03-29

To determine the actual nutritional intake of very low birth weight infants and their growth outcome during the first month of life. Additionally, we identified factors that account for a negative neonatal outcome in this population. A case-series study was conducted in a tertiary hospital in Lima, Peru between 2011 and 2012 and the data was obtained from medical records. No feeding protocol was used during this study. Daily fluids, energy and protein intakes were documented and weekly weight z-scores were calculated. A logistic regression analysis was used to identify factors for an adverse outcome, defined as neonatal mortality or extra-uterine growth restriction, during the first 28 days of life. After applying selection criteria, 76 participants were included. The nutritional intakes were similar to standard values seen in the literature, but protein intakes were suboptimal in all of the four weeks. Birth weight z-score was associated with an adverse outcome (p=0.035). It was determined that having a birth weight z-score under -1.09 predicted a negative outcome with an area under the curve of 96.8% [93.5%, 100%] with a 95% confidence interval. Protein intakes are widely deficient in the population of this study. Nevertheless, an adverse outcome during the neonatal period is more associated with a poor birth weight z-score than nutrition-related factors.

Birth weight by gestational age and congenital malformations in Northern Ethiopia.

Science.gov (United States)

Mekonen, Hayelom K; Nigatu, Balkachew; Lamers, Wouter H

2015-03-29

Studies on birth weight and congenital anomalies in sub-Saharan regions are scarce. Data on child variables (gestational age, birth weight, sex, and congenital malformations) and maternal variables (gravidity, parity, antenatal care, previous abortions, maternal illness, age, medication, and malformation history) were collected for all neonates delivered at Ayder referral and Mekelle hospitals (Northern Ehthiopia) in a prospective study between 01-12-2011 and 01-05-2012. The total number of deliveries was 1516. More female (54%) than male neonates were born. Birth weights were 700-1,000 grams between 26 and 36 weeks of pregnancy and then increased linearly to 3,500-4,000 grams at 40 weeks. Thirty-five and 54% of neonates were very-low and low birth weight, respectively, without sex difference. Very-low birth-weight prevalence was not affected by parity. Male and female neonates from parity-2 and parity-2-4 mothers, respectively, were least frequently under weight. Sixty percent of newborns to parity -3 mothers weighed less than 2,500 grams, without sex difference. The percentage male neonates dropped from ~50% in parity-1-3 mothers to ~20% in parity-6 mothers. Diagnosed congenital malformations (~2%) were 2-fold more frequent in boys than girls. The commonest malformations were in the central nervous system (CNS; ~1.5% of newborns). Parity, low birth weight, gestational age less than 35 weeks, male sex, and lack of antenatal care were the most significant risk factors for congenital anomalies. The high prevalence of neonates with low birth weight and CNS anomalies in Northern Ethiopia was very high. The findings may reflect the harsh conditions in the past 2 decades and suggest environmental and/or nutritional causes. Male sex and parity affected the outcome of pregnancy negatively.

Birth Weight, Physical Morbidity, and Mortality: A Population-based Sibling-Comparison Study

Science.gov (United States)

Class, Quetzal A.; Rickert, Martin E.; Lichtenstein, Paul; D'Onofrio, Brian M.

2014-01-01

Associations between low birth weight (≤2,500 g) and increased risk of mortality and morbidity provided the foundation for the “developmental origins of health and disease” hypothesis. Previous between-family studies could not control for unmeasured confounders. Therefore, we compared differentially exposed siblings to estimate the extent to which the associations were due to uncontrolled factors. Our population cohort included 3,291,773 persons born in Sweden from 1973 to 2008. Analyses controlled for gestational age, among other covariates, and considered birth weight as both an ordinal and a continuous variable. Outcomes included mortality after 1 year, cardiac-related death, hypertension, ischemic heart disease, pulmonary circulation problems, stroke, and type 2 diabetes mellitus. We fitted fixed-effects models to compare siblings and conducted sensitivity analyses to test alternative explanations. Across the population, the lower the birth weight, the greater the risk of mortality (e.g., cardiac-related death (low birth weight hazard ratio = 2.69, 95% confidence interval: 2.05, 3.53)) and morbidity (e.g., type 2 diabetes mellitus (low birth weight hazard ratio = 1.79, 95% confidence interval: 1.50, 2.14)) outcomes in comparison with normal birth weight. All associations were independent of shared familial confounders and measured covariates. Results emphasize the importance of birth weight as a risk factor for subsequent mortality and morbidity. PMID:24355331

Association of light-to-moderate alcohol drinking in pregnancy with preterm birth and birth weight

DEFF Research Database (Denmark)

Strandberg-Larsen, Katrine; Poulsen, Gry; Bech, Bodil Hammer

2017-01-01

Women who drink light-to-moderately during pregnancy have been observed to have lower risk of unfavourable pregnancy outcomes than abstainers. This has been suggested to be a result of bias. In a pooled sample, including 193 747 live-born singletons from nine European cohorts, we examined...... alcohol. This decreased to 39% in 2000–2004, and 14% in 2005–2011. Before 2000, every additional drink was associated with reduced mean birth weight, whereas in 2005–2011, the mean birth weight increased with increasing intake. The period-specific associations between low-to-moderate drinking and birth...

