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Sample records for delivery gestational age

  1. Relationship between 17-hydroxyprogesterone caproate concentrations and gestational age at delivery in twin gestation.

    LENUS (Irish Health Repository)

    Caritis, Steve N

    2012-11-01

    We sought to evaluate in women with twin gestation the relationship between 17-hydroxyprogesterone caproate (17-OHPC) concentration and gestational age at delivery and select biomarkers of potential pathways of drug action.

  2. Gestational age

    Science.gov (United States)

    Fetal age - gestational age; Gestation; Neonatal gestational age; Newborn gestational age ... Gestational age can be determined before or after birth. Before birth, your health care provider will use ultrasound to ...

  3. Varying gestational age patterns in cesarean delivery: An international comparison

    NARCIS (Netherlands)

    Delnord, M.; Blondel, B.; Drewniak, N.; Klungsøyr, K.; Bolumar, F.; Mohangoo, A.; Gissler, M.; Szamotulska, K.; Lack, N.; Nijhuis, J.; Velebil, P.; Sakkeus, L.; Chalmers, J.; Zeitlin, J.; Haidinger, G.; XMartens, G.; Misselwitz, B.; Wenzlaff, P.; Bonham, S.; Jaselioniene, J.; Gatt, M.; Klungsøyr, K.; Barros, H.; Novak, Z.; Gottvall, K.

    2014-01-01

    Background: While international variations in overall cesarean delivery rates are well documented, less information is available for clinical sub-groups. Cesarean data presented by subgroups can be used to evaluate uptake of cesarean reduction policies or to monitor delivery practices for high and

  4. Delivery of a small for gestational age infant and greater maternal risk of ischemic heart disease.

    Directory of Open Access Journals (Sweden)

    Radek Bukowski

    Full Text Available BACKGROUND: Delivery of a small for gestational age (SGA infant has been associated with increased maternal risk of ischemic heart disease (IHD. It is uncertain whether giving birth to SGA infant is a specific determinant of later IHD, independent of other risk factors, or a marker of general poor health. The purpose of this study was to investigate the association between delivery of a SGA infant and maternal risk for IHD in relation to traditional IHD risk factors. METHODS AND FINDINGS: Risk of maternal IHD was evaluated in a population based cross-sectional study of 6,608 women with a prior live term birth who participated in the National Health and Nutrition Examination Survey (1999-2006, a probability sample of the U.S. population. Sequence of events was determined from age at last live birth and at diagnosis of IHD. Delivery of a SGA infant is strongly associated with greater maternal risk for IHD (age adjusted OR; 95% CI: 1.8; 1.2, 2.9; p = 0.012. The association was independent of the family history of IHD, stroke, hypertension and diabetes (family history-adjusted OR; 95% CI: 1.9; 1.2, 3.0; p = 0.011 as well as other risk factors for IHD (risk factor-adjusted OR; 95% CI: 1.7; 1.1, 2.7; p = 0.025. Delivery of a SGA infant was associated with earlier onset of IHD and preceded it by a median of 30 (interquartile range: 20, 36 years. CONCLUSIONS: Giving birth to a SGA infant is strongly and independently associated with IHD and a potential risk factor that precedes IHD by decades. A pregnancy that produces a SGA infant may induce long-term cardiovascular changes that increase risk for IHD.

  5. Delivery of a small for gestational age infant and greater maternal risk of ischemic heart disease.

    Science.gov (United States)

    Bukowski, Radek; Davis, Karen E; Wilson, Peter W F

    2012-01-01

    Delivery of a small for gestational age (SGA) infant has been associated with increased maternal risk of ischemic heart disease (IHD). It is uncertain whether giving birth to SGA infant is a specific determinant of later IHD, independent of other risk factors, or a marker of general poor health. The purpose of this study was to investigate the association between delivery of a SGA infant and maternal risk for IHD in relation to traditional IHD risk factors. Risk of maternal IHD was evaluated in a population based cross-sectional study of 6,608 women with a prior live term birth who participated in the National Health and Nutrition Examination Survey (1999-2006), a probability sample of the U.S. population. Sequence of events was determined from age at last live birth and at diagnosis of IHD. Delivery of a SGA infant is strongly associated with greater maternal risk for IHD (age adjusted OR; 95% CI: 1.8; 1.2, 2.9; p = 0.012). The association was independent of the family history of IHD, stroke, hypertension and diabetes (family history-adjusted OR; 95% CI: 1.9; 1.2, 3.0; p = 0.011) as well as other risk factors for IHD (risk factor-adjusted OR; 95% CI: 1.7; 1.1, 2.7; p = 0.025). Delivery of a SGA infant was associated with earlier onset of IHD and preceded it by a median of 30 (interquartile range: 20, 36) years. Giving birth to a SGA infant is strongly and independently associated with IHD and a potential risk factor that precedes IHD by decades. A pregnancy that produces a SGA infant may induce long-term cardiovascular changes that increase risk for IHD.

  6. Social class, ethnicity and other risk factors for small for gestational age and preterm delivery in the Netherlands

    NARCIS (Netherlands)

    Verkerk, P.H.; Zaadstra, B.M.; Reerink, J.D.; Herngreen, W.P.; Verloove-Vanhorick, S.P.

    1994-01-01

    Social class and ethnicity are important risk factors for small-for-gestational-age and preterm delivery in many countries. This study was performed to assess whether this is also the case in the Netherlands, a country with a high level of social security, relatively small income differences and

  7. Social class, ethnicity and other risk factors for small for gestational age and preterm delivery in the Netherlands

    NARCIS (Netherlands)

    Verkerk, P.H.; Zaadstra, B.M.; Reerink, J.D.; Herngreen, W.P.; Verloove-Vanhorick, S.P.

    1994-01-01

    Social class and ethnicity are important risk factors for small-for-gestational-age and preterm delivery in many countries. This study was performed to assess whether this is also the case in the Netherlands, a country with a high level of social security, relatively small income differences and eas

  8. COMPARISON OF GESTATIONAL AGE AT DELIVERY BASED ON LAST MENSTRUAL PERIOD AND EARLY ULTRASOUND

    Science.gov (United States)

    Reported date of last menstrual period (LMP) is commonly used to estimate gestational age but may be unreliable if recall is inaccurate or time between menstruation and ovulation differs from the presumed 15-day interval. Early ultrasound is generally a more accurate method than ...

  9. Effect of parents occupational exposures on risk of stillbirth, preterm delivery, and small-for-gestational-age in infants

    Energy Technology Data Exchange (ETDEWEB)

    Savitz, D.A.; Whelan, E.A.; Kleckner, R.C. (Univ. of North Carolina, Chapel Hill (USA))

    1989-06-01

    Epidemiologic research on the effects of parental occupational exposures on fetal development has been limited. The National Natality and Fetal Mortality surveys obtained applicable data of probability samples of live births and fetal deaths which occurred in the US in 1980 among married women. Analyses were conducted for case groups of stillbirths (2,096 mothers, 3,170 fathers), preterm deliveries (<37 weeks completed gestation) (363 mothers, 552 fathers), and small-for gestational-age infants (218 mothers, 371 fathers) compared with controls. Occupational exposures were defined by industry of employment and by imputed exposures based on a job-exposure linkage system. For stillbirth, maternal work in the rubber, plastics, and synthetics industry and lead exposure and paternal employment in the textile industry had the largest odds ratios. Preterm birth was most strongly associated with maternal lead exposure, corroborating previous findings. Twofold increased risk of preterm delivery was found with paternal employment in the glass, clay, and stone; textile; and mining industries. Paternal exposures to x-rays and polyvinyl alcohol were associated with 1.5-fold increase in risk. The occupation of the mother was not associated with delivery of a small-for-gestational-age infant, in contrast to paternal employment in the art and textile industries. Several toxic agents were associated with risk elevation of 1.3 or greater for fathers, most notably benzene.

  10. Delivery in Twin Gestation

    Directory of Open Access Journals (Sweden)

    Mark T. Peters

    1995-01-01

    Full Text Available Objective: The objective of this study was to determine whether prophylactic treatment with oral broad-spectrum antimicrobial therapy improves pregnancy outcomes in twin gestations.

  11. The relationship between maternal insulin-like growth factors 1 and 2 (IGF-1, IGF-2) and IGFBP-3 to gestational age and preterm delivery.

    LENUS (Irish Health Repository)

    Cooley, Sharon M

    2010-05-01

    To investigate the relationship between levels of insulin-like growth factors 1 and 2 (IGF-1, IGF-2), and insulin-like growth factor binding protein 3 (IGFBP-3) in antenatal maternal serum and gestational age at delivery.

  12. Arylsulfatase-A in umbilical cord blood: gestational age and mode of delivery do not influence enzyme activity.

    Science.gov (United States)

    Georgeson, G D; Szöny, B J; Streitman, K; Sallay, E; Kovács, A; Kovács, L; László, A

    2002-03-01

    The possibility of using umbilical cord blood for transplantation in several enzyme deficiencies has received increasing attention because of the availability of cord blood, the reduced incidence of post-transplantation complications, such as graft-versus-host disease and the possible accomplishment of good corrective results following transplantation, even in cases of greater HLA disparity. The use of hematopoietic stem cells from unrelated donors is even more highly recommended for the treatment of inherited enzyme deficiencies, because it might reduce the risk of the transplanted cells originating from a carrier of the defect, which might have an inadequate corrective ability. Our study was designed to elucidate whether the gestational age and mode of delivery influences the arylsulfatase-A activity in the umbilical cord blood. Enzyme activities proved to be similar in the four populations studied (full-term normal spontaneous vaginal delivery, full-term caesarean section, preterm normal spontaneous vaginal delivery and preterm caesarean section). Therefore, umbilical cord blood samples seem to be suitable for transplantation in metachromatic leukodystrophy, regardless of gestational age and mode of delivery. Moreover, our results are the first published data on normal values for arylsulfatase-A activity in human umbilical cord blood.

  13. The relationship between maternal insulin-like growth factors 1 and 2 (IGF-1, IGF-2) and IGFBP-3 to gestational age and preterm delivery.

    LENUS (Irish Health Repository)

    Cooley, Sharon M

    2012-02-01

    AIMS: To investigate the relationship between levels of insulin-like growth factors 1 and 2 (IGF-1, IGF-2), and insulin-like growth factor binding protein 3 (IGFBP-3) in antenatal maternal serum and gestational age at delivery. METHODS: Prospective cohort study of 1650 low-risk Caucasian women in a London University teaching hospital. Maternal IGF-1, IGF-2 and IGFBP-3 were measured in maternal blood at booking and analyzed with respect to gestational age at delivery. RESULTS: There was no significant association between maternal IGF-1 or IGF-2 and preterm birth (PTB). A significant reduction in mean IGFBP-3 levels was noted with delivery <32 completed weeks (P=0.02). CONCLUSION: Maternal mean IGFBP-3 levels are significantly reduced in cases complicated by delivery <32 completed weeks.

  14. A prospective observational study of early fetal growth velocity and its association with birth weight, gestational age at delivery, preeclampsia, and perinatal mortality

    Energy Technology Data Exchange (ETDEWEB)

    Vasudeva, Akhila, E-mail: akhilavasudeva@gmail.com [Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal 576104, Karnataka State (India); Abraham, Anu Annie, E-mail: anuannieabraham@yahoo.com [Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal 576104, Karnataka State (India); Kamath, Asha, E-mail: aashakamat@gmail.com [Department of Community Medicine, Kasturba Medical College, Manipal, A Constituent College of Manipal University (India)

    2013-08-15

    Objectives: We aimed to measure early fetal growth velocity and to correlate this with the birth weight, gestational age at delivery, and with the incidence of adverse pregnancy outcomes specifically preeclampsia and perinatal mortality. Methods: A data based prospective observational study, wherein sonographic biometry data and specific pregnancy outcome related data were collected from pregnant women's records, starting soon after their first antenatal visit. Early fetal growth velocity was measured using BPD growth between 11 and 14 weeks scan and anomaly scan and standardizing this by Z scoring. Results: Out of 607 fetuses, 41 (6.7%) were slow growing, 531 (87.4%) normally growing, and 35 (5.7%) fast growing (Z scoring <10th{sup ,} 10–90th, and >90th percentiles respectively). As fetal growth velocity increased, the mean birth weight decreased from 2958.7 ± 388.9 (<10th centile), 2742.1 ± 576.6 (10–90th centile), to 2339.3 ± 729.4 (>90th centile); and gestational age at delivery decreased from 38.5 ± 1.3 (<10th centile), 37.5 ± 2.1 (10–90th centile), to 36.4 ± 2.2 (>90th centile), and both these trends were statistically significant (p < 0.001).Faster growing fetuses had a higher risk of preterm delivery(spontaneous + indicated) compared to other 2 groups [OR 4.42 (2.18,8.98)], and slower growing fetuses had a higher risk of postdated deliveries compared to other 2 groups [OR 3.042 (1.44, 6.45)].We found no significant association between early fetal growth velocity and incidence of small for gestational age at birth/low birth weight at term, preeclampsia, and perinatal mortality. Conclusions: Early fetal growth velocity between first and second trimesters, may be one of the important factors influencing ultimate birthweight and gestational age at delivery.

  15. A late-preterm, early-term stratified analysis of neonatal outcomes by gestational age in placenta previa: defining the optimal timing for delivery.

    Science.gov (United States)

    Balayla, Jacques; Wo, Bi Lan; Bédard, Marie-Josée

    2015-01-01

    Though no official guidelines address the issue of the optimal timing of delivery in placenta previa, common practice is to conduct delivery between 36 and 37 weeks gestation. Given the rising concerns regarding unnecessary premature deliveries, the objective of this study was to compare neonatal outcomes among pregnancies complicated by placenta previa delivered at the late-preterm period (35, 36 weeks) relative to the early-term period (37 and 38 weeks). We conducted a retrospective, population-based, cohort study using the CDC’s Linked Birth-Infant Death data files from the U.S. for the year 2004. We stratified the cohort according to gestational age and placenta previa status. Using 38 weeks gestation as reference controls, the effect of delivery in a pregnancy with placenta previa at 35, 36 and 37 weeks gestation on the risk of several neonatal outcomes was estimated using logistic regression analysis, adjusting for relevant confounders. We analyzed a total of 4 118 956 births, of which 5675 (0.1%) met inclusion criteria. Late-preterm delivery was associated with lower birthweight and increased adequacy of care. Relative to neonates born at 38 weeks, birth at 35, 36 and 37 weeks was associated with no greater odds of meconium passage, fetal distress, fetal anemia, neonatal seizures, increased ventilator needs, or infant death at 1 year. However, odds of 5-min APGAR scores placenta previa is associated with fewer complications and no greater risk than late-preterm delivery. This information may be helpful in the development of future guidelines, which are currently needed to guide the management of these pregnancies.

  16. Associations of blood pressure change in pregnancy with fetal growth and gestational age at delivery: findings from a prospective cohort.

    Science.gov (United States)

    Macdonald-Wallis, Corrie; Tilling, Kate; Fraser, Abigail; Nelson, Scott M; Lawlor, Debbie A

    2014-07-01

    Hypertensive disorders of pregnancy are associated with intrauterine growth restriction and preterm birth. However, the associations of patterns of blood pressure change during pregnancy with these outcomes have not been studied in detail. We studied repeat antenatal blood pressure measurements of 9697 women in the Avon Longitudinal Study of Parents and Children (median [interquartile range], 10 [9-11] measurements per woman). Bivariate linear spline models were used to relate blood pressure changes to perinatal outcomes. Higher systolic, but not diastolic, blood pressure at baseline (8 weeks of gestation) and a greater increase in systolic and diastolic blood pressure between 18 and 36 weeks of gestation were associated with lower offspring birth weight and being smaller for gestational age in confounder-adjusted models. For example, the mean difference (95% confidence interval) in birth weight per 1 mm Hg/wk greater increase in systolic blood pressure between 18 and 30 weeks was -71 g (-134 to -14) and between 30 and 36 weeks was -175 g (-208 to -145). A smaller decrease in systolic and diastolic blood pressure before 18 weeks and a greater increase between 18 and 36 weeks were associated with a shorter gestation (percentage difference in gestational duration per 1 mm Hg/wk greater increase in systolic blood pressure between 18 and 30 weeks was -0.60% [-1.01 to -0.18] and between 30 and 36 weeks was -1.01% [-1.36 to -0.74]). Associations remained strong when restricting to normotensive women. We conclude that greater increases in blood pressure, from the 18-week nadir, are related to reduced fetal growth and shorter gestation even in women whose blood pressure does not cross the threshold for hypertensive disorders of pregnancy. © 2014 American Heart Association, Inc.

  17. Appropriate for gestational age (AGA)

    Science.gov (United States)

    Fetal age; Gestation; Development - AGA; Growth - AGA; Neonatal care - AGA; Newborn care - AGA ... can range from 38 to 42 weeks. Gestational age can be determined before or after birth. Before birth, your health care provider will use ultrasound to measure the size ...

  18. Prevention of preterm delivery in twin gestations (PREDICT)

    DEFF Research Database (Denmark)

    Rode, Line; Klein, K; Nicolaides, K H;

    2011-01-01

    OBJECTIVE: Studies on high-risk singleton gestations have shown a preventive effect of progesterone treatment on preterm delivery. This study was conducted to investigate the preventive effect of vaginal micronized progesterone in a large population of twin gestations. METHODS: This was a double......-blind, placebo-controlled randomized trial performed in 17 centers in Denmark and Austria. Women with twin gestations were randomized to daily treatment with progesterone pessaries or apparently identical placebo pessaries, starting from 20-24 weeks until 34 weeks' gestation. Primary outcome was incidence...... of delivery before 34 weeks' gestation. Secondary outcomes were maternal and neonatal complications and long-term infant follow-up, by Ages and Stages Questionnaire (ASQ), 6 months and 18 months after the expected date of delivery. We also updated a published meta-analysis to include our data and those...

  19. Caesarean section and risk of autism across gestational age

    DEFF Research Database (Denmark)

    Yip, Benjamin Hon Kei; Leonard, Helen; Stock, Sarah

    2017-01-01

    BACKGROUND: The positive association between caesarean section (CS) and autism spectrum disorder (ASD) may be attributed to preterm delivery. However, due to lack of statistical power, no previous study thoroughly examined this association across gestational age. Moreover, most studies did...

  20. Persistence of placenta previa in twin gestations based on gestational age at sonographic detection.

    Science.gov (United States)

    Kohari, Katherine S; Roman, Ashley S; Fox, Nathan S; Feinberg, Jessica; Saltzman, Daniel H; Klauser, Chad K; Rebarber, Andrei

    2012-07-01

    The purpose of this study was to evaluate the gestational age at sonographic detection of placenta previa as a predictor of previa persistence until delivery in twin gestations. A retrospective cohort of twin pregnancies with placenta previa in a single ultrasound unit was analyzed from 2005 to 2010. Pregnancies were ascertained from a database. Diagnoses were confirmed by transvaginal imaging. Previa was categorized as complete if the placenta completely covered the internal os or marginal if the inferior placental edge reached within 2 cm. Gestational ages were grouped into intervals from 15 to 35 weeks. The study outcome was placenta previa at delivery. Only twin pregnancies at 25 weeks' gestation and later were analyzed using nonparametric statistics as appropriate, with P Placenta previa was detected in 120 twin pregnancies in the second trimester: 32 complete and 88 marginal. Of those with placenta previa at 15 to 19, 20 to 23, 24 to 27, 28 to 31, and 32 to 35 weeks, previa persisted until delivery in 8.3%, 19.2%, 50%, 75%, and 92.5%, respectively. Only at 15- to 19- and 20- to 23-week intervals was complete previa more likely to persist than marginal previa (P placenta previa persistence in twins is dependent on the gestational age at sonographic detection. Only at earlier gestations does the type of previa affect its persistence. As gestational age advances, the likelihood of resolution of placenta previa diminishes regardless of the type noted.

  1. Oxygen transport in newborns at different gestational ages.

    Science.gov (United States)

    Granzotto, J; Estol, P; Piriz, H; Nieto, F; Fescina, R; Schwarcz, R

    1991-01-01

    Oxygen (O2) transport was assessed through the affinity between O2 and hemoglobin (Hb) in 123 newborns of 28 to 40 week gestational ge, with a minimum of 9 newborns for each gestational age group (see table). In order to assess the O2-Hb affinity, we studied the correlation between the pO2 and the Hb saturation for each gestational age, obtaining estimates of the oxy-hemoglobin dissociation curves corresponding to each gestational age (see fig. 3). The pO2 levels corresponding to the 50% saturation (P50) for each gestational age were estimated from there. All newborns were from single vaginal deliveries with no fetal distress before birth and with an adequate weight for gestational age. The latter was calculated according to the date of the last menstrual period (78% of the cases), echography (10.6% of the cases) or neonatal physical exam (11.4% of the cases). A P50 vs. gestational age linear regression showed a high determination rate (r2 = 0.957, p less than 0.00001) (see fig. 2) which supports the hypothesis of the P50 linear growth; decrease in the Hb-O2 affinity with increasive gestational age (Hb-O2 affinity is different in newborns of different gestational ages). With these results one may conclude that the Hb-O2 uptake varies according to gestational age (P50 changes linearly as gestational age increases) and that a single measurement of pO2 in a newborns, blood does not accurately evaluate the amount of O2 that is transported to the tissues, because the transport capacity depends, among other factors, upon gestational age. The Hb saturation better represents the amount of O2 that can get to the cell level.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. Birth Weight, Gestational Age, and Infantile Colic

    DEFF Research Database (Denmark)

    Milidou, Ioanna; Søndregaard, Charlotte; Jensen, Morten Søndergaard;

    Background Infantile colic is a condition of unknown origin characterized by paroxysms of crying during the first months of life. A few studies have identified low birth weight (BW) as a risk factor among infants born at term, while the association between gestational age (GA) and infantile colic......, low BW was associated with infantile colic only in infants born at term (gestational weeks 37-41), but not in pre- or post-term infants. Conclusion The results indicate that low birth weight and preterm birth are independently associated with infantile colic. After adjusting for gestational age, low...... birth weight increased the risk of infantile colic in children born at term (gestational weeks 37-41)....

  3. Relationship between Delivery Gestational Age, Birth Weight and Fidgety Movement%分娩胎龄和出生体重与不安运动的相关性分析

    Institute of Scientific and Technical Information of China (English)

    孟令丹; 马良; 安新荣; 及春艳; 杜永青

    2013-01-01

    Objective To investigate the relationship between the delivery gestational age, birth weight and fidgety movement. Methods 81 infants in fidgety movement phase were divided into preterm group and full-term group according to their delivery gestational age, into<2500 g group and ≥2500 g group according to their birth weight. The number of different kinds of General Movements (GMs) was com-pared. The correlation between birth weight, delivery of gestational age and GMs was analysed. Results The number of fidgety movement was more in the full-term group than in the preterm group (P=0.001), while the number of absence of fidgety movement was significantly less (P=0.003). The number of fidgety movement was more in the≥2500 g group than in the<2500 g group (P=0.001), the number of ab-sence of fidget movement was significantly less (P=0.003). The GMs was correlated with birth weight and delivery gestational age. Conclu-sion Premature and low birth weight are the risk factors for abnormal fidgety movement.%  目的明确分娩胎龄、出生体重与不安运动阶段全身运动质量(GMs)的关系。方法81例不安运动阶段婴儿,根据分娩胎龄分为早产组、足月组;根据出生体重分为<2500 g组、≥2500 g组。比较各组患儿GMs评定结果。对不安运动阶段GMs结果与出生体重、分娩胎龄进行相关性分析。结果早产组、<2500 g组不安运动数分别显著少于足月组(P=0.001)、≥2500 g组(P=0.001),而不安运动缺乏分别明显多于足月组(P=0.003)、≥2500g组(P=0.003)。不安运动阶段GMs结果与出生体重、分娩胎龄正相关(P=0.000)。结论早产及低出生体重均是不安运动阶段异常GMs的高危因素。

  4. The Gestational Age Pattern of Human Mortality

    DEFF Research Database (Denmark)

    Schöley, Jonas

    I present a lifetable by gestational age from week 23 until week 100 after the last menstrual period of the mother. The lifetable shows the pre-natal, peri-natal and post-natal mortality levels for US fetus/infants conceived in the year 2009. The observed age pattern of the force of mortality...

  5. Outcome of very preterm small for gestational age infants: the first nine years of life.

    Science.gov (United States)

    Kok, J H; den Ouden, A L; Verloove-Vanhorick, S P; Brand, R

    1998-02-01

    To determine the influence of intrauterine growth retardation of preterm infants on mortality and cognitive development. A nationwide study cohort of very preterm and/or small for gestational age infants (parental questionnaire on school performance at nine years. Cognitive outcome is defined as handicap for mental and speech-language development, and need for special education. 134 small for gestational age infants (< 10th centile) and 410 appropriate for gestational age infants (between 25th and 75th centile) of all infants between 25 and 32 weeks of gestational age were identified; infants with congenital malformations and not of caucasian race were excluded. Neonatal mortality, in-hospital and five years mortality; Cognitive outcome at five years; School performance at nine years. The mortality risk for small for gestational age compared with appropriate for gestational age infants was significantly higher, after adjustment for gestational age, sex, multiple pregnancy and mode of delivery (OR 2.56, 95% CI 1.26-5.26). Small for gestational age infants showed more often gross motor and minor neurological dysfunction, but less cerebral palsy than appropriate for gestational age infants. Cognitive outcome at five years in small for gestational age infants was significantly worse than appropriate for gestational age infants stratified for mode of delivery OR 2.44 (95% CI 1.05-5.55). At nine years of age significantly more small for gestational age infants (16.4%) needed special education than appropriate for gestational age infants (11.9%). Intrauterine growth retardation increases the risk of mortality and of cognitive disorders.

  6. Validation of an Algorithm to Estimate Gestational Age in Electronic Health Plan Databases

    Science.gov (United States)

    Li, Qian; Andrade, Susan E.; Cooper, William O.; Davis, Robert L.; Dublin, Sascha; Hammad, Tarek A.; Pawloski, Pamala A.; Pinheiro, Simone P.; Raebel, Marsha A.; Scott, Pamela E.; Smith, David H.; Dashevsky, Inna; Haffenreffer, Katie; Johnson, Karin E.; Toh, Sengwee

    2013-01-01

    Purpose To validate an algorithm that uses delivery date and diagnosis codes to define gestational age at birth in electronic health plan databases. Methods Using data from 225,384 live born deliveries among women aged 15–45 years in 2001–2007 within 8 of the 11 health plans participating in the Medication Exposure in Pregnancy Risk Evaluation Program, we compared 1) the algorithm-derived gestational age versus the “gold-standard” gestational age obtained from the infant birth certificate files; and 2) the prenatal exposure status of two antidepressants (fluoxetine and sertraline) and two antibiotics (amoxicillin and azithromycin) as determined by the algorithm-derived versus the gold-standard gestational age. Results The mean algorithm-derived gestational age at birth was lower than the mean obtained from the birth certificate files among singleton deliveries (267.9 versus 273.5 days) but not among multiple-gestation deliveries (253.9 versus 252.6 days). The algorithm-derived prenatal exposure to the antidepressants had a sensitivity and a positive predictive value (PPV) of ≥95%, and a specificity and a negative predictive value (NPV) of almost 100%. Sensitivity and PPV were both ≥90%, and specificity and NPV were both >99% for the antibiotics. Conclusions A gestational age algorithm based upon electronic health plan data correctly classified medication exposure status in most live born deliveries, but misclassification may be higher for drugs typically used for short durations. PMID:23335117

  7. Gestational Age and Autism Spectrum Disorder

    DEFF Research Database (Denmark)

    Atladóttir, H Ó; Schendel, D.E.; Henriksen, T B

    2016-01-01

    Autism Spectrum Disorder (ASD) is a serious neurodevelopmental disorder. Several previous studies have identified pre-term birth as a risk factor for ASD but none has studied whether the association between gestational age and ASD has changed over time. This is a Danish population-based follow...

  8. Influential and prognostic factors of small for gestational age infants

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yong-li; LIU Jun-tao; GAO Jin-song; YANG Jian-qiu; BIAN Xu-ming

    2009-01-01

    Background Small for gestational age (SGA) infants are associated with a high rate of oligohydramnios, stillbirth and cesarean delivery. Among SGA patients there is a higher risk of neonatal complications, such as polycythemia, hyperbilirubinemia, and hypothermia. Additionally, the SGA infant is prone to suffer from major neurologic sequelae, as well as cardiovascular system disease, in later life. Proper monitoring and therapy during pregnancy are, therefore, of utmost importance. The present study aimed to investigate the influential and prognostic factors of SGA infants.Methods From January 2001 to June 2007, a total of 55 SGA neonatal infants were included in a study group. All were born at Peking Union Medical College Hospital, with regular formal antenatal examinations. In addition, a total of 122 cases of appropriate for gestational age (AGA) infants were bom at the same time and were registered into a control group. All cases were singleton pregnancies with detailed information of the maternal age, gravidity, parity, maternal height and weight, complications, uterine height and abdominal circumference, results from transabdominal ultrasonography between 32-38 gestational weeks, pregnancy duration, delivery manner, placenta, umbilical cord, and neonatal complications.Results Significant differences were observed in placenta weight and neonatal malformations between the study and control groups. Multivariate analysis revealed increased parity, maternal hyperthyroidism and hyperthyroidism history as risk factors. Fetal abdominal circumferences less than 30 and 32 cm at 32-38 gestational weeks respectively, as determined by ultrasonography, resulted in a Youden index of 0.62.Conclusions SGA infants were associated with a greater risk of smaller placentas and infant malformations. Increased parity, maternal hyperthyroidism, and a hyperthyroid history were risk factors for SGA infants. Fetal abdominal circumference less than 30 cm at 32 gestational weeks and less

  9. Trimester-Specific Gestational Weight Gain and Infant Size for Gestational Age

    Science.gov (United States)

    Sridhar, Sneha B.; Xu, Fei; Hedderson, Monique M.

    2016-01-01

    Gestational weight gain is known to influence fetal growth. However, it is unclear whether the associations between gestational weight gain and fetal growth vary by trimester. In a diverse cohort of 8,977 women who delivered a singleton between 2011 and 2013, we evaluated the associations between trimester-specific gestational weight gain and infant size for gestational age. Gestational weight gain was categorized per the 2009 Institute of Medicine (IOM) recommendations; meeting the recommendations was the referent. Large for gestational age and small for gestational age were defined as birthweight > 90th percentile or <10th percentile, respectively, based on a national reference standard birthweight distribution. Logistic regression models estimated the odds of having a large or small for gestational age versus an appropriate for gestational age infant. Only gestational weight gain exceeding the IOM recommendations in the 2nd and 3rd trimesters independently increased the odds of delivering a large for gestational age infant (Odds Ratio (95% Confidence Interval): 1st: 1.17 [0.94, 1.44], 2nd: 1.47 [1.13, 1.92], 3rd: 1.70 [1.30, 2.22]). Gestational weight gain below the IOM recommendations increased the likelihood of having a small for gestational age infant in the 2nd trimester only (1.76 [1.23, 2.52]). There was effect modification, and gestational weight gain below the IOM recommendations increased the likelihood of having a small for gestational age infant in the 2nd trimester and only among women with a pre-pregnancy body mass index from 18.5–24.9 kg/m2 (2.06 [1.35, 3.15]). These findings indicate that gestational weight gain during the 2nd and 3rd trimesters is more strongly associated with infant growth. Interventions to achieve appropriate gestational weight gain may optimize infant size at birth. PMID:27442137

  10. The gestational age pattern of human mortality

    DEFF Research Database (Denmark)

    Schöley, Jonas; Vaupel, James W.; Jacobsen, Rune

    of a "birth hump" peaking week 38. The absolute rate of decline slows down over age. The observed gestational age pattern of the force of mortality is consistent with three hypotheses concerning the causes for ontogenescense: 1) Adaptation: as the organism growths it becomes more resilient towards death, 2......) transitional timing: the transition of birth is a stressful event and momentarily increases the force of mortality, 3) mortality selection: The frailest die first, resulting in the mean force of mortality to decline with age. In order to quantify the relative importance of these three processes I fit a three...

  11. The Gestational Age Pattern of Human Mortality

    DEFF Research Database (Denmark)

    Schöley, Jonas; Vaupel, James W.; Jacobsen, Rune

    of a "birth hump" peaking week 38. The absolute rate of decline slows down over age. The observed gestational age pattern of the force of mortality is consistent with three hypotheses concerning the causes for ontogenescense: 1) Adaptation: as the organism growths it becomes more resilient towards death, 2......) transitional timing: the transition of birth is a stressful event and momentarily increases the force of mortality, 3) mortality selection: The frailest die first, resulting in the mean force of mortality to decline with age. In order to quantify the relative importance of these three processes I fit a three...

  12. Correlation between self-reported gestational age and ultrasound measurements

    DEFF Research Database (Denmark)

    Olesen, Annette Wind; Westergaard, Jes Grabow; Thomsen, Sten Grove;

    2004-01-01

    Hospital Discharge Register. METHODS: The ultrasound-estimated gestational length was based on the size of the biparietal diameter. The ultrasound-estimated gestational length was related to corrected and uncorrected last menstrual period estimates in the Danish National Cohort Study......, and to the gestational length recorded in the Danish National Discharge Register. Non-parametric statistics were used in the analysis. RESULTS: The gestational ages estimated by ultrasound were 2-3 days shorter than gestational ages estimated by the other methods. The gestational ages recorded by the Discharge Register...

  13. Obesity and gestational weight gain: cesarean delivery and labor complications

    OpenAIRE

    Seligman, Luiz Carlos; Duncan, Bruce Bartholow; Branchtein,Leandro; Gaio, Dea Suzana Miranda; Mengue, Sotero Serrate; Schmidt, Maria Inês

    2006-01-01

    OBJECTIVE: To assess the association between pre-gestational obesity and weight gain with cesarean delivery and labor complications. METHODS: A total of 4,486 women 20-28 weeks pregnant attending general prenatal care clinics of the national health system in Brazil from 1991 to 1995 were enrolled and followed up through birth. Body mass index categories based on prepregnancy weight and total weight gain were calculated. Associations between body mass index categories and labor complications w...

  14. Relationship between gestational age and endoglin levels in maternal and cord blood

    OpenAIRE

    Simmi Kharb; Tiwari, R; Nanda, S

    2016-01-01

    Background: Poor placentation at early gestational age is an important predisposing condition for the development of preeclampsia. The present study was designed to study the relationship of gestational age with endoglin levels in maternal and cord blood of normal and pre-eclamptic women. Methods: The present study was conducted in fifty pregnant women that were grouped as: group 1 (control, n=25) comprising of normotensive women immediately after delivery, group 2 (study group, n=25) comp...

  15. Gestational diabetes mellitus results in a higher prevalence of small for gestational age babies

    LENUS (Irish Health Repository)

    Avalos, G

    2011-09-01

    Background and aims: Gestational Diabetes Mellitus (GDM) is associated with increased foetal and maternal morbidity and mortality. Previous studies have shown that babies of diabetic mothers are more likely to be large for gestational age (LGA). This retrospective study aimed to assess whether the converse may also be true, that there may also a higher rate of small for gestational age (SGA) amongst babies of mothers with GDM.\\r\

  16. Which Factors Influence the Type of Delivery and Cesarean Section Rate in Women with Gestational Diabetes?

    Science.gov (United States)

    Inocêncio, Gonçalo; Braga, António; Lima, Tânia; Vieira, Bruna; Zulmira, Rosa; Carinhas, Maria; Gonçalves, Joaquim; Silva, Clara

    2015-01-01

    To discover the differences between women with gestational diabetes mellitus (GDM) who delivered vaginally and those who delivered by cesarean section, and to assess the cesarean rate in this group of women. We divided all pregnant women with GDM into 2 groups: those who had vaginal delivery and those who gave birth by cesarean section (retrospective study of 6 years). We evaluated 460 births at term (≥ 37 weeks' gestation), for a total of 240 vaginal births and 220 cesarean births. All occurred in our institution. Of all the variables that were compared between the 2 groups, we found statistically significant differences (p cesarean section. Also, the initiation of insulin treatment at an early gestational age is associated with a higher chance of a woman delivering by cesarean section. The cesarean section rate in women with GDM was 47.8%.

  17. Lean body mass in small for gestational age and appropriate for gestational age infants

    Energy Technology Data Exchange (ETDEWEB)

    Petersen, S.; Gotfredsen, A.; Knudsen, F.U.

    1988-11-01

    Dual photon absorptiometry using /sup 153/Gd in a whole-body scanner was used to measure lean body mass (LBM) in 51 newborn infants. LBM% decreased exponentially with increasing gestational age in both small for gestational age (SGA) and appropriate for gestational age (AGA) infants. In preterm SGA and AGA infants LBM was 104% and 103%, respectively, indicating that no fat was detectable. In term SGA infants LBM was 98%, which corresponded to 48 gm fat on average, and in term AGA infants LBM was 87%, which corresponded to 452 gm fat on average. The LBM%, ponderal index, and skinfold thickness were significantly different between AGA and SGA infants. Infants with clinical signs of intrauterine wastage had significantly higher LBM% than did infants without signs of weight loss. Our results on LBM% by dual photon absorptiometry agree with earlier dissection data; the clinically applicable methods of (1) height combined with weight (i.e., ponderal index), (2) skinfold thickness, and (3) scoring by clinical observations are useful for the estimation of lack of fat as an indicator of intrauterine growth retardation.

  18. Temperament of Small-for-Gestational-Age and Appropriate- for-Gestational-Age Infants across the First Year of Life.

    Science.gov (United States)

    Halpern, Leslie F.; Coll, Cynthia T. Garcia

    2000-01-01

    Temperament development was studied in 39 full-term small-for-gestational-age infants and 30 full-term appropriate-for-gestational-age infants. Temperament was measured at 4, 8, and 12 months of age using a behavioral assessment procedure and questionnaire ratings. Findings indicated that restricted fetal growth negatively affects infant…

  19. Postnatal Prediction of Gestational Age Using Newborn Fetal Hemoglobin Levels

    Directory of Open Access Journals (Sweden)

    Kumanan Wilson

    2017-02-01

    Discussion: The development of a point-of-care mechanism to allow widespread implementation of postnatal gestational age prediction tools that make use of hemoglobin or non-mass spectromietry-derived metabolites could serve areas where antenatal gestational age dating is not routinely available.

  20. Influence of gestational age and delivery mode on neonatal pulse oxygen saturation shortly after birth%胎龄及娩出方式对新生儿生后脉搏血氧饱和度的影响

    Institute of Scientific and Technical Information of China (English)

    张亚娟; 田秀英; 郑军; 马俊苓; 张银柱; 高琦; 郑珊

    2015-01-01

    Objective To explore the trend of preductal pulse oxygen saturation (SpO2) during 10 min after birth in newborns born at different gestational age and through different delivery mode.Methods From May 2014 to August 2014,319 neonates,born in Tianjin Central Hospital of Obstetrics and Gynecology and whose Apgar score at 1 min after birth ≥ 8,were included into the study.Term infants were grouped into vaginal delivery group (n=102) and caesarean group (n=117) according to the delivery mode.Infants born through caesarean section were divided into three groups,including 30-33+6 weeks (n=50),34-36+6 weeks (n=50) and 37-41+6 weeks (n=117) group according to the gestational age at birth.Immediately after the umbilical cord clamped,preductal SpO2 was recorded at each minute from one to ten minutes using the pulse oximetry.Oneway analysis of variance and two independent sample t test were applied for statistical analysis.Results At each time point within ten minutes after birth,the preductal SpO2 for preterm infants of 30-33+6 weeks gestation in the caesarean group were (54± 3)%,(59± 3)%,(65 ±4)%,(70±4)%,(75 ±4)%,(80±4)%,(84± 3)%,(89± 3)%,(91 ± 3)% and (93 ± 2)%,respectively,which were significant lower than those of the 34-36+6 weeks group [(57 ± 5)%,(66 ± 4)%,(72 ± 6)%,(78 ± 6)%,(83 ± 6)%,(87 ± 6)%,(90± 5)%,(92 ± 4)%,(94± 4)% and (95 ± 4)%,respectively] and of the term infants [(58 ± 3)%,(67 ± 4)%,(73 ± 5)%,(78 ± 6)%,(83 ± 6)%,(87 ± 6)%,(90± 5)%,(92± 5)%,(94± 3)% and (95± 3)%,respectively] (all P ≤ 0.05).While the corresponding preductal SpO2 for term infants in the vaginal delivery group were (61 ± 6)%,(69± 7)%,(75 ± 6)%,(81 ± 7)%,(86± 6)%,(90 ± 6)%,(93 ± 5)%,(94± 4)%,(95 ± 4)% and (96 ± 3)%,respectively,which were all higher than those of term infants in the caesarean group (all P ≤ 0.05).Conclusions The preductal SpO2 for preterm infants of 30

  1. High perinatal survival in monoamniotic twins managed by prophylactic sulindac, intensive ultrasound surveillance, and Cesarean delivery at 32 weeks' gestation

    National Research Council Canada - National Science Library

    Pasquini, L; Wimalasundera, R. C; Fichera, A; Barigye, O; Chappell, L; Fisk, N. M

    2006-01-01

    .... This is a retrospective review of monoamniotic pregnancies of >or=20 weeks' gestation managed with serial ultrasound surveillance, medical amnioreduction and elective Cesarean delivery at 32 weeks' gestation...

  2. Factors associated with the differential in actual gestational age and gestational age predicted from transrectal ultrasonography in pregnant dairy cows.

    Science.gov (United States)

    Fitzgerald, A M; Ryan, D P; Berry, D P

    2015-08-01

    The objective of the study was to determine (1) how gestational age predicted using transrectal ultrasonography related to actual gestational age derived as the number of days from the most recent artificial insemination date, (2) what factors, if any, were associated with the differential between the two measures, and (3) the association between this differential in gestational age and the likelihood of subsequent pregnancy loss, stillbirth, or calving dystocia. The data set contained 7340 ultrasound records from 6805 Holstein Friesian dairy cows in 175 herds. Ultrasonography assessment underestimated gestational age relative to days since last service by 0.51 days (standard error [SE]: 0.040), although the differential was less during embryonic development phase (i.e., ≤42 days of gestation; mean overestimation of 0.31 days) versus fetal development phase (i.e., >42 days of gestation; mean underestimation of 0.81 days). Predicted calving date calculated from ultrasonography was 1.41 days (SE: 0.040) later than the actual subsequent calving date and was, on average, 0.52 days later than predicted calving date, assuming a gestation length of 282 days. Parity of the dam (P gestation length. Gestation length was 1.27 days longer (SE: 0.01) for bull calves compared to heifer calves. Calves from beef sires had a longer gestation length than calves from dairy sires, and older parity cows had a longer gestation length than younger cows. The results highlight factors associated with differences in gestational age obtained from ultrasonography and insemination data and illustrate the value of ultrasonography for the prediction of calving date and pregnancy loss.

  3. Pregnancy-specific stress, preterm birth, and gestational age among high-risk young women.

    Science.gov (United States)

    Cole-Lewis, Heather J; Kershaw, Trace S; Earnshaw, Valerie A; Yonkers, Kimberly Ann; Lin, Haiqun; Ickovics, Jeannette R

    2014-09-01

    There is evidence that pregnancy-specific stress is associated with preterm birth. The purpose of this study is to examine the association between change in pregnancy-specific stress over the course of pregnancy and birth outcomes (i.e., preterm birth and gestational age) in an understudied but vulnerable group using a theoretically derived model. Multivariate linear and logistic regression techniques were used to examine the association between pregnancy-specific stress (measured in second and third trimester) and length of gestation (i.e., preterm birth and gestational age) among a sample of 920 Black and/or Latina adolescent and young women. Second trimester pregnancy-specific stress was not associated with preterm birth or gestational age. Third trimester pregnancy-specific stress was associated with preterm birth but not with gestational age. Change in pregnancy-specific stress between second and third trimester was significantly associated with increased likelihood of preterm delivery and shortened gestational age, even after controlling for important biological, behavioral, psychological, interpersonal, and sociocultural risk factors. Findings emphasize the importance of measuring pregnancy-specific stress across pregnancy, as the longitudinal change from second to third trimester was significantly associated with length of gestation measured both as a dichotomous variable (preterm birth) and a continuous variable (gestational age). Furthermore, this is the first study to observe the association of pregnancy-specific stress with length of gestation in this understudied population-unique in age, race, and ethnicity. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  4. Intraoperative blood loss and gestational age at pregnancy termination.

    Science.gov (United States)

    Marchiano; Thomas; Lapinski; Balwan; Patel

    1998-07-01

    Objective: To establish the relationship of measured intraoperative blood loss to gestational age at pregnancy termination, and to determine which factors, if any, affect the risk of bleeding.Methods: A single-operator series of 363 consecutive women undergoing pregnancy termination between 5 and 24 weeks gestational age, as dated by ultrasound, was prospectively evaluated. All pregnancies under 13 weeks gestation were terminated by mechanical dilation and suction curettage without preoperative cervical ripening. All pregnancies between 13 and 24 weeks gestation were terminated by preoperative osmotic cervical dilation with laminaria tents and subsequent uterine evacuation by a combination of suction curettage, sharp curettage, and Bierer forceps extraction. All patients over 12 weeks gestation received a postoperative oxytocin infusion. Whenever possible, amniotic fluid and blood were collected and measured separately. Patients were excluded from the data analysis for pregnancy demise, PPROM, Potter's syndrome, or inability to separate blood establish their relationship. After adjustment for gestational age, the results were analyzed to determine if blood loss was related to maternal age, smoking history, body habitus, or operative indication.Results: A curvilinear relationship between blood loss and gestational age was observed. Mean blood loss at 24 weeks exceeded 800 mL. After adjustment for gestational age, no factors significantly affected blood loss at dilation and aspiration of first trimester pregnancies. In those patients undergoing dilation and evacuation in the second trimester, both simple and stepwise regression analyses showed obesity (BMI >/=32.3) to be significantly associated with increased blood loss (P cesarean section, nor smoking history were significantly associated with increased blood loss at dilation and evacuation.Conclusions: With advancing gestational age, intraoperative blood loss increases in curvilinear fashion. Termination providers

  5. [Anencephaly at 20 weeks gestation. What is the optimal gestational age for early diagnosis?].

    Science.gov (United States)

    Porath, M; Henrich, W; Schmider, A; Dudenhausen, J W

    2002-01-01

    Anencephaly is a lethal defect resulting from a disturbed closure of the neural tube. Prenatal diagnosis during first-trimester-scan is essential but implies pitfalls. Three findings of anencephaly at 20 weeks gestation are reported. Fetuses with anencephaly are correctly identified at 12 to 13 weeks gestation. Anencephaly occurs in absence of the cranial vault. Ultrasound findings can be normal until onset of ossification has definitely failed. A first trimester scan at 12 to 13 weeks allows reliable diagnosis and active management of anencephaly. At this gestational age fetal anatomy can be screened in detail by transvaginal ultrasound and nuchal translucency can be measured.

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

    DEFF Research Database (Denmark)

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

    2006-01-01

    for socioeconomic status of the parents, family history of psychiatric disorders, conduct disorders, comorbidity, and maternal smoking during pregnancy. Results related to birth weight were unchanged after adjusting for differences in gestational age. CONCLUSIONS: Children born preterm, also close to term......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...

  7. Investment gestation lags: The difference between time-to-build and delivery lags

    OpenAIRE

    PEETERS, Marga

    1996-01-01

    The timing of investment and capital stock accumulation can differ as a result of time-to-build or delivery lags. In this study calibration methods are used to illustrate the difference in these sources of gestation lags.

  8. Prediction of gestational age of infants from the abdominal radiograph

    Energy Technology Data Exchange (ETDEWEB)

    Williamson, M.R.; Edwards, D.K.

    1980-07-01

    Measurements of lumbar spine elements on abdominal radiographs of 183 white infants were compared with the estimated gestational ages of these infants as determined by physical examination. Using the technique of multiple regression, an equation was derived to predict infant age from the measurements of the spine.

  9. Determination of gestational age by ultrasound.

    Science.gov (United States)

    Butt, Kimberly; Lim, Ken

    2014-02-01

    Objectif : Aider les cliniciens à attribuer un âge gestationnel en fonction des résultats de la biométrie échographique. Issues : Déterminer si la datation par échographie offre une évaluation plus précise de l’âge gestationnel que la datation en fonction des dernières règles avec ou sans recours à l’échographie. Offrir, aux praticiens et aux chercheurs du domaine des soins de maternité, des lignes directrices factuelles en matière d’attribution de l’âge gestationnel. Identifier les paramètres biométriques échographiques qui sont de fiabilité supérieure lorsque l’âge gestationnel est incertain. Déterminer la rentabilité de l’évaluation de l’âge gestationnel par échographie. Résultats : La littérature publiée a été récupérée par l’intermédiaire de recherches menées dans PubMed ou MEDLINE et The Cochrane Library en 2013 au moyen d’un vocabulaire contrôlé et de mots clés appropriés (p. ex. « gestational age », « ultrasound biometry » et « ultrasound dating »). Les résultats ont été restreints aux analyses systématiques, aux essais comparatifs randomisés / essais cliniques comparatifs et aux études observationnelles rédigés en anglais. Aucune restriction n’a été appliquée en matière de dates. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu’au 31 juillet 2013. La littérature grise (non publiée) a été identifiée par l’intermédiaire de recherches menées dans les sites Web d’organismes s’intéressant à l’évaluation des technologies dans le domaine de la santé et d’organismes connexes, dans des collections de directives cliniques, dans des registres d’essais cliniques et auprès de sociétés de spécialité médicale nationales et internationales. Valeurs : La qualité des résultats est évaluée au moyen des critères décrits dans le rapport du Groupe d’étude canadien sur les soins de santé pr

  10. Response to Pain by Different Gestational Age Neonates

    Institute of Scientific and Technical Information of China (English)

    夏传雄; 杨磊; 赵萍; 张小铭

    2002-01-01

    One hundred infants were divided into the following 3 gestational age (GA) groups: ( I )premature infants (n= 30) with the gestational age between 29 and 32 weeks; ( Ⅱ ) premature infants (n=30) with the gestational age between 33 and 36 weeks; ( Ⅲ ) full-term infants (n=40).The recorded responses of all infants to pain included the behavioral responses to painful stimuli (cry,facial activity and limbs movement) and the variety of heart rate. The results indicated that the infants of 3 groups had different degree response to various painful stimuli. Pain expression in full term infants was more significant than premature infants to same stimuli. 33-weeks GA infants were differential from 29-weeks GA infants. Full term infants showed more vertical mouth stretch and more taut tongue and more hand to mouth than premature infants, but more horizontal mouth stretch in premature infants.

  11. Planned early delivery versus expectant management for hypertensive disorders from 34 weeks gestation to term.

    Science.gov (United States)

    Cluver, Catherine; Novikova, Natalia; Koopmans, Corine M; West, Helen M

    2017-01-15

    differences between subgroups based on our subgroup analysis by gestational age, gestational week or condition. Planned early delivery was associated with lower risk of HELLP syndrome (RR 0.40, 95% CI 0.17 to 0.93, 1628 women; three studies) and severe renal impairment (RR 0.36, 95% CI 0.14 to 0.92, 100 women, one study).There was not enough information to draw any conclusions about the effects on composite infant mortality and severe morbidity. We observed a high level of heterogeneity between the two studies in this analysis (two studies, 1459 infants, I(2) = 87%, Tau(2) = 0.98), so we did not pool data in meta-analysis. There were no clear differences between subgroups based on our subgroup analysis by gestational age, gestational week or condition. Planned early delivery was associated with higher levels of respiratory distress syndrome (RR 2.24, 95% CI 1.20 to 4.18, three studies, 1511 infants), and NICU admission (RR 1.65, 95% CI 1.13 to 2.40, four studies, 1585 infants).There was no clear difference between groups for caesarean section (RR 0.91, 95% CI 0.78 to 1.07, 1728 women, four studies, evidence graded moderate), or in the duration of hospital stay for the mother after delivery of the baby (mean difference (MD) -0.16 days, 95% CI -0.46 to 0.15, two studies, 925 women, evidence graded moderate) or for the baby (MD -0.20 days, 95% CI -0.57 to 0.17, one study, 756 infants, evidence graded moderate).Two fairly large, well-designed trials with overall low risk of bias contributed the majority of the evidence. Other studies were at low or unclear risk of bias. No studies attempted to blind participants or clinicians to group allocation, potentially introducing bias as women and staff would have been aware of the intervention and this may have affected aspects of care and decision-making.The level of evidence was graded high (composite maternal mortality and morbidity), moderate (caesarean section, duration of hospital stay after delivery for mother, and duration of

  12. The current pattern of gestational age-related anthropometric ...

    African Journals Online (AJOL)

    Infants whose birth weights are too low or too high have been shown to have higher ... for gestational age, and to have an increased risk of complications such as peripartum ... factors or infectious or other insults in early fetal life.[11,12] A ...

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

    DEFF Research Database (Denmark)

    Linnet, K. M.; Wisborg, K; Agerbo, E

    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 ......, and children born at term with low birth weights (1500-2499 g) have an increased risk of clinically verified hyperkinetic disorder. These findings have important public health perspectives because the majority of preterm babies are born close to term.......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...

  14. Fetal Habituation Performance: Gestational Age and Sex Effects

    Science.gov (United States)

    McCorry, Noleen K.; Hepper, Peter G.

    2007-01-01

    Habituation is the decrement in response to repeated stimulation. Fetal habituation performance may reflect the functioning of the central nervous system (CNS) prenatally. However, basic characteristics of the prenatal habituation phenomena remain unclear, such as the relationship with gestational age (GA) and fetal sex. The current study…

  15. Fetal Habituation Performance: Gestational Age and Sex Effects

    Science.gov (United States)

    McCorry, Noleen K.; Hepper, Peter G.

    2007-01-01

    Habituation is the decrement in response to repeated stimulation. Fetal habituation performance may reflect the functioning of the central nervous system (CNS) prenatally. However, basic characteristics of the prenatal habituation phenomena remain unclear, such as the relationship with gestational age (GA) and fetal sex. The current study…

  16. Gestational weight gain, cesarean delivery, and cesarean delivery on maternal request: a cohort analysis of Chinese nulliparous women.

    Science.gov (United States)

    Zhou, Yubo B; Li, Hongtian T; Ye, Rongwei W; Li, Zhiwen W; Zhang, Yali L; Zhang, Le; Ren, Aiguo G; Liu, JianMeng M

    2017-02-01

    To examine the association between gestational weight gain (GWG) and cesarean delivery including cesarean delivery on maternal request (CDMR) among low-risk women. A total of 1,009,987 Chinese nulliparous women who delivered live term singletons during 1993-2010 were included. GWG, according to maternal pre-pregnancy body mass index-specified z-scores, was categorized into five groups: less than -1.2, -1.2 to less than -0.6, -0.6 to 0.6 (reference), more than 0.6 to 1.2, and more than 1.2. Multivariate log-binomial regression models were used to estimate the adjusted risk ratios and 95% confidence intervals (95% CIs). GWG was positively associated with overall cesarean and CDMR after adjusting for various confounders. Adjusted risk ratios for cesarean were 0.75 (95% CI, 0.73-0.77), 0.84 (95% CI, 0.82-0.85), 1.00, 1.16 (95% CI, 1.14-1.19), and 1.32 (95% CI, 1.29-1.35) in five ascending GWG categories, and 0.70 (95% CI, 0.67-0.73), 0.80 (95% CI, 0.78-0.82), 1.00, 1.20 (95% CI, 1.18-1.23), and 1.43 (95% CI, 1.40-1.45) for CDMR. The graded positive associations were consistent across levels of maternal pre-pregnancy body mass index, and in strata defined by southern and/or northern provinces, urban and/or rural residence, maternal age at delivery, year of delivery, and level of delivering hospital. Even among low-risk women, higher GWG was monotonically associated with an increased risk of cesarean delivery, indicating that limiting GWG could benefit to curb the rate of both medically necessary and unnecessary cesareans. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Comparison of Cord Blood Lipid Profile in Preterm Small for Gestational Age and Appropriate for Gestational Age Newborns

    Science.gov (United States)

    Katragadda, Tejasree; Shetty, Subodh; Baliga, Shantharam

    2017-01-01

    Introduction Coronary heart disease is one of the major causes of morbidity and mortality in current era. The roots of this epidemic have been traced to as early as foetal life by foetal origin hypothesis. There are a few studies which have compared the cord blood lipid profile of preterm and term babies and thereby leading a path to primordial prevention of chronic diseases. Aim To study cord blood lipid profile of preterm appropriate for gestational age and preterm small for gestational age neonates and compare atherogenic index of both groups. Materials and Methods This cross-sectional study was conducted in 109 preterm infants. Cord blood samples were collected from placental side of umbilical cord at birth and analyzed for lipid profile which includes serum cholesterol, triglycerides, Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL) and apolipoproteins which include ApoA1, Apo B. Results Preterm Small for Gestational Age (SGA) neonates had statistically significant higher values of triglycerides, Apo B and atherogenic index compared to preterm Appropriate for Gestational Age (AGA) neonates. Other measured lipid levels were not statistically significant, though the values were higher than reference ranges for term babies. Conclusion Prematurity as a factor associated with a more atherogenic lipid profile is re-affirmed and SGA as an additional risk factor has been proven giving scope for future research and primordial prevention.