Diffusion tensor imaging of the cortical plate and subplate in very-low-birth-weight infants

Energy Technology Data Exchange (ETDEWEB)

Dudink, Jeroen; Govaert, Paul; Zwol, Arjen L. van; Conneman, Nikk; Goudoever, Johannes B. van [Erasmus MC-Sophia Children' s Hospital, Division of Neonatology, Department of Paediatrics, Rotterdam (Netherlands); Buijs, Jan [Maxima Medical Center, Division of Neonatology, Department of Paediatrics, Veldhoven (Netherlands); Lequin, Maarten [Erasmus MC-Sophia Children' s Hospital, Division of Paediatrics, Department of Radiology, Rotterdam, Zuid-holland (Netherlands)

2010-08-15

Many intervention studies in preterm infants aim to improve neurodevelopmental outcome, but short-term proxy outcome measurements are lacking. Cortical plate and subplate development could be such a marker. Our aim was to provide normal DTI reference values for the cortical plate and subplate of preterm infants. As part of an ongoing study we analysed diffusion tensor imaging (DTI) images of 19 preterm infants without evidence of injury on conventional MRI, with normal outcome (Bayley-II assessed at age 2), and scanned in the first 4 days of life. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values in the frontal and temporal subplate and cortical plate were measured in single and multiple voxel regions of interest (ROI) placed on predefined regions. Using single-voxel ROIs, statistically significant inverse correlation was found between gestational age (GA) and FA of the frontal (r = -0.5938, P = 0.0058) and temporal (r = -0.4912, P = 0.0327) cortical plate. ADC values had a significant positive correlation with GA in the frontal (r = 0.5427, P = 0.0164) and temporal (r = 0.5540, P = 0.0138) subplate. Diffusion tensor imaging allows in vivo exploration of the evolving cortical plate and subplate. We provide FA and ADC values of the subplate and cortical plate in very-low-birth-weight (VLBW) infants with normal developmental outcome that can be used as reference values. (orig.)

Diffusion tensor imaging of the cortical plate and subplate in very-low-birth-weight infants

International Nuclear Information System (INIS)

Dudink, Jeroen; Govaert, Paul; Zwol, Arjen L. van; Conneman, Nikk; Goudoever, Johannes B. van; Buijs, Jan; Lequin, Maarten

2010-01-01

Many intervention studies in preterm infants aim to improve neurodevelopmental outcome, but short-term proxy outcome measurements are lacking. Cortical plate and subplate development could be such a marker. Our aim was to provide normal DTI reference values for the cortical plate and subplate of preterm infants. As part of an ongoing study we analysed diffusion tensor imaging (DTI) images of 19 preterm infants without evidence of injury on conventional MRI, with normal outcome (Bayley-II assessed at age 2), and scanned in the first 4 days of life. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values in the frontal and temporal subplate and cortical plate were measured in single and multiple voxel regions of interest (ROI) placed on predefined regions. Using single-voxel ROIs, statistically significant inverse correlation was found between gestational age (GA) and FA of the frontal (r = -0.5938, P = 0.0058) and temporal (r = -0.4912, P = 0.0327) cortical plate. ADC values had a significant positive correlation with GA in the frontal (r = 0.5427, P = 0.0164) and temporal (r = 0.5540, P = 0.0138) subplate. Diffusion tensor imaging allows in vivo exploration of the evolving cortical plate and subplate. We provide FA and ADC values of the subplate and cortical plate in very-low-birth-weight (VLBW) infants with normal developmental outcome that can be used as reference values. (orig.)

Prevalence of abnormal birth weight and related factors in Northern region, Ghana.

Science.gov (United States)

Abubakari, Abdulai; Kynast-Wolf, Gisela; Jahn, Albrecht

2015-12-15

Birth weight is a crucial determinant of the development potential of the newborn. Abnormal newborn weights are associated with negative effects on the health and survival of the baby and the mother. Therefore, this study was designed to determine the prevalence of abnormal birth weight and related factors in Northern region, Ghana. The study was a facility-based cross-sectional survey in five hospitals in Northern region, Ghana. These hospitals were selected based on the different socio-economic backgrounds of their clients. The data on birth weight and other factors were derived from hospital records. It was observed that low birth weight is still highly prevalent (29.6%), while macrosomia (10.5%) is also increasingly becoming important. There were marginal differences in low birth weight observed across public hospitals but marked difference in low birth weight was observed in Cienfuegos Suglo Specialist Hospital (Private hospital) as compared to the public hospitals. The private hospital also had the highest prevalence of macrosomia (20.1%). Parity (0-1) (p malnutrition phenomenon, which is currently being experienced by developing and transition counties. Both low birth weight and macrosomia are risk factors, which could contribute considerably to the current and future burden of diseases. This may overstretch the already fragile health system in Ghana. Therefore, it is prudent to recommend that policies aiming at reducing diet related diseases should focus on addressing malnutrition during pregnancy and early life.

Lower birth weight and diet in Taiwanese girls more than boys predicts learning impediments.