  18. Maternal and perinatal characteristics of small-for-gestational-age newborns: Ten-year experience of a single center.

    Science.gov (United States)

    Şahin Uysal, Nihal; Gülümser, Çağrı; Bilgin Yanık, Filiz

    2017-06-01

    To analyze the maternal and perinatal characteristics of small-for-gestational-age (SGA) newborns compared with appropriate-for-gestational-age (AGA) newborns in singleton pregnancies managed at our hospital between January 2006 and December 2015. The study (n=456) and control (n=4925) groups included pregnancies resulting in SGA and AGA newborns, respectively. Additionally, two SGA subgroups were defined according to abnormal (n=34) and normal (n=57) Doppler findings. Maternal demographic features; intracytoplasmic sperm injection (ICSI) pregnancies; gestational age at delivery; birth weight; major congenital anomalies, karyotype abnormalities, and genetic syndromes; maternal and obstetric problems such as hypertensive disorders, diabetes, oligohydramnios, preterm birth; admission to the neonatal intensive care unit (NICU), and perinatal mortality were recorded, and the two groups were compared with respect to these parameters. Mean maternal age, parity, gestational age at delivery, and birthweight were significantly lower; the frequencies of ICSI pregnancies, hypertensive disorders, oligohydramnios, preterm delivery, major congenital anomalies, karyotype abnormalities and genetic syndromes, admission to the NICU and perinatal mortality were significantly higher in the study group (p0.05). The association of SGA with ICSI pregnancies, hypertensive disorders, oligohydramnios, preterm delivery, congenital/chromosomal anomalies, NICU admission and perinatal mortality may be important in perinatal care. Clinical suspicion of SGA necessitates appropriate monitorization and management. Although obstetric outcomes were not significantly different between the two SGA subgroups with abnormal and normal Doppler findings in this study, this finding must be evaluated with caution due to the small sizes.

  19. Maternal and neonatal outcomes by labor onset type and gestational age.

    Science.gov (United States)

    Bailit, Jennifer L; Gregory, Kimberly D; Reddy, Uma M; Gonzalez-Quintero, Victor H; Hibbard, Judith U; Ramirez, Mildred M; Branch, D Ware; Burkman, Ronald; Haberman, Shoshana; Hatjis, Christos G; Hoffman, Matthew K; Kominiarek, Michelle; Landy, Helain J; Learman, Lee A; Troendle, James; Van Veldhuisen, Paul; Wilkins, Isabelle; Sun, Liping; Zhang, Jun

    2010-03-01

    We sought to determine maternal and neonatal outcomes by labor onset type and gestational age. We used electronic medical records data from 10 US institutions in the Consortium on Safe Labor on 115,528 deliveries from 2002 through 2008. Deliveries were divided by labor onset type (spontaneous, elective induction, indicated induction, unlabored cesarean). Neonatal and maternal outcomes were calculated by labor onset type and gestational age. Neonatal intensive care unit admissions and sepsis improved with each week of gestational age until 39 weeks (P labor was associated with a lower risk of ventilator use (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.28-0.53), sepsis (OR, 0.36; 95% CI, 0.26-0.49), and neonatal intensive care unit admissions (OR, 0.52; 95% CI, 0.48-0.57) compared to spontaneous labor. The relative risk of hysterectomy at term was 3.21 (95% CI, 1.08-9.54) with elective induction, 1.16 (95% CI, 0.24-5.58) with indicated induction, and 6.57 (95% CI, 1.78-24.30) with cesarean without labor compared to spontaneous labor. Some neonatal outcomes improved until 39 weeks. Babies born with elective induction are associated with better neonatal outcomes compared to spontaneous labor. Elective induction may be associated with an increased hysterectomy risk. Copyright 2010 Mosby, Inc. All rights reserved.

  20. GESTATIONAL-AGE DEPENDENCY OF ESSENTIAL FATTY-ACIDS IN CORD PLASMA-CHOLESTEROL ESTERS AND TRIGLYCERIDES

    NARCIS (Netherlands)

    HOVING, EB; VANBEUSEKOM, CM; NIJEBOER, HJ; MUSKIET, FAJ

    Plasma cholesterol ester and triglyceride fatty acid compositions of 38 singleton deliveries (23-42 wk), three twins (32, 39, and 40 wk), and their mothers were investigated. No gestational age-dependent changes occurred in maternal fatty acid compositions. Long-chain polyunsaturated fatty acids in

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

    DEFF Research Database (Denmark)

    Linnet, K. M.; Wisborg, K; Agerbo, E

    2006-01-01

    for socioeconomic status of the parents, family history of psychiatric disorders, conduct disorders, comorbidity, and maternal smoking during pregnancy. Results related to birth weight were unchanged after adjusting for differences in gestational age. CONCLUSIONS: Children born preterm, also close to term......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 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...

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

    DEFF Research Database (Denmark)

    Linnet, K. M.; Wisborg, K; Agerbo, E;

    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 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...... for socioeconomic status of the parents, family history of psychiatric disorders, conduct disorders, comorbidity, and maternal smoking during pregnancy. Results related to birth weight were unchanged after adjusting for differences in gestational age. CONCLUSIONS: Children born preterm, also close to term...

  3. Postnatal Growth and Psychomotor Development in Small for Gestational Age Brazilian Infants.

    Science.gov (United States)

    Paine, Patricia Ann; Pasquali, Luiz

    1984-01-01

    The early psychomotor development (DQ) of 29 term small-for-gestational-age Brazilian infants was shown to be more dependent on postnatal growth than the DQ of 51 term appropriate-for-gestational-age infants. (Author/RH)

  4. Maternal thyroid dysfunction during gestation, preterm delivery, and birthweight. The Infancia y Medio Ambiente Cohort, Spain.

    Science.gov (United States)

    León, Gemma; Murcia, Mario; Rebagliato, Marisa; Álvarez-Pedrerol, Mar; Castilla, Ane M; Basterrechea, Mikel; Iñiguez, Carmen; Fernández-Somoano, Ana; Blarduni, Elizabeth; Foradada, Carles M; Tardón, Adonina; Vioque, Jesús

    2015-03-01

    Maternal clinical thyroid disorders can cause reproductive complications. However, the effects of mild thyroid dysfunctions are not yet well established. The aim was to evaluate the association of maternal thyroid function during the first half of pregnancy with birthweight and preterm delivery. We analysed data on 2170 pregnant women and their children from a prospective population-based cohort study in four Spanish areas. Mid-gestation maternal serum and urine samples were gathered to determine thyroid-stimulating hormone (TSH), free thyroxine (fT4 ), and urinary iodine concentration (UIC). Thyroid status was defined according to percentile distribution as: euthyroid (TSH and fT4 >5th and 95th percentile and fT4 normal or 95 th percentile and TSH normal), and hyperthyroidism (TSH 95th percentile). Response variables were birthweight, small and large for gestational age (SGA/LGA), and preterm delivery. An inverse association of fT4 and TSH with birthweight was found, the former remaining when restricted to euthyroid women. High fT4 levels were also associated with an increased risk of SGA [odds ratio, 95% confidence interval (CI) 1.28 (95% CI 1.08, 1.51)]. Mean birthweight was higher in the hypothyroxinaemic group (β = 109, P < 0.01). Iodine intake and UIC were not associated with birth outcomes. High maternal fT4 levels during the first half of pregnancy were related to lower birthweight and increased risk of SGA newborns, suggesting that maternal thyroid function may affect fetal growth, even within the normal range. © 2015 John Wiley & Sons Ltd.

  5. Should Bilateral Uterine Artery Notching be used in the Risk Assessment for Preeclampsia, Small-for-Gestational-Age, and Gestational Hypertension?

    Science.gov (United States)

    Espinoza, Jimmy; Kusanovic, Juan Pedro; Bahado-Singh, Ray; Gervasi, Maria Teresa; Romero, Roberto; Lee, Wesley; Vaisbuch, Edi; Mazaki-Tovi, Shali; Mittal, Pooja; Gotsch, Francesca; Erez, Offer; Gomez, Ricardo; Yeo, Lami; Hassan, Sonia S.

    2010-01-01

    Objective To determine the value of bilateral uterine artery notching in the second trimester in the risk assessment for preeclampsia, gestational hypertension, and small-for-gestational age (SGA) without preeclampsia. Methods This prospective cohort study included 4,190 singleton pregnancies that underwent ultrasound examination between 23-25 weeks of gestation. The 95th percentile of the mean pulsatility index (PI) and resistance index (RI) of both uterine arteries were calculated. Multivariable logistic regression analyses were performed to determine if bilateral uterine artery notching is an independent explanatory variable for the occurrence of preeclampsia, early-onset preeclampsia (≤34 weeks), late-onset preeclampsia (>34 weeks), gestational hypertension and delivery of an SGA without preeclampsia, while controlling for confounding factors. Results 1) The prevalence of preeclampsia, early-onset preeclampsia, late-onset preeclampsia, SGA and gestational hypertension were 3.4%, 0.5%, 2.9%, 10%, and 7.9%, respectively; 2) 7.2% of the study population had bilateral uterine artery notching; 3) bilateral uterine artery notching was an independent explanatory variable for the development of preeclampsia [odds ratio (OR) 2.1; 95% confidence interval (CI):1.28-3.36], early-onset preeclampsia (OR: 4.47; 95%CI: 1.50-13.35), and gestational hypertension (OR: 1.50; 95%CI: 1.02-2.26), but not for late-onset preeclampsia or SGA. Conclusions Bilateral uterine notching between 23-25 weeks of gestation is an independent risk factor for the development of early-onset preeclampsia and gestational hypertension. Thus, bilateral uterine artery notching should be considered in the assessment of risk for the development of these pregnancy complications. PMID:20587434

  6. Predictors of birth weight and gestational age among adolescents.

    Science.gov (United States)

    Harville, Emily W; Madkour, Aubrey Spriggs; Xie, Yiqiong

    2012-10-01

    Although pregnant adolescents are at high risk of poor birth outcomes, the majority of adolescents go on to have full-term, healthy babies. Data from the National Longitudinal Study of Adolescent Health, a longitudinal study of a nationally representative sample of adolescents in grades 7-12 in the United States who were surveyed from 1994-1995 through 2008, were used to examine the epidemiology of preterm birth and low birth weight within this population. Outcomes of pregnancies were reported by participants in the fourth wave of data collection (when participants were 24-32 years of age); data were compared between female participants who reported a first singleton livebirth at less than 20 years of age (n = 1,101) and those who were 20 years of age or older (n = 2,846). Multivariable modeling was used to model outcomes; predictors included demographic characteristics and maternal health and behavior. Among black adolescents, low parental educational levels and older age at pregnancy were associated with higher birth weight, whereas low parental educational levels and being on birth control when one got pregnant were associated with higher gestational age. In nonblack adolescents, lower body mass index was associated with lower birth weight, whereas being unmarried was associated with lower gestational age. Predictors of birth outcomes may differ by age group and social context.

  7. Is Cesarean Delivery Preferable in Twin Pregnancies at >=36 Weeks Gestation?

    Science.gov (United States)

    Dong, Yu; Luo, Zhong-Cheng; Yang, Zu-Jing; Chen, Lu; Guo, Yu-Na; Branch, Ware; Zhang, Jun; Huang, Hong

    2016-01-01

    Background The optimal mode of delivery in twin pregnancies remains controversial. A recent randomized trial did not find any benefit of planned cesarean vs. vaginal delivery at 32–38 weeks gestation, but the trial was not powered to detect a moderate effect. We aimed to evaluate the impact of cesarean delivery on perinatal mortality and severe neonatal morbidity in twin pregnancies at ≥32 weeks through a large database exploration approach with the power to detect moderate risk differences. Methods In a retrospective birth cohort study using the U.S. matched multiple births, 1995–2000 (the available largest multiple birth dataset), we compared perinatal outcomes in twins (n = 181,810 pregnancies) delivered at 32–41 weeks gestation without congenital anomalies. The primary outcome was a composite of perinatal death and severe neonatal morbidity. Cox regression was used to estimate the adjusted hazard ratio (aHR) controlling for the propensity to cesarean delivery, fetal characteristics (sex, birth weight, birth weight discordance, same-sex twin or not) and twin-cluster level dependence. Prospective risks were calculated using the fetuses-at-risk denominators. Results The overall rates of the primary outcome were slightly lower in intended cesarean (6.20%) vs. vaginal (6.45%) deliveries. The aHRs of the primary outcome were in favor of vaginal delivery at 32 (aHR = 1.06, p = 0.03) or 33 (aHR = 1.22, pcesarean delivery at 36 (aHR = 0.94, p = 0.004), 37, 38 and 39+ weeks (aHR: 0.72 to 0.78, all pcesarean vs. vaginal deliveries at 36+ weeks of gestation remained when the analyses were restricted to different-sex (dichorionic) twins (aHR = 0.84, 95% CI 0.80–0.88). Conclusion Cesarean delivery may be beneficial for perinatal outcomes overall in twin pregnancies at ≥36 weeks gestation. PMID:27227678

  8. Gestation length, mode of delivery, and neonatal line-thickness variation.

    Science.gov (United States)

    Zanolli, Clément; Bondioli, Luca; Manni, Franz; Rossi, Paola; Macchiarelli, Roberto

    2011-12-01

    The transition from an intra- to extra-uterine environment leaves its mark in deciduous teeth (and first permanent molars) as an accentuated enamel incremental ring called the neonatal line (NL). This prominent microfeature separates the enamel formed during intrauterine life from that formed after leaving the womb. However, while the physical structure of this scar is well known, the bases of its formation are still a matter of investigation. In particular, besides the influence of the birth-related abrupt environmental and dietary changes and the role played by physiological factors such as hypocalcaemia, a direct relationship between NL thickness variation and the physical was trauma implied by the birth dynamics, the Caesarean, and the operative modes are apparently associated with the thinnest and the thickest lines, respectively. By using the histological record from a deciduous dental sample (exfoliated crowns) of 100 modern healthy school-aged children (47 males and 53 females) of reported birth histories (normal delivery mode: 55 cases; Caesarean: 40; operative: 5), we investigated the relationships between birth dynamics and NL thickness variation. The Tukey Honest Significant Difference method was used to test the differences between the means of the grouping levels. The results of our histo-morphological investigation do not support the suggestion that Caesarean-born children display, on average, a thinner enamel scar compared to children associated to a normal delivery mode. Rather, our study points to the influence exerted by factors intimately related to gestational length variation on the degree of expression of the line.

  9. The risk of infant and fetal death by each additional week of expectant management in intrahepatic cholestasis of pregnancy by gestational age.

    Science.gov (United States)

    Puljic, Anela; Kim, Elissa; Page, Jessica; Esakoff, Tania; Shaffer, Brian; LaCoursiere, Daphne Y; Caughey, Aaron B

    2015-05-01

    The objective of the study was to characterize the risk of infant and fetal death by each additional week of expectant management vs immediate delivery in pregnancies complicated by cholestasis. This was a retrospective cohort study of 1,604,386 singleton, nonanomalous pregnancies of women between 34 and 40 weeks' gestation with and without intrahepatic cholestasis of pregnancy (ICP) in the state of California during the years of 2005-2008. International Classification of Diseases, 9th version, codes and linked hospital discharge and vital statistics data were utilized. For each week of gestation, the following outcomes were assessed: the risk of stillbirth, the risk of delivery (represented by the risk of infant death at a given week of gestation), and the composite risk of expectant management for 1 additional week. Composite risk combines the risk of stillbirth at this gestational age week plus the risk of infant death if delivered at the subsequent week of gestation. Among women with ICP, the mortality risk of delivery is lower than the risk of expectant management at 36 weeks' gestation (4.7 vs 19.2 per 10,000). The risk of expectant management remains higher than delivery and continues to rise by week of gestation beyond 36 weeks. The risk of expectant management in women with ICP reaches a nadir at 35 weeks (9.1 per 10,000; 95% confidence interval, 1.4-16.9) and rises at 36 weeks (19.2 per 10,000; 95% confidence interval, 7.6-30.8). Among women with ICP, delivery at 36 weeks' gestation would reduce the perinatal mortality risk as compared with expectant management. For later diagnoses, this would also be true at gestational ages beyond 36 weeks. Timing of delivery must take into account both the reduction in stillbirth risk balanced with the morbidities associated with preterm delivery. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. GESTATIONAL AGE AT BIRTH AND RISK OF TESTICULAR CANCER

    Science.gov (United States)

    Crump, Casey; Sundquist, Kristina; Winkleby, Marilyn A.; Sieh, Weiva; Sundquist, Jan

    2011-01-01

    Most testicular germ cell tumors originate from carcinoma in situ cells in fetal life, possibly related to sex hormone imbalances in early pregnancy. Previous studies of association between gestational age at birth and testicular cancer have yielded discrepant results and have not examined extreme preterm birth. Our objective was to determine whether low gestational age at birth is independently associated with testicular cancer in later life. We conducted a national cohort study of 354,860 men born in Sweden in 1973–1979, including 19,214 born preterm (gestational age testicular cancer incidence through 2008. A total of 767 testicular cancers (296 seminomas and 471 nonseminomatous germ cell tumors) were identified in 11.2 million person-years of follow-up. Extreme preterm birth was associated with an increased risk of testicular cancer (hazard ratio 3.95; 95% CI, 1.67–9.34) after adjusting for other perinatal factors, family history of testicular cancer, and cryptorchidism. Only five cases (three seminomas and two nonseminomas) occurred among men born extremely preterm, limiting the precision of risk estimates. No association was found between later preterm birth, post-term birth, or low or high fetal growth and testicular cancer. These findings suggest that extreme but not later preterm birth may be independently associated with testicular cancer in later life. They are based on a small number of cases and will need confirmation in other large cohorts. Elucidation of the key prenatal etiologic factors may potentially lead to preventive interventions in early life. PMID:22314417

  11. Preterm small-for-gestational age children: predictive role of gestational age for mental development at the age of 2 years.

    Science.gov (United States)

    Nögel, Stephanie Christine; Deiters, Ludger; Stemmler, Mark; Rascher, Wolfgang; Trollmann, Regina

    2015-04-01

    The aim of the study was to compare the cognitive development of very low birth weight (VLBW) preterm SGA children and preterm AGA children at the age of 2 years. The hypothesis was that SGA children are at an additional risk for deficits in cognitive function. Additionally, the impact of neonatal risk factors and the parents' profession on the early cognitive development was analysed. Cognitive function of 107 preterm infants with a gestational age of 24-35 weeks was assessed with the Mental Bayley Scales of Infant Development at the age of 2 years (mean±SEM). The results of SGA (n=38) and AGA (n=69) children were compared as well as neonatal risk factors and parental education. There was a linear regression between the Mental Bayley Scales result and gestational age for preterm infants with a gestational age of 24-32 weeks. SGA and AGA children did not differ significantly in their cognitive function at the age of 2 years. A strong association was found between the parents' profession and cognitive development. Among the neonatal risk factors, bronchopulmonary dysplasia was a strong predictor of mental development. Cognitive development of two-year-old preterm children with a gestational age of 24-32 weeks was mainly related to their gestational age. Being born preterm and small for gestational age was not additionally associated with cognitive deficits at the age of 2 years. The parents' profession had a significant impact on the cognitive development. The role of the parents' profession on the early development of preterm infants should be elucidated in further studies. Copyright © 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  12. Oral health of children born small for gestational age.

    LENUS (Irish Health Repository)

    O'Connell, A C

    2010-10-01

    We sought to evaluate the oral health status of children born small for gestational age (SGA). Children now aged 4-8 years who were born SGA (birth weight < -2 SDS) were examined using standardised criteria. The parents completed a structured oral health questionnaire. Twenty females and 25 males, mean age 72.1 months, and mean birth weight 2.1 kg, participated in the study. Poor appetite was a concern; 32 (71%) children snacked between meals and 14 (30%) used carbonated beverages more than 3 times daily. Erosion was present in 9 (20%) children. Dental decay occurred in 22 (47%) children with 92% being untreated. Eight children had more than 5 decayed teeth. It is essential that clinicians working with children born SGA include oral health within the general health surveillance and refer these children for a dental assessment within the first 2 years to support parents in establishing safe feeding patterns for their children.

  13. Leptin and its Receptors in Human Placenta of Small, Adequate, and Large for Gestational Age Newborns.

    Science.gov (United States)

    Lazo-de-la-Vega-Monroy, Maria-Luisa; González-Domínguez, Martha I; Zaina, Silvio; Sabanero, Myrna; Daza-Benítez, Leonel; Malacara, Juan Manuel; Barbosa-Sabanero, Gloria

    2017-05-01

    Alterations in birth weight impact postnatal outcome and adult metabolic health. Therefore, fetal growth regulation is crucial for preventing chronic metabolic diseases. Leptin has been suggested to play an important role in placental and fetal growth, albeit its specific mechanisms of action have not been elucidated. The aim of this study was to analyze leptin concentrations in placenta, cord blood, and maternal blood of SGA, AGA, and LGA (small, adequate and large for gestational age, respectively) newborns, as well as placental leptin receptor (LEPRa and LEPRb) protein expression. We performed a cross-sectional comparative study in 3 groups of healthy mothers and their term newborns at delivery (SGA, AGA, and LGA, n=20 per group). Placental, maternal blood, and cord blood leptin content were measured by ELISA. Placental LEPRa and LEPRb protein expression were determined by Western Blot. Maternal leptin concentrations correlated positively with maternal weight before and at the end of gestation, without differences between groups. Cord leptin is higher in LGA and lower in SGA, whereas placental leptin is higher in SGA. Placental leptin was inversely correlated with placental weight, independently from maternal weight and gestational age. Both LEPRa and LEPRb expression are lower in SGA, while LEPRa positively correlated with placental weight and birthweight. The current findings indicate that placental leptin and its receptors are differentially expressed in SGA, AGA, and LGA newborns. We suggest that placental leptin and LEPR protein expression may influence placental growth and thus, birth weight. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Thyroid function in small for gestational age newborns: a review.

    Science.gov (United States)

    Franco, Bagnoli; Laura, Farmeschi; Sara, Nappini; Salvatore, Grosso

    2013-01-01

    Several studies have shown that small for gestational age (SGA) babies have a different hormonal profile than those born with a birth weight appropriate for gestational age (AGA). Thyroid hormones play an important role in growth and neurocognitive development. Only few studies analyzed the concentrations of thyroid-stimulating hormone (TSH) and thyroxine (T4) during fetal and extrauterine life in SGA and AGA newborns, and the existing data on the possible alterations of these hormones in postnatal life are controversial. It remains to be established whether SGA newborns have different blood concentrations of thyroid hormones as compared with AGA infants and if so, whether these findings play a role in the development of obesity, short stature, hypertension, and diabetes--disorders, already known to be related with SGA birth. It has also not yet been established whether and when substitutive therapy with levothyroxine (LT4) should be initiated in preterm and full-term SGA newborns. Further trials are needed to determine the thyroid hormone profile in both preterm and full-term SGA newborns and also to evaluate the effectiveness and safety of LT4 treatment in these infants.

  15. Ultrasound Determination of Gestational Age Using Placental Thickness in Female Dogs: An Experimental Study

    Directory of Open Access Journals (Sweden)

    André Luiz Louzada Maldonado

    2012-01-01

    Full Text Available Objective. To verify if the placental thickness allows determining the gestational age, evaluating the correlation between the referred gestational age with the studied one, and the accuracy of the placental thickness measurement (biometry with fetal morphologic parameters in bitches. Methods. The placental thickness of 336 bitches of diverse breeds was evaluated. Bitches were divided in three groups by body weight: small, medium, and big large size. The gestations pregnancies were evaluated by ultrasound from the third week of gestation. An analysis was performed between the mean values of the gestational age obtained of placental thickness by adjustment of curves and the reported gestational age. Student's t-test was applied to compare the mean of reported and placental thickness gestational age. Significance was defined as P<0.05. Results. A positive and statistically significant correlation exists between the placental thickness and gestational age. The expression that presents the best correlation coefficient and explanation was thickness of placenta = 0.021x gestational age −0.314. Conclusion. It is possible to determine the gestational age in relation to the placental thickness measured by ultrasound in bitches with a satisfactory accuracy in relation to fetal morphologic parameters as gestational vesicle, ribs, or kidneys.

  16. Latin American Consensus: Children Born Small for Gestational Age

    Directory of Open Access Journals (Sweden)

    Blanco Armando

    2011-07-01

    Full Text Available Abstract Background Children born small for gestational age (SGA experience higher rates of morbidity and mortality than those born appropriate for gestational age. In Latin America, identification and optimal management of children born SGA is a critical issue. Leading experts in pediatric endocrinology throughout Latin America established working groups in order to discuss key challenges regarding the evaluation and management of children born SGA and ultimately develop a consensus statement. Discussion SGA is defined as a birth weight and/or birth length greater than 2 standard deviations (SD below the population reference mean for gestational age. SGA refers to body size and implies length-weight reference data in a geographical population whose ethnicity is known and specific to this group. Ideally, each country/region within Latin America should establish its own standards and make relevant updates. SGA children should be evaluated with standardized measures by trained personnel every 3 months during year 1 and every 6 months during year 2. Those without catch-up growth within the first 6 months of life need further evaluation, as do children whose weight is ≤ -2 SD at age 2 years. Growth hormone treatment can begin in SGA children > 2 years with short stature ( 14 years for girls and > 16 years for boys is reached. Blood glucose, thyroid function, HbA1c, and insulin-like growth factor-1 (IGF-1 should be monitored once a year. Monitoring insulin changes from baseline and surrogates of insulin sensitivity is essential. Reduced fetal growth followed by excessive postnatal catch-up in height, and particularly in weight, should be closely monitored. In both sexes, gonadal function should be monitored especially during puberty. Summary Children born SGA should be carefully followed by a multidisciplinary group that includes perinatologists, pediatricians, nutritionists, and pediatric endocrinologists since 10% to 15% will continue to have

  17. The Probability of Neonatal Respiratory Distress Syndrome as a Function of Gestational Age and Lecithin/Sphingomyelin Ratio

    Science.gov (United States)

    St. Clair, Caryn; Norwitz, Errol R.; Woensdregt, Karlijn; Cackovic, Michael; Shaw, Julia A.; Malkus, Herbert; Ehrenkranz, Richard A.; Illuzzi, Jessica L.

    2011-01-01

    We sought to define the risk of neonatal respiratory distress syndrome (RDS) as a function of both lecithin/sphingomyelin (L/S) ratio and gestational age. Amniotic fluid L/S ratio data were collected from consecutive women undergoing amniocentesis for fetal lung maturity at Yale-New Haven Hospital from January 1998 to December 2004. Women were included in the study if they delivered a live-born, singleton, nonanomalous infant within 72 hours of amniocentesis. The probability of RDS was modeled using multivariate logistic regression with L/S ratio and gestational age as predictors. A total of 210 mother-neonate pairs (8 RDS, 202 non-RDS) met criteria for analysis. Both gestational age and L/S ratio were independent predictors of RDS. A probability of RDS of 3% or less was noted at an L/S ratio cutoff of ≥3.4 at 34 weeks, ≥2.6 at 36 weeks, ≥1.6 at 38 weeks, and ≥1.2 at term. Under 34 weeks of gestation, the prevalence of RDS was so high that a probability of 3% or less was not observed by this model. These data describe a means of stratifying the probability of neonatal RDS using both gestational age and the L/S ratio and may aid in clinical decision making concerning the timing of delivery. PMID:18773379

  18. The Effect of Gestational and Lactational Age on the Human Milk Metabolome

    Directory of Open Access Journals (Sweden)

    Ulrik K. Sundekilde

    2016-05-01

    Full Text Available Human milk is the ideal nutrition source for healthy infants during the first six months of life and a detailed characterisation of the composition of milk from mothers that deliver prematurely (<37 weeks gestation, and of how human milk changes during lactation, would benefit our understanding of the nutritional requirements of premature infants. Individual milk samples from mothers delivering prematurely and at term were collected. The human milk metabolome, established by nuclear magnetic resonance (NMR spectroscopy, was influenced by gestational and lactation age. Metabolite profiling identified that levels of valine, leucine, betaine, and creatinine were increased in colostrum from term mothers compared with mature milk, while those of glutamate, caprylate, and caprate were increased in mature term milk compared with colostrum. Levels of oligosaccharides, citrate, and creatinine were increased in pre-term colostrum, while those of caprylate, caprate, valine, leucine, glutamate, and pantothenate increased with time postpartum. There were differences between pre-term and full-term milk in the levels of carnitine, caprylate, caprate, pantothenate, urea, lactose, oligosaccharides, citrate, phosphocholine, choline, and formate. These findings suggest that the metabolome of pre-term milk changes within 5–7 weeks postpartum to resemble that of term milk, independent of time of gestation at pre-mature delivery.

  19. Risk of hearing loss in small for gestational age neonates

    Directory of Open Access Journals (Sweden)

    Melani Rakhmi Mantu

    2011-02-01

    Full Text Available Background Small for gestational age (SGA neonates often have intrauterine growth restriction due to placental insufficiency and chronic hypoxia. These conditions may cause developmental impairment, psychosocial disabilities, or metabolic dysfunction in later life. Previous studies have shown greater incidence of speech and language disabilities, learning impairment, and neuromotor dysfunction in term SGA infants compared to term appropriate for gestational age (AGA infants. Objective To compare hearing loss in SGA and AGA neonates using otoocoustic emission (OAE tests and to study correlations between maternal risk factors and hearing loss in SGA neonates. Methods A cross-sectional study was performed in St. Borromeus Hospital, Limijati Hospital, and Melinda Hospital in Bandung from February to May 2010. Study subjects consisted of full-term neonates born in these three hospitals. A retrospective medical record review was performed for this study. Statistical analysis was done by multivariable logistic-regression. Results There was a total of 4279 subjects in our study, including 100 SGA neonates and 4179 AGA neonates. We observed a greater percentage of OAE 'refer' (indicating abnormal OAE results in the SGA group compared to the AGA group (P<0.001, Z=13.247. For suhjects with OAE 'refer' results, we also analyzed the correlation to the following maternal risk factors: smoking, hypertension, diabetes mellitus and asthma. We also found significant differences between  those with and without each of the four maternal risk factors studied (P< 0.001. By using multivariant analysis to compare SGA and AGA neonates, we found the odds ratio (OR to he 4.34 (95% CI 2.52 to 7.49, P=0.001, meaning the SGA group had a 4.34 times higher risk of hearing loss than the AGA group. Conclusion SGA neonates had a higher risk of hearing loss than AGA neonates. In addition, maternal smoking, hypertension, diabetes mellitus and asthma significantly correlated to

  20. Growth Patterns of Large for Gestational Age Children up to Age 4 Years

    NARCIS (Netherlands)

    Bocca-Tjeertes, Inger F. A.; Kerstjens, Jorien M.; Reijneveld, Sijmen A.; Veldman, Karin; Bos, Arend F.; de Winter, Andrea F.

    2014-01-01

    OBJECTIVE:To determine how growth of large for gestational age (LGA) preterm (PT) children was affected by their PT birth and their LGA status.METHODS:This is a community-based cohort study of 1302 PT and 489 full-term (FT) children, born 2002 and 2003.RESULTS:We found that growth in height, weight,

  1. Posttraumatic stress disorder, child abuse history, birth weight, and gestational age: A prospective cohort study

    Science.gov (United States)

    Seng, Julia S.; Low, Lisa Kane; Sperlich, Mickey; Ronis, David L.; Liberzon, Israel

    2011-01-01

    Objective To determine the extent to which prenatal posttraumatic stress disorder (PTSD) is associated with lower birth weight and shorter gestation, and to explore the effects of childhood maltreatment as the antecedent trauma exposure. Design Prospective three-cohort study Setting Ann Arbor and Detroit, Michigan, United States Sample 839 diverse nulliparas in PTSD-positive (n=255), trauma-exposed, resilient (n=307), and non-exposed to trauma (n=277) cohorts Methods Standardised telephone interview prior to 28 weeks to ascertain trauma history, PTSD, depression, substance use, mental health treatment history, and sociodemographics, with chart abstraction to obtain chronic condition history, antepartum complications, and prenatal care data, as well as outcomes. Main outcome measures Infant birth weight and gestational age per delivery record. Results Women with PTSD during pregnancy had a mean birth weight 283 grams less than trauma-exposed, resilient women and 221 grams less than non-exposed women (F(3, 835) = 5.4, p = .001). PTSD was also associated with shorter gestation in multivariate models that took childhood abuse history into account. Stratified models indicated that PTSD subsequent to child abuse trauma exposure was most strongly associated with adverse outcomes. PTSD was a stronger predictor than African American race of shorter gestation and a nearly equal predictor of birth weight. Prenatal care was not associated with better outcomes among women abused in childhood. Conclusions Abuse-related PTSD may be an additional or alternative explanation for adverse perinatal outcomes associated with low socioeconomic status and African American race in the United States. Biological and interventions research is warranted along with replication studies in other nations. PMID:21790957

  2. Enamel defect of deciduous teeth in small gestational age children

    Directory of Open Access Journals (Sweden)

    Willyanti S Syarif

    2010-06-01

    Full Text Available Background: Enamel defect could be caused by genetic and environmental factors in prenatal period. Meanwhile, prenatal malnutrition could also cause small gestational age (SGA. Small Gestational Age is the term used for a neonatal baby with birthweight below the -2SD normal value or 10th percentile on the intrauterine Lubchenco curve. This condition is due to intra-uterine growth restriction, and eventually ends up with several developmental defects of organs, including teeth. In fact, deciduous tooth development has a critical phase within this development period. Purpose: The aim of this study is not only to find out the incidence of enamel defect in SGA children, but also to know the percentage of SGA risk factor to develop enamel defect. Method: This was a epidemiology research with consecutive admission technique. It consisted of 153 SGA children aged 9–48 months. Next, the Ponderal index was used to assign SGA types, symmetrical or asymmetrical one-in this study 59 and 94 respectively. On the other hand, three hundred and ninety Appropriate for Gestational Age (AGA children aged 4–48 months were also included in the study as a control group. Enamel defect then was determined by intraoral examination, classified into hypoplasia and hypocalcifications. Chi-square test was finally used to determine the relative risk ratio between the SGA and the control AGA children. Result: The result of this research showed that incidence of enamel defect in SGA children was 86.92%, meanwhile, that in AGA children was 23.08%, 66.00% of which were commonly suffered from hypocalcification. With p<0.05 it is also known that SGA children has the risk of enamel defect with hypocalcification, about 79% higher than AGA children. Conclusion: It could be concluded that 79% of SGA children had the risk of deciduous tooth enamel defect with hypocalcification as the most.Latar belakang: Defek email dapat terjadi karena faktor genetik dan lingkungan sistemik yang

  3. Preterm or not--an evaluation of estimates of gestational age in a cohort of women from Rural Papua New Guinea.

    Directory of Open Access Journals (Sweden)

    Stephan Karl

    Full Text Available Knowledge of accurate gestational age is required for comprehensive pregnancy care and is an essential component of research evaluating causes of preterm birth. In industrialised countries gestational age is determined with the help of fetal biometry in early pregnancy. Lack of ultrasound and late presentation to antenatal clinic limits this practice in low-resource settings. Instead, clinical estimators of gestational age are used, but their accuracy remains a matter of debate.In a cohort of 688 singleton pregnancies from rural Papua New Guinea, delivery gestational age was calculated from Ballard score, last menstrual period, symphysis-pubis fundal height at first visit and quickening as well as mid- and late pregnancy fetal biometry. Published models using sequential fundal height measurements and corrected last menstrual period to estimate gestational age were also tested. Novel linear models that combined clinical measurements for gestational age estimation were developed. Predictions were compared with the reference early pregnancy ultrasound (<25 gestational weeks using correlation, regression and Bland-Altman analyses and ranked for their capability to predict preterm birth using the harmonic mean of recall and precision (F-measure.Average bias between reference ultrasound and clinical methods ranged from 0-11 days (95% confidence levels: 14-42 days. Preterm birth was best predicted by mid-pregnancy ultrasound (F-measure: 0.72, and neuromuscular Ballard score provided the least reliable preterm birth prediction (F-measure: 0.17. The best clinical methods to predict gestational age and preterm birth were last menstrual period and fundal height (F-measures 0.35. A linear model combining both measures improved prediction of preterm birth (F-measure: 0.58.Estimation of gestational age without ultrasound is prone to significant error. In the absence of ultrasound facilities, last menstrual period and fundal height are among the more reliable

  4. Influence of pre-pregnancy obesity on the development of macrosomia and large for gestational age in women with or without gestational diabetes mellitus in Chinese population.

    Science.gov (United States)

    Wang, L-F; Wang, H-J; Ao, D; Liu, Z; Wang, Y; Yang, H-X

    2015-12-01

    To determine the effects of gestational diabetes mellitus (GDM) and pre-pregnancy obesity on macrosomia and large for gestational age (LGA). We conducted a prospective cohort study of 587 GDM women and 478 non-GDM women from 2012 to 2013. We collected their data of the pre-pregnancy weight, sociodemographic data, medical histories, clinical treatment, and followed-up the outcomes of delivery including birth weight. Multiple logistic regression models were used to test associations between pre-pregnant obesity and macrosomia/LGA and between GDM and macrosomia/LGA. Of 1065 women we studied, obese women had 4.17 times and 2.27 times increased risk of developing macrosomia (95% CI: 2.52 to 6.91) and LGA (95% CI: 1.60 to 3.21), respectively, than non-obese women after adjustment for maternal age, gestational weeks and GDM. We did not find GDM is a risk factor for macrosomia or LGA after GDM treatment. Pre-pregnancy obesity accounts for a high prevalence of macrosomia. Interventions that focus on pre-pregnancy obesity have the potential to reach far more women at risk of macrosomia.

  5. Functional Outcomes at Age 7 Years of Moderate Preterm and Full Term Children Born Small for Gestational Age

    NARCIS (Netherlands)

    Tanis, Jozien C; van Braeckel, Koenraad N J A; Kerstjens, Jorien M; Bocca-Tjeertes, Inger F A; Reijneveld, Sijmen A; Bos, Arend F

    2015-01-01

    OBJECTIVE: To compare functional outcomes of 7-year-old (school-age) children born small for gestational age (SGA; ie, a birth weight z score ≤ -1 SD), with appropriate for gestational age (AGA) peers, born moderately preterm or full term. STUDY DESIGN: Data were collected as part of the Longitudina

  6. Risk of hearing loss in small for gestational age neonates

    Directory of Open Access Journals (Sweden)

    Melani Rakhmi Mantu

    2011-01-01

    Full Text Available Background Small for gestational age (SGA neonates often have intrauterine growth restriction due to placental insufficiency and chronic hypoxia. These conditions may cause developmental impairment, psychosocial disabilities, or metabolic dysfunction in later life. Previous studies have shown greater incidence of speech and language disabilities, learning impairment, and ncuromotor dysfunction in term SGA infants compared to term appropriate for gestational age (AGA infants. Objective To compare hearing loss in SGA and AGA neonates using otoacoustic emission (OAE tests and to study correlations between maternal risk factors and hearing loss in SGA neonates. Methods A cross-sectional study was performed in St. Borromeus Hospital, Limijati Hospital, and Melinda Hospital in Bandung from February to May 2010. Study subjects consisted of full-term neonates born in these three hospitals. A retrospective medical record review was performed for this Study. Statistical analysis was done by multivariable logistic-regression. Results There was a total of 4279 subjects in our study, including 100 SGA neonates and 4179 AGA neonates. We observed a greater percentage of OAE 'refer' (indicating abnormal OAE results in the SGA group compared to the AGA group (P<0.001, Z=1.3.247. For subjects with OAE ,refer' results, we also analyzed the correlation to the following maternal risk factors: smoking, hypertension, diabetes mellitus and asthma. We also found significant differences between those with and without each of the four maternal risk factors studied (P<0.001. By using multivariant analysis to compare SGA and AGA neonates, we found the odds ratio (OR to be 4.34 (95% CI 2.52 to'7.49, P = 0.001, meaning the SGA group had a 4.34 times higher risk of hearing loss than the AGA group. Conclusion SGA neonates had a higher risk of hearing loss than A(3A neonates. In addition, maternal smoking, hypertension, diabetes mellitus and asthma significantly correlated to

  7. Does the risk of cerebral palsy increase or decrease with increasing gestational age?

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    Murphy-Kaulbeck Lynn

    2003-12-01

    Full Text Available Abstract Background It is generally accepted that the risk of cerebral palsy decreases with increasing gestational age of live born infants. However, recent studies have shown that cerebral palsy often has prenatal antecedents including congenital malformations, vascular insults and maternal infection. Cerebral palsy is therefore better viewed as occurring among fetuses, rather than among infants. We explored the epidemiologic implications of this change in perspective. Methods We used recently published data from Shiga Prefecture, Japan and from North-East England to examine the pattern of gestational age-specific rates of cerebral palsy under these alternative perspectives. We first calculated gestational age-specific rates of cerebral palsy as per convention, by dividing the number of cases of cerebral palsy identified among live births within any gestational age category by the number of live births in that gestational age category. Under the alternative formulation, we calculated gestational age-specific rates of cerebral palsy by dividing the number of cases of cerebral palsy identified among live births within any gestational age category by the number of fetuses who were at risk of being born at that gestation and being afflicted with cerebral palsy. Results Under the conventional formulation, cerebral palsy rates decreased with increasing gestational age from 63.9 per 1,000 live births at Conclusions The fetuses-at-risk approach is the appropriate epidemiologic formulation for calculating the gestational age-specific rate of cerebral palsy from a causal perspective. It shows that the risk of cerebral palsy increases as gestational duration increases. This compelling view of cerebral palsy risk may help refocus research aimed at understanding and preventing cerebral palsy.

  8. Vanishing twins: a predictor of small-for-gestational age in IVF singletons

    DEFF Research Database (Denmark)

    Pinborg, Anja; Lidegaard, Ojvind; Freiesleben, Nina la Cour

    2007-01-01

    The purpose of this study was to assess the effect of a vanishing twin on the risk of being small-for-gestational age (SGA) in in vitro fertilization (IVF) singletons.......The purpose of this study was to assess the effect of a vanishing twin on the risk of being small-for-gestational age (SGA) in in vitro fertilization (IVF) singletons....

  9. Vanishing twins: a predictor of small-for-gestational age in IVF singletons

    DEFF Research Database (Denmark)

    Pinborg, Anja; Lidegaard, Ojvind; Freiesleben, Nina la Cour

    2007-01-01

    The purpose of this study was to assess the effect of a vanishing twin on the risk of being small-for-gestational age (SGA) in in vitro fertilization (IVF) singletons.......The purpose of this study was to assess the effect of a vanishing twin on the risk of being small-for-gestational age (SGA) in in vitro fertilization (IVF) singletons....

  10. Polychlorinated biphenyls in adipose tissue, liver, and brain from nine stillborns of varying gestational ages

    NARCIS (Netherlands)

    Huisman, M; Muskiet, FAJ; Van Der Paauw, CG; Essed, CE; Boersma, ER

    1998-01-01

    We analyzed polychlorinated biphenyls (PCBs) in s.c. adipose tissue, liver, and brain of nine fetuses who died in utero. Their median (range) gestational ages and birth weights were 34 (17-40) wk and 2050 (162-3225) g. Three fetuses were small for gestational age. The levels of PCB congener nos. 118

  11. Adipokines in umbilical cord blood from children born large for gestational age

    DEFF Research Database (Denmark)

    Lausten-Thomsen, Ulrik; Christiansen, Michael; Hedley, Paula Louise

    2016-01-01

    of adipokines and their mutual relationship at birth in children born to non-diabetic mothers. METHODS: Adiponectin, leptin and sOB-R were measured using ELISA-based commercial kits in umbilical cord blood from 60 neonates (30 born large for gestational age [LGA] and 30 born appropriate for gestational age [AGA...

  12. Variations in gestational length and preterm delivery by race, ethnicity and migration.

    Science.gov (United States)

    Sørbye, Ingvil K; Wanigaratne, Susitha; Urquia, Marcelo L

    2016-04-01

    Preterm delivery rates within industrialized countries have been reported to vary according to the parents' race, ethnicity and migrant status; however, such disparities are poorly understood. In this paper, the available evidence and potential clinical significance of racial/ethnic and migrant disparities in gestational length and preterm delivery are assessed alongside potential explanatory factors. Although measurement bias in gestational length has the potential to inflate disparities, there is a consistently higher risk of preterm birth among some racial/ethnic groups. These differences most likely reflect lasting socio-economic disadvantage and discrimination rather than genetic mechanisms. The effect of migrant status is less conclusive due to heterogeneity of populations and the healthy migrant effect; however, environmental influences in the receiving country are implicated in driving increases of overall preterm rates. When assessing preterm delivery rates across ethnic and migrant groups, the use of standardized, ultrasound-based pregnancy dating methods is crucial to minimize bias. Current evidence does not justify the provision of a different clinical care approach to minority or immigrant women solely based on their race, ethnicity or country of origin; however, these labels may serve as flags for further inquiry on individual risk factors and a detailed obstetric history.

  13. Cognitive ability in adolescents born small for gestational age

    DEFF Research Database (Denmark)

    Jensen, Rikke Beck; Juul, Anders; Larsen, Torben

    2015-01-01

    BACKGROUND: Small size at birth may be associated with impaired cognitive ability later in life. The aim of this study was to examine the effect of being born small for gestational age (SGA), with or without intrauterine growth restriction (IUGR) on cognitive ability in late adolescence. STUDY...... cognitive ability in late adolescence. Full-scale IQ was positively related to head circumference (HC) in adolescence (B: 1.30, 95% CI: 0.32-2.28, p=0.01). HC at birth and three months was positively associated with full-scale IQ. Catch-up growth in the group of SGA children was associated...... with a significantly increased height, larger HC, increased levels of insulin-like growth factor-I (IGF-I) and increased full-scale IQ compared to those born SGA without catch-up growth. CONCLUSION: SGA and IUGR may not be harmful for adult cognitive ability, at least not in individuals born at near-term. However...

  14. Multiplicity and early gestational age contribute to an increased risk of cerebral palsy from assisted conception

    DEFF Research Database (Denmark)

    Hvidtjørn, Dorte; Grove, Jakob; Schendel, Diana;

    2010-01-01

    : The risk of CP is increased after both IVF and OI. The increased risk of CP in children born after assisted conception, and in particular IVF, is strongly associated with the high proportion of multiplicity and preterm delivery in these pregnancies. A more widespread use of single embryo transfer warrants....... When we included the intermediate factors multiplicity and gestational age in multivariate models, the risk of CP in assisted conception disappeared. In general, children with CP born after assisted conception had similar CP subtypes and co-morbidities as children with CP born after NC. CONCLUSION......BACKGROUND: This paper assesses the risk of cerebral palsy (CP) in children born after assisted conception compared with children born after natural conception (NC). METHODS: This population based follow-up study included all 588,967 children born in Denmark from 1995 to 2003. Assisted conception...

  15. Subclassification of small for gestational age children with persistent short stature: growth patterns and response to GH treatment.

    Science.gov (United States)

    Ester, Wietske; Bannink, Ellen; van Dijk, Marije; Willemsen, Ruben; van der Kaay, Danielle; de Ridder, Maria; Hokken-Koelega, Anita

    2008-01-01

    We determined whether subclassification of short small for gestational age (SGA) children according to birth anthropometrics could delineate different patterns in gestation, delivery, postnatal growth, response to growth hormone (GH) treatment and parental height. 201 short SGA children were divided into three groups, SGA(L), SGA(L+W) and SGA(L+W+HC), according to birth length (L), weight (W) and head circumference (HC) < or =-2.00 standard deviation score (SDS). SGA(L+W+HC) children were born after the shortest gestational age and more often by caesarean section than SGA(L) children (36.3 vs. 38.1 weeks, 68.4 vs. 24.4%). SGA(L+W) children had an intermediate pattern and experienced most gestational hypertension (p = 0.01). At birth, SGA(L+W+HC) children were shorter than SGA(L) or SGA(L+W) (-4.12 vs. -2.67 and -3.72 SDS, p < or = 0.001). During the first 3 years of life, SGA(L+W+HC) children exhibited an increased growth in height (0.98 SDS) and HC (1.28 SDS) than SGA(L) (height, -0.06 SDS; HC, -0.30 SDS) and SGA(L+W) (height, 0.62 SDS; HC, -0.31 SDS). However, HC SDS remained smaller for SGA(L+W+HC) than the other groups at age 3. The groups did not differ in growth response during GH treatment. SGA(L) children tended to have shorter parents and target height than SGA(L+W+HC) children. Our study shows that subclassification of short SGA children might be a useful method for investigating SGA children as the subgroups revealed a different gestation, delivery and postnatal growth pattern. Response to GH treatment was not different between the groups. (c) 2007 S. Karger AG, Basel

  16. Trends in All-Cause Mortality across Gestational Age in Days for Children Born at Term.

    Directory of Open Access Journals (Sweden)

    Chun Sen Wu

    Full Text Available Term birth is a gestational age from 259 days to 293 days. However trends in mortality according to gestational ages in days have not yet been described in this time period.Based on nation-wide registries, we conducted a population-based cohort study among all children born at term in Denmark from 1997 to 2004 to estimate differences in mortality across gestational ages in days among singletons born at term. We studied early-neonatal mortality, neonatal mortality, infant mortality, and five-year mortality. Children were followed from birth up to the last day of the defined mortality period or December 31, 2009. A total of 360,375 singletons born between 259 and 293 days of gestation were included in the study. Mortality decreased with increasing gestational age in days and the highest mortality was observed among children born at 37 week of gestation. A similar pattern was observed when analyses were restricted to children born to by mothers without pregnancy complications.This study demonstrates heterogeneity in mortality rates even among singletons born at term. The highest mortality was observed among children born 37 weeks of gestation, which call for cautions when inducing labor in term pregnancies just reaching 37 weeks of gestation. The findings support that 37 weeks of gestation should be defined as early term.

  17. The Effect of Gestational and Lactational Age on the Human Milk Metabolome.

    Science.gov (United States)

    Sundekilde, Ulrik K; Downey, Eimear; O'Mahony, James A; O'Shea, Carol-Anne; Ryan, C Anthony; Kelly, Alan L; Bertram, Hanne C

    2016-05-19

    Human milk is the ideal nutrition source for healthy infants during the first six months of life and a detailed characterisation of the composition of milk from mothers that deliver prematurely (milk changes during lactation, would benefit our understanding of the nutritional requirements of premature infants. Individual milk samples from mothers delivering prematurely and at term were collected. The human milk metabolome, established by nuclear magnetic resonance (NMR) spectroscopy, was influenced by gestational and lactation age. Metabolite profiling identified that levels of valine, leucine, betaine, and creatinine were increased in colostrum from term mothers compared with mature milk, while those of glutamate, caprylate, and caprate were increased in mature term milk compared with colostrum. Levels of oligosaccharides, citrate, and creatinine were increased in pre-term colostrum, while those of caprylate, caprate, valine, leucine, glutamate, and pantothenate increased with time postpartum. There were differences between pre-term and full-term milk in the levels of carnitine, caprylate, caprate, pantothenate, urea, lactose, oligosaccharides, citrate, phosphocholine, choline, and formate. These findings suggest that the metabolome of pre-term milk changes within 5-7 weeks postpartum to resemble that of term milk, independent of time of gestation at pre-mature delivery.

  18. The occurrence of preterm delivery is linked to pregnancy-specific distress and elevated inflammatory markers across gestation.

    Science.gov (United States)

    Coussons-Read, Mary E; Lobel, Marci; Carey, J Chris; Kreither, Marianne O; D'Anna, Kimberly; Argys, Laura; Ross, Randall G; Brandt, Chandra; Cole, Stephanie

    2012-05-01

    There is mounting evidence that stress during pregnancy can have detrimental effects on gestation and birth. Existing studies indicate that prenatal stress may increase levels of circulating inflammatory markers that are associated with prematurity and pregnancy complications, suggesting that stress-related changes in the cytokine milieu may increase the risk of poor pregnancy outcome. Previous studies, however, have not clearly connected stress during pregnancy to changes in inflammatory mediators and, in turn, to clinically-relevant outcomes such as premature delivery. The present study sought to directly connect prenatal stress and changes in inflammatory markers to preterm delivery and gestational age at birth (GAB). A sample of 173 women was recruited during the first trimester of pregnancy and followed through delivery. Overall stress, pregnancy-specific distress, and inflammatory markers were assessed early and later in pregnancy, and the predictive value of these measures for preterm birth and GAB was determined. There were significant differences in pregnancy-specific distress, IL-6, and TNF-α between women who delivered prematurely versus those who delivered at term, and elevated levels of pregnancy-specific distress, IL-6, and TNF-α were predictive of shortened GAB overall. Importantly, in many cases, the effects of overall stress and pregnancy-specific distress on GAB were mediated by levels of circulating inflammatory markers. Collectively, these data provide strong evidence that prenatal stress experiences can affect the timing of parturition via alterations in circulating inflammatory mediators, and underscore the need for ongoing research aimed at further understanding the mechanisms and effects of prenatal stress on maternal and infant health. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Age-related gestation length adjustment in a large iteroparous mammal at northern latitude.

    Science.gov (United States)

    Mysterud, Atle; Røed, Knut H; Holand, Øystein; Yoccoz, Nigel G; Nieminen, Mauri

    2009-09-01

    1. There is considerable interest in patterns of age-dependent reproductive effort and reproductive timing of large iteroparous mammals living in strongly seasonal environments. Due to lack of data on both timing of mating and birth, there is generally little insight into whether variation in gestation length play a role for life-history patterns observed for large mammals at northern latitudes. 2. Based on data on both timing of mating and birth of 88 female reindeer (and paternity confirmed with DNA fingerprinting), we explore the view that adjustment of gestation length plays a role in the reproductive tactic. 3. Observed gestation lengths of reindeer varied between 211 and 229 days (mean of 221 days). Consistent with a dynamic view of gestation length, variation could be predicted from life-history traits. Gestation length was longer for male than female offspring, which is expected in polygynous species where males benefit more from extra allocation of maternal resources. Gestation length increased with maternal age both due to direct effects and indirect effects linked to earlier mating of older, heavier females. Early mating females increased gestation length. A relatively small effect of female age on birth mass operated through variation in gestation length. 4. Our analysis supports the view that adjustment of gestation length is a part of the reproductive tactic of large mammals in northern environments.

  20. Determination of fetal thymic morphometric dimensions in relation to gestational age.

    Directory of Open Access Journals (Sweden)

    Carmen Niurka Piña Loyola

    2010-07-01

    Full Text Available Background: the appropriate relationship between gestational age and fetal weight are variables that reflect the intrauterine development and fetal welfare. There are studies that have attempted to establish morphological patterns of the thymus in relation to gestational age and who report dissimilar values. Objective: To determine the morphometric dimensions of the thymus in relation to gestational age. Methods: A descriptive, observational case series conducted in the period May 2003 to May 2008 in General Hospital Universitario "Dr. Gustavo Lima Aldereguía "of Cienfuegos. The sample consisted of 147 scams dead fetuses from 17 weeks gestational age until the end, who met the inclusion criteria. Body measurements were made such as: weight, height, width, thickness and volume. Results: We observed a progressive increase of all the morphometric dimensions of the thymus in relation to higher gestational age, marked in the late fetal stage where the values are doubled. The weight, height and volume were lower thymic 80% of the sample. For 90% of cases the thickness of the organ was below 5 mm and width, regardless of gestational age was less than 20 mm by 50%, and the remaining 50% of 20-50 mm. Conclusions: determined morphometric dimensions of the thymus and showed a gradual increase of these in relation to gestational age and fetal weight.

  1. Trends in All-Cause Mortality across Gestational Age in Days for Children Born at Term

    DEFF Research Database (Denmark)

    Wu, Chunsen; Sun, Yuelian; Nohr, Ellen Aagaard

    2015-01-01

    pattern was observed when analyses were restricted to children born to by mothers without pregnancy complications. CONCLUSIONS: This study demonstrates heterogeneity in mortality rates even among singletons born at term. The highest mortality was observed among children born 37 weeks of gestation, which...... of the defined mortality period or December 31, 2009. A total of 360,375 singletons born between 259 and 293 days of gestation were included in the study. Mortality decreased with increasing gestational age in days and the highest mortality was observed among children born at 37 week of gestation. A similar...... call for cautions when inducing labor in term pregnancies just reaching 37 weeks of gestation. The findings support that 37 weeks of gestation should be defined as early term....

  2. Gene expression in placentas from nondiabetic women giving birth to large for gestational age infants

    NARCIS (Netherlands)

    Ahlsson, F.; Åkerud, H.; Schijven, D.; Olivier, J.; Sundstrom-Poromaa, I.

    2015-01-01

    Gestational diabetes, obesity, and excessive weight gain are known independent risk factors for the birth of a large for gestational age (LGA) infant. However, only 1 of the 10 infants born LGA is born by mothers with diabetes or obesity. Thus, the aim of the present study was to compare placental g

  3. Accuracy of gestational age estimated by menstrual dating in women seeking abortion beyond nine weeks.

    Science.gov (United States)

    Norman, Wendy V; Bergunder, Jeannette; Eccles, Lisa

    2011-03-01

    We sought to quantify the accuracy of estimating gestational age by reported last menstrual period among women seeking surgical abortion. We observed that women seeking surgical abortion underestimated their gestational age when making the appointment, leading to poor allocation of resources. This tendency to underestimate has not previously been reported and differs from the accurate dating reported among women choosing either medical abortion or continuation of the pregnancy. We performed a retrospective review of randomly selected medical records for women with abortions scheduled at 9 to 20 weeks' gestation (n = 415) at two clinics in Vancouver between 2002 and 2008. The mean gestational age calculated by menstrual dates (14.3, SD 3.9) was 1.2 (95% CI 0.9 to 1.4) weeks less than that calculated by ultrasound (15.5, SD 3.4) (P abortions, illicit drug use, and contraceptive method at conception) were not significant predictors of inaccurate menstrual dating. Women seeking surgical abortion for pregnancies of 9 to 20 weeks underreport gestational age by an average of 1.2 weeks using menstrual dating. We found that women who intended to continue with their pregnancy overestimated their gestational age, those seeking very early abortion estimated most accurately, and those seeking surgical abortion at more than nine weeks had a clinically significant underestimation of their gestational age. Clinicians referring and counselling women who are considering surgical abortion must facilitate timely access to clinical or ultrasound dating of their pregnancy.

  4. Association Between Type of Screening for Gestational Diabetes Mellitus and Cesarean Delivery.

    Science.gov (United States)

    Palatnik, Anna; Swanson, Kate; Churchill, Tessa; Bilski, Ania; Grobman, William A; Miller, Emily S

    2017-09-01

    To compare maternal and neonatal outcomes using two different testing strategies for gestational diabetes mellitus (GDM) diagnosis: the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) and Carpenter-Coustan approaches. Specifically, we wanted to compare the rates of cesarean delivery between the two epochs. This was a retrospective cohort study of women with a singleton pregnancy delivering at 37 0/7 weeks of gestation or greater, between 2010 and 2015, in a single tertiary care center. The IADPSG testing was used for GDM diagnosis from December 2010 until July 2013 when institutional guidelines changed to Carpenter-Coustan testing. Maternal and neonatal outcomes were compared between these two different epochs using bivariable and multivariable analyses. The primary outcome was the frequency of cesarean delivery. The analysis included a total of 23,509 women: 14,074 (60%) from the IADPSG epoch and 9,435 (40%) from the Carpenter-Coustan epoch. The incidence of GDM diagnosis was higher using the IADPSG compared with Carpenter-Coustan criteria (8.3% compared with 7.5%, P=.042). The total (27.0% compared with 25.5% P=.022) as well as primary cesarean delivery rates (19.1% compared with 18.0%, P=.041) were higher during the IADPSG epoch. The rates of total (39.1% compared with 37.5%, P=.594) and primary (27.3% compared with 27.0%, P=.903) cesarean delivery among women with GDM did not differ between the two epochs. Secondary outcomes of shoulder dystocia (2.5% compared with 2.1%, P=.043) and neonatal intensive care unit admission (3.2% compared with 2.0%, P<.001) also were significantly higher in women screened during the IADPSG epoch, whereas hypertensive disease of pregnancy (6.9% compared with 7.7%, P=.018) was less frequent during the IADPSG epoch. These findings persisted after adjusting for potential confounding factors. Compared with testing using the Carpenter-Coustan criteria, the IADPSG criteria for diagnosis of GDM were

  5. Recent Declines in Induction of Labor by Gestational Age

    Science.gov (United States)

    ... Hispanic origin. Rates for non-Hispanic white women decreased 6%–11% for all three gestational weeks. ... Individual live birth in a singleton (one fetus) pregnancy. Singleton induction rate : Number of labor inductions for singleton births per ...

  6. ULTRASONOGRAPHIC CORRELATION OF PLACENTAL THICKNESS WITH FETAL GESTATIONAL AGE AND GRADING OF PLACENTAL MATURIT

    Directory of Open Access Journals (Sweden)

    Nagesh

    2016-03-01

    Full Text Available AIMS AND OBJECTIVES Comparative correlation of placental thickness with foetal gestational age, and evaluation of placental maturity by ultrasonography. MATERIALS AND METHODS The study includes 100 normal singleton gestations between 10 to 40 weeks of gestation referred to our centre for routine antenatal ultrasound examination. All the women were evaluated by transabdominal ultrasonography. Foetal gestational age in weeks was determined by crown rump length, biparietal diameter, head circumference, abdominal circumference and femoral length. Placental thickness was measured in millimeters. All the placentae were graded using ultrasonographic grading system. RESULTS Our observations revealed that the placental thickness gradually increased from 11.8 mm at 12 weeks to 38.5 mm at 39 weeks. Placental thickness almost corresponds to advancing gestational age exhibiting a linear and direct growth. Progressive maturity changes were noted in placenta with advancing gestational age. CONCLUSION Placental thickness measured at cord insertion site can be used as one of the parameter for estimating foetal gestational age. Placental thickness measurement can also be used to differentiate certain abnormal conditions related to thick and thin placenta. Ultrasonographic placental grading helps to rule out certain conditions associated with premature or delayed placental maturation

  7. Association of Lipid Profile in Pregnancy with Preeclampsia, Gestational Diabetes Mellitus, and Preterm Delivery.

    Science.gov (United States)

    Ghodke, Babita; Pusukuru, Raghuram; Mehta, Varshil

    2017-07-03

    Introduction During the last two trimesters of pregnancy, glucose is spared (for the foetus), while the concentration of fatty acids in plasma increases, which can create complications like preeclampsia, gestational diabetes mellitus (GDM), and preterm delivery. Aim To study the association of serum lipid levels during the second and third trimesters with the development of pregnancy-associated diseases, such as preeclampsia, GDM, and preterm delivery. Methods and Materials The present study was carried out at MGM Hospital, Navi Mumbai, India. Two hundred antenatal cases from October 2012 to October 2014 were enrolled after giving an informed consent. A lipid profile was recorded for each subject and was later accessed. The lipid profile of the subjects having either GDM, preterm, or preeclampsia was further used to find an association with the individual disorders. Statistical analyses were performed using Statistical Package for Social Sciences (SPSS) version 20 (IBM SPSS Statistics, Armonk, NY). All reported p-values are two-tailed, and confidence intervals were calculated at the 95% level. Results In preeclamptic patients, the mean systolic blood pressure was 151.40 mm/Hg and the mean diastolic blood pressure was 74.03 mm/Hg in the third trimester. In preeclamptic patients, the mean serum triglyceride levels in the second trimester were 204.00 mg/dl, while the mean was 243.20 mg/dl in the third trimester. In GDM patients, the mean serum triglyceride was 214.33 mg/dl in the second trimester, while it was 230.50 mg/dl in the third trimester. In patients with preterm, the mean triglycerides levels were 212.83 mg/dl and 240.16 mg/dl in the second and third trimesters, respectively. In preeclamptic patients, the mean serum cholesterol levels in the second trimester were 210 mg/dl, while in the third trimester, the mean was 243.60 mg/dl. In GDM patients, the mean serum cholesterol was 223.50 mg/dl and 242.83 mg/dl in the second and third trimester, respectively

  8. Weight gain in pregnancy, maternal age and gestational age in relation to fetal macrosomia.

    Science.gov (United States)

    Li, Yi; Liu, Qi-Fei; Zhang, Dan; Shen, Ying; Ye, Kui; Lai, Han-Lin; Wang, Hai-Qing; Hu, Chuan-Lai; Zhao, Qi-Hong; Li, Li

    2015-04-01

    To investigate the possible risk factors related to macrosomia. Pregnant women and their newborns (n = 1041) were recruited from a cohort study in Maternal and Child Care Center of Hefei from January 2011 to July 2012. Questionnaires were applied to collect the demographic data besides the medical records. Detailed health records of the entire pregnancy were obtained using retrospective study. Meanwhile the data of neonatal outcomes was prospectively tracked. Associations between exposure risk factors and macrosomia were analyzed using Pearson's chi squared test. Logistic regression models were used to assess the independent association between these potential predictors and macrosomia. The incidence of macrosomia of this cohort was 11.24% of which male: female = 2.55:1. Male incidence (8.07%) of macrosomia was higher than female (3.17%), p macrosomia; multiple logistic regression analysis indicated that macrosomia was mainly independently associated with weight gain in pregnancy (OR=1.14, 95% CI [1.10-1.19]), maternal age (OR = 1.09, 95% CI [1.03-1.15]) and gestational age (OR = 1.62, 95% CI [1.31-1.99]), respectively. Our findings indicate that weight gain in pregnancy, maternal age and gestational age should be considered as independent risk factors for macrosomia.

  9. Gestational age in relation to marine n-3 fatty acids in maternal erythrocytes

    DEFF Research Database (Denmark)

    Olsen, S.F.; Hansen, Harald S.; Sommer, S.;

    1991-01-01

    Gestation is longer in Faroese than Danish women, possibly because of the high intake of marine long-chain n-3 fatty acids that down regulates formation of prostaglandins from arachidonic acid. Polyunsaturated fatty acids were quantified in erythrocytes obtained within 2 days of delivery from...

  10. Gestational Age Patterns of Fetal and Neonatal Mortality Rates: The Euro Peristat Project

    NARCIS (Netherlands)

    Mohangoo, A.; Buitendijk, S.; Zeitling, J.

    2010-01-01

    Background: The recently published European Perinatal Health Report showed wide variability in perinatal mortality rates between European countries. We investigated the gestational age patterns of mortality in order to better understand differences between low versus high mortality countries.

  11. Relationship between oxygen saturation, gestational age, and level of oral feeding skills in preterm infants.

    Science.gov (United States)

    Yamamoto, Raquel Coube de Carvalho; Prade, Leila Sauer; Bolzan, Geovana de Paula; Weinmann, Angela Regina Maciel; Keske-Soares, Márcia

    2017-03-09

    To correlate the peripheral oxygen saturation with gestational age and the level of oral feeding skills in the introduction of oral feeding in preterm infants. This is a cross-sectional, quantitative study whose sample was composed of 169 clinically stable preterm infants. Peripheral oxygen saturation was assessed before and after introduction of oral feeding. The preterm infants were stratified into three groups based on their gestational age at birth: 26-29, 30-33, and 34-36 weeks. The preterm infants were classified into four levels according to their oral feeding skill and resistance. No differences in oxygen saturation were observed between the strata of gestational age and between the levels of oral feeding skill. Differences were observed in the groups of preterm infants aged 30-33 weeks (p=0.04) and 34-36 weeks (p=0.02) and on the level I of oral feeding skills (p=0.04) when oxygen saturation was compared at pre- and post-first oral feeding. Significant correlations (poral feeding skills (r=0.38); in Group A, between gestational age and oxygen saturation before the first oral feeding (r=0.83); in Group B, between the level of oral feeding skill and oxygen saturation before the first oral feeding (r=0.26) and between level of oral feeding skill and gestational age (r=0.26). Correlation was found for peripheral oxygen saturation when compared with gestational age and with the level of oral feeding skills.

  12. Does the gestation age of newborn babies influence the ultrasonic assessment of hip condition?

    Directory of Open Access Journals (Sweden)

    Simić Slavica

    2009-01-01

    Full Text Available Introduction. Ultrasound represents a method of examination of hips of newborn babies capable of defining hip condition and distinguishing stable and unstable hips based on morphological elements. It is accepted in a large number of countries as a method of examination of high risk newborns, or as a method of systematic screening. Objective. The objective of this study was to investigate correlation between ultrasonically estimated hip maturity and respective gestation maturity both in premature and term-born babies, and to investigate the influence of different delivery types on hips condition. Methods. In our study 2045 patients, 1141 males and 904 females, were examined in at the Institute of Neonatology over a period of 5 years. The average age was 34.04 gestation weeks. There were significantly more premature (1698 or 83.03% than term-born babies (347 or 16.97%. Ultrasound hip examination, as a screening method, was carried out according to Graf. It was followed by clinical examination. Results were analyzed by appropriate statistical methods (χ2-test, one-way ANOVA, multifactor ANOVA. Results. The overall frequency of unstable hips was 3.2%, 1.88% in males and 4.87% in females (p<0.05. 96.8% babies had stable hips, out of which 35.21% were mature and 61.59% immature. In the study of the breech presentation, out of 183 babies, unstable hips were found in 1.58% of male cases, and in 10.23% of female cases. Conclusion. Clinical screening of developmental dysplasia of the hip is insufficient for early diagnosis and decision about the treatment of premature babies. The high frequency of unstable hip type IIc (risky and IId (decentralized in premature babies requires early diagnosis and therapy. Wide swaddling for prematures should be applied up to eight months of age. Gentle manipulation is necessary while nursing and conducting physiotherapy of a premature baby.

  13. Maternal dietary patterns in pregnancy and the association with small-for-gestational-age infants.

    Science.gov (United States)

    Thompson, John M D; Wall, Clare; Becroft, David M O; Robinson, Elizabeth; Wild, Chris J; Mitchell, Edwin A

    2010-06-01

    Maternal nutritional status before and during pregnancy is important for the growth and development of the fetus. The effects of pre-pregnancy nutrition (estimated by maternal size) are well documented. There is little information in today's Western society on the effect of maternal nutrition during pregnancy on the fetus. The aim of the study was to describe dietary patterns of a cohort of mothers during pregnancy (using principal components analysis with a varimax rotation) and assess the effect of these dietary patterns on the risk of delivering a small-for-gestational-age (SGA) baby. The study was a case-control study investigating factors related to SGA. The population was 1714 subjects in Auckland, New Zealand, born between October 1995 and November 1997, about half of whom were born SGA ( < or = 10th percentile for sex and gestation). Maternal dietary information was collected using FFQ after delivery for the first and last months of pregnancy. Three dietary patterns (traditional, junk and fusion) were defined. Factors associated with these dietary patterns when examined in multivariable analyses included marital status, maternal weight, maternal age and ethnicity. In multivariable analysis, mothers who had higher 'traditional' diet scores in early pregnancy were less likely to deliver a SGA infant (OR = 0.86; 95 % CI 0.75, 0.99). Maternal diet, particularly in early pregnancy, is important for the development of the fetus. Socio-demographic factors tend to be significantly related to dietary patterns, suggesting that extra resources may be necessary for disadvantaged mothers to ensure good nutrition in pregnancy.

  14. Predictors of Size for Gestational Age in St. Louis City and County

    Directory of Open Access Journals (Sweden)

    Pamela K. Xaverius

    2014-01-01

    Full Text Available Objective. To identify social, behavioral, and physiological risk factors associated with small for gestational age (SGA by gestational age category in St. Louis City and County. Methods. A retrospective cohort study was conducted using birth certificate and fetal death records from 2000 to 2009 (n = 142,017. Adjusted associations of risk factors with SGA were explored using bivariate logistic regression. Four separate multivariable logistic regression analyses, stratified by gestational age, were conducted to estimate adjusted odds ratios. Results. Preeclampsia and inadequate weight gain contributed significantly to increased odds for SGA across all gestational age categories. The point estimates ranged from a 3.41 increased odds among women with preeclampsia and 1.76 for women with inadequate weight gain at 24–28 weeks’ gestational age to 2.19 and 2.11 for full-term infants, respectively. Among full-term infants, smoking (aOR = 2.08, chronic hypertension (aOR = 1.46, and inadequate prenatal care (aOR = 1.25 had the next most robust and significant impact on SGA. Conclusion. Preeclampsia and inadequate weight gain are significant risk factors for SGA, regardless of gestational age. Education on the importance of nutrition and adequate weight gain during pregnancy is vital. In this community, disparities in SGA and smoking rates are important considerations for interventions designed to improve birth outcomes.

  15. Birthweight percentiles for twin birth neonates by gestational age in China

    Science.gov (United States)

    Zhang, Bin; Cao, Zhongqiang; Zhang, Yiming; Yao, Cong; Xiong, Chao; Zhang, Yaqi; Wang, Youjie; Zhou, Aifen

    2016-01-01

    Localized birthweight references for gestational ages serve as an essential tool in accurate evaluation of atypical birth outcomes. Such references for twin births are currently not available in China. The aim of this study was to construct up-to-data sex specific birth weight references by gestational ages for twin births in China. We conducted a population-based analysis on the data of 22,507 eligible living twin infants with births dated between 8/01/2006 and 8/31/2015 from all 95 hospitals within the Wuhan area. Gestational ages in complete weeks were determined using a combination of last-menstrual-period based (LMP) estimation and ultrasound examination. Smoothed percentile curves were created by the Lambda Mu Sigma (LMS) method. Reference of the 3rd, 10th, 25th, 50th, 75th, 90th, 97th percentiles birth weight by sex and gestational age were made using 11,861 male and 10,646 female twin newborns with gestational age 26–42 weeks. Separate birthweight percentiles curves for male and female twins were constructed. In summary, our study firstly presents percentile curves of birthweight by gestational age for Chinese twin neonates. Further research is required for the validation and implementation of twin birthweight curves into clinical practice. PMID:27506479

  16. Placenta previa and the risk of delivering a small-for-gestational-age newborn.

    Science.gov (United States)

    Räisänen, Sari; Kancherla, Vijaya; Kramer, Michael R; Gissler, Mika; Heinonen, Seppo

    2014-08-01

    To evaluate whether there is an association between placenta previa and delivery of a small-for-gestational-age (SGA) newborn and to quantify the contribution of individual risk factors for SGA that are associated with placenta previa stratified by maternal parity. A cross-sectional study using the Finnish Medical Birth Register during 2000-2010. All singleton births (N=596,562) were included; major congenital anomalies were excluded. An association between SGA (less than 2 standard deviations below the mean) and placenta previa was modeled by parity-specific unadjusted and adjusted statistical models. Placenta previa complicated 625 of 249,476 singleton births among nulliparous women (2.50/1,000) and 915 of 347,086 singleton births among multiparous women (2.64/1,000). Among nulliparous women, the most common risk factor for placenta previa was in vitro fertilization; placenta previa was not associated with an increased prevalence of SGA controlling for maternal age, smoking, in vitro fertilization, socioeconomic status, and preeclampsia (adjusted odds ratio [OR] 0.81, 95% confidence interval [CI] 0.57-1.17). Among multiparous women, placenta previa was associated with a twofold increased risk of SGA controlling for maternal age, parity, prior preterm birth, prior caesarean delivery, prior SGA newborn, prior preeclampsia, smoking, in vitro fertilization, socioeconomic status, and preeclampsia (adjusted OR 2.08, 95% CI 1.50-2.89). Furthermore, only one-fourth of the association between SGA and placenta previa could be explained by controlling for risk factors clustering with placenta previa among multiparous women. Placenta previa is associated with impaired fetal growth in multiparous but not nulliparous women. II.

  17. Gestational age and neonatal brain microstructure in term born infants: a birth cohort study.

    Directory of Open Access Journals (Sweden)

    Birit F P Broekman

    Full Text Available Understanding healthy brain development in utero is crucial in order to detect abnormal developmental trajectories due to developmental disorders. However, in most studies neuroimaging was done after a significant postnatal period, and in those studies that performed neuroimaging on fetuses, the quality of data has been affected due to complications of scanning during pregnancy. To understand healthy brain development between 37-41 weeks of gestational age, our study assessed the in utero growth of the brain in healthy term born babies with DTI scanning soon after birth.A cohort of 93 infants recruited from maternity hospitals in Singapore underwent diffusion tensor imaging between 5 to 17 days after birth. We did a cross-sectional examination of white matter microstructure of the brain among healthy term infants as a function of gestational age via voxel-based analysis on fractional anisotropy.Greater gestational age at birth in term infants was associated with larger fractional anisotropy values in early developing brain regions, when corrected for age at scan. Specifically, it was associated with a cluster located at the corpus callosum (corrected p<0.001, as well as another cluster spanning areas of the anterior corona radiata, anterior limb of internal capsule, and external capsule (corrected p<0.001.Our findings show variation in brain maturation associated with gestational age amongst 'term' infants, with increased brain maturation when born with a relatively higher gestational age in comparison to those infants born with a relatively younger gestational age. Future studies should explore if these differences in brain maturation between 37 and 41 weeks of gestational age will persist over time due to development outside the womb.

  18. An epigenetic clock for gestational age at birth based on blood methylation data

    DEFF Research Database (Denmark)

    Knight, Anna K; Craig, Jeffrey M; Theda, Christiane

    2016-01-01

    BACKGROUND: Gestational age is often used as a proxy for developmental maturity by clinicians and researchers alike. DNA methylation has previously been shown to be associated with age and has been used to accurately estimate chronological age in children and adults. In the current study, we exam...

  19. The relationship of birth weight, gestational age, and postmenstrual age with ocular biometry parameters in premature infants

    Directory of Open Access Journals (Sweden)

    Ozdemir Ozdemir

    2015-06-01

    Full Text Available ABSTRACT Purpose: To analyze ocular biometry parameters and evaluate their relationship with gestational age, birth weight, and postmenstrual age in prematurely born infants. Methods: The right eyes of 361 premature infants born before the 36th gestational week were evaluated. Birth weight, gestational week, and gender were recorded. An A-scan Biometer was used for obtaining axial measurements, including anterior chamber depth, lens thickness, vitreous length, and total axial length. Results: Gestational age and birth weight values ranged from 23 to 36 weeks and from 560 to 2,670 g, respectively. The mean gestational age and birth weight were 30.8 ± 2.8 weeks and 1,497.9 ± 483.6 g, respectively. During the first examination (4-5 weeks of postnatal age, birth weight and gestational age of the infants correlated significantly and positively with lens thickness, vitreous length, and axial length (r>0.5, p<0.001, but not with anterior chamber depth (r<0.5. Increased vitreous and axial lengths correlated significantly with increasing postmenstrual age of the infants (r=0.669, p<0.001; r=0.845, p<0.001, respectively. Conclusions: Lens thickness, vitreous length, and axial length, but not anterior chamber depth, were significantly correlated with birth weight and gestational age. All four parameters increased with increasing postmenstrual age, with higher correlations for vitreous and axial lengths than for anterior chamber depth and lens thickness. It was concluded that axial elongation resulted primarily from increasing posterior chamber length.

  20. Refractive status at birth: its relation to newborn physical parameters at birth and gestational age.

    Directory of Open Access Journals (Sweden)

    Raji Mathew Varghese

    Full Text Available BACKGROUND: Refractive status at birth is related to gestational age. Preterm babies have myopia which decreases as gestational age increases and term babies are known to be hypermetropic. This study looked at the correlation of refractive status with birth weight in term and preterm babies, and with physical indicators of intra-uterine growth such as the head circumference and length of the baby at birth. METHODS: All babies delivered at St. Stephens Hospital and admitted in the nursery were eligible for the study. Refraction was performed within the first week of life. 0.8% tropicamide with 0.5% phenylephrine was used to achieve cycloplegia and paralysis of accommodation. 599 newborn babies participated in the study. Data pertaining to the right eye is utilized for all the analyses except that for anisometropia where the two eyes were compared. Growth parameters were measured soon after birth. Simple linear regression analysis was performed to see the association of refractive status, (mean spherical equivalent (MSE, astigmatism and anisometropia with each of the study variables, namely gestation, length, weight and head circumference. Subsequently, multiple linear regression was carried out to identify the independent predictors for each of the outcome parameters. RESULTS: Simple linear regression showed a significant relation between all 4 study variables and refractive error but in multiple regression only gestational age and weight were related to refractive error. The partial correlation of weight with MSE adjusted for gestation was 0.28 and that of gestation with MSE adjusted for weight was 0.10. Birth weight had a higher correlation to MSE than gestational age. CONCLUSION: This is the first study to look at refractive error against all these growth parameters, in preterm and term babies at birth. It would appear from this study that birth weight rather than gestation should be used as criteria for screening for refractive error

  1. Gender- and Gestational Age-Specific Body Fat Percentage at Birth.

    LENUS (Irish Health Repository)

    Hawkes, Colin P

    2011-08-08

    Background: There is increasing evidence that in utero growth has both immediate and far-reaching influence on health. Birth weight and length are used as surrogate measures of in utero growth. However, these measures poorly reflect neonatal adiposity. Air-displacement plethysmography has been validated for the measurement of body fat in the neonatal population. Objective: The goal of this study was to show the normal reference values of percentage body fat (%BF) in infants during the first 4 days of life. Methods: As part of a large population-based birth cohort study, fat mass, fat-free mass, and %BF were measured within the first 4 days of life using air-displacement plethsymography. Infants were grouped into gestational age and gender categories. Results: Of the 786 enrolled infants, fat mass, fat-free mass, and %BF were measured in 743 (94.5%) infants within the first 4 days of life. %BF increased significantly with gestational age. Mean (SD) %BF at 36 to 37 weeks\\' gestation was 8.9% (3.5%); at 38 to 39 weeks\\' gestation, 10.3% (4%); and at 40 to 41 weeks\\' gestation, 11.2% (4.3%) (P < .001). Female infants had significantly increased mean (SD) %BF at 38 to 39(11.1% [3.9%] vs 9.8% [3.9%]; P = .012) and at 40 to 41 (12.5% [4.4%] vs 10% [3.9%]; P < .001) weeks\\' gestation compared with male infants. Gender- and gestational age-specific centiles were calculated, and a normative table was generated for reference. Conclusion: %BF at birth is influenced by gestational age and gender. We generated accurate %BF centiles from a large population-based cohort.

  2. Birth weight-for-gestational age is associated with DNA methylation at birth and in childhood.

    Science.gov (United States)

    Agha, Golareh; Hajj, Hanine; Rifas-Shiman, Sheryl L; Just, Allan C; Hivert, Marie-France; Burris, Heather H; Lin, Xihong; Litonjua, Augusto A; Oken, Emily; DeMeo, Dawn L; Gillman, Matthew W; Baccarelli, Andrea A

    2016-01-01

    Both higher and lower fetal growth are associated with cardio-metabolic health later in life, suggesting that prenatal developmental programming determines long-term cardiovascular disease risk. Epigenetic mechanisms, which orchestrate fetal growth and development, may offer insight on the early programming of health and disease. We investigated whether birth weight-for-gestational is associated with DNA methylation at birth and mid-childhood, measured via the Infinium 450K array. Participants were from Project Viva, a pre-birth cohort of pregnant women and their children in Eastern Massachusetts. After exclusion of participants with maternal type 1 or 2 diabetes and gestational age birth weight-for-gestational age z-score was associated with cord blood DNA methylation at 34 CpGs (false discovery rate P birth weight, and several other CpGs map to genes relevant to fetal growth and development. Namely, higher birth weight-for-gestational age was associated with higher methylation at four CpGs at the PBX1 locus (e.g., β (95% CI) for lead signal at cg06750897 = 1.9 (1.2, 2.6)), which encodes a transcription factor that regulates embryonic development. Birth weight-for-gestational age was also associated with mid-childhood blood DNA methylation at four of the 34 CpGs identified in cord blood analyses, including sites at the PBX1 locus described. We identified CpG sites where birth weight-for-gestational age was associated with DNA methylation at birth, and for a subset of these sites, birth weight-for-gestational age was also associated with DNA methylation at mid-childhood.

  3. Differential effects of preterm birth and small gestational age on cognitive and motor development

    OpenAIRE

    Hutton, J; Pharoah, P; Cooke, R.; Stevenson, R

    1997-01-01

    AIMS—To determine the differential effects of preterm birth and being small for gestational age on the cognitive and motor ability of the child.
METHODS—A longitudinal cohort of all infants of gestational age ≤ 32 weeks born to mothers resident in the counties of Cheshire and Merseyside in 1980-1 was studied. The children were assessed at the age of 8 to 9 years using the Wechsler Intelligence Scale for Children, the Neale analysis of reading ability, and the Stott-Moyes-Henderson test of mot...

  4. Parental authority, patient's best interest and refusal of resuscitation at borderline gestational age.

    Science.gov (United States)

    Mercurio, M R

    2006-08-01

    Potential conflict exists when parents refuse a medical intervention for their child that the physician feels obligated to provide. For the anticipated delivery of a preterm newborn, this conflict might exist if the parents refuse resuscitation. At borderline viability, most neonatologists are likely to respect the parents' wishes. However, there will be some gestational age threshold above which the physician will feel compelled to resuscitate despite parental refusal, and will be ethically justified in doing so. The location of that threshold should be determined by the application of sound ethical reasoning, rather than relying on habit or arbitrary standards. That reasoning should include an honest assessment of the benefits and burdens to the child, short-term and long-term, of attempted resuscitation, made in light of relevant mortality and morbidity data. However, a rational analysis will also require consideration of whether the patient's best interest standard should be strictly applied, or whether the interests of others, such as family members, should also be taken into account.

  5. [Hospital Admissions due to cyanosis episodes in newborns with gestational age of 34 weeks or more].

    Science.gov (United States)

    Casanueva, C Paulina; Cifuentes, R Javier

    2015-01-01

    A retrospective study was performed between January 2007 and December 2012 to assess the admission rates of newborns due to episodes of cyanosis Retrospective study that included all the newborns hospitalized with episodes of cyanosis between January 2007 and December 2012. In them were employed two study protocols that considered first and second line tests, the latter in view of recurrence of events. The first line protocol considered general biochemical tests, chest x-ray and echocardiography in selected cases, while the second line protocol included electroencephalogram, electrocardiogram, nuclear magnetic resonance of the brain, expanded metabolic screening, pyruvic acid, lactic acid, and in case of seizures, cytochemical, and culture of cerebrospinal fluid (CSF) and PCR (polymerase chain reaction) for herpes. A total of 98 (2.8%) out of 3,454 newborns were admitted due to episodes of cyanosis. Gestational age: 37.8+1.4 weeks, birth weight: 3,145+477 g. Maternal age: 32+4.8 years. Disease was present in 19.4% of mothers; gestational diabetes (8.1%), pregnancy induced hypertension (5.1%), intrahepatic cholestasis (3.1%), and intrauterine growth retardation (3.1%). Gender: 48.8% male, 51.2% female (NS). Birth: caesarean section, 68.4%, and vaginal delivery, 31.6%. Age on admission 1.9+1.4 days. Hospital stay: 4.2+4.2 days. First line tests were performed in 100% of patients with 39.8% fulfilling the criteria for second line study. A condition was detected in 21.4%, with convulsive syndrome was the most frequent (33%). Newborns with an identified condition had 3.8+2.7 episodes versus 1.5+2,4 in those without diagnosis (NS). A home oxygen monitor was given to 15.4%. There were no re-admissions. Most newborns admitted due to cyanosis are discharged with a condition of unknown origin. In this study, convulsive syndrome was the most frequent cause. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Executive functions of six-year-old boys with normal birth weight and gestational age.

    Directory of Open Access Journals (Sweden)

    Desiree Yee-Ling Phua

    Full Text Available Impaired fetal development, reflected by low birth weight or prematurity, predicts an increased risk for psychopathology, especially attention deficit hyperactivity disorder (ADHD. Such effects cut across the normal range of birth weight and gestation. Despite the strength of existing epidemiological data, cognitive pathways that link fetal development to mental health are largely unknown. In this study we examined the relation of birth weight (>2500 g and gestational age (37-41 weeks within the normal range with specific executive functions in 195 Singaporean six-year-old boys of Chinese ethnicity. Birth weight adjusted for gestational age was used as indicator of fetal growth while gestational age was indicative of fetal maturity. Linear regression revealed that increased fetal growth within the normal range is associated with an improved ability to learn rules during the intra/extra-dimensional shift task and to retain visual information for short period of time during the delayed matching to sample task. Moreover, faster and consistent reaction times during the stop-signal task were observed among boys born at term, but with higher gestational age. Hence, even among boys born at term with normal birth weight, variations in fetal growth and maturity showed distinct effects on specific executive functions.

  7. The risk of intrauterine fetal death in the small-for-gestational-age fetus

    Science.gov (United States)

    Pilliod, Rachel A.; Cheng, Yvonne W.; Snowden, Jonathan M.; Doss, Amy E.; Caughey, Aaron B.

    2013-01-01

    OBJECTIVE We sought to evaluate the risk of intrauterine fetal death (IUFD) in small-for-gestational-age (SGA) fetuses. STUDY DESIGN We analyzed a retrospective cohort of all births in the United States in 2005, as recorded in a national database. We calculated the risk of IUFD within 3 sets of SGA threshold categories as well as within non-SGA pregnancies using the number of at-risk fetuses as the denominator. RESULTS The risk of IUFD increased with gestational age and was inversely proportional to percentile of birthweight for gestational age. The risk for IUFD in those <3rd percentile was as high as 58.0 IUFDs per 10,000 at-risk fetuses, 43.9 for <5th percentile, and 26.3 for <10th percentile compared to 5.1 for non-SGA gestations. CONCLUSION There is an increase in the risk of IUFD in SGA fetuses compared to non-SGA fetuses at all gestational ages with the greatest risk demonstrated in the lowest percentile cohort evaluated. PMID:23021697

  8. Cognitive and psychosocial development concerns in children born small for gestational age.

    Science.gov (United States)

    Lee, Peter A; Houk, Christopher P W

    Outcome information for infants born small for gestational age (SGA), whether term or premature, suggests poorer cognitive function compared with appropriate size for gestational age (AGA) infants. Poorer outcome is associated with smaller size for gestational age and with lack of catch-up growth after birth. Such data have been reported from early childhood to young adulthood. Diminished head circumference at birth and growth thereafter has also been associated with poor outcome. Based on available reports, the impact of SGA birth upon psychosocial development remains unclear. While it has not been shown that growth hormone (GH) therapy impacts either cognitive or psychosocial outcome, increased head circumference standard deviation scores have been shown to occur with GH therapy. These data need to be interpreted with caution since study populations do not define etiology of SGA and definitions of SGA vary. Further, generalized group data are not applicable to individuals.

  9. CALCIUM, CREATININE AND URINARY PHOSPHATE/CREATININE RATIO CONCENTRATIONS IN NEONATES OF VARIOUS GESTATIONAL AGES

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    O. I. Fomina

    2014-01-01

    Full Text Available Objective: specify peculiarities of calcium and phosphates excretion in neonates of various gestational ages and types of feeding in neonatal period. Patients and methods. Calcium-creatinine (Ca/Cr and phosphate-creatinine (P/Cr ratio concentrations were determined in 96 healthy neonates of 38-40 weeks of gestational age and 146 premature infants of 28-37 weeks of gestational age of various types of feeding. Results. The Ca/Cr ratio concentration in healthy term infants in the early neonatal period amounted to 0.9-2.2 (median – 1.8, the P/Cr ratio concentration – 0.8-2.1 (median – 1.6. The Ca/Cr ratio concentration in premature infants (28-37 weeks of gestational age amounted to 0.9-2.4 (median – 1.9, which is comparable to this parameter’s value in term infants. The P/Cr ratio concentration amounted to 0.7-3.1 (median – 2.4, which exceeds this parameter’s value in term infants. The lesser the gestational age and birth weight, the higher the Ca/Cr and P/Cr ratio concentrations. The authors revealed hypercalciuria and hyperphosphaturia in premature infants with a very low body weight fed with specialized formulas. Conclusions. Use of specialized formulas in small premature infants (gestational age < 33 weeks with VLBW results in excessive calcium and phosphates excretion. It is reasonable to monitor their concentrations using a non-invasive and informative method of determining Ca/Cr and P/Cr ratios. Feeding of premature infants with BW > 1,500 g with breast milk only (in case of the mother’s adequate lactation allows avoiding hypercalciuria and hyperphosphaturia and preventing risk of a renal pathology. 

  10. Preterm infants under 27 weeks gestational age: outcomes in a tertiary hospital

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    Maria Isabel Sá

    2016-02-01

    Full Text Available Introduction: Over the last decades, survival of extremely preterm infants improved but there´s still significant morbidity among this group. We pretend to evaluate if specific attitudes/characteristics are associated with higher survival or survival without severe disabilities and elaborate predicting outcome models. Material and Methods: Observational descriptive study, including the 205 liveborn/stillborn infants -gestational age 22w0d-26w6d- born at an Obstetrics Unit or transferred to a Neonatology Unit of a Level III Hospital, from January-2000 to December-2009. We collected variables related to management in the prenatal/neonatal period, neonate performances and psychomotor development(18-24 months. Significant associations between variables/outcomes were identified by chi-square test or t-test; multivariate logistic regression models were used to describe and predict mortality/morbidity. Results: Advanced Gestational Age (GA (p=0.001, antenatal corticotherapy(p=0.001, cesarean section(p=0.001, inborn delivery(p=0.021 and increased weight(p=0.001 were associated with survival. Absence of Intraventricular Hemorrhage (IVH grade 3-4(p=0.001 and absence of Periventricular Leukomalacia (PVL (p=0.005 were associated with survival without severe neurossensorial deficit. According to multivariable models, advanced GA (OR=0.353,CI95% 0.208-0.599, increased weight (OR=0.996,CI95% 0.993-0.999 and antenatal corticotherapy (OR=0.150,CI95% 0.044-0.510 were associated with lower mortality risk. Rupture of membranes less than 12 h duration was associated with higher mortality risk (OR=3.88,CI95% 1.406-10.680. IVH grades 3-4 was associated with higher morbidity risk (OR=16.931,CI95% 2.744-104.452. Mortality and severe morbidity models predicted correctly the outcome in 78.1% and 85.7% of the cases, respectively. Conclusions: Mortality/morbidity models might be valuable tools providing insight in the prediction of the outcome of these neonates and helping

  11. [Detection of subclinical hypothyroidism in pregnant women with different gestational ages].

    Science.gov (United States)

    Andrade, Luis J O; Cruz, Thomaz; Daltro, Carla; França, Caroline S; Nascimento, Avelina O S

    2005-12-01

    To detect subclinical hypothyroidism in pregnant women. Seventy-five pregnant women who resided in the town of Itabuna, state of Bahia, were voluntarily studied. Inclusion criteria were age pregnant women. In 5.4% of them, thyroid ultrasonographic changes were documented. Based on finding of a 4% prevalence of elevated TSH during pregnancy, the authors consider important the inclusion of thyroid function laboratory evaluation in the routine prenatal examination. Further studies appear necessary to establish at what gestational age thyroid function evaluation should be started in pregnant women and how frequently it should be repeated during the course of gestation.

  12. Risk for developmental coordination disorder correlates with gestational age at birth

    DEFF Research Database (Denmark)

    Zhu, Jin Liang; Olsen, Jørn; Olesen, Annette W

    2012-01-01

    BACKGROUND: Studies suggest that children born very preterm have a high risk of developmental coordination disorder (DCD). We examined the relation between the larger spectrum of gestational age at birth and the risk of DCD. METHODS:   We used the 7-year follow-up data from 22898 singletons...... in the Danish National Birth Cohort. We calculated a total score from the Developmental Coordination Disorder Questionnaire (DCDQ), incorporated in the 7-year follow-up, and defined children with a score of 46 or below as having probable DCD. Information on gestational age was obtained from the Medical Birth...

  13. The impact of birth weight and gestational age on the management of juvenile essential hypertension

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    Hogas Mihai

    2015-01-01

    Full Text Available Essential hypertension in children is a very important biological aspect in child pathology, caused by the synergic action of multiple risk factors, with an increasing prevalence. Since there is not much knowledge about juvenile essential hypertension in childhood, in this paper we will clarify the existing data about this pathology and its management, mainly by referring to the correlations during different stages. We found significant correlations between hypertension and the individual values of birth weight and gestational age, which suggest that there is an important relationship between birth weight and gestational age, as important biological markers vs. the different stages of essential hypertension.

  14. Fetal cardiac muscle contractility decreases with gestational age: a color-coded tissue velocity imaging study

    Directory of Open Access Journals (Sweden)

    Elmstedt Nina

    2012-05-01

    Full Text Available Abstract Background Present data regarding how the fetal heart works and develops throughout gestation is limited. However, the possibility to analyze the myocardial velocity profile provides new possibilities to gain further knowledge in this area. Thus, the objective of this study was to evaluate human fetal myocardial characteristics and deformation properties using color-coded tissue velocity imaging (TVI. Methods TVI recordings from 55 healthy fetuses, at 18 to 42 weeks of gestation, were acquired at a frame rate of 201–273 frames/s for offline analysis using software enabling retrieval of the myocardial velocity curve and 2D anatomical information. The measurements were taken from an apical four-chamber view, and the acquired data was correlated using regression analysis. Results Left ventricular length and width increased uniformly with gestational age. Atrioventricular plane displacement and the E’/A’ ratio also increased with gestational age, while a longitudinal shortening was demonstrated. Conclusions Fetal cardiac muscle contractility decreases with gestational age. As numerous fetal- and pregnancy-associated conditions directly influence the pumping function of the fetal heart, we believe that this new insight into the physiology of the human fetal cardiovascular system could contribute to make diagnosis and risk assessment easier and more accurate.

  15. Factors associated with the use of supplemental oxygen or positive pressure ventilation in the delivery room, in infants born with a gestational age ≥ 34 weeks

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    Maria Elisabeth Moreira

    2016-10-01

    Full Text Available Abstract Background Approximately 5–10 % of newborns require some form of resuscitationupon delivery; several factors, such as maternal abnormal conditions, gestational age and type of delivery could be responsible for this trend. This study aimed to describe the factors associated with the need for positive pressure ventilation (PPV via a mask or endotracheal tube and the use of supplemental O2 in newborns with a gestational age greater than 34 weeks in Brazil. Methods We performed a cross-sectional study and obtained data from the Birth in Brazil Survey. The inclusion criterion was a gestational age ≥34 weeks. Exclusion criteria were newborns with congenital malformations, and cases with undetermined gestational age or type of delivery (vaginal, pre labor cesarean section and cesarean section during labor. The primary outcomes were need of PPV via a mask or endotracheal tube and the use of supplemental oxygen without PPV. Confounding variables, including maternal age, source of birth payment, years of maternal schooling, previous birth, newborn presentation, multiple pregnancy, and maternal obstetric risk, were analyzed. Results We included 22,720 newborns. Of these, 2974 (13.1 % required supplementary oxygen. PPV with a bag and mask was used for 727 (3.2 % newborns and tracheal intubation for 192 (0.8 % newborns. Chest compression was necessary for 136 (0.6 % newborns and drugs administered in 114 (0.5 %. 51.3 % of newborns were delivered by cesarean section, with the majority of cesarean sections (88.7 % being performed prior to labor. Gestational age (late preterm infants: (Relative Risk-(RR 2.46; 95 % (Confidence interval-CI 1.79–3.39, maternal obstetric risk (RR 1.59; 95 % CI1.30–1.94, and maternal age of 12–19 years old (RR 1.36; 95 % CI1.06–1.74 contributed to rates of PPV in the logistic regression analysis. Newborns aged between 37–38 weeks of gestaional age weren´t less likely to require PPV compared with

  16. Estimation of Gestational Age, Using Neonatal Anthropometry: A Cross-sectional Study in India

    Science.gov (United States)

    Thawani, Rajat; Faridi, M.M.A.; Arora, Shilpa Khanna; Kumar, Rajeev

    2013-01-01

    Prematurity is a significant contributor to neonatal mortality in India. Conventionally, assessment of gestational age of newborns is based on New Ballard Technique, for which a paediatric specialist is needed. Anthropometry of the newborn, especially birthweight, has been used in the past to predict the gestational age of the neonate in peripheral health facilities where a trained paediatrician is often not available. We aimed to determine if neonatal anthropometric parameters, viz. birthweight, crown heel-length, head-circumference, mid-upper arm-circumference, lower segment-length, foot-length, umbilical nipple distance, calf-circumference, intermammary distance, and hand-length, can reliably predict the gestational age. The study also aimed to derive an equation for the same. We also assessed if these neonatal anthropometric parameters had a better prediction of gestational age when used in combination compared to individual parameters. We evaluated 1,000 newborns in a cross-sectional study conducted in Guru Teg Bahadur Hospital in Delhi. Detailed anthropometric estimation of the neonates was done within 48 hours after birth, using standard techniques. Gestational age was estimated using New Ballard Scoring. Out of 1,250 consecutive neonates, 1,000 were included in the study. Of them, 800 randomly-selected newborns were used in devising the model, and the remaining 200 newborns were used in validating the final model. Quadratic regression analysis using stepwise selection was used in building the predictive model. Birthweight (R=0.72), head-circumference (R=0.60), and mid-upper arm-circumference (R=0.67) were found highly correlated with gestation. The final equation to assess gestational age was as follows: Gestational age (weeks)=5.437×W–0.781×W2+2.815×HC–0.041×HC2+0.285×MUAC–22.745 where W=Weight, HC=Head-circumference and MUAC=Mid-upper arm-circumference; Adjusted R=0.76. On validation, the predictability of this equation is 46% (±1 week), 75

  17. Impact of ambient air pollution on gestational age is modified by season in Sydney, Australia.

    Science.gov (United States)

    Jalaludin, Bin; Mannes, Trish; Morgan, Geoffrey; Lincoln, Doug; Sheppeard, Vicky; Corbett, Stephen

    2007-06-07

    The effect of individual pollutants and the period(s) during pregnancy when pollutant levels are likely to have most impact on preterm birth is not clear. We evaluated the effect of prenatal exposure to six common urban air pollutants in the Sydney metropolitan area on preterm birth. We obtained information on all births in metropolitan Sydney between January 1, 1998 and December 31, 2000. For each birth, exposure to each air pollutant was estimated for the first trimester, the three months preceding birth, the first month after the estimated date of conception and the month prior to delivery. Gestational age was analysed as a categorical variable in logistic regression models. There were 123,840 singleton births in Sydney in 1998-2000 and 4.9% were preterm. Preterm birth was significantly associated with maternal age, maternal smoking, male infant, indigenous status and first pregnancy. Air pollutant levels in the month and three months preceding birth had no significant effect on preterm birth after adjusting for maternal and infant covariates. Ozone levels in the first trimester of pregnancy and spring months of conception and sulphur dioxide were associated with increased risks for preterm births. Nitrogen dioxide was associated with a decreased risk of preterm births. We found more protective than harmful associations between ambient air pollutants and preterm births with most associations non-significant. In view of these inconsistent associations, it is important to interpret the harmful effects with caution. If our results are confirmed by future studies then it will be imperative to reduce Sydney's already low air pollution levels even further.

  18. Impact of ambient air pollution on gestational age is modified by season in Sydney, Australia

    Directory of Open Access Journals (Sweden)

    Lincoln Doug

    2007-06-01

    Full Text Available Abstract Background The effect of individual pollutants and the period(s during pregnancy when pollutant levels are likely to have most impact on preterm birth is not clear. We evaluated the effect of prenatal exposure to six common urban air pollutants in the Sydney metropolitan area on preterm birth. Methods We obtained information on all births in metropolitan Sydney between January 1, 1998 and December 31, 2000. For each birth, exposure to each air pollutant was estimated for the first trimester, the three months preceding birth, the first month after the estimated date of conception and the month prior to delivery. Gestational age was analysed as a categorical variable in logistic regression models. Results There were 123 840 singleton births in Sydney in 1998–2000 and 4.9% were preterm. Preterm birth was significantly associated with maternal age, maternal smoking, male infant, indigenous status and first pregnancy. Air pollutant levels in the month and three months preceding birth had no significant effect on preterm birth after adjusting for maternal and infant covariates. Ozone levels in the first trimester of pregnancy and spring months of conception and sulphur dioxide were associated with increased risks for preterm births. Nitrogen dioxide was associated with a decreased risk of preterm births. Conclusion We found more protective than harmful associations between ambient air pollutants and preterm births with most associations non-significant. In view of these inconsistent associations, it is important to interpret the harmful effects with caution. If our results are confirmed by future studies then it will be imperative to reduce Sydney's already low air pollution levels even further.

  19. Plasma lipid metabolites are associated with gestational age but not bronchopulmonary dysplasia.

    Science.gov (United States)

    Rogers, Lynette K; Young, Christine M; Pennell, Michael L; Tipple, Trent E; Leonhart, Karen L; Welty, Stephen E

    2012-08-01

    To test the hypothesis that plasma lipid metabolite levels in premature infants are associated with the development of bronchopulmonary dysplasia (BPD). The studies also tested a secondary hypothesis that plasma lipid metabolite levels were correlated with gestational age. Infants born <32 weeks' gestation were enrolled during the first 72 h of life. Plasma samples were obtained and lipid levels were measured by LC-MS/MS. Clinical data were collected to determine infant outcomes and BPD diagnosis. Following adjustment for confounders, lipid levels were not associated with BPD; however, levels of specific lipid metabolites were correlated with gestational age. Immature lipid metabolism pathways in premature infants may contribute to the pathogenesis of BPD and other diseases. © 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.

  20. Effects of gestational age at birth on cognitive performance: a function of cognitive workload demands.

    Directory of Open Access Journals (Sweden)

    Julia Jaekel

    Full Text Available OBJECTIVE: Cognitive deficits have been inconsistently described for late or moderately preterm children but are consistently found in very preterm children. This study investigates the association between cognitive workload demands of tasks and cognitive performance in relation to gestational age at birth. METHODS: Data were collected as part of a prospective geographically defined whole-population study of neonatal at-risk children in Southern Bavaria. At 8;5 years, n = 1326 children (gestation range: 23-41 weeks were assessed with the K-ABC and a Mathematics Test. RESULTS: Cognitive scores of preterm children decreased as cognitive workload demands of tasks increased. The relationship between gestation and task workload was curvilinear and more pronounced the higher the cognitive workload: GA² (quadratic term on low cognitive workload: R²  = .02, p<0.001; moderate cognitive workload: R²  = .09, p<0.001; and high cognitive workload tasks: R²  = .14, p<0.001. Specifically, disproportionally lower scores were found for very (<32 weeks gestation and moderately (32-33 weeks gestation preterm children the higher the cognitive workload of the tasks. Early biological factors such as gestation and neonatal complications explained more of the variance in high (12.5% compared with moderate (8.1% and low cognitive workload tasks (1.7%. CONCLUSIONS: The cognitive workload model may help to explain variations of findings on the relationship of gestational age with cognitive performance in the literature. The findings have implications for routine cognitive follow-up, educational intervention, and basic research into neuro-plasticity and brain reorganization after preterm birth.

  1. Risk factors and obstetric complications of large for gestational age births with adjustments for community effects: results from a new cohort study

    Directory of Open Access Journals (Sweden)

    Cameron Cate M

    2010-08-01

    Full Text Available Abstract Background High birth weight has serious adverse impacts on chronic health conditions and development in children. This study identifies the social determinants and obstetric complications of high birth weight adjusted for gestational age and baby gender. Methods Pregnant women were recruited from three maternity hospitals in South-East Queensland in Australia during antenatal clinic visits. A questionnaire was completed by each participant to elicit information on eco-epidemiological exposures. Perinatal information was extracted from hospital birth records. A hierarchical mixture regression model was used in the analysis to account for the heterogeneity of birth weights and identify risk factors and obstetric complications of births that were large for gestational age. A generalized linear mixed model was used to adjust for (random "community" effects. Results Pre-pregnancy obesity (adjusted OR = 2.73, 95% CI = 1.49-5.01, previous pregnancy (adjusted OR = 2.03, 95% CI = 1.08-3.81, and married mothers (adjusted OR = 1.85, 95% CI = 1.00-3.42 were significantly associated with large for gestational age babies. Subsequent complications included the increased need for delivery by caesarean sections or instrumental procedures (adjusted OR = 1.98, 95% CI = 1.10-3.55, resuscitation (adjusted OR = 2.52, 95% CI = 1.33-4.79, and transfer to intensive/special care nursery (adjusted OR = 3.76, 95% CI = 1.89-7.49. Communities associated with a higher proportion of large for gestational age births were identified. Conclusions Pre pregnancy obesity is the principal modifiable risk factor for large for gestational age births. Large for gestational age is an important risk factor for the subsequent obstetric complications. The findings improve the evidence-base on which to base preventive interventions to reduce the impact of high birth weight on maternal and child health.

  2. Glomerulogenesis: Can it predict the gestational age? A study of 176 fetuses

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    Panduranga Chikkannaiah

    2012-01-01

    Full Text Available Background: Accurate assessment of gestational age of fetuses is essential from both clinical and medico-legal point of view. Crown-rump length, crown-heel length, foot length, and the weight of the fetus are the commonly used parameters for fetal age assessment. However, this estimate often lacks accuracy and sometimes is necessary to combine other data. An analysis of the embryological development of nephrons in the kidney can assist in this determination. Objective : To correlate the gestational age with the histological study of sequential development of nephrons in fetal kidney. Materials and Methods: This study included 176 fetuses delivered between June 2009 and June 2011 and aged from 12 to 40 weeks. The number of glomerular generations counted in hematoxylin and eosin-stained microscopic sections of the kidneys were correlated with the reported period of gestation based on obstetrical methods. Regression analysis was used to determine the statistical significance of the correlation. Results: A high degree of statistically significant correlation was observed between the period of gestation and the number of glomerular generations (P value < 0.0001. Conclusion: The histological assessment of the number of glomerular generations in kidney can be used as a reliable method of estimating fetal age.

  3. Gestational diabetes

    Science.gov (United States)

    ... first few days of life. Mothers with gestational diabetes have an increased risk for high blood pressure during pregnancy . After delivery: Your high blood sugar (glucose) level often goes back to normal. You should be ...

  4. Cesarean section or vaginal delivery at 24 to 28 weeks' gestation: comparison of survival and neonatal and two-year morbidity.