Science.gov (United States)

Lee, Meei-Shyuan; Huang, Lin-Yuan; Chang, Yu-Hung; Huang, Susana Tzy-Ying; Yu, Hsiao-Li; Wahlqvist, Mark L

2012-01-01

Possible links between lower birth weight, childhood diet, and learning in Taiwan are evaluated. The population representative Elementary School Children's Nutrition and Health Survey in Taiwan 2001-2002 and the national birth registry were used to examine school and social performance using the modified Scale for Assessing Emotional Disturbance questionnaires in relation to diet quality by the Youth Healthy Eating Index-Taiwan and birth weight of children aged 6-13 years (n=2283). Lower birth weight (≤15th percentile: ≤2850 g for boys and ≤2700 g for girls) children were mostly from mountainous areas and of indigenous descent. Compared to normal birth weight, lower birth weight girls experienced greater inability to learn and weaker overall competence. Better diet quality predicted more favorable emotional and behavioral outcomes in lower birth weight girls, and this persisted with adjustment for covariates. None of these findings were evident among boys. Girls' cognitive and social development appears to be susceptible to diet quality and birth weight, such that the adverse risk of lower birth weight on school performance may be offset by improved diet. Copyright © 2012 Elsevier Ltd. All rights reserved.

A study of birth weight of full term neonates and its′ determinants

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Yugantara R Kadam

2014-01-01

Full Text Available Background: Low birth weight (LBW is highly prevalent in India and has a multifactorial causation. There is a need to study and identify the modifiable and non-modifiable risk factors determining birth weight. This will help in planning ante natal care more effectively. Materials and Methods : Study-type-cross-sectional study-setting: Hospital based. Study-subject: Mothers and their new borns. Sample size: All the births taken place during the study period. Study period: July 2010-June 2011. Study tools : (0 i Questionnaire. (ii pediatric weighing machine. Inclusion criteria : m0 others attending ante natal care (ANC clinic from 1 st trimester with minimum three antenatal visits, non-anemic at the end of 2 nd trimester, had full-term and singleton delivery. Exclusion criteria : H/O pregnancy induced hypertension (PIH, diabetes mellieutus (DM, tuberculosis (TB, urinary tract infection (UTI, delivered preterm and tobacco chewers or mishri users. Statistical Analysis : Percentages, mean and SD of birth weight, χ2 test, ANOVA, Z-test, and Binary logistic. Results: By using birth weight as a continuous data it was observed that birth-weight was significantly associated with maternal age (F = 3.360, df = 2, P = 0.035, education (F = 4.401, df = 4, P = 0.002 and breakfast (z = 3.970, P = 0.00. Proportion of LBW was 42.4%. For analysis, groups of newborns on the basis of birth weight showed significant association between LBW and maternal education (χ2 = 12.734, df = 4, P = 0.013, breakfast (χ2 = 13.241, df = 1, P = 0.00 and evening snacks (χ2 = 4.275, df = 1, P = 0.013. According to the binary logistic regression, breakfast and education were significant and best predictors for birth weight. Conclusion: Education and breakfast are strong determinants of birth-weight. Less educated women need more intense health education.

Combined effects of prenatal exposures to environmental chemicals on birth weight

DEFF Research Database (Denmark)

Govarts, Eva; Remy, Sylvie; Bruckers, Liesbeth

2016-01-01

Prenatal chemical exposure has been frequently associated with reduced fetal growth by single pollutant regression models although inconsistent results have been obtained. Our study estimated the effects of exposure to single pollutants and mixtures on birth weight in 248 mother-child pairs...... with cadmium showed the strongest association with birth weight. In conclusion, birth weight was consistently inversely associated with exposure to pollutant mixtures. Chemicals not showing significant associations at single pollutant level contributed to stronger effects when analyzed as mixtures....

Inattention and development of toddlers born in preterm and with low birth weight.

Science.gov (United States)

Huang, June-Hui; Huang, Huei-Lin; Chen, Hsiu-Lin; Lin, Lung-Chang; Tseng, Hsing-I; Kao, Tsung-Jen

2012-07-01

The objective of this study was to examine the impact of low birth weight and preterm birth on a toddler's inattention and development, including cognitive, language, motor, social-emotional and adaptive behaviors. A total of 105 toddlers enrolled for the study; they were divided into four groups: 40 full-term and normal birth weight (NBW, birth weight greater than 2500 g) toddlers, 24 moderate birth weight (MLBW, birth weight between 2499 and 1500 g) toddlers, 20 very to extremely low birth weight (V-ELBW, 12 between 1000 and 1499 g and 8 lower than 1000 g) toddlers, and 21 term toddlers who were recruited from a clinic of developmental delay as the developmental delay at risk (DDR) group. The Bayley Scales of Infant and Toddler Development-Third Edition (BSID-III) and Disruptive Behavior Rating Scale-Toddler were used. The findings were as follows: (1) DDR group performed worst in BSID-III; (2) although there were no statistical differences among the NBW, MLBW, and V-ELBW groups in BSID-III, the lower the birth weight, the lower the average performance, especially in language, adaptive social behavior, and adaptive practical behavior; and (3) comparing the inattention score, the DDR group was the poorest, normal and V-ELBW groups were the best, and MLBW group was in the middle. In conclusion, low birth weight and preterm delivery affected children's inattention and development of language, adaptive social behavior, and adaptive practical behavior. Copyright © 2012. Published by Elsevier B.V.

Inattention and development of toddlers born in preterm and with low birth weight

Directory of Open Access Journals (Sweden)

June-Hui Huang

2012-07-01

Full Text Available The objective of this study was to examine the impact of low birth weight and preterm birth on a toddler's inattention and development, including cognitive, language, motor, social–emotional and adaptive behaviors. A total of 105 toddlers enrolled for the study; they were divided into four groups: 40 full-term and normal birth weight (NBW, birth weight greater than 2500 g toddlers, 24 moderate birth weight (MLBW, birth weight between 2499 and 1500 g toddlers, 20 very to extremely low birth weight (V-ELBW, 12 between 1000 and 1499 g and 8 lower than 1000 g toddlers, and 21 term toddlers who were recruited from a clinic of developmental delay as the developmental delay at risk (DDR group. The Bayley Scales of Infant and Toddler Development—Third Edition (BSID-III and Disruptive Behavior Rating Scale—Toddler were used. The findings were as follows: (1 DDR group performed worst in BSID-III; (2 although there were no statistical differences among the NBW, MLBW, and V-ELBW groups in BSID-III, the lower the birth weight, the lower the average performance, especially in language, adaptive social behavior, and adaptive practical behavior; and (3 comparing the inattention score, the DDR group was the poorest, normal and V-ELBW groups were the best, and MLBW group was in the middle. In conclusion, low birth weight and preterm delivery affected children's inattention and development of language, adaptive social behavior, and adaptive practical behavior.

The Relationship between Folic Acid Intake and Infant Birth Weight

Directory of Open Access Journals (Sweden)

Fariba Esmailzadeh

2016-12-01

Full Text Available Background and Objectives: Folic acid is a B vitamin which 5mg daily intake before gestation and until the tenth week of pregnancy is recommended. Since no study has been conducted in some regions of East Azerbaijan including Bostanabad, Khosroshahr and Sarab and no prevalence was spotted in country specific studies, therefore, the aim of this study was to determine the relationship between folic acid intake and infant birth weight. Material and Methods: This study was a retrospective cohort. In this study, 1939 of pregnant women who were referred to health care centers before pregnancy were selected randomly. They were divided into two groups: first group of pregnant women who regularly took folic acid before pregnancy and second group included the women who did not take folic acid supplements. Data were analyzed by SPSS 16 using T-Test and ANOVA. Results: This study was conducted on 1939 mothers who had an average age of 25.98 years and average infants birth weight was 3.209 kg. Totally, 92.9% of the mothers had regular consumption of folic acid during pregnancy. Analysis of the results showed that with increasing maternal BMI, birth weight also increased. It showed a significant relationship between regular folic acid intake and increase in infant birth weight. Conclusion : Our results showed that both high maternal pre-pregnancy weight and folic acid intake lead to higher birth weight infants.

Maternal short stature: A risk factor for low birth weight in neonates

Directory of Open Access Journals (Sweden)

Vipin Chandra Kamathi

2012-08-01

Full Text Available Low birth weight (LBW is the most common cause of perinatal mortality, causing almost 30 percent of neonatal deaths. On the other hand, maternal short stature is known to cause a lot of obstetric complications like cephalopelvic disproportion and arrest of labor, intrauterine asphyxia, intrauterine growth retardation. The objective of our study was to find out whether there was any significant statistical association between maternal height and the birth weight of the neonate. We identified a group of low birth weight neonates (n=54 and a control group (n=51 of normal weight neonates at term in Mediciti Hospital over a period of 1 year and retrospectively looked the maternal heights for both groups. Inclusion criteria being mothers who delivered at term, mothers who had a hemoglobin level more than 10 gm/dl, mothers with relatively uneventful antenatal without any significant obstetric or medical complications during the pregnancy, and neonates with relatively uneventful post-natal periods without any significant pediatric or medical complications. The odds of having been born of a mother of short stature are more than three times greater for a low birth weight baby than a normal weight baby. The mean of birth weights of babies born to mothers of normal height is more than the mean of birth weights of babies born to mothers of short stature by 277.01 gm. This study reaffirms the observation that maternal height has a direct effect on the weight of the newborn and we propose that maternal short stature be identified as an independent risk factor for low birth weight.

Genetic Evidence for Causal Relationships Between Maternal Obesity-Related Traits and Birth Weight.

Science.gov (United States)

Tyrrell, Jessica; Richmond, Rebecca C; Palmer, Tom M; Feenstra, Bjarke; Rangarajan, Janani; Metrustry, Sarah; Cavadino, Alana; Paternoster, Lavinia; Armstrong, Loren L; De Silva, N Maneka G; Wood, Andrew R; Horikoshi, Momoko; Geller, Frank; Myhre, Ronny; Bradfield, Jonathan P; Kreiner-Møller, Eskil; Huikari, Ville; Painter, Jodie N; Hottenga, Jouke-Jan; Allard, Catherine; Berry, Diane J; Bouchard, Luigi; Das, Shikta; Evans, David M; Hakonarson, Hakon; Hayes, M Geoffrey; Heikkinen, Jani; Hofman, Albert; Knight, Bridget; Lind, Penelope A; McCarthy, Mark I; McMahon, George; Medland, Sarah E; Melbye, Mads; Morris, Andrew P; Nodzenski, Michael; Reichetzeder, Christoph; Ring, Susan M; Sebert, Sylvain; Sengpiel, Verena; Sørensen, Thorkild I A; Willemsen, Gonneke; de Geus, Eco J C; Martin, Nicholas G; Spector, Tim D; Power, Christine; Järvelin, Marjo-Riitta; Bisgaard, Hans; Grant, Struan F A; Nohr, Ellen A; Jaddoe, Vincent W; Jacobsson, Bo; Murray, Jeffrey C; Hocher, Berthold; Hattersley, Andrew T; Scholtens, Denise M; Davey Smith, George; Hivert, Marie-France; Felix, Janine F; Hyppönen, Elina; Lowe, William L; Frayling, Timothy M; Lawlor, Debbie A; Freathy, Rachel M