    Science.gov (United States)

    Kitchen, W; Ford, G W; Doyle, L W; Rickards, A L; Lissenden, J V; Pepperell, R J; Duke, J E

    1985-08-01

    A large cohort of consecutive live births with gestational ages assessed antenatally from 24 to 28 weeks from one tertiary center was studied to determine the association between mode of delivery and in-hospital mortality and morbidity and morbidity at two years of age. Between 1 January 1977 and 31 March 1982, 52.8% (172 of 326) of such infants survived their primary hospitalization. Obstetric factors independently associated with improved survival were increasing gestational age (P less than .0001), the absence of maternal hypertension (P = .007), singleton pregnancy (P = .007), and antenatal steroid therapy (P = .018). Although 62.7% (32 of 51) of infants delivered by cesarean section survived compared with 50.9% (140 of 275) of infants delivered vaginally, the increased survival was not statistically significant (X 2 = 1.97). Moreover, the trend favoring cesarean section disappeared after adjustment for confounding obstetric factors. In univariate analyses cesarean births more frequently required ventilatory support and there was a trend toward a lower incidence of cerebroventricular hemorrhage; again, however, when adjusted for extraneous factors these associations disappeared. Of the 172 in-hospital survivors, five died at home unexpectedly; 162 of the remaining 167 were traced; 18 (11.1%) had cerebral palsy and two (1.2%) were deaf. Of the 111 children who were fully assessed, 13.5% had major handicaps, 23.4% were suspect, and 63.1% were free of handicap at two years' corrected age. There was no association between mode of delivery and frequency of handicap. Little evidence was found from mortality or morbidity data to support routine delivery of infants of borderline viability by cesarean section.

  5. Bloom syndrome in short children born small for gestational age: A challenging diagnosis

    NARCIS (Netherlands)

    J.S. Renes (Judith); R.H. Willemsen (Ruben); A. Wagner (Anja); M.J. Finken (Martijn); A.C.S. Hokken-Koelega (Anita)

    2013-01-01

    textabstractBackground: GH treatment has become a frequently applied growth-promoting therapy in short children born small for gestational age (SGA). In some disorders GH treatment is contraindicated, eg, chromosomal breakage syndromes. Bloom syndrome is a rare chromosomal breakage syndrome characte

  6. Morbility, clinical data and proteomic analysis of IUGR and AGA newborns at different gestational ages

    Directory of Open Access Journals (Sweden)

    M.D. Ruiz-González

    2016-12-01

    Full Text Available The data are related to the proteomic analysis of 43 newborns with intrauterine growth retardation (IUGR and 45 newborns with appropriate weight for gestational age (AGA carried out by separation via 2DE and analyzed by MS–TOF/TOF. All newborns were separated into three gestational age groups, "Very Preterm" 29–32 weeks, "Moderate Preterm" 33–36 weeks, and, "Term" ≥37weeks. From each newborn, blood was drawn three times from birth to 1 month life. High-abundant serum proteins were depleted, and the minority ones were separated by 2DE and analyzed for significant expression differences. The data reflect analytic and clinic variables analyzed globally and categorized by gestational age in relation to IUGR and the optimization of conditions for 2-DE separation. The data from this study are related to the research article entitled "Alterations of Protein Expression in Serum of Infants with Intrauterine Growth Restriction and Different Gestational Ages" (M.D. Ruis-González, M.D. Cañete, J.L. Gómez-Chaparro, N. Abril, R. Cañete, J. López-Barea, 2015 [1]. The present dataset of serum IUGR newborn proteome can be used as a reference for any study involving intrauterine growth restriction during the first month of life.

  7. Protein metabolism in the developing brain: influence of birth and gestational age.

    Science.gov (United States)

    Schain, R J; Carver, M J; Copenhaver, J H; Underdahl, N R

    1967-05-19

    Incorporation of carbon-14-labeled phenylalanine into brain protein of newborn pigs falls sharply within 24 hours after birth. This decrease is related to the time of birth rather than the gestational age of the piglets, although the latter is also associated with a gradual decrease in brain protein synthesis.

  8. Inflammatory Markers in Umbilical Cord Blood from Small-For-Gestational-Age Newborns

    DEFF Research Database (Denmark)

    Lausten-Thomsen, Ulrik; Greisen, Gorm; Olsen, Marianne;

    2014-01-01

    This study investigates the role of inflammation in intrauterine growth retardation by exploring the levels of inflammatory markers in umbilical cord blood from neonates who were born small-for-gestational-age (SGA) and comparing them to neonates who were born appropriate-for-gestational-age (AGA...... of elevated inflammatory markers in the cord blood from SGA infants compared to AGA infants, and consequently the results suggest an inflammatory component in intrauterine growth restriction (IUGR).......This study investigates the role of inflammation in intrauterine growth retardation by exploring the levels of inflammatory markers in umbilical cord blood from neonates who were born small-for-gestational-age (SGA) and comparing them to neonates who were born appropriate-for-gestational-age (AGA......-eclampsia were excluded. SGA was defined as two standard derivations below the expected for term and gender. In multivariate regression analyses significant elevation in cord blood concentration of IL-6 was demonstrated in the SGA group (mean 4.56 vs. 2.38, p = 0.002). The results indicate the presence...

  9. Defining smallness for gestational age in the early years of the Danish Medical Birth Registry

    DEFF Research Database (Denmark)

    á Rogvi, Rasmus; Mathiasen, Rene; Greisen, Gorm

    2011-01-01

    Being born small for gestational age (SGA) is associated with decreased insulin sensitivity and increased blood pressure in childhood, but the association with clinical disease in early adulthood is less certain. The Danish Medical Birth Registry has registered all births in Denmark since 1973, b...

  10. Neonatal mortality risk associated with preterm birth in East Africa, adjusted by weight for gestational age

    DEFF Research Database (Denmark)

    Marchant, Tanya; Willey, Barbara; Katz, Joanne

    2012-01-01

    Low birth weight and prematurity are amongst the strongest predictors of neonatal death. However, the extent to which they act independently is poorly understood. Our objective was to estimate the neonatal mortality risk associated with preterm birth when stratified by weight for gestational age ...

  11. Relation of polychlorinated biphenyls to birthweight and gestational age in the offspring of occupationally exposed mothers

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, P.R.; Stelma, J.; Lawrence, C.E.

    1984-09-20

    A study was made of the relation between occupational exposure of women to high homolog polychlorinated biphenyls (PCB) and birthweight and gestational age among the live offspring of these workers. In 1982 interviews were conducted with 200 women who had held jobs with direct PCB exposure. A comparison was made with 205 women who had never held such a job. When all births occurring to mothers following exposure to PCBs were considered, the unadjusted mean birthweight in the direct exposure group was 96 grams less than the comparison group. No differences in gestational age were seen between groups. The birthweight difference was reduced to 41 grams following adjustment for potential confounding factors. In a parallel analysis using a continuous exposure variable estimate generated from an independently derived serum PCB prediction model, no effect of PCBs was noted on birthweight or gestational age using either crude or adjusted analyses. The authors conclude that no evidence for a biologically meaningful effect of high homolog PCBs on gestational age or birthweight exists.

  12. Defining smallness for gestational age in the early years of the Danish Medical Birth Registry

    DEFF Research Database (Denmark)

    á Rogvi, Rasmus; Mathiasen, Rene; Greisen, Gorm

    2011-01-01

    Being born small for gestational age (SGA) is associated with decreased insulin sensitivity and increased blood pressure in childhood, but the association with clinical disease in early adulthood is less certain. The Danish Medical Birth Registry has registered all births in Denmark since 1973...

  13. Silver-Russell Syndrome & Small for Gestational Age : Long-term health perspectives

    NARCIS (Netherlands)

    C.C.J. Smeets (Lin)

    2017-01-01

    markdownabstractFor over 25 years, our research group and others have been investigating children born small for gestational age (SGA) with persistent short stature, and the efficacy and safety of biosynthetic growth hormone treatment (GH) in these children. One of the causes of short SGA is

  14. Bloom syndrome in short children born small for gestational age: A challenging diagnosis

    NARCIS (Netherlands)

    J.S. Renes (Judith); R.H. Willemsen (Ruben); A. Wagner (Anja); M.J. Finken (Martijn); A.C.S. Hokken-Koelega (Anita)

    2013-01-01

    textabstractBackground: GH treatment has become a frequently applied growth-promoting therapy in short children born small for gestational age (SGA). In some disorders GH treatment is contraindicated, eg, chromosomal breakage syndromes. Bloom syndrome is a rare chromosomal breakage syndrome characte

  15. Functioning of 7-Year-Old Children Born at 32 to 35 Weeks' Gestational Age

    NARCIS (Netherlands)

    Cserjesi, R.; Van Braeckel, K.N.J.A.; Butcher, P.R.; Kerstjens, J.M.; Reijneveld, S.A.; Bouma, A.; Geuze, R.H.; Bos, A.F.

    2012-01-01

    OBJECTIVE: To compare neuropsychological functions in moderately preterm (32-35 weeks' gestation) and full-term children at the age of 7 years and identify gender differences. METHODS: Community-based prospective cohort study of 248 moderately preterm children (138 boys) and 130 full-term children (

  16. Growth and bone mineralization in small-for-gestational-age preterm infants.

    Science.gov (United States)

    Kitazawa, Shigetaka; Itabashi, Kazuo; Umeda, You; Inoue, Makoto; Nishioka, Takashi

    2014-02-01

    Preterm infants are at risk for metabolic bone disease and suboptimal growth. This study examined the hypothesis that, apart from prematurity, intrauterine growth status (expressed as gestational age-specific birthweight standard deviation score) influences bone mineralization and body composition in early infancy. In this retrospective study, the groups consisted of preterm small-for-gestational-age (SGA) infants (n = 18; SGA group) and preterm appropriate-for-gestational-age (AGA) infants (n = 24; AGA group). Postnatal bone mineralization was measured at term-adjusted age (postmenstrual age, 37-42 weeks). Bone mineral content (BMC) and body composition were determined on dual-energy X-ray absorptiometry of the whole body. BMC and lean mass were significantly lower in the SGA group than in the AGA group at term-adjusted age (37-42 weeks postmenstrual age). Stepwise regression analysis identified weight at examination as the most significant factor, accounting for 51% of the variance in BMC. Bodyweight at term-adjusted age, rather than intrauterine growth, may affect postnatal bone mineralization in preterm low-birthweight infants. Therefore, promoting an increase in body size might increase postnatal bone mineralization in preterm SGA infants. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

  17. FETAL FOOT LENGTH AND HAND LENGTH: RELATIONSHIP WITH CROWN RUMP LENGTH AND GESTATIONAL AGE

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    Garima

    2015-12-01

    Full Text Available BACKGROUND Estimation of gestational age of fetus is of great medicolegal importance. Multiple parameters of the fetal anatomical measurements are in use. However, gestational age assessment may be difficult in fetus with anencephaly, hydrocephalus, short limb dysplasia, post mortem destruction or in mutilated case. Study of literature suggests that fetal foot has a characteristic pattern of normal growth and the fetal foot shows gradual increase in length relative to the length of the embryo and could be used to estimate gestational age. The purpose of the present study is to determine the accuracy in estimating gestational age using fetal foot and hand length by studying its relation with crown rump length in the foetuses of Manipuri origin. AIMS AND OBJECTIVES 1 To study the relationship between fetal crown rump length and fetal hand and foot length, thereby determining the accuracy in estimating gestational age by a cross-sectional study. MATERIALS AND METHODS A total of 100 formalin fixed fetuses of Manipuri origin, obtained from the Department of Obstetrics and Gynaecology, Regional Institute of Medical Sciences, Imphal, were included in the study, carried out in the Department of Anatomy, from February 2015 to July 2015. The parameters studied were crown rump length, foot length and hand length of fetuses. The data was analysed using SPSS software by regression analysis. Graphs were also plotted to determine pattern of growth and their correlation with crown rump length if any. RESULTS A total of 100 fetuses were studied, of which 43 were females and 57 were males. The mean foot length and hand length progressively increased with increase in crown rump length. Measurements were not significantly different in right or left side or among male and female fetuses. A statistically significant linear relationship was seen between foot length and crown rump length of the fetus (r=0.980, p<0.0001 and hand length and crown rump length of the fetus

  18. Congenital Heart Disease in Premature Infants 25-32 Weeks' Gestational Age.

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    Chu, Patricia Y; Li, Jennifer S; Kosinski, Andrzej S; Hornik, Christoph P; Hill, Kevin D

    2017-02-01

    To determine the birth prevalence of congenital heart defects (CHDs) across the spectrum of common defects in very/extremely premature infants and to compare mortality rates between premature infants with and without CHDs. The Kids' Inpatient Databases (2003-2012) were used to estimate the birth prevalence of CHDs (excluding patent ductus arteriosus) in very/extremely premature infants born between 25 and 32 weeks' gestational age. Birth prevalence was compared with term infants for a subset of "severe" defects expected to be near universally diagnosed in the neonatal period. Weighted multivariable logistic regression was used to calculate aORs of mortality comparing very and extremely premature infants with vs without CHDs. We identified 249 011 very/extremely premature infants, including 28 806 with CHDs. The overall birth prevalence of CHDs was 116 per 1000 very/extremely premature births. Severe CHDs had significantly higher birth prevalence in very/extremely premature infants when compared with term infants (7.4 per 1000 very/premature births vs 1.5 per 1000 term births; P premature infants with severe CHDs had an overall 26.3% in-hospital mortality and a 7.5-fold increased adjusted odds of death compared with those without CHDs. Mortality varied widely by defect in very/extremely premature infants, ranging from 12% for interrupted aortic arch to 67% for truncus arteriosus. Given the increased birth prevalence of severe CHDs in very/extremely premature infants, and significantly higher mortality, there is justification for intensive interventions aimed at decreasing the likelihood of premature delivery for patients where CHD is diagnosed in utero. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. An algorithm for the estimation of gestational age at the time of fetal death.

    Science.gov (United States)

    Conway, Deborah L; Hansen, Nellie I; Dudley, Donald J; Parker, Corette B; Reddy, Uma M; Silver, Robert M; Bukowski, Radek; Pinar, Halit; Stoll, Barbara J; Varner, Michael W; Saade, George R; Hogue, Carol; Willinger, Marian; Coustan, Donald; Koch, Matthew A; Goldenberg, Robert L

    2013-03-01

    Accurate assignment of gestational age (GA) at time of fetal death is important for research and clinical practice. An algorithm to estimate GA at fetal death was developed and evaluated. The algorithm developed by the Stillbirth Collaborative Research Network (SCRN) incorporated clinical and post-mortem data. The SCRN conducted a population-based case-control study of women with stillbirths and livebirths from 2006 to 2008 in five geographical catchment areas. Rules were developed to estimate a due date, identify an interval during which death likely occurred, and estimate GA at the time of fetal death. Reliability of using fetal foot length to estimate GA at death was assessed. The due date estimated for 620 singleton stillbirths studied was considered clinically reliable for 87%. Only 25.2% of stillbirths were documented alive within 2 days before diagnosis and 47.6% within 1 week of diagnosis. The algorithm-derived estimate of GA at time of fetal death was one or more weeks earlier than the GA at delivery for 43.5% of stillbirths. GA estimated from fetal foot length agreed with GA by algorithm within 2 weeks for 75% within a subset of well-dated stillbirths. Precise assignment of GA at death, defined as reliable dating criteria and a short interval (≤1 week) during which fetal death was known to have occurred, was possible in 46.6% of cases. Fetal foot length is a relatively accurate measure of GA at death and should be collected in all stillbirth cases. © 2013 Blackwell Publishing Ltd.

  20. Helicobacter pylori colonization and pregnancies complicated by preeclampsia, spontaneous prematurity, and small for gestational age birth.

    Science.gov (United States)

    den Hollander, Wouter J; Schalekamp-Timmermans, Sarah; Holster, I Lisanne; Jaddoe, Vincent W; Hofman, Albert; Moll, Henriëtte A; Perez-Perez, Guillermo I; Blaser, Martin J; Steegers, Eric A P; Kuipers, Ernst J

    2017-04-01

    Preeclampsia (PE), small for gestational age (SGA), and spontaneous preterm birth (PTB) each may be complications of impaired placental function in pregnancy. Although their exact pathogenesis is still unknown, certain infectious agents seem to play a role. Helicobacter pylori (H. pylori) colonization has been associated with increased risk for PE. Our aim was to assess the association between H. pylori colonization and PE, SGA, and PTB. We measured IgG anti-H. pylori and CagA antibodies in serum of pregnant women (median 20.5 weeks, range 16.5-29.4) who participated in a population-based prospective cohort study. Delivery and medical records were assessed. Information on demographics, education, and maternal risk factors was collected by questionnaire. We used multivariate logistic regression analyses to assess associations between H. pylori colonization and PE, SGA, and PTB. In total, 6348 pregnant women were assessed. H. pylori positivity was found in 2915 (46%) women, of whom 1023 (35%) also were CagA-positive. Pregnancy was complicated by PE, SGA, or PTB in 927 (15%) women. H. pylori colonization was associated with PE (aOR 1.51; 95%CI 1.03-2.25). Differentiation according to CagA status revealed the same risk. H. pylori was positively related with SGA, mainly explained by CagA-positive strains (aOR 1.34; 1.04-1.71). No association was observed between H. pylori and PTB. Our data suggest that H. pylori colonization may be a risk factor for PE and SGA. If these associations are confirmed by future studies and shown to be causal, H. pylori eradication may reduce related perinatal morbidity and mortality. © 2016 John Wiley & Sons Ltd.

  1. Evaluation of histological changes after tracheal occlusion at different gestational ages in a fetal rat model

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    Rodrigo Melo Gallindo

    2013-01-01

    Full Text Available OBJECTIVES: To evaluate the histological changes of tracheal cartilage and epithelium caused by tracheal occlusion at different gestational ages in a fetal rat model. METHODS: Rat fetuses were divided into two groups: a External control, composed of non-operated rats, and b Interventional group, composed of rats operated upon on gestational day 18.5 (term = 22 days, divided into triads: 1 Tracheal occlusion, 2 Internal control and 3 Sham (manipulated but not operated. Morphological data for body weight, total lung weight and total lung weight/body weight ratio were collected and measured on gestational days 19.5, 20.5 and 21.5. Tracheal samples were histologically processed, and epithelial, chondral and total tracheal thicknesses were measured on each gestational day. RESULTS: The tracheal occlusion group exhibited an increase in total lung weight/body weight ratio (p<0.001. Histologically, this group had a thicker epithelial thickness (p<0.05 and thinner chondral (p<0.05 and total tracheal thicknesses (p<0.001. These differences were more prominent on gestational days 20.5 and 21.5. CONCLUSION: Tracheal occlusion changed tracheal morphology, increased epithelial thickness and considerably decreased total tracheal thickness. These changes in the tracheal wall could explain the development of tracheomegaly, recently reported in some human fetuses subjected to tracheal occlusion.

  2. Reduction in Cerebral Oxygenation due to Patent Ductus Arteriosus Is Pronounced in Small-for-Gestational-Age Neonates

    NARCIS (Netherlands)

    Cohen, Emily; Dix, Laura; Baerts, Willem; Alderliesten, Thomas; Lemmers, Petra; van Bel, Frank

    2016-01-01

    BACKGROUND: A haemodynamically significant patent ductus arteriosus (hsPDA) reduces cerebral oxygenation in appropriate-for-gestational-age (AGA) preterm neonates. Reduced cerebral oxygenation has been associated with brain injury. Preterm small-for-gestational-age (SGA) neonates show higher cerebra

  3. [Association between neontal morbidity, gestational age and developmental delays in moderate to late preterm children].

    Science.gov (United States)

    Schonhaut, Luisa; Pérez, Marcela; Muñoz, Sergio

    2015-01-01

    There is evidence that children born moderate-to-late preterm (MLP) have a higher risk of hospitalisation, neonatal morbidity, and developmental delay (DD). To determine the association between DD, gestational age, and neonatal morbidity in MLP children. A case control study design nested in a cohort of MLP children born between 2006 and 2009 at a private hospital located in the Metropolitan area of Santiago. The children were assessed with the Bayley-III Scales of Infant Development at 8 or 18 months corrected age, or at 30 months of chronological age. Neonatal records were retrospectively reviewed. A multivariate analysis was performed to determine the effect of neonatal morbidity on development. A total of 130 MLP children, 25 cases and 105 controls, were studied. Most of them (83.8%) were hospitalised during the neonatal period. Significant differences between cases and controls regarding maternal age and symptomatic hypoglycaemia were observed (crude OR 3.5, adjusted OR 8.18). It was concluded that the variables that negatively affect the rate of development are male gender, being a twin, and gestational age. Symptomatic hypoglycaemia is the main risk factor for DD, while being a twin, male gender, and gestational age influenced the total development rate obtained. It is essential to develop strategies for prevention, screening, and early management of this metabolic disorder to prevent future DD. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Evaluation of placental thickness as a sonological indicator for estimation of gestational age of foetus in normal singleton pregnancy

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    Lovely Kaushal

    2015-05-01

    Conclusion: A linear increase in mean placental thickness with gestational age was observed using correlation analysis in our present study conducted to determine the relationship between placental thickness and gestational age. Placental thickness measured in millimeters increases with gestational age from 11 weeks to 37 weeks. Placental thickness can be used as a predictor of the gestational age, in women in whom the last menstrual period is unreliable or is not known. In instances when femoral length was difficult to measure due to excessive foetal movements, Placental thickness was found to be a reliable alternative biometric measurement in calculating gestational age. [Int J Res Med Sci 2015; 3(5.000: 1213-1218

  5. The relation of polychlorinated biphenyls to birth weight and gestational age in the offspring of occupationally exposed mothers

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, P.R.; Stelma, J.M.; Lawrence, C.E. (National Cancer Institute, Bethesda, MD (USA))

    1989-02-01

    The authors studied the relation of polychlorinated biphenyls (PCBs) to birth weight and gestational age among the live offspring of women occupationally exposed to PCBs during the manufacture of capacitors in Upstate New York. Interviews were conducted in 1982 with 200 women who had held jobs with direct exposure and 205 women who had never held a direct-exposure job in order to ascertain information on reproductive history and other factors influencing reproductive outcome. Exposure was assessed as high-homolog PCB (Aroclor 1254), a continuous exposure variable estimated from an independently derived prediction model. After adjustment for variables other than gestational age known to influence birth weight, a significant effect of high-homolog exposure is seen for birth weight. For gestational age, a small but significant decrease is also observed with an increase in estimated exposure. When gestational age is accounted for in addition to other variables related to birth weight, estimated serum PCB is no longer a significant predictor of birth weight. The authors conclude that these data indicate that there is a significant relation between increased estimated serum PCB level and decreased birth weight and gestational age, and that the decrease in birth weight is at least partially related to shortened gestational age. The magnitude of these effects was quite small compared with those of other known determinants of gestational age and birth weight, and the biologic importance of these effects is likely to be negligible except among already low birth weight or short gestation infants.

  6. Association of newborn diseases with weight/length ratio and the adequacy of weight for gestational age

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    José Ricardo Dias Bertagnon

    2011-09-01

    Full Text Available Objective: To compare the frequencies of newborn diseases in thosenewborns classified according to a weight/length rate and thoseclassified by the adequacy weight for gestational age. Methods: Aretrospective cross-sectional study by record assessment was carriedout enclosing all the live newborns at Hospital Geral do Grajaú, fromSeptember to December, 2009 (n =577 classified according to therate weight/length and also to the adequacy weight for gestationalage. The 10 and 90 percentiles of the weight/length distribution, nowdesignated as “indices” were calculated leading to the followingclassification: low index, for newborns below 54.8 g/cm; high index,for those over 75.8 g/cm; and average index, for the remainingnewborns. According to the adequacy weight for gestational age thenewborns were designated as pre-term for gestational age; term smallfor gestational age; appropriate term and large term. In this samplethere were no small and large pre-term or post-term newborns. Majordiseases were related to the index and adequacy extracts by the χ2test for a contingency table. Results: A significant association wasfound among low index, pre-term for gestational age newborns andterm small for gestational age; between average index and appropriatefor gestational age term newborns; and high index with large termappropriate for gestational age newborns (p< 0.001. Hypoglycemia(3.4% was associated to both low and high indices, to appropriatefor gestational age preterm newborns and to small for gestational ageterm newborns. Sepsis (3.1% was associated to both low index andpre-term appropriate for gestational age newborns. The respiratorydistress syndrome (1.3% was associated to low index and pre-termappropriate for gestational age newborns. Other respiratory distresssyndromes (3.8% were associated to low and high indices but notto the adequacy for gestational age classification. Jaundice (14.9%was not associated to the studied classifications

  7. Transient gestational diabetes insipidus diagnosed in successive pregnancies: review of pathophysiology, diagnosis, treatment, and management of delivery.

    Science.gov (United States)

    Kalelioglu, Ibrahim; Kubat Uzum, Ayse; Yildirim, Alkan; Ozkan, Tulay; Gungor, Funda; Has, Recep

    2007-01-01

    Gestational diabetes insipidus (GDI) is a rare disorder characterised by polyuria, polydypsia, and excessive thirst usually manifesting in the third trimester of pregnancy. The etiology is thought to depend on excessive vasopressinase activity, a placental enzyme that degrades arginine-vasopressin (AVP), but not 1-deamino-8-D: -arginine vasopressin (dDAVP), which is a synthetic form. This is a transient syndrome and may be associated with acute fatty liver of pregnancy and preeclampsia. The use of dDAVP in symptomatic cases has been proven as a safe method for both the mother and the fetus during the pregnancy. We report a case of recurrent gestational diabetes insipidus in successive pregnancies, which responded to dDAVP and subsided after delivery.

  8. Analysis of preterm deliveries below 35 weeks' gestation in a tertiary referral hospital in the UK. A case-control survey

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    Sellers Susan M

    2010-04-01

    Full Text Available Abstract Background Preterm birth remains a major public health problem and its incidence worldwide is increasing. Epidemiological risk factors have been investigated in the past, but there is a need for a better understanding of the causes of preterm birth in well defined obstetric populations in tertiary referral centres; it is important to repeat surveillance and identify possible changes in clinical and socioeconomic factors associated with preterm delivery. The aim of this study was to identify current risk factors associated with preterm delivery and highlight areas for further research. Findings We studied women with singleton deliveries at St Michael's Hospital, Bristol during 2002 and 2003. 274 deliveries between 23-35 weeks' gestation (preterm group, were compared to 559 randomly selected control deliveries at term (37-42 weeks using standard statistical procedures. Both groups were >80% Caucasian. Previous preterm deliveries, high maternal age (> 39 years, socioeconomic problems, smoking during pregnancy, hypertension, psychiatric disorders and uterine abnormalities were significantly associated with preterm deliveries. Both lean and obese mothers were more common in the preterm group. Women with depression/psychiatric disease were significantly more likely to have social problems, to have smoked during pregnancy and to have had previous preterm deliveries; when adjustments for these three factors were made the relationship between psychiatric disease and pregnancy outcome was no longer significant. 53% of preterm deliveries were spontaneous, and were strongly associated with episodes of threatened preterm labour. Medically indicated preterm deliveries were associated with hypertension and fetal growth restriction. Preterm premature rupture of the membranes, vaginal bleeding, anaemia and oligohydramnios were significantly increased in both spontaneous and indicated preterm deliveries compared to term controls. Conclusions More than 50

  9. Evaluating the Prevalence of Small for Gestational Age and Its Associated Risk Factors

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    Barati

    2016-03-01

    Full Text Available Background Small for gestational age (SGA fetuses have birth weights below 10th percentile or abdominal circumference less than 10th percentile for gestational age Objectives This study aimed to determine the prevalence of SGA and its associated risk factors in Iran. Patients and Methods This is a retrospective study. A total of 341 pregnant women were evaluated in fetal health care clinic of perinatology from January 2013 to January 2014. Results Of 312 pregnant women, 33 had SGA fetuses. The average of body mass index (BMI was lower in SGA group than non-SGA. Pulsatility index has no stastical meaningful between SGA and nonSGA groups. In Gestational age had no difference between 2 groups. Severe SGA (< 3rd centile estimated fetal weight was observed in 2.6% of all cases. Conclusions In conclusion, the prevalence of SGA was approximately one tenth of all pregnancies. SGA incidence was associated with nulliparity and more frequently seen in lower age group.

  10. Hypersecretion of FSH in infant boys and girls born small for gestational age.

    Science.gov (United States)

    Ibáñez, Lourdes; Valls, Carme; Cols, Maria; Ferrer, Angela; Marcos, Maria Victoria; De Zegher, Francis

    2002-05-01

    Prenatal growth restraint, as reflected in a low birthweight for gestational age, is a risk factor for postpubertal FSH hypersecretion and for reduced gonadal size. The ontogeny of the low-birthweight effect on the FSH-inhibin B feedback loop is unknown. Infancy is an episode of choice to study the possibility of an early low-birthweight effect on the FSH-inhibin B loop because this phase is characterized by high activity within the gonadal axis. We assessed serum concentrations of FSH and inhibin B in 46 infants [26 girls and 20 boys; mean age, 4 months; range, 3-6 months; 17 appropriate for gestational age (AGA), 29 small for gestational age (SGA); mean birthweight, 3.2 kg for AGA vs. 2.3 kg for SGA], together with circulating levels of LH, E2, and free androgen index. In SGA girls and boys, serum FSH levels were 2- and 4-fold higher (P hypersecretion in infancy is a marker of subsequent subfertility.

  11. Comparison of New Ballards score and Parkins score for gestational age estimation.

    Science.gov (United States)

    Sreekumar, Kavita; d'Lima, Annely; Nesargi, Saudamini; Rao, Suman; Bhat, Swarnarekha

    2013-08-01

    This prospective analytical study was done to compare the accuracy of New Ballards score (NBS) and Parkins score (PS) in assessing the gestational age (GA) in newborns. The GA of 284 babies was assessed by the NBS and PS within 24 hours of birth. The two methods of assessment were compared using the Bland Altmann Plot. The mean difference between the two measurements was 1.530576. 95% of the values lay within the limits of agreement which are -1.82982 and 4.890974. The two methods are found to be in acceptable agreement. Parkins score enables us to easily assess the gestational age of babies within ±12 days, especially in sick and preterm babies.

  12. Socioeconomic inequality in birth weight and gestational age in Denmark 1996-2007

    DEFF Research Database (Denmark)

    Mortensen, Laust Hvas

    2013-01-01

    were siblings but were different in terms of socioeconomic position. Data consisted of 471,215 live born singletons born in Denmark 1997-2007 with at least one sibling or one first cousin. We examined parental educational attainment and household income in relation to preterm birth and small...... had the highest risk. Maternal education was inversely associated with the risk of small for gestational age in cohort analyses, attenuated between mothers who were siblings, and not present between children who were siblings. For example, the hazard ratio of preterm birth of women with a college...... for gestational age using Cox regression. Household income was only weakly related to these outcomes. Paternal education was strongly associated with the outcomes only in the cohort analyses. Maternal education was inversely associated with preterm birth only in the cohort analyses, where the least educated women...

  13. Standards of Birth Weight According to Gestational Age in the Northwestern Regions of Ukraine

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    Rodych O.

    2015-05-01

    Full Text Available An analysis of the neonatal registry for 2001-2010 years in Rivne and Volyn regions of Ukraine as well as 2006-2011 years of Khmelnytsky region was carried out. General information was available about body weight of 366 607 newborns, among which 188 687 were boys and 177 920 girls. Based on the analysis we developed local standards of birth body weight in relation to gestational age separately for boys and girls. Procedure for processing local standards met international standards that have been developed by the WHO. Availability of processed local standards depending on gestational age will enable neonatologists, pediatricians and researchers to clearly identify anomalies in the health of newborns in the northwestern regions of Ukraine. Therefore, identification of newborns with low or high birth weight will enable adequate and timely steps to improve their health.

  14. Gestational age-specific reference ranges from different laboratories misclassify pregnant women's thyroid status

    DEFF Research Database (Denmark)

    Bliddal, Sofie; Feldt-Rasmussen, Ulla; Boas, Malene

    2014-01-01

    OBJECTIVES: Correct interpretation of thyroid status during pregnancy is vital to secure fetal development. Pregnancy-related changes in maternal thyroid status necessitate the use of gestational age-specific reference ranges. In this study, we investigated between-laboratory reproducibility...... of thyroid reference ranges in pregnant women. DESIGN: Comparison of two longitudinal prospective cohort studies including 255 (cohort 1) and 101 (cohort 2) healthy antibody-negative Danish pregnant women attending prenatal care at Copenhagen University Hospital. METHODS: Different immunoassays were used...... region, the use of gestational-age-specific reference ranges from different laboratories led to misclassification. Up to 100% of maternal FT4 levels fell outside the other cohort's reference range despite similar TSH levels. In clinical practice, thyroid testing of pregnant women without adding method...

  15. Gestational age at biochemical sampling in first trimester screening for trisomy 18 and 13

    DEFF Research Database (Denmark)

    Petersen, Olav Bjørn; Ekelund, Charlotte; Kirkegaard, Ida

    Objective: To determine if gestational age at serum sampling affect the discriminative value of PAPP-A and free β hCG in relation to trisomy 18 (T18) and trisomy 13 (T13). Methods: We retrospectively searched for T18 and T13 cases in the Astraia database at two large Fetal Medicne Centres......, 39 pregnancies with trisomy 18 and 26 pregnancies with trisomy 13 was identified. We found that PAPP-A MoM levels in trisomy 18 pregnancies are less discriminatory (P = 0.0004) at earlier gestations than they are at later gestations. They decrease from an estimated median MoM of 0.54 (95% CI: 0.......16 to 0.30) at the middle of week 12. For trisomy 13 pregnancies we also found a trend, though not statistically significant, towards poorer discrimination at early gestations. In the prospective, two sample data, a total of 5 T18 and 3 T13 cases was identified. The within-case MoM-variation showed...

  16. Systemic inflammation in the extremely low gestational age newborn following maternal genitourinary infections

    Science.gov (United States)

    Fichorova, Raina N.; Beatty, Noah; Sassi, Rita R. S.; Yamamoto, Hidemi S.; Allred, Elizabeth N.; Leviton, Alan

    2014-01-01

    Problem Gestational genitourinary infections are associated with life-long disabilities, but it is unknown if neonatal inflammation is involved. Method Mothers of 914 infants born before 28th gestation week reported cervical/vaginal infection (CVI), and/or urine/bladder/kidney infection (UTI), or neither. Inflammation proteins measured in baby’s blood on postnatal days 1, 7 and 14 were considered elevated if in the top quartile for gestational age. Logistic regression models adjusting for potential confounders assessed odds ratios. Results Compared to neither UTI/CVI, mothers with CVI were more likely to have infants with elevated CRP, SAA, MPO, IL-1β, IL-6, IL-6R, TNF-α, RANTES, ICAM-3, E-selectin and VEGF-R2 on day 1; those with UTI were more likely to have infants with elevated MPO, IL-6R, TNF-R1, TNF-R2, and RANTES on day 7. Placental anaerobes and genital micoplasma were more common in pregnancies with CVI. Conclusion Gestational UTI/CVI should be targeted for preventing systemic inflammation in the very preterm newborn. PMID:25164433

  17. Gene expression in placentas from non-diabetic women giving birth to large for gestational age infants

    NARCIS (Netherlands)

    Ahlsson, F; Åkerud, Helena; Schijven, D; Olivier, Jocelien; Sundström Poromaa, Inger

    2015-01-01

    Gestational diabetes, obesity and excessive weight gain are known independent risk factors for the birth of a large for gestational age (LGA) infant. However, only one out of ten infants born LGA is born by mothers with diabetes or obesity. Thus, the aim of the present study was to compare placental

  18. Trends in gestational age and birth weight in Chile, 1991–2008. A descriptive epidemiological study

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    Lopez Paulina O

    2012-11-01

    Full Text Available Abstract Background Gestational age and birth weight are the principal determinants of newborn’s health status. Chile, a middle income country traditionally has public policies that promote maternal and child health. The availability of an exhaustive database of live births has allows us to monitor over time indicators of newborns health. Methods This descriptive epidemiological study included all live births in Chile, both singleton and multiple, from 1991 through 2008. Trends in gestational age affected the rate of prevalence (% of preterm births ( Results Data from an exhaustive register of live births showed that the number of term and postterm births decreased and the number of multiple births increased significantly. Birth weights exceeding 4000 g did not vary. Total preterm births rose from 5.0% to 6.6%, with increases of 28% for the singletons and 31% for multiple births (p for trend  The overall rate of low birth weight infants ( Conclusions The gestational age and birth weight of live born child have significantly changed over the past two decades in Chile. Monitoring only overall rates of preterm births and low-birth-weight could provide restricted information of this important problem to public health. Monitoring them by specific categories provides a solid basis for planning interventions to reduce adverse perinatal outcomes. This epidemiological information also showed the need to assess several factors that could contribute to explain these trends, as the demographics changes, medical interventions and the increasing probability of survival of extremely and very preterm child.

  19. Association Between Low Dairy Intake During Pregnancy and Risk of Small-for-Gestational-Age Infants.

    Science.gov (United States)

    Olmedo-Requena, Rocío; Amezcua-Prieto, Carmen; Luna-Del-Castillo, Juan de Dios; Lewis-Mikhael, Anne-Mary; Mozas-Moreno, Juan; Bueno-Cavanillas, Aurora; Jiménez-Moleón, José Juan

    2016-06-01

    Background Inadequate maternal nutrition is regarded as one of the most important indicators of fetal growth. The aim of this study was to analyze the associated risk of having a small for gestational age (SGA) infant according to the mother's dairy intake during the first half of pregnancy. Methods A prospective cohort study was performed using 1175 healthy pregnant women selected from the catchment area of Virgen de las Nieves University Hospital, Granada (Spain). SGA was defined as neonates weighing less than the 10th percentile, adjusted for gestational age. Factors associated with SGA were analyzed using logistic regression models. Population attributable fractions of SGA according to dairy intake were estimated. Results Dairy intake among women who gave birth to SGA infants was 513.9, versus 590.3 g/day for women with appropriate size for gestational age infants (P = 0.003). An increased intake of dairy products by 100 g/day during the first half of pregnancy decreased the risk of having a SGA infant by 11.0 %, aOR = 0.89 (0.83, 0.96). A dose-response gradient between dairy intake and SGA was observed. Conclusions An inadequate intake of dairy products is associated with a higher risk of SGA. Our results suggest a possible causal relation between dairy intake during pregnancy and the weight of the newborn, although we cannot discard residual confounding. These results should be further supported by properly designed studies.

  20. Relationship between sonographic umbilical cord size and gestational age among pregnant women in Enugu, Nigeria.

    Science.gov (United States)

    Eze, Charles; Ugwuja, Mabel; Eze, Cletus; Ugwu, George; Agwuna, Kennedy; Ituk-Ozalla

    2014-06-01

    Common fetal parameters for gestational age (GA) estimation have pitfalls especially in advanced pregnancy and pregnancy complicated by fetal structural anomaly. To assess the relationship between umbilical cord size and gestational age of the fetus. A sonographic cross sectional study involving 300 pregnant women with GA between 14 weeks to 40 weeks was done in Enugu, Nigeria. Gestational ages were first estimated by use of Naegele's formula for GA estimation based on the date of onset of each subject's last menstrual period. Fetal parameters such as biparietal diameter, femur length, head circumference and abdominal circumference were measured and also used to estimate GA. Umbilical cord diameters were measured and used to compute the umbilical cord cross-sectional area. The mean umbilical cord diameter and cross-sectional area were 14.5mm ± 7.2mm and 201.6mm ± 139.5mm(2) respectively. Umbilical cord growth rate of 1.0mm/week was noted between the 14(th) and 35(th) week of pregnancy. There were significant correlations (p umbilical cord size and other fetal parameters for GA estimation. Umbilical cord size had strong linear relationship with common fetal GA estimation parameters and could be used to compliment these parameters for GA estimation.

  1. Face recognition impairment in small for gestational age and preterm children.

    Science.gov (United States)

    Perez-Roche, T; Altemir, I; Giménez, G; Prieto, E; González, I; López Pisón, J; Pueyo, V

    2017-03-01

    Infants born prematurely or with low birth weight are at increased risk of visual perceptual impairment. Face recognition is a high-order visual ability important for social development, which has been rarely assessed in premature or low birth weight children. To evaluate the influence of prematurity and low birth weight on face recognition skills. Seventy-seven children were evaluated as part of a prospective cohort study. They were divided into premature and term birth cohorts. Children with a birth weight below the 10th centile were considered small for gestational age. All children underwent a full ophthalmologic assessment and evaluation of face recognition skills using the Facial Memory subtest from the Test of Memory and Learning. Premature infants scored worse on immediate face recognition compared to term infants. However, after adjusting for birth weight, prematurity was not associated with worse outcomes. Independent of gestational age, outcomes of low birth weight children were worse than those of appropriate birth weight children, for immediate face recognition (odds ratio [OR], 5.14; 95% confidence interval [CI], 1.32-21.74) and for face memory (OR, 4.48; 95% CI, 1.14-16.95). Being born small for gestational age is associated with suboptimal face recognition skills, even in children without major neurodevelopmental problems. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Birthweight and gestational age by ethnic group, England and Wales 2005: introducing new data on births.

    Science.gov (United States)

    Moser, Kath; Stanfield, Kristina M; Leon, David A

    2008-01-01

    Low birthweight babies and babies born preterm are at increased risk of morbidity and mortality in the first year of life, as well as in the longer-term. Since information on ethnic group is not recorded at birth registration in England and Wales, it has not been possible to produce routine statistics on birthweight or gestational age by ethnic group. A new system, introduced in 2002, for allocating NHS numbers at birth (NN4B) provided the opportunity to obtain ethnic group information. The NN4B record includes information on the ethnic group of the baby classified according to the 2001 Census categories. This paper presents the first analyses of ethnic differences in birthweight and gestational age at birth for England and Wales as a whole. Utilising NN4B records linked with birth registration records for all births occurring in England and Wales in 2005, birthweight and gestational age distributions, including the percentages low birthweight and preterm, are compared between ethnic groups. The paper also examines how parental socio-demographic circumstances vary by ethnic group.

  3. Respiratory water loss in relation to gestational age in infants on their first day after birth.

    Science.gov (United States)

    Riesenfeld, T; Hammarlund, K; Sedin, G

    1995-09-01

    Respiratory water loss, oxygen consumption and carbon dioxide production were measured in 32 infants on their first day after birth. Gestational age was between 27 and 41 weeks. All infants were studied in incubators with 50% ambient relative humidity and an ambient temperature that allowed the infant to maintain a normal and stable body temperature. During the measurements the infants were usually asleep. Respiratory water loss was found to be highest in the most preterm infants and lower in more mature infants. Respiratory water loss per breath (mg/kg) was almost the same at all gestational ages and the higher respiratory water loss found in the most preterm as compared with the more mature infants is thus and increased with increasing gestational age. Thus, in full-term infants respiratory water loss and transepidermal water loss are of approximately equal magnitude at an ambient humidity of 50%, while respiratory water loss constitutes a smaller proportion than transepidermal water loss in very preterm infants. Respiratory water loss increases with the rate of breathing.

  4. Prevalence of hypospadias in Italy according to severity, gestational age and birthweight: an epidemiological study

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    Magnani Cinzia

    2009-06-01

    Full Text Available Abstract Background Hypospadias is a congenital displacement of the urethral meatus in male newborns, being either an isolated defect at birth or a sign of sexual development disorders. The aim of this study was to assess the prevalence rate of hypospadias in different Districts of Italy, in order to make a comparison with other countries all over the world. Methods We reviewed all the newborns file records (years 2001–2004 in 15 Italian Hospitals. Results We found an overall hypospadias prevalence rate of 3.066 ± 0.99 per 1000 live births (82.48% mild hypospadias, 17.52% moderate-severe. In newborns Small for Gestational Age (birthweight th percentile of any gestational age the prevalence rate of hypospadias was 6.25 per 1000 live births. Performing multivariate logistic regression analysis for different degrees of hypospadias according to severity, being born SGA remained the only risk factor for moderate-severe hypospadias (p = 0.00898 but not for mild forms (p > 0.1. Conclusion In our sample the prevalence of hypospadias results as high as reported in previous European and American studies (3–4 per 1000 live births. Pathogenesis of isolated hypospadias is multifactorial (genetic, endocrine and environmental factors: however, the prevalence rate of hypospadias is higher in infants born small for gestational age than in newborns with normal birth weight.

  5. The effect of gestational age on angiogenic gene expression in the rat placenta.

    Directory of Open Access Journals (Sweden)

    Kanchan Vaswani

    Full Text Available The placenta plays a central role in determining the outcome of pregnancy. It undergoes changes during gestation as the fetus develops and as demands for energy substrate transfer and gas exchange increase. The molecular mechanisms that coordinate these changes have yet to be fully elucidated. The study performed a large scale screen of the transcriptome of the rat placenta throughout mid-late gestation (E14.25-E20 with emphasis on characterizing gestational age associated changes in the expression of genes involved in angiogenic pathways. Sprague Dawley dams were sacrificed at E14.25, E15.25, E17.25 and E20 (n = 6 per group and RNA was isolated from one placenta per dam. Changes in placental gene expression were identified using Illumina Rat Ref-12 Expression BeadChip Microarrays. Differentially expressed genes (>2-fold change, <1% false discovery rate, FDR were functionally categorised by gene ontology pathway analysis. A subset of differentially expressed genes identified by microarrays were confirmed using Real-Time qPCR. The expression of thirty one genes involved in the angiogenic pathway was shown to change over time, using microarray analysis (22 genes displayed increased and 9 gene decreased expression. Five genes (4 up regulated: Cd36, Mmp14, Rhob and Angpt4 and 1 down regulated: Foxm1 involved in angiogenesis and blood vessel morphogenesis were subjected to further validation. qPCR confirmed late gestational increased expression of Cd36, Mmp14, Rhob and Angpt4 and a decrease in expression of Foxm1 before labour onset (P<0.0001. The observed acute, pre-labour changes in the expression of the 31 genes during gestation warrant further investigation to elucidate their role in pregnancy.

  6. Determination of gestational age by ultrasonography - wrong, wrong and wrong again. Bestemmelse av foedselstermin ved tidlig ultralydundersoekelse - galt, galere, galest

    Energy Technology Data Exchange (ETDEWEB)

    Bratlid, D. (Rikshospitalet, Oslo (Norway))

    1991-04-01

    The article is a critical review of principal weaknesses in the current use of ultrasonography for determination of gestational age and discusses the fact that the method in its practical use disregards any biological variation in biparietal diameter. It is concluded that second trimester determination of gestational age by ultrasonography has an accuracy no greater than +-1.5 weeks. This is comparable to the accuracy of the clinical assessment of maturation in the newborn baby. Ultrasonography as the main indicator of gestational age should be used only when the pregnant woman's own menstrual history is obviously incorrect. 6 refs., 1 fig.

  7. Small-for-gestational age and its association with maternal blood glucose, body mass index and stature: a perinatal cohort study among Chinese women

    Science.gov (United States)

    Leng, Junhong; Hay, John; Liu, Gongshu; Zhang, Jing; Wang, Jing; Liu, Huihuan; Yang, Xilin; Liu, Jian

    2016-01-01

    Objective To examine whether maternal low blood glucose (BG), low body mass index (BMI) and small stature have a joint effect on the risk of delivery of a small-for-gestational age (SGA) infant. Design Women from a perinatal cohort were followed up from receiving perinatal healthcare to giving birth. Setting Beichen District, Tianjin, China between June 2011 and October 2012. Participants 1572 women aged 19–39 years with valid values of stature, BMI and BG level at gestational diabetes mellitus screening (gestational weeks 24–28), glucose challenge test <7.8 mmol/L and singleton birth (≥37 weeks’ gestation). Main outcome measures SGA was defined as birth weight <10th centile for gender separated gestational age of Tianjin singletons. Results 164 neonates (10.4%) were identified as SGA. From multiple logistic regression models, the ORs (95% CI) of delivery of SGA were 0.84 (0.72 to 0.98), 0.61 (0.49 to 0.74) and 0.64 (0.54 to 0.76) for every 1 SD increase in maternal BG, BMI and stature, respectively. When dichotomises, maternal BG (<6.0 vs ≥6.0 mmol/L), BMI (<24 vs ≥24 kg/m2) and stature (<160.0 vs ≥160.0 cm), those with BG, BMI and stature all in the lower categories had ∼8 times higher odds of delivering an SGA neonate (OR (95% CI) 8.01 (3.78 to 16.96)) relative to the reference that had BG, BMI and stature all in the high categories. The odds for an SGA delivery among women who had any 2 variables in the lower categories were ∼2–4 times higher. Conclusions Low maternal BG is associated with an increased risk of having an SGA infant. The risk of SGA is significantly increased when the mother is also short and has a low BMI. This may be a useful clinical tool to identify women at higher risk for having an SGA infant at delivery. PMID:27633632

  8. Kidney development in the first year of life in small-for-gestational-age preterm infants

    Energy Technology Data Exchange (ETDEWEB)

    Hotoura, Efthalia; Giapros, Vasilios; Drougia, Aikaterini [University Hospital of Ioannina, Neonatal Intensive Care Unit, Ioannina (Greece); Argyropoulou, Maria; Papadopoulou, Frederica; Nikolopoulos, Panayiotis [University Hospital of Ioannina, Radiology Department, Ioannina (Greece); Andronikou, Styliani [University Hospital of Ioannina, Neonatal Intensive Care Unit, Ioannina (Greece); University of Ioannina Medical School, Child Health Department, Ioannina (Greece)

    2005-10-01

    Small-for-gestational-age (SGA) infants have been reported to have a significantly reduced number of nephrons that could be a risk factor for development of hypertension later in life. To evaluate kidney size prospectively in relation to other anthropometric parameters during the first year of life in SGA babies. The babies in the study were 31-36 weeks' gestational age (GA) at birth and were matched with control preterm infants of similar GA, but appropriate for gestational age (AGA). The SGA infants were further classified as symmetrical and asymmetrical according to the anthropometric parameters. The total number of measurements in symmetrical SGA preterm infants was 324, in asymmetrical SGA preterm infants 295, and in AGA infants 536. In symmetrical SGA preterm infants (31-36 weeks' GA) mean kidney length ({+-} SD) of 56{+-}4 mm was significantly different from the controls (58.9{+-}4.6 mm) up to 6 months' chronological age (P < 0.05). In the asymmetrical SGA preterm infants, mean kidney length (45.3{+-}4.0 mm) was significantly different from the controls (48.2{+-}4.4 mm) up to 40 weeks' corrected age. At 1 year chronological age, all preterm infants (symmetrical and asymmetrical SGA and AGA) had similar mean kidney length (61.6{+-}4.6, 62.8{+-}4.3, and 62.3{+-}4.0 mm, respectively). The ratio of kidney length to crown-to-heel length was similar in all preterm groups. Kidney length in preterm SGA infants (symmetrical and asymmetrical) follows closely the other auxological parameters during the first year of life. (orig.)

  9. Prognostic value of neonatal electroencephalography in premature newborns less than 33 weeks of gestational age.

    Science.gov (United States)

    Marret, S; Parain, D; Ménard, J F; Blanc, T; Devaux, A M; Ensel, P; Fessard, C; Samson-Dollfus, D

    1997-03-01

    In a prospective study of 417 premature neonates born before 33 weeks' gestational age, neonatal tracings were reviewed to evaluate the use of EEG in prognosis of neurological injuries. The population was divided into two groups: Group 1, infants who died before the age of 1, and Group 2, survivors in which two categories of motor development were considered. Category A, were abnormal, and Category B, were always normal. Positive rolandic sharp waves (PRSW), which reflect white matter injury, occurred equally in both groups, indicating a similar incidence of white matter damage in Groups 1 and 2. In Group 2, there was a significant correlation of PRSW with developmental motor sequelae (Category A). A frequency of PRSW above 2/min (suggesting more severe periventricular white matter injury) and seizures were significantly more prevalent in Group 1 than in Group 2 and in Category A of Group 2 than in Category B. Background abnormalities occurred equally in both subgroups of extremely premature infants ( 28 weeks' gestation) and extremely (< or = 28 weeks' gestation) premature newborns.

  10. Cardiovascular risk factors in parents of short children born small for gestational age.

    Science.gov (United States)

    De Kort, Sandra W K; Van Dijk, Marije; Willemsen, Ruben H; Ester, Wietske A; Viet, Lucie; De Rijke, Yolanda B; Hokken-Koelega, Anita C S

    2008-07-01

    Small for gestational age (SGA) children have a higher prevalence of cardiovascular risk factors at a young age. It is not known whether this increased risk is caused by their size at birth, a familial predisposition for cardiovascular disease or smallness at birth or a combination of these factors. The cardiovascular risk profile of parents of SGA children is unknown. We compared anthropometry, blood pressure, fasting serum lipid, glucose, and insulin levels of 482 parents (mean age 41 y) and 286 short SGA children with age- and sex-matched references. We also investigated whether these parameters correlated between parents and their offspring. Mothers had higher systolic blood pressure, fathers had a higher body mass index and parents had more frequently high fasting glucose levels than age- and sex-matched references. Children had significantly higher systolic and diastolic blood pressure than sex- and height-matched references. Twenty-four percent (mothers) and 10% (fathers) were born SGA but they did not have more cardiovascular risk factors than those born appropriate for gestational age. Cardiovascular risk factors did not correlate between parents and children. In conclusion, parents of short SGA children have a modest increase in some cardiovascular risk factors but risk factors did not correlate between parents and children.

  11. Efficacy and safety of growth hormone treatment for children born small for gestational age

    OpenAIRE

    Hwang, Il Tae

    2014-01-01

    Recombinant growth hormone (GH) is an effective treatment for short children who are born small for gestational age (SGA). Short children born SGA who fail to demonstrate catch-up growth by 2-4 years of age are candidates for GH treatment initiated to achieve catch-up growth to a normal height in early childhood, maintain a normal height gain throughout childhood, and achieve an adult height within the normal target range. GH treatment at a dose of 35-70 µg/kg/day should be considered for tho...

  12. Gestational age at initiation of 17-alpha hydroxyprogesterone caproate and recurrent preterm birth.

    Science.gov (United States)

    Ning, Angela; Vladutiu, Catherine J; Dotters-Katz, Sarah K; Goodnight, William H; Manuck, Tracy A

    2017-09-01

    Preterm birth is the leading cause of neonatal morbidity and mortality in nonanomalous neonates in the United States. Women with a previous early spontaneous preterm birth are at highest risk for recurrence. Weekly intramuscular 17-alpha hydroxyprogesterone caproate reduces the risk of recurrent prematurity. Although current guidelines recommend 17-alpha hydroxyprogesterone caproate initiation between 16 and 20 weeks, in clinical practice, 17-alpha hydroxyprogesterone caproate is started across a spectrum of gestational ages. The objective of the study was to examine the relationship between the gestational age at 17-alpha hydroxyprogesterone caproate initiation and recurrent preterm birth among women with a prior spontaneous preterm birth 16-28 weeks' gestation. This was a retrospective cohort study of women from a single tertiary care center, 2005-2016. All women with ≥1 singleton preterm births because of a spontaneous onset of contractions, preterm prelabor rupture of membranes, or painless cervical dilation between 16 and 28 weeks followed by a subsequent singleton pregnancy treated with 17-alpha hydroxyprogesterone caproate were included. Women were grouped based on quartiles of gestational age of 17-alpha hydroxyprogesterone caproate initiation (quartile 1, 14(0/7) to 16(1/7); quartile 2, 16(2/7) to 17(0/7); quartile 3, 17(1/7) to 18(6/7); and quartile 4, 19(0/7) to 27(5/7)). Women with a gestational age of 17-alpha hydroxyprogesterone caproate initiation in quartiles 1 and 2 were considered to have early-start 17-alpha hydroxyprogesterone caproate; those in quartiles 3 and 4 were considered to have late-start 17-alpha hydroxyprogesterone caproate. The primary outcome was recurrent preterm birth preterm birth preterm birth preterm birth preterm birth preterm birth preterm birth among women with a prior spontaneous preterm birth 16-28 weeks are high. Women beginning 17-alpha hydroxyprogesterone caproate early deliver later and have improved neonatal

  13. Clinical sonography in premature infant: Sonographic analysis of incidence and grade of germinal metrixhemorrhage according to gestational age,risk

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Hyoung; Kim, I. W.; Yeon, K. M. [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1989-12-15

    The authors reviewed 63 premature infants who was born from January 1986 to August 1988 at College of Medicine Seoul National University, to analyze grade of germinal metrixhemorrhage to gestational age, risk.