2016-03-15

Neonates born to overweight or obese women are larger and at higher risk of birth complications. Many maternal obesity-related traits are observationally associated with birth weight, but the causal nature of these associations is uncertain. To test for genetic evidence of causal associations of maternal body mass index (BMI) and related traits with birth weight. Mendelian randomization to test whether maternal BMI and obesity-related traits are potentially causally related to offspring birth weight. Data from 30,487 women in 18 studies were analyzed. Participants were of European ancestry from population- or community-based studies in Europe, North America, or Australia and were part of the Early Growth Genetics Consortium. Live, term, singleton offspring born between 1929 and 2013 were included. Genetic scores for BMI, fasting glucose level, type 2 diabetes, systolic blood pressure (SBP), triglyceride level, high-density lipoprotein cholesterol (HDL-C) level, vitamin D status, and adiponectin level. Offspring birth weight from 18 studies. Among the 30,487 newborns the mean birth weight in the various cohorts ranged from 3325 g to 3679 g. The maternal genetic score for BMI was associated with a 2-g (95% CI, 0 to 3 g) higher offspring birth weight per maternal BMI-raising allele (P = .008). The maternal genetic scores for fasting glucose and SBP were also associated with birth weight with effect sizes of 8 g (95% CI, 6 to 10 g) per glucose-raising allele (P = 7 × 10(-14)) and -4 g (95% CI, -6 to -2 g) per SBP-raising allele (P = 1×10(-5)), respectively. A 1-SD ( ≈ 4 points) genetically higher maternal BMI was associated with a 55-g higher offspring birth weight (95% CI, 17 to 93 g). A 1-SD ( ≈ 7.2 mg/dL) genetically higher maternal fasting glucose concentration was associated with 114-g higher offspring birth weight (95% CI, 80 to 147 g). However, a 1-SD ( ≈ 10 mm Hg) genetically higher maternal SBP was associated with a 208-g

The effects of maternal total protein, albumin and hemoglobin levels on birth weight

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Berna Haliloglu

2007-12-01

Full Text Available OBJECTIVE: The present study was designed to investigate the influence of third trimester maternal total protein, albumin, hemoglobin levels on birth weight.\tMATERIAL-METHOD: Between January 2005 and July 2005, 750 pregnant women applied for delivery at Zeynep Kamil Women’s and Children Education and Research Hospital at 37-40 week’s gestation were examined. Maternal total protein, albumin and hemoglobin levels were measured. Data included maternal age, gravidity, parity, gestational age, birth weight, gender, presence of iron supplementation and its duration.\tRESULTS: The birth weight was significantly higher in anemic and hypoproteinemic groups compared those with normal levels. After adjusting for counfounding factors, significance of both findings lost. The cases received iron supplementation had infants with higher birth weight, however, it was not statistically significant (p: 0.055. A significant positive relation was observed between birth weight and maternal age, gravidity, parity and gestational age. No relation found between maternal total protein, albumin, hemoglobin levels and birth weight.\tCONCLUSION: The last trimester maternal total protein, albumin, hemoglobin levels seem not to be a determining factor on infant's birth weight.

Male scarcity is associated with higher prevalence of premature gestation and low birth weight births across the United States.

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Kruger, Daniel J; Clark, Jillian; Vanas, Sarah

2013-01-01

Modern adverse birth outcomes may partially result from mechanisms evolved to evaluate environmental conditions and regulate maternal investment trade-offs. Male scarcity in a population is associated with a cluster of characteristics related to higher mating effort and lower paternal investment. We predicted that modern populations with male scarcity would have shorter gestational times and lower birth weights on average. We compared US Centers for Disease Control and Prevention county-aggregated year 2000 birth records with US Decennial Census data. We combined these data in a path model with the degree of male scarcity and known socio-economic predictors of birth outcomes as exogenous predictors of prematurity and low birth weight, with single mother households as a proportion of families with children as a mediator (N = 450). Male scarcity was directly associated with higher rates of low birth weight. Male scarcity made significant indirect predictions of rates of prematurity and low birth weight, as mediated by the proportion of families headed by single mothers. Aggregate socio-economic status also indirectly predicted birth outcomes, as mediated by the proportion of families headed by single mothers, whereas the proportion African American retained both direct and indirect predictions of adverse birth outcomes. Male scarcity influences life history tradeoffs, with consequences for important social and public health issues such as adverse birth outcomes. Copyright © 2013 Wiley Periodicals, Inc.

Low Birth Weight as The Risk factor of Coronary Heart Diseases

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Joko Wahyu Wibowo

2011-12-01

Full Text Available Low birth weight, a nutritional deficiency is related to the increased in the coronary heart disease insidence. Low birth weight is correlated with the hipotalamus-pituitary-adrenal responsible for the the concentration of cortisol in sirculation, increased in homosistein, insuline resistence and increased C reactive protein playing role on the aterosclerosis process predispose the corronary disease. This paper will discuss the relationship between the low birth weight and the ateroclesoris process leading to coronary heart disesase (Sains Medika, 3(2:185-200.