  14. Secondary Measures of Access to Abortion Services in the United States, 2011 and 2012: Gestational Age Limits, Cost, and Harassment

    OpenAIRE

    Jerman, Jenna; Jones, Rachel K.

    2014-01-01

    Background Aspects of U.S. clinical abortion service provision such as gestational age limits, charges for abortion services, and anti-abortion harassment can impact the accessibility of abortion; this study documents changes in these measures between 2008 and 2012. Methods In 2012 and 2013, we surveyed all known abortion-providing facilities in the United States (n = 1,720). This study summarizes information obtained about gestational age limits, charges, and exposure to anti-abortion harass...

  15. Premature Birth and Large for Gestational Age Are Associated with Risk of Barrett's Esophagus in Adults.

    Science.gov (United States)

    Shiota, Seiji; El-Serag, Hashem B; Thrift, Aaron P

    2016-04-01

    Birth characteristics, including weight and gestational age, may be associated with risk of Barrett's esophagus (BE), the only known precursor for esophageal adenocarcinoma; however, data are limited. To examine associations between various birth characteristics and BE, and whether these associations are mediated by known risk factors for BE. Data were obtained from a cross-sectional study among eligible Veterans Affairs patients scheduled for an upper endoscopy, and a sample identified from primary care clinics. Participants underwent an esophagogastroduodenoscopy and completed a survey that captured information on sociodemographic and clinical factors, as well as birth information. We compared 263 patients with histologically confirmed BE to 1416 controls without BE on endoscopy. Odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using multivariate logistic regression. Premature birth was independently associated with risk of BE after adjusted by age, sex, race, and other birth characteristics (OR 3.28, 95 % CI 1.22-8.79). On the other hand, large for gestational age was inversely associated with risk of BE (OR 0.46, 95 % CI 0.21-0.98). These effects were stronger for patients with long-segment BE than with short-segment BE. The associations were not mediated by gastroesophageal reflux disease symptoms, use of proton pump inhibitors, Helicobacter Pylori infection, waist-hip-ratio, height or the presence of hiatus hernia. Premature birth and large for gestational age may be associated with risk of BE in adults. These associations do not appear to be mediated through known risk factors for BE; however, additional studies are required to confirm our findings.

  16. Hypoadiponectinemia in extremely low gestational age newborns with severe hyperglycemia--a matched-paired analysis.

    Directory of Open Access Journals (Sweden)

    Andre Oberthuer

    Full Text Available BACKGROUND: Hyperglycemia is commonly observed in extremely low gestational age newborns (ELGANs and is associated with both increased morbidity and mortality. The objective of this study was to examine the relationship between neonatal hyperglycemia and adiponectin levels in ELGANs. METHODOLOGY/PRINCIPAL FINDINGS: Ten preterm infants between 22+6/7 and 27+3/7 weeks' gestation with neonatal hyperglycemia (defined as pre-feeding blood glucose levels above 200mg/dl on two consecutive measurements with a maximum parenteral glucose infusion of 4 mg/kg*min(-1 formed the case cohort of this study. To every single patient of this case cohort a patient with normal fasting ( = pre-feeding blood glucose levels was matched in terms of gestational age and gender. Adiponectin ELISAs were performed both at onset of hyperglycemia and at term-equivalent age. In the case cohort 9/10 patients had to be treated with insulin for 1-26 days (range 0.01-0.4 IU/kg*h(-1. Compared to matched-paired controls, significant hypoadiponectinemia was observed at onset of hyperglycemia in these affected patients (6.9 µg/ml versus 15.1 µg/ml, p = 0.009. At term equivalent age, normoglycemia without any insulin treatment was found in both groups. Moreover, adiponectin levels at that time were no longer significantly different (12.3 µg/ml versus 20.0 µg/ml; p = 0.051 possibly indicating a mechanistic relevance of this adipokine in regulating insulin sensitivity in ELGANs. CONCLUSIONS/SIGNIFICANCE: Decreased circulating adiponectin levels are correlated with hyperglycemia in ELGANs and may contribute to the pathogenesis of impaired glucose homeostasis in these infants. These findings suggest that adiponectin might be a potential future drug target for the potentially save treatment of hyperglycemia in pre-term infants.

  17. Respiratory distress syndrome in newborns of gestational age of over 32 weeks.

    Science.gov (United States)

    Rimar, Zeljka; Milas, Vesna; Medimurec, Maja; Mesić, Ivana

    2014-06-01

    Albeit the aetiology of the respiratory distress syndrome (RDS) is well known, the paper shall demonstrate that the causes of RDS changed over the years 2006 and 2010. This retrospective study comprises analysis of the data collected from 60 newborns of over 32 weeks gestation with RDS in the Neonatal Intensive Care Unit at the Clinical Hospital Centre in Osijek. The focus of the paper lies in the difference in the incidence of RDS over two research periods (2006 and 2010), the most common and possible causes of RDS in newborns of over 32 weeks gestation as well as in the potential changes in the aetiology over the two research periods. An increase in the incidence of RDS was established in 2010, but it was statistically significant only for newborns of gestational age of 35 1/7 to 36 6/7 weeks. The most common cause of RDS in both research periods was sepsis, which decreased in its share in 2010, whereas the incidence of asphyxia and complications during pregnancy increased. The new potential cause in 2010 was maternal thrombophilia. The share of unknown causes of RDS decreased, although not significantly so. The results of the research indicate that the causes of RDS changed over the observed periods and that further research should focus on thrombophilia and other complications during pregnancy with the aim of reducing morbidity and improving neonatal outcomes as well as further reducing the incidence of RDS with unknown causes in newborns.

  18. Feto-maternal heart rate ratio in pregnant bitches: effect of gestational age and maternal size.

    Science.gov (United States)

    Alonge, S; Mauri, M; Faustini, M; Luvoni, G C

    2016-10-01

    Few information is available on parameters that can be used to objectively assess the foetal health during canine pregnancy. To identify a reliable parameter for the evaluation of foetal well-being, the effect of pre-gestational maternal bodyweight and gestational age on foetal heart rate (FHR) and on feto-maternal heart rate ratio (FHR/MHR) was investigated. Seventeen client-owned pregnant bitches of different pre-gestational maternal bodyweight were examined by serial echo colour Doppler. Only data from 11 uncomplicated pregnancies were included in the statistical analysis. The relationship between FHR, and FHR/MHR, and independent variables was analysed by polynomial regression (p ≤ .05). The FHR and the FHR/MHR significantly fitted a multiple quadratic regression for all independent variables. They both increased from 35 to 20 days before parturition and then a decreasing pattern followed. Higher values of both parameters were observed in bitches of lowest and highest bodyweight. Patterns of FHR and FHR/MHR were similar, but the ratio better describes the effect of the independent variables on the data. Thus, the highest significance of FHR/MHR compared to FHR alone encourages the application of this ratio to evaluate foetal well-being. The equation derived by the regression analysis of FHR/MHR could be applied in clinical practice to obtain its expected values in healthy pregnancies. © 2016 Blackwell Verlag GmbH.

  19. Prediction of parturition in dogs and cats: accuracy at different gestational ages.

    Science.gov (United States)

    Beccaglia, M; Luvoni, G C

    2012-12-01

    In bitches and queens, the ultrasonographic measurement of extrafoetal and foetal structures allows the evaluation of gestational age and the prediction of the parturition term for an extended period of time. The aim of this study was to investigate whether the accuracy of parturition date prediction is affected by the week of pregnancy when the ultrasonographic examination is performed. The results were obtained by retrospective analysis on the gestational period basis (from week 4 to week 9 of pregnancy) in 495 ultrasonographic examinations of pregnant bitches (small and medium size) and 60 of pregnant queens. They demonstrated that a similar accuracy (p > 0.05) was obtained by the measurement of inner chorionic cavity at week 4 and 5 of pregnancy (± 1 day, 81% vs 67.7%; ± 2 days, 93.1% vs 85.9%). Accuracy (± 1 day) based on biparietal (BP) measurement was similar at week 5 and 6 of pregnancy (78.6% vs 78.9%; p > 0.05), whereas a significant decrease (p pregnancy, the accuracy at ± 1 and ± 2 days of prediction of parturition term is highly consistent for 6 and 8 weeks of gestation, respectively.

  20. Cardiorespiratory parameters and their relation with gestational age and level of oral feeding skills in preterm infants.

    Science.gov (United States)

    Yamamoto, Raquel Coube de Carvalho; Prade, Leila Sauer; Berwig, Luana Cristina; Weinmann, Angela Regina Maciel; Keske-Soares, Márcia

    2016-01-01

    To correlate cardiorespiratory parameters with gestational age and level of oral feeding skills in the first oral feeding in preterm infants. Study participants were 37 clinically stable preterm infants. Cardiorespiratory rate was assessed before and after introduction of oral feeding. The newborns were divided into three strata according to gestational age at birth. Oral skill was classified into four levels: I - low oral skill and low resistance to feeding; II - low oral skill and high resistance to feeding; III - high oral skill and low resistance to feeding; IV - high oral skill and high resistance to feeding. No difference was observed in heart and respiratory rate between the strata of gestational age at birth and between the levels of oral skill. Comparison between pre- and post-cardiorespiratory rates within each level of oral skill and stratum of gestational age showed difference between heart rate in the strata of gestational ages of 30 to 33 weeks and of 34 to 36 weeks, as well as between oral skill of levels I, II, and IV. With regard to the comparison between pre- and post- respiratory rates, difference was found in the oral skill of level I. Differences were observed between pre- and post-prandial cardiorespiratory rates regarding the first oral feeding, as well as between strata of gestational age at birth and levels of oral feeding skills.

  1. Dependence of malformation upon gestational age and exposed dose of gamma radiation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sung-Ho; Lee, Jong-Hwan; Oh, Heon; Kim, Se-Ra [Chonnam National Univ., Kwangju (Korea, Republic of). Coll. of Veterinary Medicine; Lee, Cha-Soo; Jo, Sung-Kee; Kim, Tae-Hwan; Lee, Yun-Sil

    2001-09-01

    In order to evaluate the importance of gestational age and the dose-incidence relationship by gamma radiation, pregnant ICR mice at gestational days from 2.5 to 15.5 days post-coitus (p.c.) were exposed to a single dose of 2.0 Gy and also at day 11.5 after conception, which was the most sensitive stage for the induction of major congenital malformations. The animals were sacrificed on day 18 of gestation and the fetuses were examined for mortality, growth retardation, changes in head size and other morphological abnormalities. The only demonstrable effect of irradiation during the pre-implantation period was an increase in prenatal mortality. Resorptions were maximal on exposure at day 2.5 after conception. The pre-implantation irradiated embryos which survived did not show any major fetal abnormalities. A small head, growth retardation, a cleft palate, dilatation of the cerebral ventricle, a renal pelvis, and abnormalities of the extremities and tail after exposure were prominent during the organogenesis period, especially on day 11.5 of gestation. As for the dose-incidence relationship, the incidence of a small head, growth-retarded fetuses, a cleft palate, dilatation of cerebral ventricle and abnormalities of the extremities in live fetuses rose as the radiation dose increased. The result indicated that the late period of organogenesis in the development of the brain, skull and extremities of a mouse was a particularly sensitive phase. The threshold doses of radiation that induced a cleft palate and dilatation of the cerebral ventricle, and abnormal extremities were between 1.0 and 2.0 Gy, and between 0.5 and 1.0 Gy, respectively. (author)

  2. The effect of hypertensive disorders in pregnancy on small for gestational age and stillbirth: a population based study

    Directory of Open Access Journals (Sweden)

    Magee Laura A

    2004-08-01

    Full Text Available Abstract Background Hypertensive disorders in pregnancy are leading causes of maternal, fetal and neonatal morbidity and mortality worldwide. However, studies attempting to quantify the effect of hypertension on adverse perinatal outcomes have been mostly conducted in tertiary centres. This population-based study explored the frequency of hypertensive disorders in pregnancy and the associated increase in small for gestational age (SGA and stillbirth. Methods We used information on all pregnant women and births, in the Canadian province of Nova Scotia, between 1988 and 2000. Pregnancies were excluded if delivery occurred Results The study population included 135,466 pregnancies. Of these, 7.7% had mild pregnancy-induced hypertension (PIH, 1.3% had severe PIH, 0.2% had HELLP (hemolysis, elevated liver enzymes, low platelets, 0.02% had eclampsia, 0.6% had chronic hypertension, and 0.4% had chronic hypertension with superimposed PIH. Women with any hypertension in pregnancy were 1.6 (95% CI 1.5–1.6 times more likely to have a live birth with SGA and 1.4 (95% CI 1.1–1.8 times more likely to have a stillbirth as compared with normotensive women. Adjusted analyses showed that women with gestational hypertension without proteinuria (mild PIH and with proteinuria (severe PIH, HELLP, or eclampsia were more likely to have infants with SGA (RR 1.5, 95% CI 1.4–1.6 and RR 3.2, 95% CI 2.8–3.6, respectively. Women with pre-existing hypertension were also more likely to give birth to an infant with SGA (RR 2.5, 95% CI 2.2–3.0 or to have a stillbirth (RR 3.2, 95% CI 1.9–5.4. Conclusions This large, population-based study confirms and quantifies the magnitude of the excess risk of small for gestational age and stillbirth among births to women with hypertensive disease in pregnancy.

  3. [The relationship between metabolic disorders and small for gestational age with idiopathic premature adrenarche].

    Science.gov (United States)

    Mejorado Molano, Francisco Javier; Andrés Zallo, Laura; Fornos Rodríguez, Marta; Pérez Segura, Pilar; Gavela Pérez, Teresa; Sanz Calvo, María Luisa; Soriano Guillén, Leandro

    2016-11-09

    There is still controversy on the relationship between idiopathic premature adrenarche (IPA) and a history of small for gestational age, as well as the concomitant presence of obesity and other metabolic disturbances. An attempt is made to study these potential associations in a cohort of girls with IPA from our hospital. A descriptive cross-sectional study was conducted that included girls with a diagnosis of IPA from the Paediatric Department of the Fundación Jiménez Díaz (Madrid, Spain) between January 2007 and May 2015. A record was made of family and personal history with perinatal data, as well as anthropometric data and biochemical values at the time of diagnosis. Out of a total of 76 girls with IPA, 2.7% had a history of small for gestational age. When body mass index was analysed according to modified criteria of WHO 2007/Cole 2000, 11.8% were overweight, and 11.8% were obese at diagnosis. Using the criteria set by the Spanish Ministry of Health, 6.6% were overweight and 18.4% obese, with 21.2% of the girls being insulin resistance, and 13.95% having dyslipidaemia. None of them had hypertension. From a comparative analysis between normal and overweight and obesity IPA girls, the latter had significantly higher levels of triglycerides and insulin, a higher HOMA index, and lower levels of HDL cholesterol. IPA girls included in the study do not have a higher prevalence of small for gestational age compared to the general population. Prevalence of overweight and obesity in girls with IPA is not higher than the prevalence in the normal population. Copyright © 2016. Publicado por Elsevier España, S.L.U.

  4. Accuracy and correlates of maternal recall of birthweight and gestational age

    DEFF Research Database (Denmark)

    Adegboye, Amanda Rodrigues Amorim; Heitmann, B.

    2008-01-01

    the two sources was evaluated by mean differences (MD), intraclass correlation coefficient (ICC) and Bland-Altman's plots. The misclassification of the various BW and GA categories were also estimated. MAIN OUTCOME MEASURES: Differences between recalled and registered BW and GA. RESULTS: There was high......OBJECTIVE: To determine the accuracy of maternal recall of children birthweight (BW) and gestational age (GA), using the Danish Medical Birth Register (DBR) as reference and to examine the reliability of recalled BW and its potential correlates. DESIGN: Comparison of data from the DBR...

  5. The Effect of Gestational Age on Axial Length of the Eyes of Premature Infants

    Directory of Open Access Journals (Sweden)

    Mehmet Ali Sekeroglu

    2016-01-01

    Full Text Available Aim: The aim of the present study is to evaluate the axial length of the eyes of premature infants without retinopathy of prematurity and to document the relationship with gestational age and changes as infants grew-up. Material and Method: The axial length of the eyes were measured by using a mobile A-scan ultrasonographic biometry device just before the first retinopathy of prematurity screening examination and 4-weeks thereafter. Results: One-hundred and thirty-six infants with a mean gestational age of 31,7±2,7 weeks and a birth-weight of 1561.0±379.3 g were included in the study. Axial length measurements were done at a mean postconceptional age of 35.8 ±2.6 (31-40 and 39.8±2.7 (35-44 weeks, consecutively. The mean axial length at first and second visits were 16.43±0.42 mm (15.28-17.13 and 16.69±0.41 mm (15.60-17.70, consecutively (p

  6. Maternal obesity, gestational diabetes, breastfeeding and childhood overweight at age 2 years.

    Science.gov (United States)

    Bider-Canfield, Z; Martinez, M P; Wang, X; Yu, W; Bautista, M P; Brookey, J; Page, K A; Buchanan, T A; Xiang, A H

    2017-04-01

    Maternal obesity, excessive gestational weight gain (EGWG), gestational diabetes mellitus (GDM) and breastfeeding are four important factors associated with childhood obesity. The objective of the study was to assess the interplay among these four factors and their independent contributions to childhood overweight in a cohort with standard clinical care. The cohort included 15 710 mother-offspring pairs delivered in 2011. Logistic regression was used to assess associations between maternal exposures and childhood overweight (body mass index >85th percentile) at age 2 years. Mothers with pre-pregnancy obesity or overweight were more likely to have EGWG, GDM and less likely to breastfeed ≥6 months. Mothers with GDM had 40-49% lower EGWG rates and similar breastfeeding rates compared with mothers without GDM. Analysis adjusted for exposures and covariates revealed an adjusted odds ratio (95% confidence interval) associated with childhood overweight at age 2 years of 2.34 (2.09-2.62), 1.50 (1.34-1.68), 1.23 (1.12-1.35), 0.95 (0.83-1.10) and 0.76 (0.69-0.83) for maternal obesity, overweight, EGWG, GDM and breastfeeding ≥6 months vs. obesity or overweight and EGWG were independently associated with an increased risk, and breastfeeding ≥6 months was associated with a decreased risk of childhood overweight at age 2 years. © 2016 World Obesity Federation.

  7. Children with cerebral palsy and periventricular white matter injury: does gestational age affect functional outcome?

    Science.gov (United States)

    Harvey, Adrienne R; Randall, Melinda; Reid, Susan M; Lee, Katherine J; Imms, Christine; Rodda, Jillian; Eldridge, Beverley; Orsini, Francesca; Reddihough, Dinah

    2013-09-01

    This study aimed to determine differences in functional profiles and movement disorder patterns in children aged 4-12 years with cerebral palsy (CP) and periventricular white matter injury (PWMI) born >34 weeks gestation compared with those born earlier. Eligible children born between 1999 and 2006 were recruited through the Victorian CP register. Functional profiles were determined using the Gross Motor Function Classification System (GMFCS), Manual Abilities Classification System (MACS), Communication Function Classification System (CFCS), Functional Mobility Scale (FMS) and Bimanual Fine Motor Function (BFMF). Movement disorder and topography were classified using the Surveillance of Cerebral Palsy in Europe (SCPE) classification. 49 children born >34 weeks (65% males, mean age 8 y 9 mo [standard deviation (SD) 2 y 2 mo]) and 60 children born ≤ 34 weeks (62% males, mean age 8 y 2 mo [SD 2 y 2 mo]) were recruited. There was evidence of differences between the groups for the GMFCS (p=0.003), FMS 5, 50 and 500 (p=0.003, 0.002 and 0.012), MACS (p=0.04) and CFCS (p=0.035), with a greater number of children born ≤ 34 weeks more severely impaired compared with children born later. Children with CP and PWMI born >34 weeks gestation had milder limitations in gross motor function, mobility, manual ability and communication compared with those born earlier.

  8. Weight for gestational age and metabolically healthy obesity in adults from the Haguenau cohort

    Science.gov (United States)

    Matta, Joane; Carette, Claire; Levy Marchal, Claire; Bertrand, Julien; Pétéra, Mélanie; Zins, Marie; Pujos-Guillot, Estelle; Comte, Blandine; Czernichow, Sébastien

    2016-01-01

    Background An obesity subphenotype, named ‘metabolically healthy obese’ (MHO) has been recently defined to characterise a subgroup of obese individuals with less risk for cardiometabolic abnormalities. To date no data are available on participants born with small weight for gestational age (SGA) and the risk of metabolically unhealthy obesity (MUHO). Objective Assess the risk of MUHO in SGA versus appropriate for gestational age (AGA) adult participants. Methods 129 young obese individuals (body mass index ≥30 kg/m²) from data of an 8-year follow-up Haguenau cohort (France), were identified out of 1308 participants and were divided into 2 groups: SGA (n=72) and AGA (n=57). Metabolic characteristics were analysed and compared using unpaired t-test. The HOMA-IR index was determined for the population and divided into quartiles. Obese participants within the first 3 quartiles were considered as MHO and those in the fourth quartile as MUHO. Relative risks (RRs) and 95% CI for being MUHO in SGA versus AGA participants were computed. Results The SGA-obese group had a higher risk of MUHO versus the AGA-obese group: RR=1.27 (95% CI 1.10 to 1.6) independently of age and sex. Conclusions In case of obesity, SGA might confer a higher risk of MUHO compared with AGA. PMID:27580829

  9. Association between maternal work activity on birth weight and gestational age

    Institute of Scientific and Technical Information of China (English)

    OmidAminian; SeyedAliAkbarSharifian; NazaninIzadi; KhosroSadeghniiat; AnahitaRashedi

    2014-01-01

    Objective:To evaluate the effect of maternal employment on birth weight and gestational age. Methods:In this project,1272 pregnant women were recruited from whom referred toTehran hospitals during1 year via randomized sampling.Data were gathered through history taking and medical records.In this study,564 employed women were classified as exposure group and708 housekeepers were as the control group.Chisquare test,t-test,One-wayANOVA and logistic regression were used to analyze data. Results:In this study, mean mother age was25.01 years and mean birth weight was(2884±684) g.The mean birth weight in housekeepers was significantly higher (2991±457 g) than employees(2726±476 g)(P=0.002).The infants’ mean birth weights in farmer were the lowest and in office workers(2831±526 g) was the highest(P<0.01).Gestational age less than37 weeks was more common among employees.The mean birth weight decreased when the working hours increased(P<0.01).In those mothers who were working less than3 months there were a higher mean birth weight(P<0.01).Also the mean birth weight decreased due to the hours of standing during a day.Conclusion:Women employment during pregnancy has an important role in low birth weight and preterm labor compared to those who do not work.

  10. Reduced genetic influence on childhood obesity in small for gestational age children

    Directory of Open Access Journals (Sweden)

    Han Dug Yeo

    2013-01-01

    Full Text Available Abstract Background Children born small-for-gestational-age (SGA are at increased risk of developing obesity and metabolic diseases later in life, a risk which is magnified if followed by accelerated postnatal growth. We investigated whether common gene variants associated with adult obesity were associated with increased postnatal growth, as measured by BMI z-score, in children born SGA and appropriate for gestational age (AGA in the Auckland Birthweight Collaborative. Methods A total of 37 candidate SNPs were genotyped on 547 European children (228 SGA and 319 AGA. Repeated measures of BMI (z-score were used for assessing obesity status, and results were corrected for multiple testing using the false discovery rate. Results SGA children had a lower BMI z-score than non-SGA children at assessment age 3.5, 7 and 11 years. We confirmed 27 variants within 14 obesity risk genes to be individually associated with increasing early childhood BMI, predominantly in those born AGA. Conclusions Genetic risk variants are less important in influencing early childhood BMI in those born SGA than in those born AGA, suggesting that non-genetic or environmental factors may be more important in influencing childhood BMI in those born SGA.

  11. Temporal Trends in Chorioamnionitis by Maternal Race/Ethnicity and Gestational Age (1995–2010

    Directory of Open Access Journals (Sweden)

    Michael J. Fassett

    2013-01-01

    Full Text Available Objective. To characterize trends in chorioamnionitis (CAM by maternal race/ethnicity and gestational age. Study Design. We examined trends in CAM from 1995–2010 among singleton births in all Kaiser Permanente Southern California hospitals (. Data were extracted from Perinatal Service System and clinical utilization records. Gestational age- and race/ethnicity-specific biannual diagnosis rates were estimated using the Poisson regression after adjusting for potential confounding factors. Results. Overall diagnosis rates of CAM increased from 2.7% in 1995-1996 to 6.0% in 2009-2010 with a relative increase of 126% (95% confidence intervals [CI] 113%–149%. From 1995-1996 to 2009-2010, CAM increased among the Whites (1.8% to 4.3%, -value for trend <.001, Blacks (2.2% to 3.7%, -value for trend <.001, Hispanics (2.4% to 5.8%, -value for trend <.001, and Asian/Pacific Islanders (3.6% to 9.0%, -value for trend <.001. The adjusted relative percentage change in CAM from 1995-1996 to 2009-2010 was for Whites [preterm 21% (9%–78%, term 138% (108%–173%], for Blacks [preterm 24% (−9%–81%, term 62% (30%–101%], for Hispanics [preterm 31% (3%–66%, term 135% (114%–159%], and for Asian/Pacific Islanders [preterm 44% (9%–127%, term 145% (109%–188%]. Conclusion. The findings suggest that CAM diagnosis rate has increased for all race/ethnic groups. This increase is primarily due to increased diagnosis at term gestation.

  12. Resting-state oscillatory activity in children born small for gestational age: a magnetoencephalographic study

    Directory of Open Access Journals (Sweden)

    Maria eBoersma

    2013-09-01

    Full Text Available Growth restriction in utero during a period that is critical for normal growth of the brain, has previously been associated with deviations in cognitive abilities and brain anatomical and functional changes. We measured magnetoencephalography (MEG in 4-7 year old children to test if children born small for gestational age (SGA show deviations in resting-state brain oscillatory activity. Children born SGA children with postnatally spontaneous catch-up growth (SGA+; 6 boys, 7 girls; mean age 6.3 y (SD=0.9 and children born appropriate for gestational age (AGA; 7 boys, 3 girls; mean age 6.0 y (SD=1.2 participated in a resting-state MEG study. We calculated absolute and relative power spectra and used nonparametric statistics to test for group differences. SGA+ and AGA born children showed no significant differences in absolute and relative power except for reduced absolute gamma band power in SGA children. At time of MEG investigation, SGA+ children showed was significantly lower head circumference (HC and a trend toward lower IQ, however there was no association of HC or IQ with absolute or relative power. Except for reduced absolute gamma band power, our findings suggest normal brain activity patterns at school age in a group of children born SGA in which spontaneous catch-up growth of bodily length after birth occurred. Although previous findings suggest that being born SGA alters brain oscillatory activity early in neonatal life, we show that these neonatal alterations do not persist at early school age when spontaneous postnatal catch-up growth occurs after birth.

  13. Abortion barriers and perceptions of gestational age among women seeking abortion care in the latter half of the second trimester.

    Science.gov (United States)

    Janiak, Elizabeth; Kawachi, Ichiro; Goldberg, Alisa; Gottlieb, Barbara

    2014-04-01

    Later second-trimester abortion (gestational age ≥ 19 weeks) is higher risk, more expensive and more difficult to access than abortion earlier in pregnancy. We sought to enumerate barriers to care described by women seeking abortion in the latter half of the second trimester. We also assessed the accuracy of later second-trimester abortion patients' perceptions of their pregnancies' gestational ages. A retrospective analysis of data from 232 women served by a referral program for women seeking abortion care between 19 and 24 weeks of gestational age was performed. Data collected included demographics, pregnancy history, gestational age by ultrasound, perceived gestational age, barriers to abortion care experienced and time lapsed from pregnancy recognition to presentation for care. Difficulty deciding whether to terminate (44.8%), financial barriers to care (22.0%) and the patient having recently realized she was pregnant (21.6%) were the most common delaying barriers cited. Nearly half (46.6%) of women underestimated their own gestational ages by greater than 4 weeks. Risk factors for experiencing at least 3 months time lapsed from pregnancy recognition to program referral included difficulty deciding whether to terminate [odds ratio (OR) 4.08, 95% confidence interval (CI) 2.51-8.70] and nonwhite race/ethnicity (OR 2.04, 95% CI 1.16-3.57). Women seeking abortion care in the latter half of the second trimester encounter many of the same barriers previously identified among other abortion patient populations. Because many risk factors for delayed presentation for care are not amenable to intervention, abortion must remain available later in the second trimester. Women presenting for abortion in the later second trimester are delayed by structural and individual-level barriers, and many substantially underestimate their own gestational age. Removing financial barriers may help reduce abortion delay; however, many risk factors are nonmodifiable, underscoring the

  14. Disparities in Birth Weight and Gestational Age by Ethnic Ancestry in South American countries

    Science.gov (United States)

    Wehby, George L.; Gili, Juan A.; Pawluk, Mariela; Castilla, Eduardo E.; López-Camelo, Jorge S.

    2015-01-01

    Objective We examine disparities in birth weight and gestational age by ethnic ancestry in 2000–2011 in eight South American countries. Methods The sample included 60480 singleton live-births. Regression models were estimated to evaluate differences in birth outcomes by ethnic ancestry controlling for time trends. Results Significant disparities were found in seven countries. In four countries – Brazil, Ecuador, Uruguay, and Venezuela – we found significant disparities in both low birth weight and preterm birth. Disparities in preterm birth alone were observed in Argentina, Bolivia, and Colombia. Several differences in continuous birth weight, gestational age, and fetal growth rate were also observed. There were no systematic patterns of disparities between the evaluated ethnic ancestry groups across the study countries, in that no racial/ethnic group consistently had the best or worst outcomes in all countries. Conclusions Racial/ethnic disparities in infant health are common in several South American countries. Differences across countries suggest that racial/ethnic disparities are driven by social and economic mechanisms. Researchers and policymakers should acknowledge these disparities and develop research and policy programs to effectively target them. PMID:25542227

  15. Small for Gestational Age and Magnesium: Intrauterine magnesium deficiency may induce metabolic syndrome in later life

    Directory of Open Access Journals (Sweden)

    Junji Takaya

    2015-12-01

    Full Text Available Magnesium deficiency during pregnancy as a result of insufficient or low intake of magnesium is common in developing and developed countries. Previous reports have shown that intracellular magnesium of cord blood platelets is lower among small for gestational age (SGA groups than that of appropriate for gestational age (AGA groups, suggesting that intrauterine magnesium deficiency may result in SGA. Additionally, the risk of adult-onset diseases such as insulin resistance syndrome is greater among children whose mothers were malnourished during pregnancy, and who consequently had a low birth weight. In a number of animal models, poor nutrition during pregnancy leads to offspring that exhibit pathophysiological changes similar to human diseases. The offspring of pregnant rats fed a magensium restricted diet have developed hypermethylation in the hepatic 11β-hydroxysteroid dehydrogenase-2 promoter. These findings indicate that maternal magnesium deficiencies during pregnancy influence regulation of non-imprinted genes by altering the epigenetic regulation of gene expression, thereby inducing different metabolic phenotypes. Magnesium deficiency during pregnancy may be responsible for not only maternal and fetal nutritional problems, but also lifelong consequences that affect the offspring throughout their life. Epidemiological, clinical, and basic research on the effects of magnesium deficiency now indicates underlying mechanisms, especially epigenetic processes.

  16. Global and regional differences in brain anatomy of young children born small for gestational age.

    Directory of Open Access Journals (Sweden)

    Henrica M A De Bie

    Full Text Available In children who are born small for gestational age (SGA, an adverse intrauterine environment has led to underdevelopment of both the body and the brain. The delay in body growth is (partially restored during the first two years in a majority of these children. In addition to a negative influence on these physical parameters, decreased levels of intelligence and cognitive impairments have been described in children born SGA. In this study, we used magnetic resonance imaging to examine brain anatomy in 4- to 7-year-old SGA children with and without complete bodily catch-up growth and compared them to healthy children born appropriate for gestational age. Our findings demonstrate that these children strongly differ on brain organisation when compared with healthy controls relating to both global and regional anatomical differences. Children born SGA displayed reduced cerebral and cerebellar grey and white matter volumes, smaller volumes of subcortical structures and reduced cortical surface area. Regional differences in prefrontal cortical thickness suggest a different development of the cerebral cortex. SGA children with bodily catch-up growth constitute an intermediate between those children without catch-up growth and healthy controls. Therefore, bodily catch-up growth in children born SGA does not implicate full catch-up growth of the brain.

  17. Using fMRI to Investigate Memory in Young Children Born Small for Gestational Age.

    Directory of Open Access Journals (Sweden)

    Henrica M A de Bie

    Full Text Available Intrauterine growth restriction (IUGR can lead to infants being born small for gestational age (SGA. SGA is associated with differences in brain anatomy and impaired cognition. We investigated learning and memory in children born SGA using neuropsychological testing and functional Magnetic Resonance Imaging (fMRI.18 children born appropriate for gestational age (AGA and 34 SGA born children (18 with and 16 without postnatal catch-up growth participated in this study. All children were between 4 and 7 years old. Cognitive functioning was assessed by IQ and memory testing (Digit/Word Span and Location Learning. A newly developed fMRI picture encoding task was completed by all children in order to assess brain regions involved in memory processes.Neuropsychological testing demonstrated that SGA children had IQ's within the normal range but lower than in AGA and poorer performances across measures of memory. Using fMRI, we observed memory related activity in posterior parahippocampal gyrus as well as the hippocampus proper. Additionally, activation was seen bilaterally in the prefrontal gyrus. Children born SGA showed less activation in the left parahippocampal region compared to AGA.This is the first fMRI study demonstrating different brain activation patterns in 4-7 year old children born SGA, suggesting that intrauterine growth restriction continues to affect neural functioning in children later-on.

  18. Sonographic Biometry of Fetal Interorbital Distance as a Predictor of Gestational Age in Enugu, Southeast Nigeria.

    Science.gov (United States)

    Nwadike, U I; Agwu, K K; Eze, C U; Okpala, O C; Onu, A O

    2015-05-13

    The objective of this study was to develop a sonographic technique for the measurement of fetal interorbital distance (IOD) for gestational age (GA) determination and to establish a normogram of IOD for the local population. The fronto-transverse sonographic technique was established as a feasible and reproducible technique for IOD measurement. Two independent and experienced sonographers tested the technique and had a coefficient of variation of 17.64% and 19.72%, respectively, which is statistically insignificant. The established technique was used to measure the IOD of 320 fetuses from the 13(th) week to 40(th) week GA, while standard technique was used to measure biparietal diameter (BPD), head circumference (HC) and femur length (FL) of the fetuses. The data obtained were used to determine the regression equation GA = 6.24 + 4.89 IOD for the prediction of the gestational age. There was good correlation between IOD, BPD, HC and FL. The predicted normogram of IOD was compared with normogram of the Caucasian population. The result showed that there was no statistical difference between them (p < 0.05). Results from the study suggest that the fronto-transverse technique is a feasible and reproducible technique for IOD measurement and the established normogram of IOD can be a veritable statistic for GA prediction in our locality.

  19. Long-Term Survival of Individuals Born Small and Large for Gestational Age.

    Directory of Open Access Journals (Sweden)

    E Christina M Wennerström

    Full Text Available Little is known on long-term survival and causes of death among individuals born small or large for gestational age. This study investigates birth weight in relation to survival and causes of death over time.A national cohort of 1.7 million live-born singletons in Denmark was followed during 1979-2011, using the Danish Civil Registration System, the Medical Birth Registry and the Cause of Death Registry. Cox proportional hazards were estimated for the impact of small (SGA and large (LGA gestation weight and mortality overall, by age group and birth cohort.Compared to normal weight children, SGA children were associated with increased risk of dying over time. Though most of the deaths occurred during the first year of life, the cumulative mortality risk was increased until 30 years of age. The hazard ratios [HR] for dying among SGA children ages <2 years were: 3.47 (95% CI, 3.30-3.64 and 1.06 (95% CI, 0.60-1.87 in 30 years and older. HR for dying among SGA adults (20-29 years were: 1.20 (95% CI, 0.99-1.46 in years 1979-1982 and 1.61 (95% CI, 1.04-2.51 in years 1989-1994. The SGA born had increased risk of dying from infection, heart disease, respiratory disease, digestive disease, congenital malformation, perinatal conditions, and accidents, suicide, and homicide. Individuals born LGA were associated with decreased mortality risk, but with increased risk of dying from malignant neoplasm.Survival has improved independently of birth weight the past 30 years. However, children born SGA remain at significantly increased risk of dying up till they turn 30 years of age. Individuals born LGA have lower mortality risk but only in the first two years of life.

  20. Genetic, environmental and phenotypic relationships among gestation length, birth weight, growth traits and age at first calving in beef cattle.

    Science.gov (United States)

    Bourdon, R M; Brinks, J S

    1982-09-01

    Data on the Red Angus, Angus and Hereford herds of Pioneer Hi-Bred International, Inc., Des Moines, Iowa, collected from 1968 to 1976, were analyzed for relationships among gestation length, birth weight, prenatal gain (birth weight adjusted for gestation length), growth traits and age at first calving. A total of 5,691 calf records, 1,783 listing gestation length, were included in the study. Paternal half-sib analyses and least-squares procedures were used to compute heritability estimates and genetic, environmental and phenotypic correlations among traits. Genetic correlations among growth traits, including prenatal gain, were high in all cases. Heritability estimates for gestation length and birth weight were .36 and .43, respectively, for bull calves and .37 and .35 for heifer calves. Genetic correlations between these traits were .25 and .22 for bull and heifer calves, respectively. Gestation length was negatively correlated (genetically) with all growth traits except birth weight. This result suggests that faster growing fetuses may trigger parturition earlier than average. Age at first calving was negatively correlated (genetically) with growth traits, indicating a favorable relationship between growth and early reproduction. Analysis of several selection indexes combining either birth weight and yearling weight or gestation length and yearling weight indicated that continued response to selection for growth without excessive increase in birth weight is feasible. Selection for growth and moderate birth weight would be more effective than selection for growth and shorter gestation, suggesting that the former method would both shorten gestation and alter the growth curve. Repeatability estimates for gestation length and birth weight were .20 and .22, respectively. Maternal effects accounted for approximately 10% of the variation in each trait.

  1. Gestational Age at Birth and 'Body-Mind' Health at 5 Years of Age: A Population Based Cohort Study.

    LENUS (Irish Health Repository)

    Cronin, Frances M

    2016-01-01

    Numerous studies have identified the effects of prematurity on the neonate\\'s physical health, however few studies have explored the effects of prematurity on both the physical and mental health of the child as they develop. Secondary analysis of data from the Millennium Cohort Study, a longitudinal study of infants (n = 18 818, born 2000-2002 in the United Kingdom) was performed. Effects of gestational age at birth on health outcomes at 5 years were measured using parental rating of their children\\'s general health and severity of behavior problems. The association between parent\\'s general health ratings and behavior problem ratings was low: 86% of those reporting serious behavior problems (5% of the sample, n = 764) rated their child as being in excellent, very good, or good health. Still, a gradient of increasing risk of poorer outcome with decreasing gestational age was observed for a composite health measure (poor\\/fair health and\\/or serious behavior problems), suggesting an association with prematurity for this composite assessment of health status. The greatest contribution to the childhood composite health measure at 5 years was for children born at 32-36 weeks gestation: population attributable fractions for having poor outcomes was 3.4% (Bonferroni-adjusted 95% confidence interval 1.1%-6.2%), compared to 1% (0.2-2.3) for birth at less than 32 weeks. Results suggest that preterm children, by school entry, are not only at high risk of physical health problems, but also of behavioral health problems. The recognition of, and response to comprehensive health and well-being outcomes related to prematurity are important in order to correctly plan and deliver adequate paediatric health services and policies.

  2. Effects of docosahexaenoic acid supplementation during pregnancy on gestational age and size at birth: randomized, double-blind, placebo-controlled trial in Mexico.

    Science.gov (United States)

    Ramakrishnan, Usha; Stein, Aryeh D; Parra-Cabrera, Socorro; Wang, Meng; Imhoff-Kunsch, Beth; Juárez-Márquez, Sergio; Rivera, Juan; Martorell, Reynaldo

    2010-06-01

    The need for omega-3 fatty acids, especially docosahexaenoic acid (DHA), during pregnancy has received much attention, but evidence of effects on birth outcomes is limited. To evaluate whether prenatal DHA supplementation increases gestational age and birth size. We conducted a double-blind, randomized, placebo-controlled trial in Cuernavaca, Mexico. We randomly assigned 1,094 pregnant women (18 to 35 years of age; median DHA dietary intake, 55 mg/day) to 400 mg/day of algal DHA or placebo from 18 to 22 weeks of gestation through delivery. Birth outcomes (968 live births and 5 stillbirths) were ascertained from hospital records within 24 hours of delivery. Intention-to-treat analysis showed no differences between the control and DHA group (all p > .05) in mean gestational age (39.1 + 1.7 and 39.0 +/- 1.9 weeks, respectively), weight (3.20 + 0.47 and 3.21 +/- 0.45 kg, respectively), length (50.3 +/- 2.7 and 50.3 +/- 2.3 cm, respectively) and head circumference (34.3 +/- 1.8 and 34.3 +/- 1.5 cm, respectively) at birth. Offspring of supplemented primigravidae (n = 370) were heavier (difference, 99.4 g; 95% CI, 5.5 to 193.4) and had larger head circumferences (difference, 0.5 cm; 95% CI, 0.1 to 0.9) than controls; the differences in multigravidae (n = 603) were -53.3 g (95% CI, -126.8 to 20.2) and -0.2 cm (95% CI, -0.4 to 0.1), respectively (p size in a population where dietary DHA intakes are very low. Benefits of the intervention on infant health and neurodevelopment are under study.

  3. Respiratory support strategy in 499 preterm newborns with gestational age ≤ 32 weeks

    Directory of Open Access Journals (Sweden)

    Sara Aguilar

    2013-04-01

    Full Text Available Objectives: To evaluate the respiratory support strategy and its association with morbidity and mortality in preterm infants with Gestational Age (GA ≤ 32 weeks, admitted between 2000 and 2008. Methods: Chart data from newborns with GA ≤ 32 weeks admitted to a tertiary Neonatal Intensive Care Unit between 2000-2008, were reviewed retrospectively. Newborns were divided into two groups according to the year of birth: Group 1 (2000-2004 and Group 2 (2005-2008. Each group of newborns was subdivided in subgroups according to their GA: 23-28 gestational weeks and 29-32 gestational weeks. Each group was compared in terms of ventilation and surfactant strategy, morbility and mortality. The statistical analysis was carried out with SPSS 21.0. Results: We included 499 newborns, 224 in Group 1 and 275 in Group 2. The mean GA, sex and birth weight were similar in both groups. The comparison of the two groups showed a statistically significant difference in the rate of invasive ventilation and surfactant strategy. The mortality before discharge rate was 17.4% for Group 1 and 13.5% for Group 2. The comparison of the subgroups, revealed a statistically higher incidence of INSURE strategy and noninvasive ventilation in newborns born after 2004, with reduction of the mortality rate in newborns with GA comprised between 29-32 weeks and reduction of pneumothorax, severe chronic lung disease and intraventricular hemorrhage in newborns with GA comprised between 23-28 weeks. Conclusion: There was a tendency towards non-invasive strategy and INSURE administration of surfactant over the years. Mortality and major morbidity decreased along with these changes in the therapeutic approach of the respiratory distress syndrome in preterm newborns.

  4. Dynamics of lipoprotein level in blood plasma of pregnant women as a function of gestational age according to FTIR spectroscopy

    Science.gov (United States)

    Korolik, E. V.; Korolenko, E. A.; Tretinnikov, O. N.; Kozlyakova, O. V.; Korolik, A. K.; Kirkovskiy, V. V.

    2013-01-01

    Results of an IR spectroscopic investigation of films of blood plasma taken from women of reproductive age, pregnant women with positive and negative Rh factors, and Rh-immunized women were presented as a function of gestational age. It was found that the lipoprotein content in blood plasma of all groups of pregnant women increased during the early stages of pregnancy (17-23 weeks) irrespective of the Rh factor and attained its peak value by weeks 30-35. It was shown that the lipoprotein level in blood plasma as a function of gestational age was quantitatively the same for pregnant women with positive and negative Rh factors. It was established for the first time that this dependence for Rh-immunized women featured a considerable increase of lipoprotein content at gestational age 30-32 weeks and declined acutely by week 36.

  5. Nutritional requirements and feeding recommendations for small for gestational age infants.

    Science.gov (United States)

    Tudehope, David; Vento, Maximo; Bhutta, Zulfiqar; Pachi, Paulo

    2013-03-01

    We define the small for gestational age (SGA) infant as an infant born ≥ 35 weeks' gestation and nutritional requirements and provides short- and long-term benefits. Several distinct patterns of intrauterine growth restriction are identified among the heterogeneous grouping of SGA infants; each varies with regard to neonatal morbidities, requirements for neonatal management, postnatal growth velocities, neurodevelopmental progress, and adult health outcomes. There is much we do not know about nutritional management of the SGA infant. We need to identify and define: infants who have "true" growth restriction and are at high risk for adverse metabolic outcomes in later life; optimal growth velocity and "catch-up" growth rates that are conducive with life-long health and well being; global approaches to management of hypoglycemia; and an optimal model for postdischarge care. Large, rigorously conducted trials are required to determine whether aggressive feeding of SGA infants results in improved nutritional rehabilitation, growth, and neurodevelopmental outcomes. Before birth, maternal supplementation with specific nutrients reduces the rate and severity of growth restriction and may prevent nutrient deficiency states if infants are born SGA. After birth, the generally accepted goal is to provide enough nutrients to achieve postnatal growth similar to that of a normal fetus. In addition, we recommend SGA infants be allowed to "room in" with their mothers to promote breastfeeding, mother-infant attachment, and skin-to-skin contact to assist with thermoregulation. Crown Copyright © 2013. Published by Mosby, Inc. All rights reserved.

  6. Neu-Laxova syndrome in an appropriate for gestational age newborn

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    Dilli Dilek

    2008-01-01

    Full Text Available Neu-Laxova syndrome is a rare lethal congenital disorder involving multiple systems. Intrauterine growth retardation, ichthyosis, microcephaly, abnormal facial findings, and limb contractures are its key features. We present a case of Neu-Laxova syndrome in a male appropriate for gestational age (AGA newborn with characteristic features including ichthyosis, microcephaly, severe ectropion, rudimentary ears, eclabion, limb contractures, and hypoplastic genitalia. The patient was born at 38 weeks of gestation to consanguinous Turkish parents. The mother was a 20-year-old primi gravida with lack of prenatal follow-up. Therefore, the case was diagnosed postnatally, and he died 5 days later. Because of the autosomal recessive inheritance of Neu-Laxova syndrome, in countries with high rates of consanguineous marriage, such as Turkey, physicians have to know this syndrome, and serial prenatal ultrasound examinations with genetic counseling should be performed on pregnant women at high risk. To the best of our knowledge, this is the first case described in an AGA newborn.

  7. [Intensive care at extremely low gestational age: ethical issues and treatment choices].

    Science.gov (United States)

    Pignotti, M S; Toraldo di Francia, M; Donzelli, G

    2007-01-01

    With the continuing progress of obstetrical and neonatal care, the limit of human viability has continued to shift towards younger gestational ages. The survival rate as well as the survival without disability increases with each additional week of gestation but, for infants born from 22 to 25 w GA, it is still really low, and the threshold of human viability appears to be limited to the physiological development of the lungs, which take place around the 23rd-24th w GA. At present, the care of such infants, born at the threshold of human viability, presents a variety of complex medical, social, and economical decisions assuming the characteristics of ethical decisions in that the limits between benefits and disadvantages is not so clearcut. What is the true infant's best interest is far to be understood and concern about the ethical basis of providing such intensive care is arising in the scientific community. In this paper the authors provide a review of the ethical basis of decisions related to the care of such infants: to treat, not to treat, intensive or compassionate care, withhold or withdraw treatment.

  8. Association between maternal vascular murmur and the small-for-gestational-age fetus with abnormal umbilical artery Doppler flow

    DEFF Research Database (Denmark)

    Riknagel, Diana; Farlie, Richard; Hedegaard, Morten

    2017-01-01

    OBJECTIVE: To investigate the association between maternal vascular murmurs (MVMs) and fetal growth restriction (defined as small-for-gestational-age [SGA] fetus) and abnormal Doppler pulsatility index (PI) of the uterine and/or umbilical arteries. METHODS: A cross-sectional study of women aged 18...

  9. Maternal occupation during pregnancy, birth weight, and length of gestation

    DEFF Research Database (Denmark)

    Casas, Maribel; Cordier, Sylvaine; Martínez, David

    2015-01-01

    OBJECTIVES: 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....

  10. Expectant management of severe preeclampsia at 27(0/7) to 33(6/7) weeks' gestation: maternal and perinatal outcomes according to gestational age by weeks at onset of expectant management.

    Science.gov (United States)

    Bombrys, Annette E; Barton, John R; Habli, Mounira; Sibai, Baha M

    2009-06-01

    We sought to determine perinatal outcome and maternal morbidities based on gestational age (GA) at onset of expectant management in severe preeclampsia (PE) between 27(0/7) and 33 (6/7) weeks. In this retrospective analysis of outcome in patients with severe preeclampsia, we studied 66 patients (71 fetuses) with severe PE at 27 (0)/ (7) to 33(6/ 7). All patients received corticosteroids. Perinatal and maternal complications were analyzed. Five patients had twin gestations. Median for days of prolongation was 5 days (range, 3 to 35). Birth weights of 19 (27%) were or= grade ?). Rate of abruption was significantly higher at 27 to 28 weeks as compared with > 28 weeks (25% vs 6%, p = 0.05). There was no eclampsia, and two had transient renal insufficiency at 27 weeks. Four of 11 (36%) patients with expectant management at >or= 32 weeks had pulmonary edema or hemolytic anemia, elevated liver enzymes, and low platelet count. During expectant management, rate of respiratory distress syndrome and other serious neonatal complications decrease with increasing GA, supporting a role for such management in early severe preeclampsia. Because there is significant maternal morbidity at >or= 32 weeks with minimal neonatal benefit, consideration should be given for delivery of these pregnancies following corticosteroid administration.

  11. Estimates of burden and consequences of infants born small for gestational age in low and middle income countries with INTERGROWTH-21st standard

    DEFF Research Database (Denmark)

    Lee, Anne Cc; Kozuki, Naoko; Cousens, Simon

    2017-01-01

     CHERG birth cohorts from 14 population based sites in low and middle income countries. Main outcome measures In low and middle income countries in the year 2012, the number and proportion of infants born small for gestational age; number and proportion of neonatal deaths attributable to small...... for gestational age; the number and proportion of neonatal deaths that could be prevented by reducing the prevalence of small for gestational age to 10%. Results  In 2012, an estimated 23.3 million infants (uncertainty range 17.6 to 31.9; 19.3% of live births) were born small for gestational age in low and middle...... deaths were attributable to infants born small for gestational age, 21.9% of all neonatal deaths. The largest burden was in South Asia, where the prevalence was the highest (34%); about 26% of neonatal deaths were attributable to infants born small for gestational age. Reduction of the prevalence...

  12. [Dutch Preventive Youth Health Care Service guideline on children born too early and/or too small for gestational age].

    Science.gov (United States)

    van der Pal, Sylvia M; Heerdink, Nen; Kamphuis, Mascha; Pols, Margreet A

    2014-01-01

    In children who are born prematurely or whose birth weight is too low for gestational age (small for gestational age (SGA)) intensive care and follow up are desirable.However, obstacles include the shared care of children born very preterm (care service (and other professionals) and the identification of possible late onset health problems in children born late preterm (32-37 weeks of gestation). This guideline is multidisciplinary and evidence based and is relevant to all professionals involved in the care of this group of children. The main recommendations are: (a) timely and complete transfer of information after discharge from hospital; (b) structured exchange of information in aftercare; (c) assigning a case manager to each child; (d) monitoring growth and development by adjusting age for preterm birth, and (e) using special growth charts for children born preterm to evaluate growth and development.

  13. Maternal weight determines the association between Hbalc in second half of pregnancy and risk of large for gestational age babies

    DEFF Research Database (Denmark)

    Nielsen, Gunnar Lauge; Dethlefsen, Claus; Møller, Margrethe

    Aim: To assess the association between maternal glycosylated haemoglobin (HbA1c) in diabetic pregnancies and the risk of delivering large for gestational age babies (LGA) taking into account maternal body mass index (BMI), weight gain, age, White class, and smoking habits.  Method: We identified...... on maternal BMI disclosed that the association was restricted to pregnancies with a pre-pregnancy BMI >23 kg/m2 below that we found no association.  Conclusion: The association between glycosylated haemoglobin and birth of a LGA baby seems to be restricted to women with BMI >23 kg/m2....... all pregnant diabetic women in a Danish county. HbA1c values after 20th gestational week were collected and offspring was categorized as large, normal or small for gestational age. Logistic regression models we fitted to assess the association between HbA1c and risk of delivering a LGA baby taking...

  14. Ovarian morphology and function during growth hormone therapy of short girls born small for gestational age

    DEFF Research Database (Denmark)

    Tinggaard, Jeanette; Jensen, Rikke; Sundberg, Karin

    2014-01-01

    OBJECTIVE: To study the effect of growth hormone (GH) treatment on ovarian and uterine morphology and function in short, prepubertal small-for-gestational-age (SGA) girls.DESIGN: A multinational, randomized controlled trial on safety and efficacy of GH therapy in short, prepubertal children born...... SGA.SETTING: Not applicable.PATIENT(S): A subgroup of 18 Danish girls born SGA included in North European SGA Study (NESGAS).INTERVENTION(S): One year of GH treatment (67 μg/kg/day) followed by 2 years of randomized GH treatment (67 μg/kg/day, 35 μg/kg/day, or IGF-I titrated).MAIN OUTCOME MEASURE...... normal reference ranges. Ovarian follicles became visible in 58% after 1 year compared with 28% before GH therapy. Anti-Müllerian hormone increased significantly during the 3 years of GH therapy but remained within the normal range. Precocious puberty was observed in one girl; another girl developed...

  15. Microscopic Appearance of Human Spleen at Different Gestational Age Groups: A Fetal Histological Study

    Directory of Open Access Journals (Sweden)

    Anne D Souza

    2015-03-01

    Results: The microscopic anatomy of the spleen was observed at different gestational age. At first trimester the spleen was covered with a capsule. The lymphoid aggregations were observed throughout the spleen without any well differentiated red pulp. At second trimester the lymphoid aggregations started differentiating around the central arteriole forming the periarteriolar lymphoid sheath by 20 weeks. The red pulp was distinctly observed containing the RBCs and sinusoids and the white pulp containing lymphoid follicles were observed by 23rd week. At third trimester distinct red and white pulp was observed. By 30th week well developed lymphoid follicles with central arteriole were seen. At 36 weeks the central arteriole was seen at the periphery of the lymphoid follicle. Conclusion: A detailed description of the development of parenchymal and vascular components is essential in understanding the normal development of spleen. [Cukurova Med J 2015; 40(1.000: 36-41

  16. Brain development, intelligence and cognitive outcome in children born small for gestational age.

    Science.gov (United States)

    de Bie, H M A; Oostrom, K J; Delemarre-van de Waal, H A

    2010-01-01

    Intrauterine growth restriction (IUGR) can lead to infants being born small for gestational age (SGA). SGA is associated with increased neonatal morbidity and mortality as well as short stature, cardiovascular disease, insulin resistance, diabetes mellitus type 2, dyslipidemia and end-stage renal disease in adulthood. In addition, SGA children have decreased levels of intelligence and cognition, although the effects are mostly subtle. The overall outcome of each child is the result of a complex interaction between intrauterine and extrauterine factors. Animal and human studies show structural alterations in the brains of individuals with IUGR/SGA. The presence of growth hormone (GH) receptors in the brain implies that the brain is also a target for GH. Exogenous GH theoretically has the ability to act on the brain. This is exemplified by the effects of GH on cognition in GH-deficient adults. In SGA children, data on the effect of exogenous GH on intelligence and cognition are scant and contradictory.

  17. Accuracy and correlates of maternal recall of birthweight and gestational age

    DEFF Research Database (Denmark)

    Adegboye, A R A; Heitmann, Berit Lilienthal

    2008-01-01

    OBJECTIVE: To determine the accuracy of maternal recall of children birthweight (BW) and gestational age (GA), using the Danish Medical Birth Register (DBR) as reference and to examine the reliability of recalled BW and its potential correlates. DESIGN: Comparison of data from the DBR...... and the European Youth Heart Study (EYHS). SETTING: Schools in Odense, Denmark. POPULATION: A total of 1271 and 678 mothers of school children participated with information in the accuracy studies of BW and GA, respectively. The reliability sample of BW was composed of 359 women. METHOD: The agreement between...... the two sources was evaluated by mean differences (MD), intraclass correlation coefficient (ICC) and Bland-Altman's plots. The misclassification of the various BW and GA categories were also estimated. MAIN OUTCOME MEASURES: Differences between recalled and registered BW and GA. RESULTS: There was high...

  18. Blood and urine 8-iso-PGF2α levels in babies of different gestational ages.

    Science.gov (United States)

    Li, Sitao; Hao, Hu; Zhou, Ping; Gao, Ping Ming; Xiao, Xin

    2014-01-01

    We measured cord blood and urine 8-iso-prostaglandin F2α (8-iso-PGF2α) levels in babies of different gestational ages to determine lipid peroxidation status. Babies at gestational ages of 28-43 weeks were divided into group A (28-32 weeks), group B (33-36 weeks), group C (37-41 weeks), and group D (42-43 weeks). 8-iso-PGF2α in umbilical cord blood (UCB) at birth and urine at 6 hours after birth was and tested by ELISA. UCB and urine 8-iso-PGF2α levels in group C were 130.09 ± 31.73 pg/ml and 27.14 ± 6.73 pg/ml, respectively. UCB 8-iso-PGF2α levels in group A and B were 188.42 ± 59.34 pg/ml and 189.37 ± 68.46 pg/ml, and urine 8-iso-PGF2α were 32.14 ± 7.32 pg/ml and 30.46 ± 8.83 pg/ml, respectively. Blood and urine 8-iso-PGF2α levels in group D (post-term) were 252.01 ± 46.42 pg/ml and 44.00 ± 8.50 pg/ml. For all babies, UCB and urine iso-PGF2α levels were significantly correlated (r = 0.65, P iso-PGF2α levels in normal full-term babies. Urine 8-iso-PGF2α levels may reflect the extent of lipid peroxidation in babies. In pre-term and post-term babies, there was evidence for increased lipid peroxidation.

  19. Cord blood calcium, phosphate, magnesium, and alkaline phosphatase gestational age-specific reference intervals for preterm infants

    Directory of Open Access Journals (Sweden)

    Lyon Andrew W

    2011-08-01

    Full Text Available Abstract Background The objective was to determine the influence of gestational age, maternal, and neonatal variables on reference intervals for cord blood bone minerals (calcium, phosphate, magnesium and related laboratory tests (alkaline phosphatase, and albumin-adjusted calcium, and to develop gestational age specific reference intervals based on infants without influential pathological conditions. Methods Cross-sectional study. 702 babies were identified as candidates for this study in a regional referral neonatal unit. After exclusions (for anomalies, asphyxia, maternal magnesium sulfate administration, and death, relationships were examined between cord blood serum laboratory analytes (calcium, phosphate, magnesium, alkaline phosphatase, and albumin-adjusted calcium with gestation age and also with maternal and neonatal variables using multiple linear regression. Infants with influential pathological conditions were omitted from the development of gestational age specific reference intervals for the following categories: 23-27, 28-31, 32-34, 35-36 and > 36 weeks. Results Among the 506 preterm and 54 terms infants included in the sample. Phosphate, magnesium, and alkaline phosphatase in cord blood serum decreased with gestational age, calcium increased with gestational age. Those who were triplets, small for gestational age, and those whose mother had pregnancy-induced hypertension were influential for most of the analytes. The reference ranges for the preterm infants ≥ 36 weeks were: phosphate 1.5 to 2.6 mmol/L (4.5 to 8.0 mg/dL, calcium: 2.1 to 3.1 mmol/L (8.3 to 12.4 mg/dL; albumin-adjusted calcium: 2.3 to 3.2 mmol/L (9.1 to 12.9 mg/dL; magnesium 0.6 to 1.0 mmol/L (1.4 to 2.3 mg/dL, and alkaline phosphatase 60 to 301 units/L. Conclusions These data suggest that gestational age, as well as potentially pathogenic maternal and neonatal variables should be considered in the development of reference intervals for preterm infants.

  20. Developmental performance in small for gestational age children with and without catch-up growth

    Directory of Open Access Journals (Sweden)

    Hesti Lestari

    2015-07-01

    Full Text Available Background Infants born small for gestational age (SGA have an increased risk of developmental delay. The influence of catch-up growth on developmental function remains unknown.Objective To compare the development of SGA children with and without catch-up growth.Methods We conducted a cross-sectional study in Manado from March to July 2013. Subjects were children aged 2-3 years, that born SGA from March 2010 to June 2011 in Prof. Dr. R.D. Kandou Hospital. Catch-up growth was defined as height-for-age more than -2SD on the 2006 WHO growth chart, and subjects were classified into the with and without catch-up growth groups. Developmental status was assessed using the Ages and Stages Questionnaire (ASQ 3rd edition, through interviews with parents. We compared the developmental status between the with and without catch-up growth groups used Mann-Whitney test with a significance level of P < 0.05.Results Of the 112 SGA children, 66 (58.9% had catch-up growth and 46 (41.1% did not. The SGA children with catch up growth had significant better development performances of gross motor, fine motor, and problem solving. The mean ASQ centiles of the with and without catch-up groups were 55.15 (SD 7.843 [95%CI 53.52 to 57.08] and 48.80 (SD 11.264 [95%CI 45.46 to 52.15] in gross motor, respectively; 42.5 (SD 13.163 [95%CI 39.26 to 45.74] and 32.93 (SD 14.475 [95%CI 28.64 to 37.23] in fine motor, respectively; 46.74 (SD 13.112 [95%CI 43.52 to 49.97] and 40.98 (SD 11.480 [95%CI 37.57 to 44.39] in problem solving, respectively.Conclusion Small for gestational age children with catch-up growth have significantly better gross motor, fine motor, and problem-solving performance than those without catch-up growth.

  1. Association of Maternal Age to Development and Progression of Retinopathy of Prematurity in Infants of Gestational Age under 33 Weeks

    Directory of Open Access Journals (Sweden)

    Atsuro Uchida

    2014-01-01

    Full Text Available Aim. To find predictive and indicative markers of risk for development of retinopathy of prematurity (ROP and its progression to the stage requiring laser treatment, in premature infants whose gestational age (GA was under 33 weeks. Methods. We retrospectively reviewed medical records of 197 premature infants born in 2005–2010 whose GA<33 weeks and underwent eye screening at Keio University Hospital. The association between candidate risk factors and development or progression of ROP was assessed. Results. Among the 182 eligible infants (median GA, 29.1 weeks; median birth weight (BW, 1028 g, 84 (46% developed any stage of ROP, of which 45 (25% required laser treatment. Multivariate analysis using a stepwise method showed that GA (P=0.002; 95% confidence interval (CI, 0.508–0.858, BW (P<0.001; 95% CI, 0.994–0.998, and lower maternal age (P=0.032; 95% CI, 0.819–0.991 were the risk factors for ROP development and GA (P<0.001; 95% CI, 0.387–0.609 and lower maternal age (P=0.012; 95% CI, 0.795–0.973 were for laser treatment. The odds ratio of requiring laser treatment was 3.3 when the maternal age was <33 years. Conclusion. ROP was more likely to be developed and progressed in infants born from younger mother and low GA.

  2. The risk of emergency cesarean section after failure of vaginal delivery according to prepregnancy body mass index or gestational weight gain by the 2009 Institute of Medicine guidelines

    Science.gov (United States)

    Kwon, Ha Yan; Kwon, Ja-Young; Park, Yong Won

    2016-01-01

    Objective To evaluate the risk of emergency cesarean section according to the prepregnancy body mass index (BMI) and gestational weight gain per the 2009 Institute of Medicine guidelines. Methods A retrospective analysis of data from 2,765 women with singleton full-term births (2009 to 2012) who attempted a vaginal delivery was conducted. Pregnancies with preeclampsia, chronic hypertension, diabetes, planned cesarean section, placenta previa, or cesarean section due to fetal anomalies or intrauterine growth restriction were excluded. Odds ratios (ORs) and confidence intervals (CIs) for emergency cesarean section were calculated after adjusting for prepregnancy BMI or gestational weight gain. Results Three-hundred and fifty nine (13.0%) women underwent emergency cesarean section. The adjusted OR for overweight, obese, and extremely obese women indicated a significantly increased risk of cesarean delivery. Gestational weight gain by Institute of Medicine guidelines was not associated with an increased risk of cesarean delivery. However, inadequate and excessive weight gain in obese women was highly associated with an increased risk of emergency cesarean section, compared to these in normal BMI (OR, 5.56; 95% CI, 1.36 to 22.72; OR, 3.63; 95% CI, 1.05 to 12.54; respectively), while there was no significant difference between normal BMI and obese women with adequate weight gain. Conclusion Obese women should be provided special advice before and during pregnancy for controlling weight and careful consideration should be needed at the time of vaginal delivery to avoid emergency cesarean section. PMID:27200306

  3. The risk of emergency cesarean section after failure of vaginal delivery according to prepregnancy body mass index or gestational weight gain by the 2009 Institute of Medicine guidelines.

    Science.gov (United States)

    Kwon, Ha Yan; Kwon, Ja-Young; Park, Yong Won; Kim, Young-Han

    2016-05-01

    To evaluate the risk of emergency cesarean section according to the prepregnancy body mass index (BMI) and gestational weight gain per the 2009 Institute of Medicine guidelines. A retrospective analysis of data from 2,765 women with singleton full-term births (2009 to 2012) who attempted a vaginal delivery was conducted. Pregnancies with preeclampsia, chronic hypertension, diabetes, planned cesarean section, placenta previa, or cesarean section due to fetal anomalies or intrauterine growth restriction were excluded. Odds ratios (ORs) and confidence intervals (CIs) for emergency cesarean section were calculated after adjusting for prepregnancy BMI or gestational weight gain. Three-hundred and fifty nine (13.0%) women underwent emergency cesarean section. The adjusted OR for overweight, obese, and extremely obese women indicated a significantly increased risk of cesarean delivery. Gestational weight gain by Institute of Medicine guidelines was not associated with an increased risk of cesarean delivery. However, inadequate and excessive weight gain in obese women was highly associated with an increased risk of emergency cesarean section, compared to these in normal BMI (OR, 5.56; 95% CI, 1.36 to 22.72; OR, 3.63; 95% CI, 1.05 to 12.54; respectively), while there was no significant difference between normal BMI and obese women with adequate weight gain. Obese women should be provided special advice before and during pregnancy for controlling weight and careful consideration should be needed at the time of vaginal delivery to avoid emergency cesarean section.

  4. Small for gestational age and exposure to particulate air pollution in the early-life environment of twins.

    Science.gov (United States)

    Bijnens, Esmée M; Derom, Catherine; Gielen, Marij; Winckelmans, Ellen; Fierens, Frans; Vlietinck, Robert; Zeegers, Maurice P; Nawrot, Tim S

    2016-07-01

    Several studies in singletons have shown that maternal exposure to ambient air pollutants is associated with restricted fetal growth. About half of twins have low birth weight compared with six percent in singletons. So far, no studies have investigated maternal air pollution exposure in association with birth weight and small for gestational age in twins. We examined 4760 twins of the East Flanders Prospective Twins Survey (2002-2013), to study the association between in utero exposure to air pollution with birth weight and small for gestational age. Maternal particulate air pollution (PM10) and nitric dioxide (NO2) exposure was estimated using a spatial temporal interpolation method over various time windows during pregnancy. In the total group of twins, we observed that higher PM10 and NO2 exposure during the third trimester was significantly associated with a lower birth weight and higher risk of small for gestational age. However, the association was driven by moderate to late preterm twins (32-36 weeks of gestation). In these twins born between 32 and 36 weeks of gestation, birth weight decreased by 40.2g (95% CI: -69.0 to -11.3; p=0.006) and by 27.3g (95% CI: -52.9 to -1.7; p=0.04) in association for each 10µg/m³ increment in PM10 and NO2 concentration during the third trimester. The corresponding odds ratio for small for gestational age were 1.68 (95% CI: 1.27-2.33; p=0.0003) and 1.51 (95% CI: 1.18-1.95; p=0.001) for PM10 or NO2, respectively. No associations between air pollution and birth weight or small for gestational age were observed among term born twins. Finally, in all twins, we found that for each 10µg/m³ increase in PM10 during the last month of pregnancy the within-pair birth weight difference increased by 19.6g (95% CI: 3.7-35.4; p=0.02). Assuming causality, an achievement of a 10µg/m³ decrease of particulate air pollution may account for a reduction by 40% in small for gestational age, in twins born moderate to late preterm.

  5. Pequenos para idade gestacional: fator de risco para mortalidade neonatal Small for gestational age

    Directory of Open Access Journals (Sweden)

    Márcia Furquim de Almeida

    1998-06-01

    Full Text Available OBJETIVO: Estudar as variáveis contempladas na Declaração de Nascimento (DN como possíveis fatores de risco para nascimentos pequenos para a idade gestacional (PIG e o retardo de crescimento intra-uterino como fator de risco para a mortalidade neonatal. MATERIAL E MÉTODO: As variáveis existentes na DN foram obtidas diretamente de prontuários hospitalares. Os dados referem-se a uma coorte de nascimentos obtida por meio da vinculação das declarações de nascimento e óbito, correspondendo a 2.251 nascimentos vivos hospitalares, de mães residentes, ocorridos no Município de Santo André, Região Metropolitana de São Paulo, no período de l/1 a 30/6/1992, e aos óbitos neonatais verificados nessa coorte. RESULTADOS: Obteve-se a proporção de 4,3% de nascimentos PIG, significativamente maior entre os recém-nascidos de pré-termo e pós-termo, entre os nascimentos cujas mães tinham mais de 35 anos de idade e grau de instrução inferior ao primeiro grau completo. Os recém-nascidos PIG apresentam maior risco de morte neonatal que aqueles que não apresentavam sinais de retardo de crescimento intra-uterino. CONCLUSÕES: Em áreas com menor freqüência de baixo peso ao nascer, é importante investigar a presença de retardo de crescimento intra-uterino entre os nascimentos prematuros e não apenas nos nascimentos de termo. O registro da data da última menstruação (ou da idade gestacional em semanas não agregadas na DN facilitaria a detecção de PIGs na população de recém-nascidos.INTRODUCTION: Variables of birth certificates were analysed as risk factors of SGA (Small for Gestational Age infantis, and with a view to discovering if retarded intra-uterine growth was a risk factor neonatal mortality. MATERIAL AND METHOD: Data were obtained directly from 11 hospital medical records. A cohort of 2.251 hospital live births was obtained. Linkage of the death and birth certificates was undertaken to identify the neonatal deaths. The

  6. Metabolic response to 36 hours of fasting in young men born small vs appropriate for gestational age

    DEFF Research Database (Denmark)

    Jørgensen, Sine W; Brøns, Charlotte; Bluck, Les

    2015-01-01

    fasting differed between 21 young adults born SGA and 18 matched controls born appropriate for gestational age (AGA). METHODS: A frequently sampled IVGTT and indirect calorimetry measurements were performed after a 36 h fast. Endogenous glucose production, insulin sensitivity (SI), first-phase insulin...

  7. Adiponectin levels measured in dried blood spot samples from neonates born small and appropriate for gestational age

    DEFF Research Database (Denmark)

    Klamer, A; Skogstrand, Kristin; Hougaard, D M

    2007-01-01

    Adiponectin levels measured in neonatal dried blood spot samples (DBSS) might be affected by both prematurity and being born small for gestational age (SGA). The aim of the study was to measure adiponectin levels in routinely collected neonatal DBSS taken on day 5 (range 3-12) postnatal from...

  8. On the evaluation of routine ultrasound screening in the third trimester for detection of light for gestational age (LGA) infants

    DEFF Research Database (Denmark)

    Secher, Niels Jørgen; Kern Hansen, P; Lenstrup, C;

    1987-01-01

    % of the pregnancies. The usefulness of the screening was evaluated on the remaining 36%. An attempt to diagnose light for gestational age (LGA) infants resulted in either a low sensitivity or a low predictive value of a positive test. The late third trimester screening was more sensitive than the early, indicating...

  9. Adiponectin levels measured in dried blood spot samples from neonates born small and appropriate for gestational age

    DEFF Research Database (Denmark)

    Klamer, A; Skogstrand, Kristin; Hougaard, D M;

    2007-01-01

    Adiponectin levels measured in neonatal dried blood spot samples (DBSS) might be affected by both prematurity and being born small for gestational age (SGA). The aim of the study was to measure adiponectin levels in routinely collected neonatal DBSS taken on day 5 (range 3-12) postnatal from...

  10. Effect of discontinuation of growth hormone treatment on risk factors for cardiovascular disease in adolescents born small for gestational age

    NARCIS (Netherlands)

    Y. van Pareren; M. Houdijk; M. Jansen (Maarten); M. Reeser; P.G.H. Mulder (Paul); A.C.S. Hokken-Koelega (Anita)

    2003-01-01

    textabstractHyperlipidemia, diabetes mellitus type 2, and coronary heart disease have been associated with being born small for gestational age (SGA). It has been reported that GH treatment induced higher insulin levels, which has led to concern regarding the long-term effect of GH

  11. Bloom syndrome in short children born small for gestational age: a challenging diagnosis.

    Science.gov (United States)

    Renes, Judith S; Willemsen, Ruben H; Wagner, Anja; Finken, Martijn J J; Hokken-Koelega, Anita C S

    2013-10-01

    GH treatment has become a frequently applied growth-promoting therapy in short children born small for gestational age (SGA). In some disorders GH treatment is contraindicated, eg, chromosomal breakage syndromes. Bloom syndrome is a rare chromosomal breakage syndrome characterized by severe pre- and postnatal growth deficiency, a photosensitive facial erythema, immunodeficiency, mental retardation or learning disabilities, endocrinopathies, and a predisposition to develop a wide variety of cancers. We report 2 patients with Bloom syndrome illustrating the variety in clinical manifestations. They were initially diagnosed with short stature after SGA birth and Silver Russell syndrome and treated with GH. Both patients presented with pre- and postnatal growth failure but no clear other characteristic features associated with Bloom syndrome. Photosensitive skin lesions developed only at a pubertal age and were minimal. Also, both children showed normal immunoglobulin levels, normal development, and no signs of endocrinopathies at start of GH. Dysmorphic features resembling Silver Russell syndrome were observed in both patients. Remarkably, during GH treatment IGF-1 levels increased to values greater than 3.5 SD score, with normal IGF binding protein-3 levels. Short children born SGA comprise a heterogeneous group. Bloom syndrome should be tested for in children with consanguineous parents, dysmorphic features (particularly resembling Silver Russell syndrome), skin abnormalities, and/or IGF-1 levels greater than 2.5 SD score during standard GH treatment with normal IGF binding protein-3 levels.

  12. The transverse diameter of the chest on routine radiographs reliably estimates gestational age and weight in premature infants

    Energy Technology Data Exchange (ETDEWEB)

    Dietz, Kelly R. [University of Minnesota, Department of Radiology, Minneapolis, MN (United States); Zhang, Lei [University of Minnesota, Biostatistical Design and Analysis Center, Minneapolis, MN (United States); Seidel, Frank G. [Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States)

    2015-08-15

    Prior to digital radiography it was possible for a radiologist to easily estimate the size of a patient on an analog film. Because variable magnification may be applied at the time of processing an image, it is now more difficult to visually estimate an infant's size on the monitor. Since gestational age and weight significantly impact the differential diagnosis of neonatal diseases and determine the expected size of kidneys or appearance of the brain by MRI or US, this information is useful to a pediatric radiologist. Although this information may be present in the electronic medical record, it is frequently not readily available to the pediatric radiologist at the time of image interpretation. To determine if there was a correlation between gestational age and weight of a premature infant with their transverse chest diameter (rib to rib) on admission chest radiographs. This retrospective study was approved by the institutional review board, which waived informed consent. The maximum transverse chest diameter outer rib to outer rib was measured on admission portable chest radiographs of 464 patients admitted to the neonatal intensive care unit (NICU) during the 2010 calendar year. Regression analysis was used to investigate the association between chest diameter and gestational age/birth weight. Quadratic term of chest diameter was used in the regression model. Chest diameter was statistically significantly associated with both gestational age (P < 0.0001) and birth weight (P < 0.0001). An infant's gestational age and birth weight can be reliably estimated by comparing a simple measurement of the transverse chest diameter on digital chest radiograph with the tables and graphs in our study. (orig.)

  13. Maternal caffeine consumption and small for gestational age births: results from a population-based case-control study.

    Science.gov (United States)

    Hoyt, Adrienne T; Browne, Marilyn; Richardson, Sandra; Romitti, Paul; Druschel, Charlotte

    2014-08-01

    Caffeine is consumed in various forms during pregnancy, has increased half-life during pregnancy and crosses the placental barrier. Small for gestational age (SGA) is an important perinatal outcome and has been associated with long term complications. We examined the association between maternal caffeine intake and SGA using National Birth Defects Prevention Study data. Non-malformed live born infants with an estimated date of delivery from 1997-2007 (n = 7,943) were included in this analysis. Maternal caffeine exposure was examined as total caffeine intake and individual caffeinated beverage type (coffee, tea, and soda); sex-, race/ethnic-, and parity-specific growth curves were constructed to estimate SGA births. Crude and adjusted odds ratios (aORs) and 95% confidence intervals were estimated using unconditional logistic regression. Interaction with caffeine exposures was assessed for maternal smoking, vasoconstrictor medication use, and folic acid. Six hundred forty-eight infants (8.2%) were found to be SGA in this analysis. Increasing aORs were observed for increasing intakes of total caffeine and for each caffeinated beverage with aORs (adjusting for maternal education, high blood pressure, and smoking) ranging from 1.3 to 2.1 for the highest intake categories (300+ mg/day total caffeine and 3+ servings/day for each beverage type). Little indication of additive interaction by maternal smoking, vasoconstrictor medication use, or folic acid intake was observed. We observed an increase in SGA births for mothers with higher caffeine intake, particularly for those consuming 300+ mg of caffeine per day. Increased aORs were also observed for tea intake but were more attenuated for coffee and soda intake.

  14. Estimation of gestational age from measurement of crown-rump length with transvaginal sonography in early pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hyun Ju; Lee, Young Ho; Kim, Young Hwa [Cheil General Hospital, Seoul (Korea, Republic of)

    1994-12-15

    Estimation of gestational age using crown-rump length (CRL) has been considered to be relatively accurate. The purpose of this study was to determine the relationship between the gestational age (GA) and the CRL seen ontransvaginal sonography and to improve the gestational dating creteria. One hundred and ninety five patients with known date of conception, who were pregnant between February 1990 and December 1992, were examined with high resolution transvaginal ultrasonography. There was a linear relationship between the CRL and the GA from the 27th to the 56th day of ovulation. It was defined by equation, as GA=0.97xCRL+42.4 (r=0.95, p<0.0001). Regression values with 95% confidence limit for CRL were +3.9-4.0 days. Comparison of regression lines between the data from the natural cycle group (N=53) and those from the hormonally treated group (N=142) was performed. There was no statistically significant difference between the two groups (analysis of convariance, p>0.05) In conclusion, trasvaginal sonography was useful in the determination of the GA in the early pregnancy from the 27th day of ovulation up to the 56th day. A new reference chart is provided for the estimation of gestational age according to the CRL

  15. Survival and major neurodevelopmental impairment in extremely low gestational age newborns born 1990–2000: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    deRegnier Raye-Ann

    2007-05-01

    Full Text Available Abstract Background It is important to determine if rates of survival and major neurodevelopmental impairment in extremely low gestational age newborns (ELGANs; infants born at 23–27 weeks gestation are changing over time. Methods Study infants were born at 23 to 27 weeks of gestation without congenital anomalies at a tertiary medical center between July 1, 1990 and June 30, 2000, to mothers residing in a thirteen-county region in North Carolina. Outcomes at one year adjusted age were compared for two epochs of birth: epoch 1, July 1, 1990 to June 30, 1995; epoch 2, July 1, 1995 to June 30, 2000. Major neurodevelopmental impairment was defined as cerebral palsy, Bayley Scales of Infant Development Mental Developmental Index more than two standard deviations below the mean, or blindness. Results Survival of ELGANs, as a percentage of live births, was 67% [95% confidence interval: (61, 72] in epoch 1 and 71% (65, 75 in epoch 2. Major neurodevelopmental impairment was present in 20% (15, 27 of survivors in epoch 1 and 14% (10, 20 in epoch 2. When adjusted for gestational age, survival increased [odds ratio 1.5 (1.0, 2.2, p = .03] and major neurodevelopmental impairment decreased [odds ratio 0.54 (0.31, 0.93, p = .02] from epoch 1 to epoch 2. Conclusion The probability of survival increased while that of major neurodevelopmental impairment decreased during the 1990's in this regionally based sample of ELGANs.

  16. ‘The influence of gestational age and socioeconomic status on neonatal outcomes in late preterm and early term gestation: a population based study’

    Directory of Open Access Journals (Sweden)

    Ruth Chelsea A

    2012-06-01

    Full Text Available Abstract Background Infants born late preterm (34 + 0 to 36 + 6 weeks GA (gestational age are known to have higher neonatal morbidity than term (37 + 0 to 41 + 6 weeks GA infants. There is emerging evidence that these risks may not be homogenous within the term cohort and may be higher in early term (37 + 0 to 38 + 6 weeks GA. These risks may also be affected by socioeconomic status, a risk factor for preterm birth. Methods A retrospective population based cohort of infants born at 34 to 41 weeks of GA was assembled; individual and area-level income was used to develop three socioeconomic (SES groups. Neonatal morbidity was grouped into respiratory distress syndrome (RDS, other respiratory disorders, other complications of prematurity, admission to a Level II/III nursery and receipt of phototherapy. Regression models were constructed to examine the relationship of GA and SES to neonatal morbidity while controlling for other perinatal variables. Results The cohort contained 25 312 infants of whom 6.1% (n = 1524 were born preterm and 32.4% (n = 8203 were of low SES. Using 39/40 weeks GA as the reference group there was a decrease in neonatal morbidity at each week of gestation. The odds ratios remained significantly higher at 37 weeks for RDS or other respiratory disorders, and at 38 weeks for all other outcomes. SES had an independent effect, increasing morbidity with odds ratios ranging from 1.2–1.5 for all outcomes except for the RDS group, where it was not significant. Conclusions The risks of morbidity fell throughout late preterm and early term gestation for both respiratory and non-respiratory morbidity. Low SES was associated with an independent increased risk. Recognition that the morbidities associated with prematurity continue into early term gestation and are further compounded by SES is important to develop strategies for improving care of early term infants, avoiding iatrogenic

  17. Longitudinal study of aortic isthmus Doppler in appropriately grown and small-for-gestational-age fetuses with normal and abnormal umbilical artery Doppler.

    LENUS (Irish Health Repository)

    Kennelly, M M

    2012-04-01

    To establish reference ranges using longitudinal data for aortic isthmus (AoI) Doppler indices in appropriate-for-gestational-age (AGA) fetuses and to document the longitudinal trends in a cohort of small-for-gestational-age (SGA) fetuses with normal umbilical artery Doppler and in fetuses with intrauterine growth restriction (IUGR) and abnormal umbilical artery Doppler.

  18. The impact of gestational age on resource utilization after open heart surgery for congenital cardiac disease from birth to 1 year of age.

    Science.gov (United States)

    Bishop, Naomi B; Zhou, Theresa X; Chen, Jonathan M; Ward, Mary J; Carroll, Sheila J

    2013-03-01

    The impact of gestational age on perioperative morbidity was examined using a novel construct, the resource utilization index (RUI). The medical records of subjects from birth to 1 year of age entered into a pediatric cardiothoracic surgery database from a major academic medical center between 2007 and 2011 were reviewed. The hypothesis tested was that infants born at 37-38 weeks (early-term infants) experience greater resource utilization after open heart surgery than those born at 39 completed weeks and that this association can be observed until 1 year of age. The results support the premise that resource utilization increases linearly with declining gestational age among infants at 0-12 months who undergo cardiac surgery. Five of the six variables comprising the RUI showed statistically significant linear associations with gestational age in the predicted direction. Multivariate linear regression analysis showed that gestational age was a significant predictor of an increased RUI composite. Further investigation is needed to test the concept and to expand on these findings.

  19. Small for Gestational Age and Higher Birth Weight Predict Childhood Obesity in Preterm Infants

    Science.gov (United States)

    Gaskins, Ronnesia B.; LaGasse, Linda L.; Liu, Jing; Shankaran, Seetha; Lester, Barry M.; Bada, Henrietta S.; Bauer, Charles R.; Das, Abhik; Higgins, Rosemary D.; Roberts, Mary

    2010-01-01

    We sought to determine the association between small for gestational age (SGA), birth weight, and childhood obesity within preterm polysubstance exposed children. We sampled 312 preterm children with 11-year body mass index (BMI; age- and sex-specific) data from the Maternal Lifestyle Study (51% girls, 21.5% SGA, 46% prenatal cocaine, and 55% tobacco exposed). Multinomial regression analyzed the association between 11-year obesity (OBE) and overweight (OW) and SGA, birth weight, first-year growth velocity, diet, and physical activity variables. Overall, 24% were OBE (BMI for age ≥95th percentile) and 16.7% were OW (BMI ≥85th and <95th percentiles). In adjusted analyses, SGA was associated with OW (odds ratio [OR]=3.4, confidence interval [CI] 1.5 to 7.5). Higher birth weight was associated with OBE (OR = 1.8, CI 1.3 to 2.4) and OW (OR=1.4, CI 1.1 to 2.0). Growth velocity was associated with OBE (OR=2.7, CI 1.8 to 4.0) and OW (OR=1.6, CI 1.1 to 2.4). Low exercise was associated with OBE (OR=2.1, CI 1.0 to 4.4) and OW (OR=2.1, CI 1.0 to 4.5). There was no effect of substance exposure on obesity outcomes. Many (41%) of these high-risk preterm 11-year-olds were obese/overweight. Multiple growth-related processes may be involved in obesity risk for preterm children, including fetal programming as indicated by the SGA effect. PMID:20408111

  20. Estimating Gestational Age in Late Presenters to Antenatal Care in a Resource-Limited Setting on the Thai-Myanmar Border.

    Science.gov (United States)

    Moore, Kerryn A; Simpson, Julie A; Thomas, Kyla H; Rijken, Marcus J; White, Lisa J; Dwell, Saw Lu Moo; Paw, Moo Kho; Wiladphaingern, Jacher; Pukrittayakamee, Sasithon; Nosten, François; Fowkes, Freya J I; McGready, Rose

    2015-01-01

    Estimating gestational age in resource-limited settings is prone to considerable inaccuracy because crown-rump length measured by ultrasound before 14 weeks gestation, the recommended method for estimating gestational age, is often unavailable. Judgements regarding provision of appropriate obstetric and neonatal care are dependent on accurate estimation of gestational age. We determined the accuracy of the Dubowitz Gestational Age Assessment, a population-specific symphysis-fundal height formula, and ultrasound biometry performed between 16 and 40 weeks gestation in estimating gestational age using pre-existing data from antenatal clinics of the Shoklo Malaria Research Unit on the Thai-Myanmar border, where malaria is endemic. Two cohorts of women who gave birth to live singletons were analysed: 1) 250 women who attended antenatal care between July 2001 and May 2006 and had both ultrasound crown-rump length (reference) and a Dubowitz Gestational Age Assessment; 2) 975 women attending antenatal care between April 2007 and October 2010 who had ultrasound crown-rump length, symphysis-fundal measurements, and an additional study ultrasound (biparietal diameter and head circumference) randomly scheduled between 16 and 40 weeks gestation. Mean difference in estimated newborn gestational age between methods and 95% limits of agreement (LOA) were determined from linear mixed-effects models. The Dubowitz method and the symphysis-fundal height formula performed well in term newborns, but overestimated gestational age of preterms by 2.57 weeks (95% LOA: 0.49, 4.65) and 3.94 weeks (95% LOA: 2.50, 5.38), respectively. Biparietal diameter overestimated gestational age by 0.83 weeks (95% LOA: -0.93, 2.58). Head circumference underestimated gestational age by 0.39 weeks (95% LOA: -2.60, 1.82), especially if measured after 24 weeks gestation. The results of this study can be used to quantify biases associated with alternative methods for estimating gestational age in the absence of

  1. Estimating Gestational Age in Late Presenters to Antenatal Care in a Resource-Limited Setting on the Thai-Myanmar Border.

    Directory of Open Access Journals (Sweden)

    Kerryn A Moore

    Full Text Available Estimating gestational age in resource-limited settings is prone to considerable inaccuracy because crown-rump length measured by ultrasound before 14 weeks gestation, the recommended method for estimating gestational age, is often unavailable. Judgements regarding provision of appropriate obstetric and neonatal care are dependent on accurate estimation of gestational age. We determined the accuracy of the Dubowitz Gestational Age Assessment, a population-specific symphysis-fundal height formula, and ultrasound biometry performed between 16 and 40 weeks gestation in estimating gestational age using pre-existing data from antenatal clinics of the Shoklo Malaria Research Unit on the Thai-Myanmar border, where malaria is endemic. Two cohorts of women who gave birth to live singletons were analysed: 1 250 women who attended antenatal care between July 2001 and May 2006 and had both ultrasound crown-rump length (reference and a Dubowitz Gestational Age Assessment; 2 975 women attending antenatal care between April 2007 and October 2010 who had ultrasound crown-rump length, symphysis-fundal measurements, and an additional study ultrasound (biparietal diameter and head circumference randomly scheduled between 16 and 40 weeks gestation. Mean difference in estimated newborn gestational age between methods and 95% limits of agreement (LOA were determined from linear mixed-effects models. The Dubowitz method and the symphysis-fundal height formula performed well in term newborns, but overestimated gestational age of preterms by 2.57 weeks (95% LOA: 0.49, 4.65 and 3.94 weeks (95% LOA: 2.50, 5.38, respectively. Biparietal diameter overestimated gestational age by 0.83 weeks (95% LOA: -0.93, 2.58. Head circumference underestimated gestational age by 0.39 weeks (95% LOA: -2.60, 1.82, especially if measured after 24 weeks gestation. The results of this study can be used to quantify biases associated with alternative methods for estimating gestational age in the

  2. Animal models for small for gestational age and fetal programming of adult disease.

    Science.gov (United States)

    Vuguin, Patricia M

    2007-01-01

    Fetal growth retardation is a fetal adaptation in response to inadequate supply of oxygen and/or nutrients. Animal models of intrauterine growth retardation are an invaluable tool to question the genetic, molecular and cellular events that determine fetal growth and development. Rodent and non-litter bearing animals are mammalian system with similar embryology,anatomy and physiology to humans. Utilization of these systems has led to a greater understanding of the pathophysiology and consequences of intrauterine growth retardation. These observations are comparable to that observed in humans born small for gestational age, and are of interest because of the known association between poor fetal growth and development of adult disease. All the experimental manipulations described here have altered a number of metabolic and physiological variables, but the pattern of alterations seems to vary with the procedure and species employed. This review describes animal models for intrauterine growth retardation and assesses their potentials and limitations at aiming to improve strategies for the prevention of adult disease.

  3. Intrauterine nicotine exposure, birth weight, gestational age and the risk of infantile colic

    DEFF Research Database (Denmark)

    Milidou, Ioanna; Søndergaard, Charlotte; Jensen, Morten Søndergaard

    Background and aim: Infantile colic is characterised by crying bouts in a healthy infant during the first months. Smoking in pregnancy and low birth weight (BW) have been previously identified as risk factors for infantile colic. Nicotine acts as a neurotransmitter and is known to affect the intr......Background and aim: Infantile colic is characterised by crying bouts in a healthy infant during the first months. Smoking in pregnancy and low birth weight (BW) have been previously identified as risk factors for infantile colic. Nicotine acts as a neurotransmitter and is known to affect...... the intrauterine central nervous system development, while low BW and premature birth have both been related to adverse neurodevelopmental outcomes. We investigated the association between intrauterine nicotine exposure, BW, gestational age (GA) and infantile colic in a large cohort study. Materials and methods......: We used data from the Danish National Birth Cohort. The study on nicotine exposure included 63,128 infants and the study on BW and GA included 62, 785 infants with complete data. Infantile colic was defined according to the modified Wessel’s criteria based on maternal interview 6 months postpartum...

  4. Metabolic profiling uncovers a phenotypic signature of small for gestational age in early pregnancy.

    LENUS (Irish Health Repository)

    Horgan, Richard P

    2012-01-31

    Being born small for gestational age (SGA) confers increased risks of perinatal morbidity and mortality and increases the risk of cardiovascular complications and diabetes in later life. Accumulating evidence suggests that the etiology of SGA is usually associated with poor placental vascular development in early pregnancy. We examined metabolomic profiles using ultra performance liquid chromatography-mass spectrometry (UPLC-MS) in three independent studies: (a) venous cord plasma from normal and SGA babies, (b) plasma from a rat model of placental insufficiency and controls, and (c) early pregnancy peripheral plasma samples from women who subsequently delivered a SGA baby and controls. Multivariate analysis by cross-validated Partial Least Squares Discriminant Analysis (PLS-DA) of all 3 studies showed a comprehensive and similar disruption of plasma metabolism. A multivariate predictive model combining 19 metabolites produced by a Genetic Algorithm-based search program gave an Odds Ratio for developing SGA of 44, with an area under the Receiver Operator Characteristic curve of 0.9. Sphingolipids, phospholipids, carnitines, and fatty acids were among this panel of metabolites. The finding of a consistent discriminatory metabolite signature in early pregnancy plasma preceding the onset of SGA offers insight into disease pathogenesis and offers the promise of a robust presymptomatic screening test.

  5. Prolonged exclusive breastfeeding, autumn birth and increased gestational age are associated with lower risk of fever in children with hand, foot, and mouth disease.

    Science.gov (United States)

    Zhu, Q; Li, Y; Li, N; Han, Q; Liu, Z; Li, Z; Qiu, J; Zhang, G; Li, F; Tian, N

    2012-09-01

    Epidemics of hand, foot, and mouth disease (HFMD) have been emerging and reemerging in recent years. This study aims to investigate whether breastfeeding and other factors may affect the profile of fever and disease course in children with HFMD. Three hundred seventy-two preschool children with HFMD were included. The demographics, environmental factors, and delivery- and feeding-associated factors in the children were obtained and their effects on the profile of fever and disease course were analyzed. Of the 372 children, 139 (37.37%) had fever during the disease course. Gender, breastfeeding pattern, birth season and gestational age were significantly different between the children with and without fever (p = 0.034, p fever.

  6. Parental age at delivery and a man's semen quality

    DEFF Research Database (Denmark)

    Priskorn, Lærke; Jensen, Tina K; Lindahl-Jacobsen, Rune;

    2014-01-01

    the possibility that a trend may have been identified with a still larger sample. In addition, the Danish Civil Registration System is merely administrative and hence does not discriminate between biological and adopted children. However, the low rate of adoption (≈2%) suggests that misclassification would have......STUDY QUESTION: Is parental age at delivery associated with a man's semen quality? SUMMARY ANSWER: In this large register-based study both mother's and father's age are found to have minimal effects on semen quality in men. WHAT IS KNOWN ALREADY: Both maternal and paternal age have been associated...... with a range of adverse health effects in the offspring. Given the varied health effects of parental age upon offspring, and the sensitivity of genital development to external factors, it is plausible that the age of a man's mother and father at conception may impact his reproductive health. To our knowledge...

  7. Evaluation of cardiac function in a group of small for gestational age school-age children treated with growth hormone.

    Science.gov (United States)

    Aurensanz Clemente, Esther; Ayerza Casas, Ariadna; Samper Villagrasa, Pilar; Ruiz Frontera, Pablo; Bueno Lozano, Gloria

    2017-02-09

    Small for gestational age (SGA) patients have an increased risk of developing a cardiovascular pathology, as well as a metabolic syndrome. Our objective is to evaluate the cardiac morphology and function of SGA children treated with growth hormone (GH), identifying changes that could potentially have long-term consequences. We selected 23 SGA school-age patients and 23 healthy children. We measured their weight, height, blood pressure and heart rate. Using transthoracic echocardiography, we evaluated cardiac chamber size, ascending and abdominal aortic diameter as well as the systolic and diastolic function of both ventricles. SGA children have a higher systolic and diastolic blood pressure (P<.05) without significant changes in their heart rate. They also have a thicker interventricular septum (SGA Z-score 1.57 vs. 0.89; P=.026) and a worse right ventricular systolic function, with a lower TAPSE (SGA Z-score -0.98 vs. 0.95; P=.000), as well as a lower blood flow rate in the pulmonary artery (SGA 0.85m/s vs. 0.97m/s; P=.045). No significant difference was observed in the patients' left ventricular function. SGA patients' ascending aortic diameter was greater (SGA Z-score -1.09 vs. -1.93; P=.026), whereas the systolic abdominal aortic diameter was smaller (SGA Z-score-0.89 vs. -0.19; P=.015). We found functional and morphological cardiac changes in SGA school-age patients treated with GH. It is important to follow-up this patient group in order to determine if these changes contribute to an increased cardiac morbidity in adulthood. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  8. [Study on growth hormone treatment in small for gestational age children].

    Science.gov (United States)

    Sánchez Zahonero, Julia; López García, María José

    2017-02-01

    To analyse the effectiveness of growth hormone (GH) therapy in short-stature children born small for gestational age (SGA) without catch-up growth (height at the beginning of treatment<-2.5 SDS), in Valencia (Spain), between 01/01/2003 and 12/31/2013; and to compare our findings with previously published data. Anthropometric data from the SGA children were obtained from the database of the «Ministry of Health of Valencia». These data were retrospectively reviewed. A total of 115 SGA children, with a mean age of 8.10±2.75 years and height of -3.14±0.59 SDS started treatment (dose: 0.035±0.004mg/kg/day) between January 1st, 2003 and March 31st, 2013. After 2 years of therapy (n=115, age: 10.50±2.72 years) the height SDS was -2.11±0.66; and after 4 years (n = 96, age: 12.65±2.46 years) of -1.76±0.75 SDS. This latest improvement in stature matches ages at which the growth spurt usually occurs. Only 35 out of 115 children reached adult height, although impaired (-2.22±0.86 SDS), and failed to achieve their target height (-1.72 ±0.75 SDS). However, this sub-group grew to near the height of the shorter parent (-1.95 ±1.28 SDS), and 42,9% of these 35 cases increased their stature by more than 1 SDS. The studied sample did not achieve satisfactory growth results, as in other published series. Our findings might be improved by starting treatment earlier, and with doses individualised according to patient characteristics. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Primary prevention of gestational diabetes mellitus and large-for-gestational-age newborns by lifestyle counseling: a cluster-randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Riitta Luoto

    2011-05-01

    Full Text Available BACKGROUND: Our objective was to examine whether gestational diabetes mellitus (GDM or newborns' high birthweight can be prevented by lifestyle counseling in pregnant women at high risk of GDM. METHOD AND FINDINGS: We conducted a cluster-randomized trial, the NELLI study, in 14 municipalities in Finland, where 2,271 women were screened by oral glucose tolerance test (OGTT at 8-12 wk gestation. Euglycemic (n = 399 women with at least one GDM risk factor (body mass index [BMI] ≥ 25 kg/m(2, glucose intolerance or newborn's macrosomia (≥ 4,500 g in any earlier pregnancy, family history of diabetes, age ≥ 40 y were included. The intervention included individual intensified counseling on physical activity and diet and weight gain at five antenatal visits. Primary outcomes were incidence of GDM as assessed by OGTT (maternal outcome and newborns' birthweight adjusted for gestational age (neonatal outcome. Secondary outcomes were maternal weight gain and the need for insulin treatment during pregnancy. Adherence to the intervention was evaluated on the basis of changes in physical activity (weekly metabolic equivalent task (MET minutes and diet (intake of total fat, saturated and polyunsaturated fatty acids, saccharose, and fiber. Multilevel analyses took into account cluster, maternity clinic, and nurse level influences in addition to age, education, parity, and prepregnancy BMI. 15.8% (34/216 of women in the intervention group and 12.4% (22/179 in the usual care group developed GDM (absolute effect size 1.36, 95% confidence interval [CI] 0.71-2.62, p = 0.36. Neonatal birthweight was lower in the intervention than in the usual care group (absolute effect size -133 g, 95% CI -231 to -35, p = 0.008 as was proportion of large-for-gestational-age (LGA newborns (26/216, 12.1% versus 34/179, 19.7%, p = 0.042. Women in the intervention group increased their intake of dietary fiber (adjusted coefficient 1.83, 95% CI 0.30-3.25, p = 0.023 and

  10. Mifepristone-misoprostol midtrimester abortion: impact of gestational age on the induction-to-abortion interval.

    Science.gov (United States)

    Gómez, Olga; Borrás, Aina; Rabanal, Aintzane; Palacio, Montse; Carceller, Antonia; Coll, Oriol; Gratacós, Eduard

    2010-02-01

    This study was conducted to explore the effect of gestational age (GA) on the induction-to-abortion interval of mifepristone-misoprostol midtrimester termination of pregnancy (TOP) regimen. This study involved a consecutive series of 270 pregnancies between 12.0 and 22.6 weeks that have undergone legal TOP from April 2006 to June 2009. All women received a single oral dose of 200 mg mifepristone and, 36-48 h later, a course of misoprostol (an initial vaginal dose of 800 mcg plus four oral doses of 400 mcg at 3-hourly intervals). Treatment was considered to be a failure if abortion did not occur within 24 h. The impact of GA, parity and maternal age on the induction-to-abortion interval was assessed by means of Cox regression. Overall, the mean GA at TOP was 18.0 weeks. The mean induction-to-abortion interval was 9.8 h (SD=8.2 h; range=1-50 h), and 246 women (91%) aborted successfully within 24 h. GA at TOP and parity were the only two variables independently associated with the induction-to-abortion interval. The mean induction-to-abortion interval was increased by about 50% in patients undergoing TOP between 20.0 and 22.6 weeks (12.9 h, SD=8.9), as compared with those at 16.0-19.6 weeks (7.8 h, SD=5.9) and 12.0-15.6 weeks (8.2 h, SD=8.3) (pabortion interval was more modest, with a 20% increase in induction-to-abortion interval in nulliparous (10.1 h, SD=9.1), as compared with women with a previous live birth (8.1 h, SD=6.7). The mean induction-to-abortion interval increases by 4 h after 20 weeks GA. This information may be relevant for counseling and planning of the procedure.

  11. Men becoming fathers by intracytoplasmic sperm injection were more often born small for gestational age

    Directory of Open Access Journals (Sweden)

    Susanne Liffner

    2017-01-01

    Full Text Available Being born with nonoptimal birth characteristics decreases the chance of becoming a father. Urogenital malformations as well as metabolic syndrome are more common in men born small for gestational age (SGA and could be contributing factors to the reduced fertility rate seen in these men. It could imply that men becoming fathers by assisted reproductive technology (ART more often are born with low birth weight (LBW, preterm, and/or SGA than men conceiving without treatment and also that men where intracytoplasmic sperm injection (ICSI had to be performed more often are born with nonoptimal birth characteristics than men where conventional in vitro fertilization (IVF successfully could be used. In this retrospective, case-control study using Swedish national registers, we compared the birth characteristics of 1206 men who have become fathers by ART with a control group consisting of age-matched men who became fathers without treatment. The differences in birth characteristics between men becoming fathers by IVF and ICSI were also assessed. For men becoming fathers by ART, OR of being born with LBW was 1.66 (95% CI = 1.17-2.36 compared with fathers who conceived without treatment. OR of being born prematurely was 1.32 (95% CI = 1.00-1.77. Men becoming fathers via ICSI had a doubled increased likelihood of being born SGA compared with men who became fathers via IVF (OR = 2.12; 95% CI = 1.17-3.83. In conclusion, we have found that men becoming fathers by ICSI treatments had more often been born SGA than men becoming fathers by conventional IVF.

  12. Post‐traumatic stress disorder, child abuse history, birthweight and gestational age: a prospective cohort study

    National Research Council Canada - National Science Library

    Seng, JS; Low, LK; Sperlich, M; Ronis, DL; Liberzon, I

    2011-01-01

    ...‐traumatic stress disorder (PTSD) is associated with lower birthweight and shorter gestation, and to explore the effects of childhood maltreatment as the antecedent trauma exposure. Design  Prospective three‐cohort study. Setting...

  13. [46-OR] : Early and late onset preeclampsia versus small for gestational age risks in subsequent pregnancies

    NARCIS (Netherlands)

    Bernardes, Thomas P; Mol, Ben W; Ravelli, Anita C; van den Berg, Paul P; Stolk, Ronald P; Groen, Henk

    OBJECTIVES: Current literature suggests that early and late onset preeclampsia should be treated as distinct entities and that early onset preeclampsia shares pathophysiology aspects with intrauterine growth restriction. Our objective was to investigate whether 5th percentile small for gestational

  14. Socioeconomic differences and the impact of being small for gestational age on neurodevelopment among preschool-aged children.

    Science.gov (United States)

    Drews-Botsch, Carolyn; Schieve, Laura A; Kable, Julie; Coles, Claire

    2011-01-01

    Studies of small for gestational age (SGA) birth and subsequent childhood cognitive outcomes are inconsistent. Few studies have assessed whether effects varied by socioeconomic status (SES). To assess child cognitive and behavioral outcomes according to SGA and severe SGA (VABS). The mother completed the Child Behavior Checklist (CBCL). Associations were analyzed using multiple linear regression. Among AGA children, the mean DAS score was >1 standard deviation lower for children born at the public vs. the private hospital (75.2 vs. 95.7 among boys; 76.3 vs. 101.8 among girls). Being SGA had a weaker effect on DAS scores, overall. Severe SGA had a significant effect on DAS scores of children born at the private hospital (average reduction 8.0 +/- 2.5 points), but not on children born at the public hospital (average reduction 1.1 +/- 2.2 points). In the latter group, severe SGA was associated with a lower VABS score (average reduction 9.2 +/- 2.5 points). Poor fetal growth influences neurodevelopment, but this influence is modified by postnatal environment. Adverse effects associated with low SES might mask or attenuate associations between prenatal exposures and developmental outcomes in some populations.

  15. Neonatal mortality risk associated with preterm birth in East Africa, adjusted by weight for gestational age: individual participant level meta-analysis.

    Directory of Open Access Journals (Sweden)

    Tanya Marchant

    Full Text Available BACKGROUND: Low birth weight and prematurity are amongst the strongest predictors of neonatal death. However, the extent to which they act independently is poorly understood. Our objective was to estimate the neonatal mortality risk associated with preterm birth when stratified by weight for gestational age in the high mortality setting of East Africa. METHODS AND FINDINGS: Members and collaborators of the Malaria and the MARCH Centers, at the London School of Hygiene & Tropical Medicine, were contacted and protocols reviewed for East African studies that measured (1 birth weight, (2 gestational age at birth using antenatal ultrasound or neonatal assessment, and (3 neonatal mortality. Ten datasets were identified and four met the inclusion criteria. The four datasets (from Uganda, Kenya, and two from Tanzania contained 5,727 births recorded between 1999-2010. 4,843 births had complete outcome data and were included in an individual participant level meta-analysis. 99% of 445 low birth weight (< 2,500 g babies were either preterm (< 37 weeks gestation or small for gestational age (below tenth percentile of weight for gestational age. 52% of 87 neonatal deaths occurred in preterm or small for gestational age babies. Babies born < 34 weeks gestation had the highest odds of death compared to term babies (odds ratio [OR] 58.7 [95% CI 28.4-121.4], with little difference when stratified by weight for gestational age. Babies born 34-36 weeks gestation with appropriate weight for gestational age had just three times the likelihood of neonatal death compared to babies born term, (OR 3.2 [95% CI 1.0-10.7], but the likelihood for babies born 34-36 weeks who were also small for gestational age was 20 times higher (OR 19.8 [95% CI 8.3-47.4]. Only 1% of babies were born moderately premature and small for gestational age, but this group suffered 8% of deaths. Individual level data on newborns are scarce in East Africa; potential biases arising due to the non

  16. Blood pressure and heart rate during stress in children born small for gestational age.

    Science.gov (United States)

    Pirojsakul, Kwanchai; Thanapinyo, Apinya; Nuntnarumit, Pracha

    2017-06-01

    Increased sympathetic nervous system activity has been proposed as a potential mechanism for the blood pressure (BP) elevation seen in individuals born small for gestational age (SGA). This study was carried out to detect the changes in BP and heart rate (HR) in children born SGA during exposure to stress and to assess for changes in urinary catecholamine excretion. Nineteen children aged 6-14 years born SGA and 17 age- and gender-matched healthy controls were included in the study. The stress test included a mathematical test and venipuncture. BP and HR were monitored during the test. Spot urine samples were collected at baseline and after the stress test to determine dopamine, epinephrine and norepinephrine levels. At baseline, there was no difference in BP and HR between the SGA and control groups, but mean urinary norepinephrine levels were slightly higher in the SGA group (55.7 ± 16.1 vs. 43.4 ± 3.8 mcg/gCr; P = 0.10). Compared to the control group, mean maximal HR increase was higher in the SGA group (31.3 ± 3.1 vs. 19.2 ± 3.8%; P = 0.008), and mean duration of maximal HR to baseline HR was longer (186 ± 23 vs. 97 ± 13 s, respectively; P = 0.003). There was a significant negative correlation between birth weight and maximal HR increase (r = -0.497, P = 0.003). Children born SGA showed significantly greater increases in HR and significantly longer periods of tachycardia during exposure to stress than did healthy controls. The rise in HR was inversely correlated with birth weight. These findings suggest that children born SGA have a greater increase in sympathetic response when exposed to stress than do healthy individuals.

  17. Methylphenidate and the response to growth hormone treatment in short children born small for gestational age.

    Directory of Open Access Journals (Sweden)

    Judith S Renes

    Full Text Available BACKGROUND: Growth hormone (GH treatment has become a frequently applied growth promoting therapy in short children born small for gestational age (SGA. Children born SGA have a higher risk of developing attention deficit hyperactivity disorder (ADHD. Treatment of ADHD with methylphenidate (MP has greatly increased in recent years, therefore more children are being treated with GH and MP simultaneously. Some studies have found an association between MP treatment and growth deceleration, but data are contradictory. OBJECTIVE: To explore the effects of MP treatment on growth in GH-treated short SGA children METHODS: Anthropometric measurements were performed in 78 GH-treated short SGA children (mean age 10.6 yr, 39 of whom were also treated with MP (SGA-GH/MP. The SGA-GH/MP group was compared to 39 SGA-GH treated subjects. They were matched for sex, age and height at start of GH, height SDS at start of MP treatment and target height SDS. Serum insulin-like growth factor-I (IGF-I and IGF binding protein-3 (IGFBP-3 levels were yearly determined. Growth, serum IGF-I and IGFBP-3 levels during the first three years of treatment were analyzed using repeated measures regression analysis. RESULTS: The SGA-GH/MP group had a lower height gain during the first 3 years than the SGA-GH subjects, only significant between 6 and 12 months of MP treatment. After 3 years of MP treatment, the height gain was 0.2 SDS (± 0.1 SD lower in the SGA-GH/MP group (P = 0.17. Adult height was not significantly different between the SGA-GH/MP and SGA-GH group (-1.9 SDS and -1.9 SDS respectively, P = 0.46. Moreover, during the first 3 years of MP treatment IGF-I and IGFBP-3 measurements were similar in both groups. CONCLUSION: MP has some negative effect on growth during the first years in short SGA children treated with GH, but adult height is not affected.