The neglected sociobehavioral risk factors of low birth weight

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Mohsen Momeni

2016-08-01

Full Text Available Background: Low Birth Weight (LBW is one of the most important health indicators in the world. It has certain known and unknown causes. The present study was designed to evaluate the role of socio-behavioral factors on neonatal birth weight.Methods: The current case-control study was conducted on 300 eligible neonates (150 LBW infants as cases and 150 normal body weight infants as controls in 2015. The national pregnancy care forms of the neonates kept in heath care centers in Kerman were used. The data was analyzed running Independent samples t-test, Chi square test, and Fisher’s Exact test in SPSS. The significance level was set as 0.05.Results: Preterm birth (P<0.001, number of primary care during pregnancy (P=0.001, mother’s age (P=0.049, consumption of supplements during pregnancy (P=0.03, and history of substance abuse in mothers (P=0.03 were found to have significant roles in having LBW neonate.Conclusion: Identifying the sociobehavioral risk factors of Preterm labor and modifying them to prevent preterm birth are essential approaches to prevent LBW. Governments should pay special attention to nutritional status of teenage and young girls to have healthy mothers and babies in the future. Women of childbearing age should be screened and educated about risky behaviors. Pregnancy care and support should be delivered to all pregnant women according to the standard methods.Keywords: Low Birth Weight; Risk Factors; Behavior; Preterm Labor

Prepregnancy body mass index, gestational weight gain, and birth weight in the BRISA cohort

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Lima, Raina Jansen Cutrim Propp; Batista, Rosângela Fernandes Lucena; Ribeiro, Marizélia Rodrigues Costa; Ribeiro, Cecília Cláudia Costa; Simões, Vanda Maria Ferreira; Lima Neto, Pedro Martins; Silva, Antônio Augusto Moura da; Bettiol, Heloisa

2018-01-01

ABSTRACT OBJECTIVE To analyze the effects of maternal pre-pregnancy body mass index and weight gain during pregnancy on the baby's birth weight. METHODS We conducted a cross-sectional study with 5,024 mothers and their newborns using a Brazilian birth cohort study. In the proposed model, estimated by structural equation modeling, we tested socioeconomic status, age, marital status, pre-pregnancy body mass index, smoking habit and alcohol consumption during pregnancy, hypertension and gestat...

Pattern and determinants of birth weight in Oman.

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Islam, M M; ElSayed, M K

2015-12-01

The aim of this study was to analyse the pattern of birth weight (BW) and identify the factors affecting BW and the risk factors of low birth weight (LBW) in Oman. The data for the study came from the 2000 Oman National Health Survey conducted by the Ministry of Health. The survey covered a nationally representative sample of 2037 ever married Omani women of reproductive age. Data on birth weight were gathered from health cards of the infants born within five years before the survey date. The study considered 977 singleton live births for whom data on birth weights were available. LBW was defined as BW less than 2500 g. Descriptive statistics, analysis of variance, multivariate linear regression and logistic regression models were used for data analysis. The mean BW was found to be 3.09 (SD 0.51) kg. BW was found to be significantly lower among the infants with the following characteristics: born in Ad-Dhakhliyah region, born in rural areas, and whose mothers had low economic status, low parity (0-2), and late initiation of antenatal care (ANC) visit. The incidence of LBW was found to be 9% in Oman in 2000. Mother's education, economic status, region of residence, late initiation of first ANC visit and experience of pregnancy complications appeared as the significant determinants of LBW in Oman. In contrast to most other studies, this study demonstrates that mothers with an advanced level of education (secondary and above) are more likely to have infants with LBW in Oman. The study findings highlight the need of intervention for specific groups of women with higher risk of adverse BW outcomes. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Neonatal physiological correlates of near-term brain development on MRI and DTI in very-low-birth-weight preterm infants.

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Rose, Jessica; Vassar, Rachel; Cahill-Rowley, Katelyn; Stecher Guzman, Ximena; Hintz, Susan R; Stevenson, David K; Barnea-Goraly, Naama

2014-01-01

Structural brain abnormalities identified at near-term age have been recognized as potential predictors of neurodevelopment in children born preterm. The aim of this study was to examine the relationship between neonatal physiological risk factors and early brain structure in very-low-birth-weight (VLBW) preterm infants using structural MRI and diffusion tensor imaging (DTI) at near-term age. Structural brain MRI, diffusion-weighted scans, and neonatal physiological risk factors were analyzed in a cross-sectional sample of 102 VLBW preterm infants (BW ≤ 1500 g, gestational age (GA) ≤ 32 weeks), who were admitted to the Lucile Packard Children's Hospital, Stanford NICU and recruited to participate prior to routine near-term brain MRI conducted at 36.6 ± 1.8 weeks postmenstrual age (PMA) from 2010 to 2011; 66/102 also underwent a diffusion-weighted scan. Brain abnormalities were assessed qualitatively on structural MRI, and white matter (WM) microstructure was analyzed quantitatively on DTI in six subcortical regions defined by DiffeoMap neonatal brain atlas. Specific regions of interest included the genu and splenium of the corpus callosum, anterior and posterior limbs of the internal capsule, the thalamus, and the globus pallidus. Regional fractional anisotropy (FA) and mean diffusivity (MD) were calculated using DTI data and examined in relation to neonatal physiological risk factors including gestational age (GA), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), and sepsis, as well as serum levels of C-reactive protein (CRP), glucose, albumin, and total bilirubin. Brain abnormalities were observed on structural MRI in 38/102 infants including 35% of females and 40% of males. Infants with brain abnormalities observed on MRI had higher incidence of BPD (42% vs. 25%) and sepsis (21% vs. 6%) and higher mean and peak serum CRP levels, respectively, (0.64 vs. 0.34 mg/dL, p = .008; 1.57 vs. 0.67�

Effect of prenatal exposure to kitchen fuel on birth weight

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Yugantara Ramesh Kadam

2013-01-01

Full Text Available Background: Maternal exposure to kitchen fuel smoke may lead to impaired fetal growth. Objective: To study the effect of exposure to various kitchen fuels on birth weight. Methodology : Study type: Retrospective analytical. Study setting: Hospital based. Study Subjects: Mothers and their newborns. Inclusion Criteria: Mothers registered in first trimester with minimum 3 visits, non-anemic, full-term, and singleton delivery. Exclusion Criteria: History of Pregnancy Induced Hypertension (PIH, Diabetes Mellitus (DM, tobacco chewers or mishri users. Sample size: 328 mothers and their new-borne. Study period: Six months. Study tools: Chi-square, Z-test, ANOVA, and binary logistic regression. Results: Effect of confounders on birth weight was tested and found to be non-significant. Mean ± SD of birth weight was 2.669 ± 0.442 in Liquid Petroleium Gas (LPG users (n = 178, 2.465 ± 0.465 in wood users (n = 94, 2.557 ± 0.603 in LPG + wood users (n = 27 and 2.617 ± 0.470 in kerosene users (n = 29. Infants born to wood users had lowest birth weight and averagely 204 g lighter than LPG users (F = 4.056, P < 0.01. Percentage of newborns with low birth weight (LBW in wood users was 44.68% which was significantly higher than in LPG users (24.16%, LPG + wood users (40.74% and in kerosene users (34.48% (Chi-square = 12.926, P < 0.01. As duration of exposure to wood fuel increases there is significant decline in birth weight (F = 3.825, P < 0.05. By using logistic regression type of fuel is only best predictor. Conclusion: Cooking with wood fuel is a significant risk-factor for LBW, which is modifiable.

The Study of Mothers’ Periodontal Status and Newborn’s Low Birth Weight

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M. Shirinzad

2006-10-01

Full Text Available Introduction & Objective: Recent studies have presented evidence that periodontal disease in pregnant women may be a determining factor for newborn’s low birth weight. The present investigation was carried out to verify whether there is an association between maternal periodontal disease and low birth weight of newborns.Materials and Methods: This was a case-control study on 330 women, containing 110 mothers having live newborns with weight 2500 g (control group. The existence of an association between periodontal disease and newborn’s low birth weight was evaluated by means of analytic statistics that considered other risk factors for low weight. The two groups were compared with regard to urinary infection, preeclampsia, premature rupture of membrane, placenta previa, primiparous, smoking, age, height, socioeconomic status and periodontal disease.Results: There were no statistically significant differences between the case and control groups for any of the covariables (P>0.05, but there was significant differences for principal independent variable (periodontal disease P<0.05.Conclusion: Results indicated a positive association between periodontal disease and newborn’s low birth weight. Thus periodontal disease is a possible risk factor for low birth weight.

The relationship between air pollution and low birth weight: effects by mother's age, infant sex, co-pollutants, and pre-term births

International Nuclear Information System (INIS)

Bell, Michelle L; Ebisu, Keita; Belanger, Kathleen

2008-01-01

Previously we identified associations between the mother's air pollution exposure and birth weight for births in Connecticut and Massachusetts from 1999-2002. Other studies also found effects, though results are inconsistent. We explored potential uncertainties in earlier work and further explored associations between air pollution and birth weight for PM 10 , PM 2.5 , CO, NO 2 , and SO 2 . Specifically we investigated: (1) whether infants of younger (≤24 years) and older (≥40 years) mothers are particularly susceptible to air pollution's effects on birth weight; (2) whether the relationship between air pollution and birth weight differed by infant sex; (3) confounding by co-pollutants and differences in pollutants' measurement frequencies; and (4) whether observed associations were influenced by inclusion of pre-term births. Findings did not indicate higher susceptibility to the relationship between air pollution and birth weight based on the mother's age or the infant's sex. Results were robust to exclusion of pre-term infants and co-pollutant adjustment, although sample size decreased for some pollutant pairs. These findings provide additional evidence for the relationship between air pollution and birth weight, and do not identify susceptible sub-populations based on infant sex or mother's age. We conclude with discussion of key challenges in research on air pollution and pregnancy outcomes.

[Joint effect of birth weight and obesity measures on abnormal glucose metabolism at adulthood].

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Xi, Bo; Cheng, Hong; Chen, Fangfang; Zhao, Xiaoyuan; Mi, Jie