  18. [Growth hormone treatment in small for gestational age children in Spain].

    Science.gov (United States)

    Rial Rodríguez, José Manuel; de Arriba Muñoz, Antonio; Bosch Muñoz, Jordi; Cabanas Rodríguez, Paloma; Cañete Estrada, Ramón; Díez López, Ignacio; Hawkins Solís, María Magdalena; Martínez-Aedo Ollero, María José; Rodríguez Dehli, Ana Cristina; Ibáñez Toda, Lourdes

    2017-05-01

    Since its approval by the European Medicines Agency, a great number of patients born small for gestational date have received recombinant growth hormone treatment in Spain. The aim of this study is to analyse its outcome in the setting of ordinary clinical practice. Information was gathered from the registers of the assessment boards that authorise all growth hormone treatments prescribed in public hospitals in six autonomic communities (regions). Valid data from 974 patients was obtained. All of them complied with criteria established by the European Medicines Agency. Patients in the sample were smaller in length than weight at birth, with their median target height being below 1 standard deviation (SD), and 23% of them had been delivered prematurely. Treatment was started at 7.2±2.8 years (mean±SD). The mean patient height at start was -3.1±0.8 SD. They gained 0.7±0.2 SD in the first year, and 1.2±0.8 SD after two years. Final height was attained by 8% of the sample, reaching -1.4±0.7 SD. These results are similar to other Spanish and international published studies, and are representative of the current practice in Spain. Despite treatment being started at a late age, adequate growth is observed in the short term and in the final height. Up to a 24% of patients show a poor response in the first year. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Gestational Age Estimation Based on Fetal Pelvimetry on Fetal Ultrasound in Iraqi Women

    Directory of Open Access Journals (Sweden)

    Sattar Razzaq Al-Esawi

    2016-08-01

    Full Text Available Ultrasound is an integral part of obstetric practice, and assessment of gestational age (GA is a central element of obstetric ultrasonography. Sonographic estimation of GA is derived from calculations based on fetal measurements. Numerous equations for GA calculation from fetal biometry have been adopted in routine practice. This study reports a new method of estimating GA in the second and third trimester using interischial distance (IID, the distance between the two ischial primary ossification centers, on fetal ultrasound. Four hundred women with uncomplicated normal singleton pregnancies from 16 weeks to term were examined. Standard fetal obstetric ultrasound was done measuring biparietal diameter (BPD and femur length (FL for each fetus. The IID, in millimeters, was correlated with the GA in weeks based upon the BPD and FL individually, and the BPD and FL together. Statistical analysis showed strong correlation between the IID and GA calculated from the FL with correlation coefficient (r =0.989, P < 0.001. Strong linear correlation was also found between the IID and GA based upon BPD and BPD+FL. Further statistical analysis using regression equations also showed that the IID was slightly wider in female fetuses, but this difference was not statistically significant. Resulting from this analysis, we have arrived at an easy-to-use equation: GA Weeks = (IID mm + 8 ±1 week. We feel this method can be especially applicable in the developing world, where midwives may not have access to software for fetal biometry in their basic handheld ultrasound machines. Even more sophisticated machines may not come with loaded software for obstetrics analysis. There are several limitations to this study, discussed below. We recommend further studies correlating the IID with other biometric parameters.

  20. Social correlates of term small for gestational age babies in a Russian Arctic setting

    Science.gov (United States)

    Usynina, Anna A.; Grjibovski, Andrej M.; Odland, Jon Øyvind; Krettek, Alexandra

    2016-01-01

    Background Small for gestational age (SGA) births have been associated with both short- and long-term adverse health outcomes. Although social risk factors for SGA births have been studied earlier, such data are limited from Northern Russia. Objective We assessed maternal social risk factors for term SGA births based on data from the population-based Murmansk County Birth Registry (MCBR). Design Data on term live-born singleton infants born between 2006 and 2011 in Murmansk County were obtained from the MCBR. We applied the 10th percentile for only birth weight (SGAW) or for both birth weight and birth length (SGAWL). Binary logistic regression was used to estimate the effect of independent variables on SGA males and females with adjustment for known risk factors and potential confounders. Both crude and adjusted odds ratios with 95% confidence intervals for the studied risk factors were calculated. Results The proportions of term SGAW and SGAWL births were 9.7 and 4.1%, respectively. After adjustment for potential confounders, the risk of term SGA births among less educated, unemployed, unmarried, smoking and underweight women was higher compared with women from the reference groups. Evidence of alcohol abuse was also associated with birth of SGAWL and SGAW boys. Maternal overweight and obesity decreased the risk of SGA. Conclusions Maternal low education, unemployment, unmarried status, smoking, evidence of alcohol abuse and underweight increased the risk of term SGA births in a Russian Arctic setting. This emphasizes the importance of both social and lifestyle factors for pregnancy outcomes. Public health efforts to reduce smoking, alcohol consumption and underweight of pregnant women may therefore promote a decrease in the prevalence of SGA births. PMID:27906118

  1. [Body composition and metabolic risk in small for gestational age children treated with growth hormone].

    Science.gov (United States)

    Aurensanz Clemente, Esther; Samper Villagrasa, Pilar; Ayerza Casas, Ariadna; Ruiz Frontera, Pablo; Moreno Aznar, Luis Alberto; Bueno Lozano, Gloria

    2016-09-16

    Small for gestational age (SGA) children are at increased risk of metabolic syndrome. Our objective is to evaluate changes in body composition produced by growth hormone (GH) treatment. A group of 28 SGA children without catch-up growth and undergoing treatment with GH was selected for evaluation. Over the course of 3 years from the beginning of the treatment with GH, the children's body composition variables (bone mineral density [BMD], fat and lean body mass proportion) were evaluated annually with dual-energy X-ray absorptiometry. A study of correlation between metabolic and body composition variables was also made. Treatment with GH produces a reduction in fat mass proportion in relation to lean body mass, decreasing from 25.94±6.09 to 22.88±5.38% (P=.034). In the abdominal regions we observe an increase in lean mass, from 1,356,91±426,71 to 2,570,96±814,36g (P=.000) and a tendency for visceral fat deposits to decrease. BMD in lumbar vertebrae improved from -1.55±0.68 to -0.90±0.79Z (P=.019). Treatment with GH produces changes in body composition, improving BMD and increasing the proportion of lean body mass with a reduction in fat mass. If these changes persisted into adulthood, they may cause a reduction in the metabolic and cardiovascular risk in this group of patients. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  2. What is the strongest predictor of birth weight: Gestational age, hbalc, maternal weight, weight gain, or birth weight of sibling?

    DEFF Research Database (Denmark)

    Nielsen, Gunnar Lauge; Dethlefsen, Claus

    Aim: To assess the effect of various maternal characteristics in diabetic pregnancies on birthweight (BW) taking into account birthweight of an elderly sibling.  Method: We identified all pregnant diabetic women in North Jutland County. Birthweight and certain maternal characteristics including H...... for various increments in each of the 9 variables are seen in the table. All significant values are in bold face.  Conclusion: Weight of sibling is a very strong predictor of birthweight attenuating the predictive power of all other variablesapart from gestational age....... adjusted for age and sex using a Danish reference. E.g. an observed sibling weight of 3800 g with expected BW 3400 g predicts 11.8% extra weight equal to 134 grams (114x11.8) and one extra gestational day predicts an additional weight of 27 grams.  Results: The effects in terms of additional grams in BW...

  3. Small for Gestational Age and Magnesium in Cord Blood Platelets: Intrauterine Magnesium Deficiency May Induce Metabolic Syndrome in Later Life

    Directory of Open Access Journals (Sweden)

    Junji Takaya

    2011-01-01

    Full Text Available Magnesium deficiency in pregnancy frequently occurs because of inadequate or low intake of magnesium. Magnesium deficiency during pregnancy can induce not only maternal and fetal nutritional problems, but also consequences that might last in offspring throughout life. Many epidemiological studies have disclosed that small for gestational age (SGA is associated with an increased risk of insulin resistance in adult life. We reported that intracellular magnesium of cord blood platelets is lower in SGA groups than that in appropriate for gestational age groups, suggesting that intrauterine magnesium deficiency may result in SGA. Taken together, intrauterine magnesium deficiency in the fetus may lead to or at least program insulin resistance after birth. In this review, we propose that intrauterine magnesium deficiency may induce metabolic syndrome in later life. We discuss the potential contribution of aberrant magnesium regulation to SGA and to the pathogenesis of metabolic syndrome.

  4. Profiling gene expression in human placentae of different gestational ages: an OPRU Network and UW SCOR Study.

    Science.gov (United States)

    Mikheev, Andrei M; Nabekura, Tomohiro; Kaddoumi, Amal; Bammler, Theo K; Govindarajan, Rajgopal; Hebert, Mary F; Unadkat, Jashvant D

    2008-11-01

    We used the whole-genome approach to identify major functional categories of genes whose expression depends on gestational age. Using microarray analysis, we compared gene expression profiles in the villous tissues of first (45-59 days) and second trimester (109-115 days) placentae with C-section term placentae. We found that in first trimester placentae, genes related to cell cycle, DNA, amino acids, and carbohydrate metabolism were significantly overrepresented, while genes related to signal transduction were underrepresented. Among genes involved in organism defense, we identified genes involved in chemical response, metabolism, and transport. Analysis of signal transduction pathways suggested, and subsequently confirmed independently, that the Wnt pathway was changed with gestational age leading to inhibition of beta-catenin protein expression. Our study will serve as a reference database to gain insight into the regulation of gene expression in the developing placentae and to compare with gene expression in placentae from complicated pregnancies.

  5. Dependency of magnetocardiographically determined fetal cardiac time intervals on gestational age, gender and postnatal biometrics in healthy pregnancies

    Directory of Open Access Journals (Sweden)

    Geue Daniel

    2004-04-01

    Full Text Available Abstract Background Magnetocardiography enables the precise determination of fetal cardiac time intervals (CTI as early as the second trimester of pregnancy. It has been shown that fetal CTI change in course of gestation. The aim of this work was to investigate the dependency of fetal CTI on gestational age, gender and postnatal biometric data in a substantial sample of subjects during normal pregnancy. Methods A total of 230 fetal magnetocardiograms were obtained in 47 healthy fetuses between the 15th and 42nd week of gestation. In each recording, after subtraction of the maternal cardiac artifact and the identification of fetal beats, fetal PQRST courses were signal averaged. On the basis of therein detected wave onsets and ends, the following CTI were determined: P wave, PR interval, PQ interval, QRS complex, ST segment, T wave, QT and QTc interval. Using regression analysis, the dependency of the CTI were examined with respect to gestational age, gender and postnatal biometric data. Results Atrioventricular conduction and ventricular depolarization times could be determined dependably whereas the T wave was often difficult to detect. Linear and nonlinear regression analysis established strong dependency on age for the P wave and QRS complex (r2 = 0.67, p r2 = 0.66, p r2 = 0.21, p r2 = 0.13, p st week onward (p Conclusion We conclude that 1 from approximately the 18th week to term, fetal CTI which quantify depolarization times can be reliably determined using magnetocardiography, 2 the P wave and QRS complex duration show a high dependency on age which to a large part reflects fetal growth and 3 fetal gender plays a role in QRS complex duration in the third trimester. Fetal development is thus in part reflected in the CTI and may be useful in the identification of intrauterine growth retardation.

  6. Gestational age and 1-year hospital admission or mortality: a nation-wide population-based study

    OpenAIRE

    Iacobelli, Silvia; Combier, Evelyne; Roussot, Adrien; Cottenet, Jonathan; Gouyon, Jean-Bernard; Quantin, Catherine

    2017-01-01

    Background Describe the 1-year hospitalization and in-hospital mortality rates, in infants born after 31?weeks of gestational age (GA). Methods This nation-wide population-based study used the French medico-administrative database to assess the following outcomes in singleton live-born infants (32?43?weeks) without congenital anomalies (year 2011): neonatal hospitalization (day of life 1 ? 28), post-neonatal hospitalization (day of life 29 ? 365), and 1-year in-hospital mortality rates. Margi...

  7. Ultrasound assessment of placental function: the effectiveness of placental biometry in a low-risk population as a predictor of a small for gestational age neonate.

    LENUS (Irish Health Repository)

    McGinty, Patricia

    2012-07-01

    The aims of the study were to establish reference ranges for placental length and thickness in a low-risk obstetric population and to assess the likelihood of a small for gestational age (SGA) neonate on the basis of placental length at 18-24 weeks\\' gestation.

  8. Obesity and diabetes genes are associated with being born small for gestational age: Results from the Auckland Birthweight Collaborative study

    Directory of Open Access Journals (Sweden)

    Morgan Angharad R

    2010-08-01

    Full Text Available Abstract Background Individuals born small for gestational age (SGA are at increased risk of rapid postnatal weight gain, later obesity and diseases in adulthood such as type 2 diabetes, hypertension and cardiovascular diseases. Environmental risk factors for SGA are well established and include smoking, low pregnancy weight, maternal short stature, maternal diet, ethnic origin of mother and hypertension. However, in a large proportion of SGA, no underlying cause is evident, and these individuals may have a larger genetic contribution. Methods In this study we tested the association between SGA and polymorphisms in genes that have previously been associated with obesity and/or diabetes. We undertook analysis of 54 single nucleotide polymorphisms (SNPs in 546 samples from the Auckland Birthweight Collaborative (ABC study. 227 children were born small for gestational age (SGA and 319 were appropriate for gestational age (AGA. Results and Conclusion The results demonstrated that genetic variation in KCNJ11, BDNF, PFKP, PTER and SEC16B were associated with SGA and support the concept that genetic factors associated with obesity and/or type 2 diabetes are more prevalent in those born SGA compared to those born AGA. We have previously determined that environmental factors are associated with differences in birthweight in the ABC study and now we have demonstrated a significant genetic contribution, suggesting that the interaction between genetics and the environment are important.

  9. Metabolic and energy balance in small- and appropriate-for-gestational-age, very low-birth-weight infants.

    Science.gov (United States)

    Picaud, J C; Putet, G; Rigo, J; Salle, B L; Senterre, J

    1994-12-01

    This study compared nutrient utilization and postnatal weight gain composition in eight appropriate for gestational age (AGA: birth weight 1293 +/- 107 g; gestational age 28.8 +/- 1.4 weeks) and eight symmetrically growth-retarded (SGA: birth weight 1110 +/- 230 g; gestational age 32.7 +/- 1.9 weeks), very low-birth-weight (VLBW) infants. There was no significant difference in protein, mineral and energy intake between AGA and SGA infants. Nitrogen absorption (84 +/- 3 and 83 +/- 4%) and nitrogen retention (356 +/- 48 and 352 +/- 43 mg/kg/day) were similar in both groups. Fat absorption tended to be lower in AGA (78 +/- 15%) than in SGA (87 +/- 4%) infants. Calcium, phosphorus and magnesium absorptions were similar in AGA and SGA infants. Metabolizable energy utilization was similar in both groups; about 55% was expended and 45% stored in new tissues. Energy expenditure was 58 +/- 4 kcal/kg/day in SGA infants and 61 +/- 9 kcal/kg/day in AGA infants. Weight gain and its composition were similar in both groups. We conclude that nutrient and energy utilization are similar in AGA and symmetrically growth-retarded, VLBW infants.

  10. Obesity and diabetes genes are associated with being born small for gestational age: Results from the Auckland Birthweight Collaborative study

    Science.gov (United States)

    2010-01-01

    Background Individuals born small for gestational age (SGA) are at increased risk of rapid postnatal weight gain, later obesity and diseases in adulthood such as type 2 diabetes, hypertension and cardiovascular diseases. Environmental risk factors for SGA are well established and include smoking, low pregnancy weight, maternal short stature, maternal diet, ethnic origin of mother and hypertension. However, in a large proportion of SGA, no underlying cause is evident, and these individuals may have a larger genetic contribution. Methods In this study we tested the association between SGA and polymorphisms in genes that have previously been associated with obesity and/or diabetes. We undertook analysis of 54 single nucleotide polymorphisms (SNPs) in 546 samples from the Auckland Birthweight Collaborative (ABC) study. 227 children were born small for gestational age (SGA) and 319 were appropriate for gestational age (AGA). Results and Conclusion The results demonstrated that genetic variation in KCNJ11, BDNF, PFKP, PTER and SEC16B were associated with SGA and support the concept that genetic factors associated with obesity and/or type 2 diabetes are more prevalent in those born SGA compared to those born AGA. We have previously determined that environmental factors are associated with differences in birthweight in the ABC study and now we have demonstrated a significant genetic contribution, suggesting that the interaction between genetics and the environment are important. PMID:20712903

  11. Aortic intima-media thickness and aortic diameter in small for gestational age and growth restricted fetuses.

    Directory of Open Access Journals (Sweden)

    M Dolores Gomez-Roig

    Full Text Available The objective of this study is to measure aortic intima-media thickness (aIMT and aortic diameter (AD in appropriate for gestational age (AGA fetuses, small for gestational age (SGA fetuses, and intrauterine growth restricted (IUGR fetuses.Case-control study performed between June 2011 and June 2012. Forty-nine AGA fetuses, 40 SGA fetuses, and 35 IUGR fetuses underwent concomitant measurement of aIMT and AD at a mean gestational age of 34.4 weeks.Median aIMT was higher in fetuses with IUGR (0.504 mm [95%CI: 0.477-0.530 mm], than in SGA fetuses (0.466 mm [95% CI: 0.447-0.485 mm], and AGA fetuses (0.471 mm [95% CI: 0.454-0.488 mm] (p = 0.023. Mean AD was significantly lower in fetuses with IUGR (4.451 mm [95% CI: 4.258-4.655 mm], than in AGA fetuses (4.74 mm [95% CI: 4.63-4.843 mm] (p = 0.028.Growth restricted fetuses have a thicker aortic wall than AGA and SGA fetuses, which possibly represents preclinical atherosclerosis and a predisposition to later cardiovascular disease.

  12. Effect of mercuric acetate on selected enzymes of maternal and fetal hamsters at different gestational ages

    Energy Technology Data Exchange (ETDEWEB)

    Karp, W.B.; Gale, T.F.; Subramanyam, S.B.; DuRant, R.H.

    1985-04-01

    This study establishes levels of activity of glucose-6-phosphate dehydrogenase (G6PD), glycogen phosphorlyase (GP), and cytochrome c oxidase (cyt c ox) in maternal, placental, and fetal tissues at Days 9, 12, and 15 in the 16-day gestation period of the hamster, and following a single dose of either 8 or 15 mg/kg mercuric acetate on the eighth gestational day. Mercury significantly elevated maternal kidney G6PD activity and decreased GP activity. The increase in kidney G6PD strongly correlated with observed urine and kidney abnormalities.

  13. A comparison of transabdominal and transvaginal ultrasonography for determination of gestational age and clinical outcomes in women undergoing early medical abortion.

    Science.gov (United States)

    Lohr, Patricia A; Reeves, Matthew F; Creinin, Mitchell D

    2010-03-01

    We sought to establish the accuracy of abdominal ultrasonography in determining gestational age and identifying the presence of a gestational sac and embryonic pole before and after medical abortion. We included all 120 women enrolled in a study of simultaneous oral mifepristone and buccal misoprostol for abortion through 63 days' gestation. Vaginal and abdominal ultrasound examinations were performed before and 24 h after medication administration. Visualization of a gestational sac and embryonic pole and presence or absence of cardiac activity were recorded. Sensitivity and specificity were calculated with the results from vaginal ultrasonography as the gold standard. The effect of body mass index (BMI) on ultrasound findings was also assessed. Before treatment, the sensitivities of abdominal ultrasonography were 100% (95% CI 97-100) and 68% (95% CI 58-77) for presence of a gestational sac and an embryonic pole, respectively. Overall, abdominal imaging underestimated mean gestational age by 1.6 days (95% CI 1.0-2.2). After treatment, abdominal ultrasonography missed three of 34 retained gestational sacs (sensitivity 91%, 95% CI 76-98%). Fourteen women had gestational cardiac activity by vaginal ultrasound at follow-up. Abdominal imaging identified the gestational sac in all cases, but cardiac motion was only visible in 10 (71%, 95% CI 42-92%). For every 10-point increase in BMI, the odds ratio for missing an embryonic pole at baseline was 2.8 (95% CI 1.5-5.0). Abdominal ultrasonography is sensitive for diagnosing the presence or absence of a gestational sac, but less sensitive at detecting an embryonic pole. This may lead to a small underestimation of gestational age and missing a continuing pregnancy at follow-up when one exists. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  14. Bone measurements of infants in the first 3 months of life by quantitative ultrasound: the influence of gestational age, season, and postnatal age

    Energy Technology Data Exchange (ETDEWEB)

    Liao, Xiang-peng [Shanghai Second Medical University, Shanghai Institute for Pediatric Research, Shanghai Xinhua Hospital, Shanghai (China); Wuxi Hospital for Maternal and Children' s Health Care, Neonatal Intensive Care Unit, Wuxi (China); Zhang, Wei-li; He, Jiamin [Shanghai Second Medical University, Shanghai Institute for Pediatric Research, Shanghai Xinhua Hospital, Shanghai (China); Sun, Jian-hua; Huang, Ping [Shanghai Children' s Medical Center, Neonatal Intensive Care Unit, Shanghai (China)

    2005-09-01

    There are a few quantitative ultrasound (QUS) studies of bone status for Chinese children. To evaluate the clinical application and to investigate the bone status of neonates and young infants with QUS. An ultrasound bone sonometer was used to measure the bone speed of sound (SOS) of the tibia in 542 neonates within 3 months of birth. At birth, no significant difference of SOS was found between boys and girls, but there was a significant difference of SOS between premature infants and full-term infants. The SOS in neonates born during spring and summer was significantly lower than those born during autumn and winter. There were significant correlations between SOS and gestational age, and between bone SOS and birth weight in appropriate for gestational age (AGA) infants. Multiple regression analysis found that gestational age and infant birth season were two important factors influencing SOS. During the first 3 months, there was no significant difference in SOS between sexes. The SOS of infants showed an inverse correlation with postnatal age, and the decrease of bone SOS with age in premature infants was more marked than in full-term infants. QUS is suitable for evaluating bone status in infants with high precision. The study offers some basic data for neonates and young infants. (orig.)

  15. Influence Of Sympathetic Hyperactivity And Levels Of Endothelin-1 In Hypertension To Pregnancy And Small For Gestational Age SGA

    Directory of Open Access Journals (Sweden)

    Pesta Corry Sihotang

    2015-05-01

    Full Text Available Abstract Pesta Corry Sihotang. Effect of sympathetic hyperactivity Endothelial Dysfunction Due to Hypertension and Small for gestational age SGA. In Indonesia hypertension due to pregnancy Pregnancy Induced Hypertension range from 5-10 of all pregnancies. This is a major cause of death after bleeding. Hypertension due to pregnancy can be Preeclampsia and eclampsia if not handled appropriately. This study aimed to prove the influence of the sympathetic hyperactivity endothelial dysfunction on the incidence of PIH and SGA. The study design is nested cohort. Methods and ways of working 30 pregnant women who were willing to participate in this study examined after signing the agreement informed consent. Research subjects are grouped into groups of PIH and Normal and followed until delivery. In conclusion there was a significant difference between the incidence hype-reactor and hypo-reactor second trimester with the incidence of PIH and normotensive with Chi-Square P 0.05 against the incidence of hypertension. While the risk of PIH on hype-reactor group in the second trimester has RR 3.66 CI 1.04 to 12.9 while the results of the third trimester there is a difference between having hype-reactor and hypo-reactor with RR of 5.83 CI 1.37 to 24.6. Results ET-1 shows the differences in levels of endothelin in the third trimester with PIH and normotensive patients namely R 0.38 p 0.038 and R 0.49 p 0.005. Furthermore in the third trimester relationship with the incidence of PIH R 0.74 or 0.01 p in the end there are differences between the mean levels of ET-1 in the third trimester between PIH and normotensive group p 0.05. Recommendations CPT Cord Pressure Test is a tool that can be used to predict the incidence of hypertension in pregnancy especially in the second trimester while the results of Elisa can predict the incidence of hypertension in pregnancy.

  16. [46-OR] : Early and late onset preeclampsia versus small for gestational age risks in subsequent pregnancies

    NARCIS (Netherlands)

    Bernardes, Thomas P; Mol, Ben W; Ravelli, Anita C; van den Berg, Paul P; Stolk, Ronald P; Groen, Henk

    2015-01-01

    OBJECTIVES: Current literature suggests that early and late onset preeclampsia should be treated as distinct entities and that early onset preeclampsia shares pathophysiology aspects with intrauterine growth restriction. Our objective was to investigate whether 5th percentile small for gestational a

  17. Factors Affecting Vocabulary Acquisition at Age 2 in Children Born between 23 and 28 Weeks' Gestation

    Science.gov (United States)

    Marston, Louise; Peacock, Janet L.; Calvert, Sandra A.; Greenough, Anne; Marlow, Neil

    2007-01-01

    Language development is often slower in preterm children compared with their term peers. We investigated factors associated with vocabulary acquisition at 2 years in a cohort of children born at 28 weeks' gestation or less. For children entered into the United Kingdom Oscillation Study, language development was evaluated by using the…

  18. Prediction of Survival for Preterm Births by Weight and Gestational Age: Retrospective Population Based Study

    National Research Council Canada - National Science Library

    Elizabeth S. Draper; Bradley Manktelow; David J. Field; David James

    1999-01-01

    ... (a) known to be alive at the onset of labour, and (b) admitted for neonatal care. Results 738 deaths occurred in 3760 infants born between 22 and 32 weeks' gestation during the study period, giving an overall survival rate of 80.4...

  19. FETAL GESTATIONAL AGE ESTIMATION BY FETAL FOOT LENGTH MEASUREMENT AND FETAL FEMUR TO FOOT LENGTH RATIO IN INDIAN POPULATION - A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Mukta

    2014-03-01

    Full Text Available BACKGROUND: Multiple parameters are in use for the accurate assessment of the gestational age by ultrasound, but the literature suggests that fetal foot length can be used to estimate gestational age, when other parameters are not available for measurement. Foetal femur/ foot length ratio can help in differentiating the foeti that have dysplastic limb reduction, from those whose limbs are short because of constitutional factors/IUGR. A prospective study was done to measure the fetal foot length for gestational age and to evaluate fetal femur to foot length ratio in pregnant women of 16-37 weeks gestation. MATERIALS & METHOD: One hundred and three normal singleton pregnant women of 16-37 weeks gestation were examined for routine obstetrics ultrasound. In these patients fetal foot length measurements were taken and the gestational age was assessed. In addition, fetal femur length to foot length ratio was calculated in each patient. RESULTS/OBSERVATION: Linear relationship between foot length and gestational age was present with a R2 value of 0.90 (p < than 0.001 and the fetal femur length/foot length ratio was found to be more than or equal to 0.92.The foot length can be a reliable parameter for use in assessment of gestational age and as most skeletal dysplasias spare the feet, the fetal femur length/foot length ratio can be used to detect most skeletal dysplasia. CONCLUSIONS: Foetal foot length is a reliable parameter for assessment of gestational age and femur length/foot length ratio is approximately 1 and a ratio of < 0.92 shall be useful in the detection of most skeletal dysplasia.

  20. Maternal immune markers in serum during gestation and in breast milk and the risk of asthma-like symptoms at ages 6 and 12 months: a longitudinal study

    OpenAIRE

    Soto-Ramírez Nelís; Karmaus Wilfried; Yousefi Mitra; Zhang Hongmei; Liu Jihong; Gangur Venugopal

    2012-01-01

    Abstract Background The role of breast milk on the risk of childhood asthma is in dispute. The aim of this prospective study is to determine the relationship of immune markers in maternal serum during gestation and breast milk to asthma-like symptoms (AS) in infancy. Methods Pregnant women were recruited in Columbia and Charleston, South Carolina. Blood (median: three weeks before delivery) and breast milk (three weeks after delivery) samples were collected. Concentrations of interferon (IFN)...

  1. Linear growth patterns in small for gestational age and preterm infants after zinc supplementation

    Directory of Open Access Journals (Sweden)

    Caecilia Nancy Setiawan

    2016-07-01

    Full Text Available Background Low birth weight (LBW infants are at risk for growth disturbances due to intrauterine zinc deficiency. Zinc supplementation is expected to improve the linear growth of LBW babies. Objective To assess the effect of zinc supplementation on linear growth in preterm and small for gestational age (SGA infants. Methods This quasi-experimental study had a pre- and post-test design. Subjects were LBW infants hospitalized in Kariadi Hospital during March-December 2011, consisted of SGA and preterm neonates. All subjects were given 5 mg of zinc syrup daily for 3 months. Subjects’ head circumference, weight, and length were measured monthly. Serum zinc levels were measured before and after supplementation. Data were analyzed with Chi-square test, independent T-test, and general linear model repeated measure. Results A total of 61 subjects were enrolled consisted of 31 preterm and 30 SGA neonates. Mean serum zinc levels in the preterm group were 168.2 (SD 54.5 μg/dL pre-supplementation and 163.6 (SD 50.7 μg/dL post-supplementation (P=0.049, while mean serum zinc levels in the SGA group were 174.8 (SD 46.6 μg/dL pre-supplementation and 167.4 (SD 49.4 μg/dL post-supplementation (P=0.271. Median percentage preterm weight and length increased from 87.3 to 102.4% in the third month (P<0.001 and from 95.8 to 103.9% in the third month (P<0.001, respectively. Median percentage SGA weight and length increased from 73.5 to 98.3% in the third month (P<0.001 and from 94.5 to 102.2% in the third month (P<0.001, respectively. Conclusion Both, the preterm and SGA infants exhibit catch-up growth after three months of zinc supplementation. [

  2. Clinical Observation of Insulin in the Treatment of Gestational Diabetes in Different Gestational Age%不同孕周给予胰岛素治疗妊娠期糖尿病的临床观察

    Institute of Scientific and Technical Information of China (English)

    翟悦静; 李彩辉; 朱慧芳

    2016-01-01

    -tion group (63 cases) and control group (58 cases) based on first use of insulin in different gestational age. All patients received dirt control [(calorie control in 30-35 kJ/(kg·d),55% carbohydrates,25% fat and 20% protein)];based on it,Biosynthetic hu-man insulin injection was injected before meals and at bedtime by 4∶2∶3∶1 with 4-6 units before pregnant 30 weeks according to the FPG and postprandial 2 h blood glucose(2 h PG)levels in observation group,the blood glucose of women with gestational dia-betes was monitored to prevent the occurrence of complications such as hypoglycemia. Control group received Biosynthetic human insulin injection(the same dosage with control group)when no less than 30 weeks. The treatment course for both groups was 15 d. FPG and 2 h PG levels when first diagnosed and delivery,pregnancy outcomes and neonatal conditions in 2 groups were observed, and the incidence of adverse reactions was recorded. RESULTS:When first diagnosed,there were no significant differences in FPG and 2 h PG levels in 2 groups(P>0.50). When delivery,FPG and 2 h PG levels in 2 groups were significantly lower than first di-agnosed,and observation group was lower than control group,the differences were statistically significant (P0.05). There were no obvious adverse reactions during treatment. CONCLUSIONS:Based on diet control,insulin in the treatment of gestational diabetes before pregnant 30 weeks can effectively control blood glucose level and improve pregnancy outcomes,with good safety.

  3. 双胎妊娠中胎儿性别和分娩孕周的相关性研究%Correlation of the Fetal Sex of Twin Pregnancy and Gestational Age

    Institute of Scientific and Technical Information of China (English)

    季景环; 姚晓玲; 李莉; 杨素琴; 张曼丽

    2011-01-01

    Objective To explore the influence of fetus's sex in twin pregnancy on gestation. Methods Retrospectively analyse the 94 cases of twin pregnancy from our hospital during the period from March 2008 to July 2009, which are divided into three groups by fetus's sex of twin male, twin female, a male and a female fpr comparison and analysis of gestation and premature delivery rate. Result No statistical difference in maternal age and average twin body weight( P > 0.05 ). Twin male fetuses average gestation 256.84 day,premature delivery rate 58.06%; twin female fetus 263.65 day, 16. 13% ;one male one female 260.76 day, 24.24%. The average gestation and premature delivery rate are statistically significantly different between twin male fetuses and twin female fetus( P < 0.05 ), Conclusion fetus's sex will influence gestation and premature delivery rate in twin pregnancy, female fetus is one of the premature delivery factors.%目的 探讨双胎妊娠中胎儿性别对分娩孕周的影响.方法 回顾性分析我院2008年3月至2009年7月住院分娩的94例双胎妊娠产妇资料,按胎儿性别分为双男胎、双女胎、一男一女胎三组,对其孕周及早产率进行比较与分析.结果 三组双胎妊娠产妇年龄和双胎儿平均体质量间差异无统计学意义(P>0.05),孕周和早产例数间差异有统计学意义(P<0.05).双男胎组孕周最短,双女胎组孕周最长.三组双胎妊娠产妇双男胎组早产率最高,双女胎组早产率最低.结论 双胎妊娠中胎儿性别影响妊娠孕周,男胎是导致早产的一个因素.

  4. Brain growth in Down syndrome subjects 15 to 22 weeks of gestational age and birth to 60 months.

    Science.gov (United States)

    Schmidt-Sidor, B; Wisniewski, K E; Shepard, T H; Sersen, E A

    1990-01-01

    We have found similarities of skull shape, brain growth and brain maturation in 17 DS and 10 non-DS (control) fetuses, ages 15-22 weeks of gestational age (Group A), and differences in 101 DS and 80 non-DS cases, from birth to 60 months (Group B). Postnatally, the gross neuropathological differences between DS and control brains are more distinct after 3-5 months of age. The anterior posterior diameter fronto-occipital length of the brain hemispheres is shortened and that is secondary to reduction of frontal lobe growth. Also flattening of occipital poles, narrowing of the superior temporal gyruses and generalized retardation of brain growth were common findings. Standard morphometric methods indicate changes from birth [Wisniewski et al. 1984, 1986, 1990]. The cerebral cortex of the DS cases had a 20-50% reduction of neurons since birth, mainly in the granular layers [Wisniewski et al. 1984, 1986, 1990]. Changes in brain weight with age were greater in the non-DS than in the DS cases, and greater in males than in females. CHD and GI malformations were associated with less brain weight in both DS and non-DS cases. We suggest that the prenatal retardation of neurogenesis begins after 22 weeks' gestational age. The postnatal retardation of brain growth is secondary to pre- and postnatal abnormalities in synaptogenesis.

  5. The telomere attrition rate is not accelerated in women born small for gestational age: A birth cohort study.

    Science.gov (United States)

    de Melo, Anderson Sanches; Reis, Rosana Maria Dos; Calado, Rodrigo T; de Carvalho Cavalli, Ricardo; Bettiol, Heloisa; Cardoso, Viviane Cunha; Ferriani, Rui Alberto; Barbieri, Marco Antonio; Vieira, Carolina Sales

    2017-02-05

    Physiologically, a reduction in telomere length (LTL) occurs with aging, but epigenetic changes may accelerate telomere shortening and also facilitate the onset of oxidative/inflammatory stress and the development of clinical/metabolic comorbidities in life spam. Although individuals born small for gestational age (SGA) may be related to those epigenetic changes, the assessment of LTL in individuals born SGA has yielded conflicting results (only cross-sectional studies) and has not been carried out in longitudinal studies. We performed a birth cohort study to evaluate the rate of telomere erosion in women born SGA in comparison to women born appropriate for gestational age (AGA) assessed at two different time points during the third decade of life. In our research, born SGA or AGA showed no difference in LTL shortening during a period of five years in the third decade of life. Our finding may have implications for understanding the natural history of diseases in lifespan because the same women (under the influence of similar environmental factors) may be accessed in different phases of life. Thus, the analysis of the present cohort population at a more advanced age may reveal a dynamics of telomere shortening different from here and its possible relation with onset of age-related diseases. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. The association of cerebral palsy and death with small-for-gestational-age birthweight in preterm neonates by individualized and population-based percentiles.

    LENUS (Irish Health Repository)

    Grobman, William A

    2013-10-01

    The objective of the study was to determine whether an individualized growth standard (IS) improves the identification of preterm small-for-gestational-age (SGA) neonates at risk of developing moderate\\/severe cerebral palsy (CP) or death.

  7. Serial transvaginal sonographic measurement of cervical dimensions after 20 weeks of gestation in South Indian women

    Directory of Open Access Journals (Sweden)

    Dr. Samjhana Koirala

    2007-01-01

    Full Text Available This study was conducted with objective to assess serial changes of cervical dimensions during pregnancy from mid second trimester till delivery by transvaginal sonography. It comprises 50 healthy pregnant women who underwent serial transvaginal ultrasound every four week from 20th week of gestation till delivery. Cervical length and width were measured. The gestational age at delivery was recorded. Cervical changes were analysed using student – t test with three classifying factors; gestational age ( 23. Percentile charts were established for cervical length and width from 20th week of pregnancy till delivery. The associations between cervical dimensions and gestational age, parity and body mass index were calculated by multiple linear regression analysis. Cervical length decreased gradually from 4.05 cm from 20th week to 3.25 cm at term. The equivalent values were 2.98 cm and 3.86 cm for cervical width measurement showing opposite trend. The rate of cervical length reduction was significantly higher in preterm delivery group compared to term delivery group (0.65 mm vs. 0.37 mm per week of gestation, p 23; however this was statistically significant only in the beginning (at 20th and 24th week of gestation. Cervical length decreases gradually through out the gestation where as cervical width increases and these changes are not affected by parity. The knowledge of pattern of change in cervical length may help in early detection of preterm labour.

  8. Decreased maternal hypothalamic-pituitary-adrenal axis activity in very severely obese pregnancy: Associations with birthweight and gestation at delivery.

    Science.gov (United States)

    Stirrat, Laura I; O'Reilly, James R; Barr, Sarah M; Andrew, Ruth; Riley, Simon C; Howie, Alexander F; Bowman, Maria; Smith, Roger; Lewis, John G; Denison, Fiona C; Forbes, Shareen; Seckl, Jonathan R; Walker, Brian R; Norman, Jane E; Reynolds, Rebecca M

    2016-01-01

    The maternal hypothalamic-pituitary-adrenal-axis (HPAA) undergoes dramatic activation during pregnancy. Increased cortisol and corticotrophin-releasing-hormone (CRH) associate with low birthweight and preterm labor. In non-pregnant obesity, the HPAA is activated but circulating cortisol levels are normal or lower than in lean women. We hypothesized that maternal cortisol levels would be lower in obese pregnancy, and would associate with increased fetal size and length of gestation. Fasting serum cortisol was measured at 16, 28 and 36 weeks gestation and at 3-6 months postpartum in 276 severely obese and 135 lean women. In a subset of obese (n=20) and lean (n=20) we measured CRH, hormones that regulate bioavailable cortisol (corticosteroid-binding-globulin, estradiol, estriol, and progesterone). Urinary glucocorticoid metabolites were measured in pregnant (obese n=6, lean n=5) and non-pregnant (obese n=7, lean n=7) subjects. Maternal cortisol and HPAA hormones were lower in obese pregnancy. Total urinary glucocorticoid metabolites increased significantly in lean pregnancy, but not in obese. Lower maternal cortisol in obese tended to be associated with increased birthweight (r=-0.13, p=0.066). In obese, CRH at 28 weeks correlated inversely with gestational length (r=-0.49, p=0.04), and independently predicted gestational length after adjustment for confounding factors (mean decrease in CRH of -0.25 pmol/L (95% CI -0.45 to -0.043 pmol/L) per/day increase in gestation). In obese pregnancy, lower maternal cortisol without an increase in urinary glucocorticoid clearance may indicate a lesser activation of the HPAA than in lean pregnancy. This may offer a novel mechanism underlying increased birthweight and longer gestation in obese pregnancy. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Income-related and educational inequality in small-for-gestational age and preterm birth in Denmark and Finland 1987-2003

    DEFF Research Database (Denmark)

    Mortensen, Laust H; Lauridsen, Jørgen T; Diderichsen, Finn;

    2010-01-01

    In this paper, we examine income- and education-related inequality in small-for-gestational age (SGA) and preterm birth in Denmark and Finland from 1987 to 2003 using concentration indexes (CIXs).......In this paper, we examine income- and education-related inequality in small-for-gestational age (SGA) and preterm birth in Denmark and Finland from 1987 to 2003 using concentration indexes (CIXs)....

  10. Premature Birth and Large for Gestational Age Are Associated with Risk of Barrett’s Esophagus in Adults

    Science.gov (United States)

    Shiota, Seiji; El-Serag, Hashem B.; Thrift, Aaron P.

    2015-01-01

    Background Birth characteristics, including weight and gestational age, may be associated with risk of Barrett’s esophagus (BE), the only known precursor for esophageal adenocarcinoma; however, data are limited. Aims To examine associations between various birth characteristics and BE, and whether these associations are mediated by known risk factors for BE. Methods Data were obtained from a cross-sectional study among eligible Veterans Affairs patients scheduled for an upper endoscopy, and a sample identified from primary care clinics. Participants underwent an esophagogastroduodenoscopy and completed a survey that captured information on sociodemographic and clinical factors, as well as birth information. We compared 263 patients with histologically confirmed BE to 1,416 controls without BE on endoscopy. Odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using multivariate logistic regression. Results Premature birth was independently associated with risk of BE after adjusted by age, sex, race, and other birth characteristics (OR 3.28, 95% CI 1.22–8.79). On the other hand, large for gestational age was inversely associated with risk of BE (OR 0.46, 95% CI 0.21–0.98). These effects were stronger for patients with long-segment BE than short-segment BE. The associations were not mediated by gastroesophageal reflux disease symptoms, use of proton pump inhibitors, Helicobacter Pylori infection, waist-hip-ratio, height or presence of hiatus hernia. Conclusions Premature birth and large for gestational age may be associated with risk of BE in adults. These associations do not appear to be mediated through known risk factors for BE; however, additional studies are required to confirm our findings. PMID:26611860

  11. The contribution of attenuated selection in utero to small-for-gestational-age (SGA) among term African American male infants.

    Science.gov (United States)

    Goodman, Julia M; Karasek, Deborah; Anderson, Elizabeth; Catalano, Ralph A

    2013-07-01

    Natural selection conserves mechanisms allowing women to spontaneously abort gestations least likely to yield fit offspring. Small gestational size has been proposed as an indicator of fitness observable by maternal biology. Previous research suggests that exposure to ambient stress in utero results in more "culling" of small fetuses and therefore lower rates of small-for-gestational-age (SGA). However, African American women persistently have higher rates of SGA than non-Hispanic white women, despite experiencing more ambient stress. This paper tests whether attenuation of the stress response among highly stressed African American women, as suggested by the weathering hypothesis, may help to explain this apparent inconsistency. We apply time-series modeling to over 2 million African American and non-Hispanic white male term births in California over the period of January 1989 through December 2010. We test for the parabolic (i.e., "U" shaped) relationship, implied by an attenuated stress response, between unusually strong labor market contraction and the rate of SGA among African American term male infants, and a linear relationship among non-Hispanic whites. We find the hypothesized parabolic relationship among term male African American infants. As expected, we find a linear relationship between unexpected layoffs and the rate of SGA among term male non-Hispanic whites. These results are robust to sensitivity analyses. These results may help to explain the high rates of SGA among term male African American infants, despite greater maternal exposure to ambient stress during pregnancy.

  12. Uptake of /sup 65/Zn in the mouse fetus as a function of gestational age

    Energy Technology Data Exchange (ETDEWEB)

    Matsusaka, N.

    1977-01-01

    Radioactive zinc (/sup 65/Zn) uptake in the mouse fetus was studied as a function of time after administration. The fetal uptake of /sup 65/Zn increased markedly with time after administration to the pregnant mice of gestation period Day 17, i.e., from 0.28 percent of the dose 30 min after administration to 2.25 percent of the dose 24 hr after administration. The similar increasing tendency of /sup 65/Zn uptake was also observed in the fetal membranes, whereas the placental uptake decreased with time. The pregnant mice of Days 12, 15, 17, and 18 of gestation received a single dose of /sup 65/Zn, and the fetal uptake was observed daily until parturition. The fetal uptake of /sup 65/Zn increased with progression of gestation period after administration, and the /sup 65/Zn concentrations in the fetus exceeded those in the maternal blood. From these observations, it was assumed that there was no placental barrier against /sup 65/Zn transfer from dam to fetus in mice.

  13. Neonatal morbidity associated with late preterm and early term birth: the roles of gestational age and biological determinants of preterm birth

    Science.gov (United States)

    Brown, Hilary K; Speechley, Kathy Nixon; Macnab, Jennifer; Natale, Renato; Campbell, M Karen

    2014-01-01

    Background The aim of this study was to elucidate the role of gestational age in determining the risk of neonatal morbidity among infants born late preterm (34–36 weeks) and early term (37–38 weeks) compared with those born full term (39–41 weeks) by examining the contribution of gestational age within the context of biological determinants of preterm birth. Methods This was a retrospective cohort study. The sample included singleton live births with no major congenital anomalies, delivered at 34–41 weeks of gestation to London-Middlesex (Canada) mothers in 2002–11. Data from a city-wide perinatal database were linked with discharge abstract data. Multivariable models used modified Poisson regression to directly estimate adjusted relative risks (aRRs). The roles of gestational age and biological determinants of preterm birth were further examined using mediation and moderation analyses. Results Compared with infants born full term, infants born late preterm and early term were at increased risk for neonatal intensive care unit triage/admission [late preterm aRR = 6.14, 95% confidence interval (CI) 5.63, 6.71; early term aRR = 1.54, 95% CI 1.41, 1.68] and neonatal respiratory morbidity (late preterm aRR = 6.16, 95% CI 5.39, 7.03; early term aRR = 1.46, 95% CI 1.29, 1.65). The effect of gestational age was partially explained by biological determinants of preterm birth acting through gestational age. Moreover, placental ischaemia and other hypoxia exacerbated the effect of gestational age on poor outcomes. Conclusions Poor outcomes among infants born late preterm and early term are not only due to physiological immaturity but also to biological determinants of preterm birth acting through and with gestational age to produce poor outcomes. PMID:24374829

  14. Using postnatal age to determine test dates leads to misinterpretations when treatments alter gestation length: results from a collaborative behavioral teratology study in Japan.

    Science.gov (United States)

    Tachibana, T; Narita, H; Ogawa, T; Tanimura, T

    1998-01-01

    A collaborative study was conducted by researchers from 18 laboratories that participated in the Behavioral Teratology Meeting in Japan. Pregnant Sprague-Dawley rats from four breeders received subcutaneous injections of nicotine (6 mg/kg body weight) from day 7 to day 20 of gestation. Results of preweaning tests were closely related to length of gestation, and prolonged gestation was seen in the nicotine group. The effects of nicotine were compared with and without the adjustment of the mean difference in gestational lengths. Without the adjustment (i.e., by employing assessment in terms of postnatal day) several perplexing results were obtained, indicating that the nicotine group developed more quickly than the control group on several preweaning tests. By employing the adjustment, these perplexing results disappeared, indicating that the nicotine group developed more slowly than the control group. The merit of employing gestational day (or postcoital age) as an alternative index is emphasized.

  15. First trimester combined screening for preeclampsia and small for gestational age - a single centre experience and validation of the FMF screening algorithm.

    Science.gov (United States)

    Mosimann, Beatrice; Pfiffner, Chantal; Amylidi-Mohr, Sofia; Risch, Lorenz; Surbek, Daniel; Raio, Luigi

    2017-09-05

    Preeclampsia (PE) is associated with severe maternal and fetal morbidity in the acute presentation and there is increasing evidence that it is also an important risk factor for cardiovascular disease later in life. Therefore, preventive strategies are of utmost importance. The Fetal Medicine Foundation (FMF) London recently developed a first trimester screening algorithm for placenta-related pregnancy complications, in particular early onset preeclampsia (eoPE) requiring delivery before 34 weeks, and preterm small for gestational age (pSGA), with a birth weight <5th percentile and delivery before 37 weeks of gestation, based on maternal history and characteristics, and biochemical and biophysical parameters. The aim of this study was to test the performance of this algorithm in our setting and to perform an external validation of the screening algorithm. Between September 2013 and April 2016, all consecutive women with singleton pregnancies who agreed to this screening were included in the study. The proposed cut-offs of ≥1:200 for eoPE, and ≥1:150 for pSGA were applied. Risk calculations were performed with Viewpoint® program (GE, Mountainview, CA, USA) and statistical analysis with GraphPad version 5.0 for Windows. 1372 women agreed to PE screening; the 1129 with complete data and a live birth were included in this study. Nineteen (1.68%) developed PE: 14 (1.24%) at term (tPE) and 5 (0.44%) preterm (pPE, <37 weeks), including 2 (0.18%) with eoPE. Overall, 97/1129 (8.6%) screened positive for eoPE, including both pregnancies that resulted in eoPE and 4/5 (80%) that resulted in pPE. Forty-nine of 1110 (4.41%) pregnancies without PE resulted in SGA, 3 (0.27%) of them in pSGA. A total of 210/1110 (18.9%) non-PE pregnancies screened positive for pSGA, including 2/3 (66.7%) of the pSGA deliveries and 18/46 (39.1%) of term SGA infants. Our results show that first trimester PE screening in our population performs well and according to expectations, whereas screening

  16. Frequency and risk factors for the birth of small-for-gestational-age newborns in a public maternity hospital.

    Science.gov (United States)

    Teixeira, Marina Parca Cavelagna; Queiroga, Tatiana Peloso Reis; Mesquita, Maria Dos Anjos

    2016-01-01

    To determine the frequency and risk factors of small-for-gestational-age newborns in a high-risk maternity. This is an observational, cross-sectional, and case-control study, conducted in a public tertiary care maternity hospital. Data from 998 newborns and their mothers were collected through interviews and review of medical records and prenatal care cards. Some placentas underwent histopathological analysis. The variables of small-for-gestational-age and non-small-for-gestational-age newborns and of their mothers were statistically compared by means of Student's t test, Fisher's exact test, and odds ratio. The significance level used was 0.050. There was a 17.9% frequency of small-for-gestational-age newborns. The statistically significant factors associated with the birth of these babies were female sex (p=0.012); positive history of another small-for-gestational-age child (p=0.006); inadequate prenatal care (p=0.019); smoking (p=0.003); hypertensive disorders of pregnancy (p=0.007); placental bleeding (p=0.009) and infarction (p=0.001). In the population studied, the frequency of small-for-gestational-age newborns was high and associated with sex, inappropriate prenatal care, presence of maternal diseases and addictions, and placental abnormalities. Determinar a frequência e os fatores de risco de recém-nascidos pequenos para idade gestacional em uma maternidade de alto risco. Trata-se de um estudo observacional, transversal e caso-controle, realizado em maternidade pública de nível terciário. Foram levantados dados de 998 recém-nascidos e de suas respectivas mães por meio de entrevista e análise de prontuários e de cartões do pré-natal. Algumas placentas foram submetidas à análise anatomopatológica. As variáveis dos recém-nascidos pequenos e não pequenos para idade gestacional e de suas respectivas mães foram comparadas estatisticamente pelo teste paramétrico t de Student, pelo teste exato de Fisher e por odds ratio. O nível de signific

  17. Neonatal outcomes among multiple births ≤ 32 weeks gestational age: Does mode of conception have an impact? A Cohort Study

    Directory of Open Access Journals (Sweden)

    Yoon Woojin

    2011-06-01

    Full Text Available Abstract Background Studies comparing perinatal outcomes in multiples conceived following the use of artificial reproductive technologies (ART vs. spontaneous conception (SC have reported conflicting results in terms of mortality and morbidity. Therefore, the objective of our study was to compare composite outcome of mortality and severe neonatal morbidities amongst preterm multiple births ≤ 32 weeks gestation infant born following ART vs. SC. Methods We conducted a single center cohort study at Mount Sinai Hospital, Toronto, Ontario, Canada. Data on all preterm multiple births (≤ 32 weeks GA discharged between July 2005 and June 2008 were retrospectively collected from a prospective database at our centre. Details regarding mode of conception were collected retrospectively from maternal health records. Preterm multiple births were categorized into those born following ART vs. SC. Composite outcome was defined as combination of death or any of the three neonatal morbidities (grade 3/4 intraventricular hemorrhage or periventricular leukomalacia; retinopathy of prematurity > stage 2 or chronic lung disease. Univariate and multivariate regression analysis were preformed after adjustment of confounders (maternal age, parity, triplets, gestational age, sex, and small for gestational age. Results One hundred and thirty seven neonates were born following use of ART and 233 following SC. The unadjusted composite outcome rate was significantly higher in preterm multiples born following ART vs. SC [43.1% vs. 26.6%, p = 0.001; OR 1.98 (95% CI 1.13, 3.45]; however, when adjusted for confounders the difference between groups was not statistically significant [OR 1.39, 95% CI 0.67, 2.89]. Conclusion In our population of preterm multiple births, the mode of conception had no detectable effect on the adjusted composite neonatal outcome of mortality and/or three neonatal morbidities.

  18. Neonatal gut function, measured by the one hour blood D (+) xylose test: influence of gestational age and size.

    OpenAIRE

    Ducker, D A; Hughes, C A; Warren, I.; McNeish, A S

    1980-01-01

    D(+) Xylose absorption, assessed by one hour blood xylose levels, has been measured after intraduodenal infusion of the sugar in 35 infants of differing gestational age and size. The test was performed between the 2nd and 6th days of life. Full-term appropriately grown infants had higher blood xylose levels (1.41+/-0.07 mmol/l) at one hour than pre-term appropriately grown infants (1.17+/-0.07 mmol/l; P less than 0.05), or 'light for dates' infants, both full-term (0.73+/-0.06 mmol/l; P less ...

  19. Spontaneous uterine rupture after abdominal myomectomy at the gestational age of 20 weeks in pregnancy: A case report

    Science.gov (United States)

    Pakniat, Hamideh; Soofizadeh, Nasrin; Khezri, Marzieh Beigom

    2016-01-01

    Background: Uterine rupture in pregnancy is rare and often could be life threatening and catastrophic. Myomectomy is one of very common surgeries in gynecology, performed as the vaginal, abdominal and laparoscopic surgeries. Pregnancies occured after abdominal and laparoscopic myomectomy are high risk for uterine rapture. Case: Patient was a 28 Years old female, pregnant woman at the 20 wks of gestational age with abdominal pain and a history of abdominal myomectomy 6 yrs ago. Uterus was ruptured and fetus in amniotic sac was found in abdominal cavity. Conclusion: Early diagnosis of uterine rupture after myomectomy can save patients from death. PMID:27525334

  20. On the evaluation of routine ultrasound screening in the third trimester for detection of light for gestational age (LGA) infants

    DEFF Research Database (Denmark)

    Secher, Niels Jørgen; Kern Hansen, P; Lenstrup, C

    1987-01-01

    % of the pregnancies. The usefulness of the screening was evaluated on the remaining 36%. An attempt to diagnose light for gestational age (LGA) infants resulted in either a low sensitivity or a low predictive value of a positive test. The late third trimester screening was more sensitive than the early, indicating...... LGA as a late phenomenon in pregnancy. Knowing the result from the late scanning, the result from the early scanning contributed almost no further information about whether the infant would be LGA at birth. Basic epidemiological characteristics of other comparable investigations on high...

  1. Changes in Cesarean Delivery Rates by Gestational Age: United States, 1996-2011

    Science.gov (United States)

    ... approaches to change and the impact on neonatal intensive care admission and stillbirth. Am J Obstet Gynecol 203(5):449.e1–6. 2010. Association of Women's Health, Obstetric and Neonatal Nurses. 40 reasons to go the ...