2016-01-01

To investigate the joint effect of birth weight and each of obesity measures (body mass index (BMI) and waist circumference (WC)) on abnormal glucose metabolism (including diabetes) at adulthood. Using the historical cohort study design and the convenience sampling method, 1 921 infants who were born in Beijing Union Medical College Hospital from June 1948 to December 1954 were selected to do the follow-up in 1995 and 2001 respectively. Through Beijing Household Registration and Management System, they were invited to participate in this study. A total of 972 subjects (627 were followed up in 1995 and 345 were followed up in 2001) with complete information on genders, age, birth weight, family history of diabetes, BMI, WC, fasting plasma glucose (FPG) and 2-hour plasma glucose (2 h PG) met the study inclusion criteria at the follow-up visits. In the data analysis, they were divided into low, normal, and high birth weight, respectively. The ANOVA and Chi-squared tests were used to compare the differences in their characteristics by birth weight group. In addition, multiple binary Logistic regression model was used to investigate the single effect of birth weight, BMI, and waist circumference on abnormal glucose metabolism at adulthood. Stratification analysis was used to investigate the joint effect of birth weight and each of obesity measures (BMI and WC) on abnormal glucose metabolism. There were 972 subjects (males: 50.7%, mean age: (46.0±2.2) years) included in the final data analysis. The 2 h PG in low birth weight group was (7.6±3.2) mmol/L , which was higher than that in normal birth weight group (6.9±2.1) mmol/L and high birth weight group (6.4±1.3) mmol/L (F=3.88, P=0.021). After adjustment for genders, age, body length, gestation age, family history of diabetes, physical activity, smoking and alcohol consumption, and duration of follow-up, subjects with overweight and obesity at adulthood had 2.73 (95% confidence interval (CI) =2.06- 3.62) times risk

Black/white differences in very low birth weight neonatal mortality rates among New York City hospitals.

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Howell, Elizabeth A; Hebert, Paul; Chatterjee, Samprit; Kleinman, Lawrence C; Chassin, Mark R

2008-03-01

We sought to determine whether differences in the hospitals at which black and white infants are born contribute to black/white disparities in very low birth weight neonatal mortality rates in New York City. We performed a population-based cohort study using New York City vital statistics records on all live births and deaths of infants weighing 500 to 1499 g who were born in 45 hospitals between January 1, 1996, and December 31, 2001 (N = 11 781). We measured very low birth weight risk-adjusted neonatal mortality rates for each New York City hospital and assessed differences in the distributions of non-Hispanic black and non-Hispanic white very low birth weight births among these hospitals. Risk-adjusted neonatal mortality rates for very low birth weight infants in New York City hospitals ranged from 9.6 to 27.2 deaths per 1000 births. White very low birth weight infants were more likely to be born in the lowest mortality tertile of hospitals (49%), compared with black very low birth weight infants (29%). We estimated that, if black women delivered in the same hospitals as white women, then black very low birth weight mortality rates would be reduced by 6.7 deaths per 1000 very low birth weight births, removing 34.5% of the black/white disparity in very low birth weight neonatal mortality rates in New York City. Volume of very low birth weight deliveries was modestly associated with very low birth weight mortality rates but explained little of the racial disparity. Black very low birth weight infants more likely to be born in New York City hospitals with higher risk-adjusted neonatal mortality rates than were very low birth weight infants, contributing substantially to black-white disparities.

Trends in incidence of low birth weight deliveries in a tertiary hospital, in Northern Nigeria

OpenAIRE

O Hassan; Z Muhammad

2011-01-01

Background: Low birth weight is an important determinant of both infant and neonatal mortality rates and is also an indicator of social and economic development. The World Health Organization described any baby with birth weight of less than 2.5kg as low birth weight baby. Objective: To determine the incidence of low birth weight deliveries in Aminu Kano Teaching Hospital, Kano. Study design: A retrospective descriptive study. Results: The overall incidence of low birth weight delive...

Magnitude and Correlates of Low Birth Weight at Term in Rural Wardha, Central India

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Kumar V

2016-05-01

Full Text Available Introduction: Birth weight is one of the most important determinant of the neonatal and infant survival. The goal of reducing low birth weight incidence by at least one third between 2000 and 2010 was one of the major goals in ‘A World Fit for Children’. The prevention of low birth weight is a public health priority, particularly in developing countries with high magnitude. Knowledge regarding magnitude and correlates help prevent the condition. Hence, the present study was carried out to study the magnitude and the correlates of low birth weight. Methodology: Two hundred and six newborn babies were recruited on a birth cohort from two Primary Health Centres (PHC of Wardha district to study growth in first year of life. Here, we present the baseline analysis of 172 children who were born full term to study the correlates of low birth weight babies born full term. The children were recruited within first week of their birth. Data was collected on socio-demographic profile, birth history, and maternal characteristics. Proportion of low birth weight was expressed in percentage along with 95% confidence interval. Univariate and multivariate logistic regression was used to study the correlates. Findings are expressed in odds ratios with their 95% confidence intervals. Results: The magnitude of low birth weight at term was found to be 33.1% (95% CI: 26.4%-40.4%. On univariate analysis, significant correlates of low birth weight were consumption of less than 50 iron-folic acid tables and being born to than mother. On multivariate analysis, the significant correlates were female sex of child (OR=2.856, being born to thin mother (OR=5.320, consumption of less than 50 tablets (OR=4.648, and complications of pregnancy (OR=2.917. Conclusions: The magnitude of low birth weight is very high and modifiable correlates of low birth weight are nutritional status of mother, lower consumption of IFA tablets and complications of pregnancy.

Pre-Eclampsia, Birth Weight, and Autism Spectrum Disorders

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Mann, Joshua R.; McDermott, Suzanne; Bao, Haikun; Hardin, James; Gregg, Anthony

2010-01-01

Autism spectrum disorders (ASD) are primarily inherited, but perinatal or other environmental factors may also be important. In an analysis of 87,677 births from 1996 through 2002, insured by the South Carolina Medicaid program, birth weight was significantly inversely associated with the odds of ASD (OR = 0.78, p = 0.001 for each additional…

Neonatal and Infant Mortality in Korea, Japan, and the U.S.: Effect of Birth Weight Distribution and Birth Weight-Specific Mortality Rates.