  2. First-trimester screening for trisomy 21 combining biochemistry and ultrasound at individually optimal gestational ages. An interventional study.

    Science.gov (United States)

    Borrell, Antoni; Casals, Elena; Fortuny, Albert; Farre, M Teresa; Gonce, Anna; Sanchez, Aurora; Soler, Anna; Cararach, Vicençc; Vanrell, Joan A

    2004-07-01

    To assess the effectiveness of the Combined Test in the prenatal detection of trisomy 21 in the general pregnant population using a new timing for the screening approach. First-trimester maternal serum biochemical markers (pregnancy-associated plasma protein-A and free-beta hCG) were determined in maternal serum at 7 to 12 weeks. Fetal nuchal translucency and gestational age were assessed at the 10- to 14-week ultrasound scan. A combined risk was estimated and delivered to the women the same day. When the risk was 1:250 or above, chorionic villus sampling was offered. Mean gestational age at biochemistry was 9.4 weeks, being 12.3 at ultrasound. In the 2780 studied pregnancies with a complete follow-up, observed detection rates were 88% (7/8) for trisomy 21 and 75% (3/4) for trisomy 18, with a 3.3% (92/2765) false-positive rate. The Combined Test, assessing biochemistry and ultrasound at individually optimal ages in the first trimester, showed an 88% detection rate for trisomy 21 with a remarkably reduced false-positive rate (3.3%). Copyright 2004 John Wiley and Sons, Ltd.

  3. Retinal structure assessed by OCT as a biomarker of brain development in children born small for gestational age.

    Science.gov (United States)

    Pueyo, Victoria; Pérez, Teresa; González, Inmaculada; Altemir, Irene; Gimenez, Galadriel; Prieto, Esther; Paules, Cristina; Oros, Daniel; Lopez-Pison, Javier; Fayed, Nicolás; Garcia-Martí, Gracián; Sanz-Requena, Roberto; Marin, Miguel Angel

    2017-09-01

    To identify differences in neuronal tissue from retinal and brain structures in children born small for gestational age (SGA) with no abnormality in neonatal brain ultrasonography and no previous neurological impairment, and to evaluate the relationship between retinal structure and brain changes in school-age children born SGA. Two cohorts of children were recruited: 25 children born SGA and 25 children born with an appropriate birth weight according to gestational age. All the children underwent an ophthalmic examination, which included retinal imaging using spectral-domain optical coherence tomography, and a brain MRI. MRI images were automatically segmented and global and regional brain volumes were obtained. Although visual function did not differ between both groups, the complex ganglion cell and inner plexiform layers (GCL-IPL) was thinner in SGA children. Total intracranial volume, and global grey and white matter volumes in brain and cerebellum were correlated with birthweight centile, as were certain regional volumes (temporal and parietal lobes, hippocampus and putamen). Abnormal GCL-IPL measurements accurately identified SGA children with the most severe grey and white matter changes in the brain. SGA children, both preterm and term born, showed evidence of structural abnormalities in the retina, which may be an accurate and non-invasive biomarker of neuronal damage in brain tissue. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. Obesity and cell-free DNA "no calls": is there an optimal gestational age at time of sampling?

    Science.gov (United States)

    Livergood, Mary C; LeChien, Kay A; Trudell, Amanda S

    2017-04-01

    Cell-free DNA screen failures or "no calls" occur in 1-12% of samples and are frustrating for both clinician and patient. The rate of "no calls" has been shown to have an inverse relationship with gestational age. Recent studies have shown an increased risk for "no calls" among obese women. We sought to determine the optimal gestational age for cell-free DNA among obese women. We performed a retrospective cohort study of women who underwent cell-free DNA at a single tertiary care center from 2011 through 2016. Adjusted odds ratios with 95% confidence intervals for a "no call" were determined for each weight class and compared to normal-weight women. The predicted probability of a "no call" with 95% confidence intervals were determined for each week of gestation for normal-weight and obese women and compared. Among 2385 patients meeting inclusion criteria, 105 (4.4%) had a "no call". Compared to normal-weight women, the adjusted odds ratio of a "no call" increased with increasing weight class from overweight to obesity class III (respectively: adjusted odds ratio, 2.31; 95% confidence interval, 1.21-4.42 to adjusted odds ratio, 8.55; 95% confidence interval, 4.16-17.56). A cut point at 21 weeks was identified for obesity class II/III women at which there is no longer a significant difference in the probability of a "no call" for obese women compared to normal weight women. From 8-16 weeks, there is a 4.5% reduction in the probability of a "no call" for obesity class II/III women (respectively: 14.9%; 95% confidence interval, 8.95-20.78 and 10.4%; 95% confidence interval, 7.20-13.61; Ptrend DNA limits reproductive choices. However, a progressive fall in the probability of a "no call" with advancing gestational age suggests that delaying cell-free DNA for obese women is a reasonable strategy to reduce the probability of a "no call". Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Metabolism of medium- and long-chain fatty acids by isolated hepatocytes from small-for-gestational-age (SGA) and appropriate for-gestational-age (AGA) piglets

    Energy Technology Data Exchange (ETDEWEB)

    Odle, J.; Benevenga, N.J.; Crenshaw, T.D. (Univ. of Wisconsin, Madison (United States))

    1990-02-26

    Hepatocytes were isolated from full-term, SGA and AGA piglets at 6 or 48 hours postpartum and were incubated with 1 mM (1-{sup 14}C)-octanoate (C8), -nonanoate (C9) or-oleate (C18:1). The cells oxidized (natom 1-C/(h 10{sup 6} cells)) C9 to Co{sub 2} (12.5) and acid soluble products (28.9) faster than C8 (10.9, 20.6, respectively), and both were oxidized faster than C18:1 (3.9, 9.9) regardless of the piglet age or weight. Oleate accumulated in lipid products 8-fold faster than C8 and C9. No differences between cells from SGA and AGA piglets were detected. Recovery of 1-C in CO{sub 2} was 48% higher in incubations with cells from 48 hours old than from 6 hour old piglets. This increase was attributable to a 70% higher oxygen consumption by 48 hour old cells. Theoretical oxygen consumption rates were computed from the fatty acid flux data and compared to measured oxygen consumption. hepatocytes from SGA and AGA piglets were equally capable of satisfying more that 57% of their energy needs from fatty acid oxidation. The oxygen consumption attributable to C9 metabolism was 30% higher than observed for C8 and C18:1. All fatty acids apparently spared endogenous fuels to a greater degree in 6 hour than in 48 hour piglets.

  6. Gestational age, mode of birth and breastmilk feeding all influence acute early childhood gastroenteritis: a record-linkage cohort study

    OpenAIRE

    Bentley, Jason P; Simpson, Judy M; Bowen, Jenny R.; Morris, Jonathan M.; Roberts, Christine L; Nassar, Natasha

    2016-01-01

    Background Acute gastroenteritis (AGE) is a leading cause of infectious morbidity in childhood. Clinical studies have implicated caesarean section, early birth and formula feeding in modifying normal gut microbiota development and immune system homeostasis in early life. Rates of early birth and cesarean delivery are also increasing worldwide. This study aimed to investigate the independent and combined associations of the mode and timing of birth and breastmilk feeding with AGE hospitalisati...

  7. New Korean reference for birth weight by gestational age and sex: data from the Korean Statistical Information Service (2008-2012)

    Science.gov (United States)

    Lim, Jung Sub; Lim, Se Won; Ahn, Ju Hyun; Song, Bong Sub; Shim, Kye Shik

    2014-01-01

    Purpose To construct new Korean reference curves for birth weight by sex and gestational age using contemporary Korean birth weight data and to compare them with the Lubchenco and the 2010 United States (US) intrauterine growth curves. Methods Data of 2,336,727 newborns by the Korean Statistical Information Service (2008-2012) were used. Smoothed percentile curves were created by the Lambda Mu Sigma method using subsample of singleton. The new Korean reference curves were compared with the Lubchenco and the 2010 US intrauterine growth curves. Results Reference of the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles birth weight by gestational age were made using 2,249,804 (male, 1,159,070) singleton newborns with gestational age 23-43 weeks. Separate birth weight curves were constructed for male and female. The Korean reference curves are similar to the 2010 US intrauterine growth curves. However, the cutoff values for small for gestational age (<10th percentile) of the new Korean curves differed from those of the Lubchenco curves for each gestational age. The Lubchenco curves underestimated the percentage of infants who were born small for gestational age. Conclusion The new Korean reference curves for birth weight show a different pattern from the Lubchenco curves, which were made from white neonates more than 60 years ago. Further research on short-term and long-term health outcomes of small for gestational age babies based on the new Korean reference data is needed. PMID:25346919

  8. Gestational age and birth weight in relation to school performance of 10-year-old children: a follow-up study of children born after 32 completed weeks

    DEFF Research Database (Denmark)

    Kirkegaard, Ida; Obel, Carsten; Hedegaard, Morten

    2006-01-01

    the children were between 9 and 11 years of age, we gathered information about their school performance (reading, spelling, and arithmetic) from questionnaires completed by the parents and the children's primary school teachers. RESULTS: The association between birth weight and reading, as well as spelling......BACKGROUND: Children born extremely premature (birth weight (children born at term with a normal birth weight. Much less is known about children of higher gestational ages and birth weights. We studied gestational age...... after 32 completed weeks and birth weight in relation to the child's school performance at the age of 10 years. METHODS: We performed a follow-up study of 5319 children born between January 1990 and June 1992. We got the information on birth weight and gestational age from birth registration forms; when...

  9. A neonatal piglet model for investigating brain and cognitive development in small for gestational age human infants.

    Science.gov (United States)

    Radlowski, Emily C; Conrad, Matthew S; Lezmi, Stephane; Dilger, Ryan N; Sutton, Brad; Larsen, Ryan; Johnson, Rodney W

    2014-01-01

    The piglet was investigated as a potential model for studying brain and cognitive deficits associated with being born small for gestational age (SGA). Naturally farrowed SGA (0.7-1.0 kg BW) and average for gestational age (AGA, 1.3-1.6 kg BW) piglets were obtained on postnatal day (PD) 2, placed in individual cages, and provided a nutritionally adequate milk replacer diet (285 ml/kg/d). Beginning at PD14, performance in a spatial T-maze task was assessed. At PD28, piglets were anesthetized for magnetic resonance (MR) imaging to assess brain structure (voxel-based morphometry), connectivity (diffusion-tensor imaging) and metabolites in the hippocampus and corpus callosum (proton MR spectroscopy). Piglets born SGA showed compensatory growth such that BW of SGA and AGA piglets was similar (P>0.05), by PD15. Birth weight affected maze performance, with SGA piglets taking longer to reach criterion than AGA piglets (pdevelopment and connectivity. None of the metabolites measured were different between groups. Collectively, the results show that SGA piglets have spatial learning deficits and abnormal development of white matter. As learning deficits and abnormalities in white matter are common in SGA human infants, the piglet is a tractable translational model that can be used to investigate SGA-associated cognitive deficits and potential interventions.

  10. Obesity and gestational weight gain: cesarean delivery and labor complications Obesidade e ganho de peso gestacional: cesariana e complicações de parto

    Directory of Open Access Journals (Sweden)

    Luiz Carlos Seligman

    2006-06-01

    Full Text Available OBJECTIVE: To assess the association between pre-gestational obesity and weight gain with cesarean delivery and labor complications. METHODS: A total of 4,486 women 20-28 weeks pregnant attending general prenatal care clinics of the national health system in Brazil from 1991 to 1995 were enrolled and followed up through birth. Body mass index categories based on prepregnancy weight and total weight gain were calculated. Associations between body mass index categories and labor complications were adjusted through logistic regression analysis. RESULTS: Obesity was present in 308 (6.9% patients. Cesarean delivery was performed in 164 (53.2% obese, 407 (43.1% pre-obese, 1,045 (35.1% normal weight and 64 (24.5% underweight women. The relative risk for cesarean delivery in obese women was 1.8 (95% CI: 1.5-2.0 compared to normal weight women. Greater weight gain was particularly associated with cesarean among the obese (RR 4th vs 2nd weight gain quartile 2.2; 95% CI: 1.4-3.2. Increased weight at the beginning of pregnancy was associated with a significantly higher adjusted risk of meconium with vaginal delivery and perinatal death and infection in women submitted to cesarean section. Similarly, greater weight gain during pregnancy increased the risk for meconium and hemorrhage in women submitted to vaginal delivery and for prematurity with cesarean. CONCLUSIONS: Pre-gestational obesity and greater weight gain independently increase the risk of cesarean delivery, as well as of several adverse outcomes with vaginal delivery. These findings provide further evidence of the negative effects of prepregnancy obesity and greater gestational weight gain on pregnancy outcomes.OBJETIVO: Avaliar a associação de obesidade pré-gestacional e ganho de peso excessivo com cesariana e outras complicações do parto. MÉTODOS: Um total de 4.486 mulheres com 20-28 semanas de gravidez do pré-natal geral do Sistema Único de Saúde de seis capitais brasileiras foram

  11. Women born preterm or with inappropriate weight for gestational age are at risk of subsequent gestational diabetes and pre-eclampsia

    DEFF Research Database (Denmark)

    á Rogvi, Rasmus; Forman, Julie Lyng; Damm, Peter;

    2012-01-01

    Low birthweight, which can be caused by inappropriate intrauterine growth or prematurity, is associated with development of gestational diabetes mellitus (GDM) as well as pre-eclampsia later in life, but the relative effects of prematurity and inappropriate intrauterine growth remain uncertain....

  12. Decreased plasma chemerin levels in women with gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Hare, K J; Bonde, L; Svare, J A

    2014-01-01

    AIMS: To evaluate fasting and post-prandial serum chemerin levels in pregnant women with and without gestational diabetes, and again following delivery when normal glucose homeostasis is re-established. METHODS: Chemerin levels were measured in serum from nine women with gestational diabetes......, and from eight age- and BMI-matched pregnant women with normal glucose tolerance during two meal tests: in the third trimester and 3-4 months post partum. All women with gestational diabetes re-established normal glucose tolerance after delivery. RESULTS: Meal intake did not affect serum chemerin levels....... The group with gestational diabetes had lower mean serum chemerin levels during the third trimester compared with the group with normal glucose tolerance (28 ± 1.3 vs. 88 ± 3.5 ng/ml, P

  13. An Influence of Birth Weight, Gestational Age, and Apgar Score on Pattern Visual Evoked Potentials in Children with History of Prematurity

    Directory of Open Access Journals (Sweden)

    Marta Michalczuk

    2015-01-01

    Full Text Available Purpose. The objective of our study was to examine a possible influence of gestational age, birth weight, and Apgar score on amplitudes and latencies of P100 wave in preterm born school-age children. Materials and Methods. We examined the following group of school-age children: 28 with history of prematurity (mean age 10.56 ± 1.66 years and 25 born at term (mean age 11.2 ± 1.94 years. The monocular PVEP was performed in all children. Results. The P100 wave amplitudes and latencies significantly differ between preterm born school-age children and those born at term. There was an essential positive linear correlation of the P100 wave amplitudes with birth weight, gestational age, and Apgar score. There were the negative linear correlations of P100 latencies in 15-minute stimulation from O1 and Oz electrode with Apgar score and O1 and O2 electrode with gestational age. Conclusions. PVEP responses vary in preterm born children in comparison to term. Low birth weight, early gestational age, and poor baseline output seem to be the predicting factors for the developmental rate of a brain function in children with history of prematurity. Further investigations are necessary to determine perinatal factors that can affect the modified visual system function in preterm born children.

  14. Infant mortality and morbidity associated with preterm and small-for-gestational-age births in Southern Mozambique: A retrospective cohort study.

    Science.gov (United States)

    García-Basteiro, Alberto L; Quintó, Llorenç; Macete, Eusebio; Bardají, Azucena; González, Raquel; Nhacolo, Arsenio; Sigauque, Betuel; Sacoor, Charfudin; Rupérez, María; Sicuri, Elisa; Bassat, Quique; Sevene, Esperança; Menéndez, Clara

    2017-01-01

    Preterm and small for gestational age (SGA) births have been associated with adverse outcomes during the first stages of life. We evaluated the morbidity and mortality associated with preterm and SGA births during the first year of life in a rural area of Southern Mozambique. This is a retrospective cohort study using previously collected data from children born at the Manhiça District Hospital in two different periods (2003-2005 and 2010-2012). Newborns were classified as being preterm and/or SGA or as babies not fulfilling any of the previous conditions (term non-SGA). All children were followed up for a year for morbidity and mortality outcomes. A total of 5574 live babies were included in the analysis. The prevalence of preterm delivery was 6.2% (345/5574); the prevalence of SGA was 14.0% (776/5542) and 2.2% (114/5542) of the children presented both conditions. During the neonatal period, preterm delivery and SGA were associated with 13 (HR: 13.0, 95% CI 4.0-42.2) and 5 times (HR: 4.5, 95% CI: 1.6-12.6) higher mortality compared to term non SGA babies. Risk of hospitalization was only increased when both conditions were present (IRR: 3.5, 95%CI: 1.5-8.1). Mortality is also increased during the entire first year, although at a lower rate. Neonatal and infant mortality rates are remarkably high among preterm and SGA babies in southern Mozambique. These increased rates are concentrated within the neonatal period. Prompt identification of these conditions is needed to implement interventions aimed at increasing survival of these high-risk newborns.

  15. Live-born infants of 24 to 28 weeks' gestation: survival and sequelae at two years of age.

    Science.gov (United States)

    Kitchen, W H; Rickards, A L; Ford, G W; Ryan, M M; Lissenden, J V

    1985-01-01

    The survival rate of infants born alive between 24 and 28 weeks of gestation has increased significantly in this tertiary care centre, from about 9% in the first cohort studied (1966-1970), to 19.5% in the second cohort (1971-1974) and 50.3% in the third cohort (1977-1982); the borderline of practical viability decreased from 27 to 24 weeks over the years of the study. The number of mothers with a history of prior termination of pregnancy increased about sixfold from the second to the third cohorts but the rate of premature births increased by only 50%. The augmented survival rate was accompanied by an increase in the prevalence and total number of children with cerebral palsy, but bilateral blindness due to retinopathy of prematurity and severe sensorineural deafness were reduced. When 96% of children in the third cohort were assessed at two years of age. 13% had severe handicaps, 59% were considered normal and in 24% some handicap was suspected. The serious handicap rate was 28% for children born at 24-26 weeks compared with 8.5% for those born at 27-28 weeks of gestation.

  16. Gestational age at booking for antenatal care in a tertiary health facility in north-central, Nigeria

    Directory of Open Access Journals (Sweden)

    Dennis Isaac Ifenne

    2012-01-01

    Full Text Available Background: Early initiation of antenatal care is widely believed to improve maternal and fetal outcome. This study was designed to ascertain the gestational age at booking using World Health Organization recommendations for developing countries. Materials and Methods: This cross-sectional study was carried out using interviewer-administered questionnaire to 345 willing participants at a booking clinic in a tertiary health facility in North-Central, Nigeria. Results: A total of 345 women were interviewed. The average age of the clients was 27.1±5.1 years. Almost (45.8% had at least secondary level of education. One-third of the women were not working women. The average gestational age at booking was 19.1±7.8. Late booking (≥17 weeks was significantly influenced by the client′s level of education ( P=0.017. Reasons for booking late were given as follows: Not being sick (26.1%, Lack of knowledge of booking time (22.8%, having booked elsewhere (14.1%, financial constraints (9.2%, fear of too many follow-up visits (4.9%, spouse′s un co-operative attitude (3.9%, lack of transport to the health care facility (2.2%, and other minor reasons (16.8%. Conclusion: Most women booked for antenatal care (ANC late. Efforts toward maternal education, public health enlightenment campaigns, poverty reduction, and use of focused antenatal care model should be sustained as measures to encourage early initiation of ANC.

  17. Genetic factors associated with small for gestational age birth and the use of human growth hormone in treating the disorder

    Directory of Open Access Journals (Sweden)

    Saenger Paul

    2012-05-01

    Full Text Available Abstract The term small for gestational age (SGA refers to infants whose birth weights and/or lengths are at least two standard deviation (SD units less than the mean for gestational age. This condition affects approximately 3%–10% of newborns. Causes for SGA birth include environmental factors, placental factors such as abnormal uteroplacental blood flow, and inherited genetic mutations. In the past two decades, an enhanced understanding of genetics has identified several potential causes for SGA. These include mutations that affect the growth hormone (GH/insulin-like growth factor (IGF-1 axis, including mutations in the IGF-1 gene and acid-labile subunit (ALS deficiency. In addition, select polymorphisms observed in patients with SGA include those involved in genes associated with obesity, type 2 diabetes, hypertension, ischemic heart disease and deletion of exon 3 growth hormone receptor (d3-GHR polymorphism. Uniparental disomy (UPD and imprinting effects may also underlie some of the phenotypes observed in SGA individuals. The variety of genetic mutations associated with SGA births helps explain the diversity of phenotype characteristics, such as impaired motor or mental development, present in individuals with this disorder. Predicting the effectiveness of recombinant human GH (hGH therapy for each type of mutation remains challenging. Factors affecting response to hGH therapy include the dose and method of hGH administration as well as the age of initiation of hGH therapy. This article reviews the results of these studies and summarizes the success of hGH therapy in treating this difficult and genetically heterogenous disorder.

  18. Genetic factors associated with small for gestational age birth and the use of human growth hormone in treating the disorder.

    Science.gov (United States)

    Saenger, Paul; Reiter, Edward

    2012-05-15

    The term small for gestational age (SGA) refers to infants whose birth weights and/or lengths are at least two standard deviation (SD) units less than the mean for gestational age. This condition affects approximately 3%-10% of newborns. Causes for SGA birth include environmental factors, placental factors such as abnormal uteroplacental blood flow, and inherited genetic mutations. In the past two decades, an enhanced understanding of genetics has identified several potential causes for SGA. These include mutations that affect the growth hormone (GH)/insulin-like growth factor (IGF)-1 axis, including mutations in the IGF-1 gene and acid-labile subunit (ALS) deficiency. In addition, select polymorphisms observed in patients with SGA include those involved in genes associated with obesity, type 2 diabetes, hypertension, ischemic heart disease and deletion of exon 3 growth hormone receptor (d3-GHR) polymorphism. Uniparental disomy (UPD) and imprinting effects may also underlie some of the phenotypes observed in SGA individuals. The variety of genetic mutations associated with SGA births helps explain the diversity of phenotype characteristics, such as impaired motor or mental development, present in individuals with this disorder. Predicting the effectiveness of recombinant human GH (hGH) therapy for each type of mutation remains challenging. Factors affecting response to hGH therapy include the dose and method of hGH administration as well as the age of initiation of hGH therapy. This article reviews the results of these studies and summarizes the success of hGH therapy in treating this difficult and genetically heterogenous disorder.

  19. Short children born small for gestational age (SGA) : puberty, hormonal profiles, combined GnRHa and GH treatment and (epi)genetics of 2 IGFBP gene promotors

    NARCIS (Netherlands)

    D.C.M. van der Kaay (Danielle)

    2008-01-01

    textabstractIn the Netherlands, children who remain short after being born small for gestational age (SGA) are treated with growth hormone (GH). The clinical studies described in this thesis focused on treatment options in short children born SGA who came under medical attention around pubertal age.

  20. [Nutritional status of women with gestational diabetes and characteristics of newborn].

    Science.gov (United States)

    González Stäger, Maria Angelica; Rodríguez Fernández, Alejandra; Ortega Quintana, Victoria; Oliveras Vega, Leslie

    2012-12-01

    The objective was to determine the relationship between the mother's nutritional status and the newborn's gestational characteristics. A sample of 149 women with gestational diabetes was controlled in the High Risk Obstetric Unit of the Medical Specialties Public Health Center before delivery in the maternity ward of the Hospital Clinico Herminda Martín de Chillán, Chile in 2010. Data were obtained from the perinatal clinical history and the newborn's chart. The variables recorded for the mother were nutritional status, type of delivery, number of pregnancies, and metabolic control. Data for the newborn were weight, length, head circumference, and gestational diagnosis. These data were analyzed by ANOVA, Chi-square test, and Multiple Correspondence. Women with a normal nutritional status were multiparous with natural childbirth; the newborn had an adequate gestational age and normal head circumference. On the other hand, maternal obesity was related to a Cesarean; the newborn was large for gestational age and had a larger head circumference. Overweight women were primiparous and the newborn was small for gestational age with a smaller head circumference (p obesity in women with gestational diabetes explains variables such as type of delivery, number of gestations, and the newborn's diagnosis.

  1. First trimester PAPP-A2, PAPP-A and hCGβ in small-for-gestational-age pregnancies

    DEFF Research Database (Denmark)

    Hansen, Young Bae; Myrhøj, Vibeke; Jørgensen, Finn Stener;

    2015-01-01

    BACKGROUND: Pregnancy-associated plasma protein-A2 (PAPP-A2) is a recently discovered protease that cleaves a subset of insulin-like growth factor binding proteins (IGFBP). The molecular function suggests its involvement in the IGF system that is vital for fetal growth and development. Our...... objectives were to establish first trimester median curves of PAPP-A2, PAPP-A and hCGβ for singleton normal pregnancies and to investigate whether an altered level of one or more of the biomarkers is associated with small-for-gestational-age (SGA) neonates before and after stratification according...... to maternal hypertension and/or proteinuria. METHODS: This was a case-control study based on 985 pregnant women delivering normal-weighted neonates and 170 pregnant women delivering SGA neonates. PAPP-A2 was measured by ELISA. PAPP-A and hCGβ were measured by an automatic analyzer. Median curves from 8...

  2. Differences in mortality and morbidity according to gestational ages and birth weights in infants with trisomy 18.

    Science.gov (United States)

    Imai, Ken; Uchiyama, Atsushi; Okamura, Tomoka; Ago, Mako; Suenaga, Hideyo; Sugita, Eri; Ono, Hideko; Shuri, Kyoko; Masumoto, Kenichi; Totsu, Satsuki; Nakanishi, Hidehiko; Kusuda, Satoshi

    2015-11-01

    The aim of this study was to clarify the effects of gestational age and birth weight on outcomes of the infants. Medical records of 36 infants with trisomy 18 admitted to Tokyo Women's Medical University Hospital from 1991 to 2012 were reviewed retrospectively. We compared clinical characteristics between term infants (n = 15) and preterm infants (n = 21). There were one very-low-birth-weight (VLBW) term infant (5%) and 12 VLBW preterm infants (80%). Although there were no significant differences in clinical characteristics and provided management between the two groups, none of the preterm infants achieved survival to discharge. On the other hand, 6 of 21 term infants (29%) achieved survival to discharge (P trisomy 18. In both preterm and term groups, the infants who died before 30 days commonly died of respiratory failure or apnea. Whereas, the infants who survived more than 30 days mostly died of heart failure.

  3. Gestational Age-specific Cut-off Values Are Needed for Diagnosis of Subclinical Hypothyroidism in Early Pregnancy.

    Science.gov (United States)

    Kim, Hye Sung; Kim, Byoung Jae; Oh, Sohee; Lee, Da Young; Hwang, Kyu Ri; Jeon, Hye Won; Lee, Seung Mi

    2015-09-01

    During the first trimester of pregnancy, thyroid-stimulating hormone (TSH) >2.5 mIU/L has been suggested as the universal criterion for subclinical hypothyroidism. However, TSH levels change continuously during pregnancy, even in the first trimester. Therefore the use of a fixed cut-off value for TSH may result in a different diagnosis rate of subclinical hypothyroidism according to gestational age. The objective of this study was to obtain the normal reference range of TSH during the first trimester in Korean gravida and to determine the diagnosis rate of subclinical hypothyroidism using the fixed cut-off value (TSH >2.5 mIU/L). The study population consisted of pregnant women who were measured for TSH during the first trimester of pregnancy (n=492) and nonpregnant women (n=984). Median concentration of TSH in pregnant women was lower than in non-pregnant women. There was a continuous decrease of median TSH concentration during the first trimester of pregnancy (median TSH concentration: 1.82 mIU/L for 3+0 to 6+6 weeks; 1.53 mIU/L for 7+0 to 7+6 weeks; and 1.05 mIU/L for 8+0 to 13+6 weeks). Using the fixed cut-off value of TSH >2.5 mIU/L, the diagnosis rate of subclinical hypothyroidism decreased significantly according to the gestational age (GA) at TSH (25% in 3+0 to 6+6 weeks, 13% in 7+0 to 7+6 weeks, and 9% for 8+0 to 13+6 weeks, Phypothyroidism.

  4. Preconception Blood Pressure and Risk of Low Birth Weight and Small for Gestational Age: A Large Cohort Study in China.

    Science.gov (United States)

    Li, Nan; Li, Zhiwen; Ye, Rongwei; Zhang, Le; Li, Hongtian; Zhu, Yibing; Li, Shun; Yang, Na; Liu, Jianmeng; Ren, Aiguo

    2016-10-01

    Our objective was to examine whether high blood pressure in the preconception period was associated with low birth weight (LBW) and small-for-gestational age (SGA) in Chinese women. Data were obtained from the China-US Collaborative Project for Neural Tube Defects Prevention, a large population-based cohort study. We included 43 718 singleton live births delivered at gestational ages of 28-45 weeks to women who were registered before pregnancy in 7 counties in southern China. Blood pressure was measured during registration by trained healthcare workers, and other health-related information was recorded prospectively. We used logistic regression to evaluate the associations between preconception blood pressure and the risk of LBW and SGA, adjusting for potential confounders. The prevalence of hypertension in the preconception study population was 4.62% (2019/43 718). The incidences of LBW and SGA were 2.33% and 5.05% for the hypertension group and 2.01% and 5.68% for the nonhypertension group. Compared with the nonhypertension group, the hypertension group did not show significantly increased risk for LBW overall (adjusted risk ratio =1.16, 95% confidence interval 0.86-1.57) or SGA (adjusted risk ratio =0.89, 95% confidence interval 0.73-1.09). When participants with normal blood pressure were used as the reference, the adjusted risk ratio of SGA for prehypertensive women was 1.13 (95% confidence interval 1.03-1.25). Our results do not support an association between hypertension or higher blood pressure before pregnancy and increased risk of LBW or SGA. © 2016 American Heart Association, Inc.

  5. Second-Trimester 3-Dimensional Placental Sonography as a Predictor of Small-for-Gestational-Age Birth Weight.

    Science.gov (United States)

    Quant, Hayley S; Sammel, Mary D; Parry, Samuel; Schwartz, Nadav

    2016-08-01

    We previously reported the association between first-trimester 3-dimensional (3D) placental measurements and small-for-gestational-age (SGA) neonates. In this study, we sought to determine whether second-trimester measurements further contribute to the antenatal detection of SGA and preeclampsia. We prospectively collected 3D sonographic volume sets and uterine artery pulsatility indices of singleton pregnancies at 18 to 24 weeks. Placental volume, placental quotient (placental volume/gestational age), mean placental diameter and chorionic diameter, placental morphologic index (mean placental diameter/placental quotient), placental chorionic index (mean chorionic diameter/placental quotient), and placental growth (volume per week) were assessed and evaluated as predictors of SGA and preeclampsia as a composite and alone. Of 373 pregnancies, the composite outcome occurred in 67 (18.0%): 36 (9.7%) manifested SGA alone; 27 (7.2%) developed preeclampsia alone, and 4 (1.1%) developed both. The placental volume, placental quotient, mean placental diameter, mean chorionic diameter, and volume per week were significantly smaller, whereas the placental morphologic index and chorionic index were significantly larger in pregnancies with the composite outcome (P < .01). Further analyses revealed that the significant associations with placental parameters were limited to the SGA outcome. Each placental measure remained significantly associated with SGA after adjusting for confounders. The mean uterine artery pulsatility index was not associated with either outcome. Placental parameters were moderately predictive of SGA, with adjusted areas under the curve ranging from 0.72 to 0.76. Sensitivity for detection of SGA ranged from 32.5% to 45.0%, with positive predictive values ranging from 17.3% to 22.7%. Second-trimester 3D placental measurements can identify pregnancies at risk of SGA. However, there appears to be no significant improvement compared to those obtained in the first

  6. Association between soluble (Prorenin receptor concentration in cord blood and small for gestational age birth: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Noriyoshi Watanabe

    Full Text Available OBJECTIVE: The (prorenin receptor [(PRR] has been recognized as a multifunctional receptor. The purpose of this study was to assess the association between plasma soluble (PRR [s(PRR] concentration in human cord blood (i.e., neonatal blood at birth and small for gestational age (SGA birth. METHODS: Participants were women with a singleton pregnancy who delivered at the National Center for Child Health and Development between January 2010 and December 2011. Inclusion criteria were availability of maternal pre-pregnancy and paternal body mass index, and the absence of structural anomalies in neonates. s(PRR concentration in cord blood was measured in 621 neonates. The 621 pairs of mothers and neonates were categorized into four groups based on quartiles of s(PRR concentrations in cord blood. SGA was defined as a birth weight below the 10(th percentile for gestational age. Logistic regression analysis was performed to assess the association between cord plasma s(PRR concentration (quartiles and incidence of SGA births. RESULTS: Among 621 neonates, 55 (8.9% were diagnosed as SGA (SGA group and 566 (91.1% were not (non-SGA group. Average s(PRR concentration in cord blood was 66.1±12.6 ng/ml (mean±standard deviation. There were 155 pairs in the first plasma s(PRR concentration quartile (Q1: 73.1 ng/ml. The distribution of SGA births was 18 (11.6% in Q1, 14 (9.2% in Q2, 16 (10.2% in Q3 and 7 (4.5% in Q4, respectively. The odds ratio of SGA births was 0.24 (95% confidence interval: 0.08-0.71 for the fourth quartile compared to the first quartile in multivariate models. The P-value for trend was also significant (P = 0.020. CONCLUSION: High s(PRR concentration is associated with a lower SGA birth likelihood.

  7. Small for gestational age and poor fluid intelligence in childhood predict externalizing behaviors among young adults born at extremely low birth weight.

    Science.gov (United States)

    Lahat, Ayelet; Van Lieshout, Ryan J; Saigal, Saroj; Boyle, Michael H; Schmidt, Louis A

    2015-02-01

    Although infants born at extremely low birth weight (ELBW; birth weight intelligence. As young adults, a subset of ELBW survivors free of major neurosensory impairments provided self-reports of personality characteristics related to psychopathology. Data from 66 participants indicated that, as predicted, the association between ELBW and externalizing behaviors was moderated by fluid intelligence. Specifically, ELBW individuals with poor fluid intelligence who were born small for gestational age (birth weight intelligence might be a cognitive mechanism contributing to the development of psychopathology among nonimpaired individuals who were born at ELBW and small for gestational age.

  8. Early growth patterns are associated with intelligence quotient scores in children born small-for-gestational age.

    Science.gov (United States)

    Varella, Marcia H; Moss, William J

    2015-08-01

    To assess whether patterns of growth trajectory during infancy are associated with intelligence quotient (IQ) scores at 4 years of age in children born small-for-gestational age (SGA). Children in the Collaborative Perinatal Project born SGA were eligible for analysis. The primary outcome was the Stanford-Binet IQ score at 4 years of age. Growth patterns were defined based on changes in weight-for-age z-scores from birth to 4 months and 4 to 12 months of age and consisted of steady, early catch-up, late catch-up, constant catch-up, early catch-down, late catch-down, constant catch-down, early catch-up & late catch-down, and early catch-down & late catch-up. Multivariate linear regression was used to assess associations between patterns of growth and IQ. We evaluated patterns of growth and IQ in 5640 children. Compared with children with steady growth, IQ scores were 2.9 [standard deviation (SD)=0.54], 1.5 (SD=0.63), and 2.2 (SD=0.9) higher in children with early catch-up, early catch-up and later catch-down, and constant catch-up growth patterns, respectively, and 4.4 (SD=1.4) and 3.9 (SD=1.5) lower in children with early catch-down & late catch-up, and early catch-down growth patterns, respectively. Patterns in weight gain before 4 months of age were associated with differences in IQ scores at 4 years of age, with children with early catch-up having slightly higher IQ scores than children with steady growth and children with early catch-down having slightly lower IQ scores. These findings have implications for early infant nutrition in children born SGA. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Associations of gestational age and intrauterine growth with systolic blood pressure in a family-based study of 386,485 men in 331,089 families.

    Science.gov (United States)

    Lawlor, Debbie A; Hübinette, Anna; Tynelius, Per; Leon, David A; Smith, George Davey; Rasmussen, Finn

    2007-02-06

    We conducted a family-based study to explore mechanisms underlying the associations of birth weight and gestational age with systolic blood pressure measured at 17 to 19 years of age. A record linkage study of 386,485 singleton-born men from 331,089 families was undertaken. Birth weight was inversely associated with systolic blood pressure within siblings, with a mean difference (adjusted for age at examination, examination center, and year of examination) within siblings per 1-SD difference in birth weight of -0.21 mm Hg (95% CI, -0.33 to -0.08) and between nonsiblings of -0.12 (95% CI, -0.16 to -0.08). Gestational age was inversely associated with systolic blood pressure within siblings (-0.18 mm Hg; 95% CI, -0.25 to -0.11, per week of gestational age) and between nonsiblings (-0.26 mm Hg; 95% CI, -0.29 to -0.24). Adjustment for socioeconomic position and maternal characteristics did not alter these within- or between-family associations. Furthermore, the associations were not affected by adjustment for paternal height, body mass index, or systolic blood pressure. Our present findings suggest that the inverse associations of birth weight and gestational age with systolic blood pressure are not explained by confounding resulting from family socioeconomic position or other factors that are shared by siblings. Variations in maternal metabolic or vascular health during pregnancy or placental implantation and function may explain these associations.

  10. Serum screening with Down's syndrome markers to predict pre-eclampsia and small for gestational age: Systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Langejans Marloes

    2008-08-01

    Full Text Available Abstract Background Reliable antenatal identification of pre-eclampsia and small for gestational age is crucial to judicious allocation of monitoring resources and use of preventative treatment with the prospect of improving maternal/perinatal outcome. The purpose of this systematic review was to determine the accuracy of five serum analytes used in Down's serum screening for prediction of pre-eclampsia and/or small for gestational age. Methods The data sources included Medline, Embase, Cochrane library, Medion (inception to February 2007, hand searching of relevant journals, reference list checking of included articles, contact with experts. Two reviewers independently selected the articles in which the accuracy of an analyte used in Downs's serum screening before the 25th gestational week was associated with the occurrence of pre-eclampsia and/or small for gestational age without language restrictions. Two authors independently extracted data on study characteristics, quality and results. Results Five serum screening markers were evaluated. 44 studies, testing 169,637 pregnant women (4376 pre-eclampsia cases and 86 studies, testing 382,005 women (20,339 fetal growth restriction cases met the selection criteria. The results showed low predictive accuracy overall. For pre-eclampsia the best predictor was inhibin A>2.79MoM positive likelihood ratio 19.52 (8.33,45.79 and negative likelihood ratio 0.30 (0.13,0.68 (single study. For small for gestational age it was AFP>2.0MoM to predict birth weight th centile with birth There were methodological and reporting limitations in the included studies thus studies were heterogeneous giving pooled results with wide confidence intervals. Conclusion Down's serum screening analytes have low predictive accuracy for pre-eclampsia and small for gestational age. They may be a useful means of risk assessment or of use in prediction when combined with other tests.

  11. Maternal glycated haemoglobin, pre-gestational weight, pregnancy weight gain and risk of large-for-gestational-age babies: a Danish cohort study of 209 singleton Type 1 diabetic pregnacies

    DEFF Research Database (Denmark)

    Nielsen, G.L.; Dethlefsen, Claus; Møller, M.

    2007-01-01

    Aims To examine the association between maternal glycated haemoglobin in the second half of diabetic pregnancies and the relative risk of delivering large-for-gestational-age (LGA) babies, controlling for maternal body mass index (BMI) before pregnancy, weight gain, age, White class and smoking...... to pregnancies with pre-pregnancy BMI > 23 kg/m2. We found no association between HbA1c and risk of delivering an LGA baby in pregnancies with lower BMI. Conclusion The positive association between glycated haemoglobin and birth of an LGA baby seems to be restricted to women with BMI > 23 kg/m2....... habits. Methods We identified all pregnant diabetic women in North Jutland County, Denmark from 1985 to 2003. Data on HbA1c values from the 20th gestational week to term were collected from medical records and the babies were classified as large, normal or small for gestational age. The association...

  12. The role of gestational diabetes, pre-pregnancy body mass index and gestational weight gain on the risk of newborn macrosomia: results from a prospective multicentre study.

    Science.gov (United States)

    Alberico, Salvatore; Montico, Marcella; Barresi, Valentina; Monasta, Lorenzo; Businelli, Caterina; Soini, Valentina; Erenbourg, Anna; Ronfani, Luca; Maso, Gianpaolo

    2014-01-15

    It is crucial to identify in large population samples the most important determinants of excessive fetal growth. The aim of the study was to evaluate the independent role of pre-pregnancy body mass index (BMI), gestational weight gain and gestational diabetes on the risk of macrosomia. A prospective study collected data on mode of delivery and maternal/neonatal outcomes in eleven Hospitals in Italy. Multiple pregnancies and preterm deliveries were excluded. The sample included 14109 women with complete records. Associations between exposure variables and newborn macrosomia were analyzed using Pearson's chi squared test. Multiple logistic regression models were built to assess the independent association between potential predictors and macrosomia. Maternal obesity (adjusted OR 1.7, 95% CI 1.4-2.2), excessive gestational weight gain (adjusted OR 1.9, 95% CI 1.6-2.2) and diabetes (adjusted OR 2.1, 95% CI 1.5-3.0 for gestational; adjusted OR 3.0, 95% CI 1.2-7.6 for pre-gestational) resulted to be independent predictors of macrosomia, when adjusted for other recognized risk factors. Since no significant interaction was found between pre-gestational BMI and gestational weight gain, excessive weight gain should be considered an independent risk factor for macrosomia. In the sub-group of women affected by gestational or pre-gestational diabetes, pre-gestational BMI was not significantly associated to macrosomia, while excessive pregnancy weight gain, maternal height and gestational age at delivery were significantly associated. In this sub-population, pregnancy weight gain less than recommended was not significantly associated to a reduction in macrosomia. Our findings indicate that maternal obesity, gestational weight gain excess and diabetes should be considered as independent risk factors for newborn macrosomia. To adequately evaluate the clinical evolution of pregnancy all three variables need to be carefully assessed and monitored.

  13. Conservative management of preterm premature rupture of membranes beyond 32 weeks' gestation: is it worthwhile?

    Science.gov (United States)

    Tsafrir, Z; Margolis, G; Cohen, Y; Cohen, A; Laskov, I; Levin, I; Mandel, D; Many, A

    2015-01-01

    We aimed to investigate whether conservative management of preterm premature rupture of membranes (PPROM) at 32-34 weeks' gestation improves outcome. In this retrospective analysis of singleton pregnancies, the study group included patients with PPROM at 28-34 weeks' gestation and the control group included patients presented with spontaneous preterm delivery at 28-34 weeks' gestation. Both groups were subdivided according to gestational age - early (28-31 weeks' gestation) versus late (32-34 weeks' gestation). Adverse neonatal outcome included neonatal death, intraventricular haemorrhage grade 3/4, respiratory distress syndrome, periventricular leucomalacia and neonatal sepsis. The study and control groups included 94 and 86 women, respectively. The study group had a lower incidence of adverse neonatal outcome at the earlier weeks (28-31), compared with the control group at the same gestational age. In contrast, at 32-34 weeks' gestation no difference in the risk for adverse neonatal outcome was noticed. Additionally, within the study group, chorioamnionitis rate was significantly higher among those who delivered at 32-34 weeks' gestation (p < 0.01). No advantage for conservative management of PPROM was demonstrated beyond 31 weeks' gestation. Moreover, conservative management of PPROM at 32-34 weeks' gestation may expose both mother and neonate to infectious morbidity.

  14. Fatores de risco para nascimento de crianças pequenas para idade gestacional Risk factors for small-for-gestational age births among infants in Brazil

    Directory of Open Access Journals (Sweden)

    Ana Maria Krusser Zambonato

    2004-02-01

    Full Text Available OBJETIVO: Determinar os fatores de risco para o nascimento de crianças pequenas para a idade gestacional. MÉTODOS: Nos meses de outubro a dezembro de 1996, cinco maternidades de Pelotas, RS, foram visitadas diariamente para entrevistar puérperas. O peso ao nascer foi obtido do registro dos berçários. A idade gestacional foi calculada a partir da data da última menstruação. Considerou-se como pequena para a idade gestacional (PIG aquelas crianças cujo peso ao nascer, de acordo com o sexo e a idade gestacional, estava abaixo do percentil 10 da população de referência de Williams. O teste qui-quadrado foi usado nas análises bivariadas e a regressão logística, não-condicional, na análise multivariada. RESULTADOS: Foram estudadas 1.082 puérperas e a prevalência de nascimento PIG foi de 13,1%. Mesmo após controle para possíveis fatores de confusão, as crianças cuja renda familiar era ³10 salários-mínimos. Um pré-natal de baixa qualidade também aumentou a chance de PIG (OR: 3,28 IC95% 1,09-9,91. Baixa estatura materna e exposição ao tabaco também estiveram associados com nascimentos PIG. CONCLUSÕES: O baixo nível socioeconômico, tabagismo materno, estatura materna e pré-natal de baixa qualidade foram os principais fatores de risco para PIG.OBJECTIVE: To assess the risk factors for small-for-gestational-age (SGA births. METHODS: All live births occurring in the city of Pelotas, Brazil, between October and December 1993 were identified and mothers interviewed soon after delivery. Birthweight was recorded by the maternity staff. Gestational age was obtained from the mothers' ´recall of their date of last menstrual period. SGA was defined as a birthweight below the 10th percentile for gestational age and sex, according to the reference developed by Williams. Chi-square test and logistic regression were used in the crude and multivariate analysis, respectively. RESULTS: In all, 1082 births were identified. The prevalence

  15. Reported prevalence of gestational diabetes in Scotland: The relationship with obesity, age, socioeconomic status, smoking and macrosomia, and how many are we missing?

    Science.gov (United States)

    Collier, Andrew; Abraham, E Christie; Armstrong, Julie; Godwin, Jon; Monteath, Kirsten; Lindsay, Robert

    2017-03-01

    Gestational diabetes mellitus (GDM) is defined as 'carbohydrate intolerance of varying degrees of severity with onset or first recognition during pregnancy,' and is associated with increased fetal and maternal risks. The aims of the present study were to investigate the prevalence of GDM in Scotland over 32 years (1981-2012), and using the data from 2012, to assess how GDM related to maternal body mass index, maternal age, parity, smoking, Scottish Index of Multiple Deprivation, infant gender and macrosomia status. GDM prevalence along with anthropometric, obstetric and demographic data were collected on a total of 1,891,097 women with a delivery episode between 1 January 1981 and 31 December 2012 using data extracted from the Scottish Morbidity Record 02. Univariate and multivariate logistic regression analysis was undertaken to investigate their association with GDM. A ninefold increase in GDM prevalence was observed from 1981 to 2012 (P macrosomia were positively associated with GDM. Reported smoking status at booking was inversely associated with GDM. Multivariable analysis showed that fetal macrosomia was not associated with GDM status. The present study confirmed that the reporting of GDM is low in Scotland, and that GDM is associated with maternal body mass index, maternal age, multiparity and social deprivation. GDM was negatively associated with smoking and requires further investigation. The lack of association between GDM and macrosomia (following multivariate analysis) might reflect the screening processes undertaken in Scotland. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

  16. Maternal and neonatal outcomes after implementation of a hospital policy to limit low-risk planned caesarean deliveries before 39 weeks of gestation: an interrupted time-series analysis.

    Science.gov (United States)

    Hutcheon, J A; Strumpf, E C; Harper, S; Giesbrecht, E

    2015-08-01

    To evaluate the extent to which implementing a hospital policy to limit planned caesarean deliveries before 39 weeks of gestation improved neonatal health, maternal health, and healthcare costs. Retrospective cohort study. British Columbia Women's Hospital, Vancouver, Canada, in the period 2005-2012. Women with a low-risk planned repeat caesarean delivery. An interrupted time series design was used to evaluate the policy to limit planned caesarean deliveries before 39 weeks of gestation, introduced on 1 April 2008. Composite adverse neonatal health outcome (respiratory morbidity, 5-minute Apgar score of policy, the proportion of planned caesareans dropped by 20 percentage points (adjusted risk difference of 20 fewer cases per 100 deliveries; 95% CI -25.8, -14.3) to 41% (1033/2518). The policy had no detectable impact on adverse neonatal outcomes (2.2 excess cases per 100; 95% CI -0.4, 4.8), maternal complications, or healthcare costs, but increased the risk of out-of-hours delivery from 16.2 to 21.1% (adjusted risk difference 6.3 per 100; 95% CI 1.6, 10.9). We found little evidence that a hospital policy to limit planned caesareans before 39 weeks of gestation reduced adverse neonatal outcomes. Hospital administrators intending to introduce such policies should anticipate, and plan for, modest increases in out-of-hours and emergency-timing. © 2015 Royal College of Obstetricians and Gynaecologists.

  17. Association of gestational age with the option of pregnancy termination for fetal abnormalities incompatible with neonatal survival.

    Science.gov (United States)

    Westphal, Flavia; Fustinoni, Suzete Maria; Pinto, Vânia Lopes; Melo, Patrícia de Souza; Abrahão, Anelise Riedel

    2016-01-01

    To identify the profile of women seen in a Fetal Medicine unit, diagnosed with fetal abnormality incompatible with neonatal survival in their current pregnancy, and to check the association of gestational age upon diagnosis with the option of pregnancy termination. This is a retrospective cohort study carried out in the Fetal Medicine Outpatients Clinic of a university hospital, in the city of São Paulo (SP), Brazil, using medical records of pregnant women with fetus presenting abnormalities incompatible with neonatal survival. The sample comprised 94 medical records. The Statistical Package for the Social Sciences (SPSS), version 19, was used for the data statistical analysis. The population of the study included young adult women, who had complete or incomplete high school education, employed, with family income of one to three minimum wages, single, nonsmokers, who did not drink alcoholic beverages or used illicit drugs. Women with more advanced gestational age upon fetal diagnosis (p=0.0066) and/or upon admission to the specialized unit (p=0.0018) presented a lower percentage of termination of pregnancy. Due to characteristics different from those classically considered as of high gestational risk, these women might not be easily identified during the classification of gestational risk, what may contribute to a late diagnosis of fetal diseases. Early diagnosis enables access to specialized multiprofessional care in the proper time for couple's counseling on the possibility of requesting legal authorization for pregnancy termination. Identificar o perfil de mulheres atendidas em um serviço de Medicina Fetal, que receberam diagnóstico de anomalia fetal incompatível com a sobrevida neonatal na gestação atual, e verificar a associação da idade gestacional no diagnóstico com a opção pela interrupção da gravidez. Trata-se de um estudo de coorte retrospectivo, realizado no ambulatório de Medicina Fetal de um hospital universitário da cidade de S

  18. Zinc status of breastfed and formula-fed infants of different gestational ages.

    Science.gov (United States)

    Hemalatha, P; Bhaskaram, P; Kumar, P A; Khan, M M; Islam, M A

    1997-02-01

    Zinc status in 186 full term and preterm infants was determined at birth, and 3, 6, 9, and 12 months of age along with determination of zinc levels in breast or formula milk to find out if routine zinc supplements are needed during infancy. The leukocyte and plasma zinc levels in all breastfed infants were high at birth and gradually declined reaching lowest values by 4-6 months of age, and improved to normal levels by 9 months following weaning. The preterm infants however, had significantly (P term infants. Colostrum of all the mothers had higher zinc concentrations which declined to significantly lower levels in breastmilk by 4-6 months of lactation, corresponding to the age when the breastfed infants had lower zinc levels. The improvement of the levels to normal after weaning suggests that the fall in zinc status during early infancy could be a transient phenomenon which could be reversed by proper weaning, thus strengthening the plea for timely food supplements rather than the need for single nutrient supplements. Formula-fed full term infants had significantly lower leukocyte zinc levels (49.3 +/- 2.59 micrograms/10(10) cells) at 3 months of age compared to breastfed infants of the same age (92.8 +/- 14.04 micrograms/10(10) cells). Even these infants improved their zinc status after weaning on par with breastfed infants. The functional significance of their transient, but low zinc values during early infancy needs to be investigated.

  19. Histologic Chorioamnionitis and Bronchopulmonary Dysplasia in Preterm Infants: The Epidemiologic Study on Low Gestational Ages 2 Cohort.

    Science.gov (United States)

    Torchin, Héloïse; Lorthe, Elsa; Goffinet, François; Kayem, Gilles; Subtil, Damien; Truffert, Patrick; Devisme, Louise; Benhammou, Valérie; Jarreau, Pierre-Henri; Ancel, Pierre-Yves

    2017-08-01

    To investigate the association between histologic chorioamnionitis (HCA) and bronchopulmonary dysplasia (BPD) in very preterm infants, both in a general population and for those born after spontaneous preterm labor and after preterm premature rupture of membranes (pPROM). This study included 2513 live born singletons delivered at 24-31 weeks of gestation from a national prospective population-based cohort of preterm births; 1731 placenta reports were available. HCA was defined as neutrophil infiltrates in the amnion, chorion of the membranes, or chorionic plate, associated or not with funisitis. The main outcome measure was moderate or severe BPD. Analyses involved logistic regressions and multiple imputation for missing data. The incidence of HCA was 28.4% overall: 38% in cases of preterm labor, 64% in cases of pPROM, and less than 5% in cases of vascular disorders. Overall, the risk of BPD after adjustment for gestational age, sex, and antenatal steroids was reduced for infants with HCA (HCA alone: aOR 0.6 [95% CI 0.4-0.9]; associated with funisitis: aOR 0.5 [95% CI 0.3-0.8]). This finding was explained by the high rate of BPD and low rate of chorioamnionitis among children with fetal growth restriction. HCA was not associated with BPD in the preterm labor (13.4% vs 8.5%; aOR 0.9; 95% CI 0.5-1.8) or in the pPROM group (12.9% vs 12.1%; aOR 0.6; 95% CI 0.3-1.3). In homogeneous groups of infants born after preterm labor or pPROM, HCA is not associated with BPD. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Association of pre-pregnancy body mass index, gestational weight gain with cesarean section in term deliveries of China.

    Science.gov (United States)

    Xiong, Chao; Zhou, Aifen; Cao, Zhongqiang; Zhang, Yaqi; Qiu, Lin; Yao, Cong; Wang, Youjie; Zhang, Bin

    2016-11-22

    China has one of the highest rates of cesarean sections in the world. However, limited epidemiological studies have evaluated the risk factors for cesarean section among Chinese women. Thus, the aim of this cohort study was to investigate the associations between pre-pregnancy BMI, gestational weight gain (GWG) and the risk of cesarean section in China. A total of 57,891 women with singleton, live-born, term pregnancies were included in this analysis. We found that women who were overweight or obese before pregnancy had an elevated risk of cesarean section. Women with a total GWG above the Institute of Medicine (IOM) recommendations had an adjusted OR for cesarean section of 1.45 (95% CI, 1.40-1.51) compared with women who had GWG within the IOM recommendations. Women with excessive BMI gain during pregnancy also had an increased risk of cesarean section. When stratified by maternal pre-pregnancy BMI, there was a significant association between excessive GWG and increased odds of cesarean section across all pre-pregnancy BMI categories. These results suggest that weight control efforts before and during pregnancy may help to reduce the rate of cesarean sections.

  1. Maternal and fetal outcome of mothers with gestational diabetes mellitus attending BIRDEM Hospital.

    Science.gov (United States)

    Sajani, T T; Rahman, M T; Karim, M R

    2014-04-01

    Gestational diabetes mellitus, most of which progress to type-2 diabetes mellitus is increasing worldwide. Identification of gestational diabetes and control of glucose can reduce such complications and improve maternal and neonatal health. A hospital based cross sectional study was conducted to find out maternal and fetal outcome of gestational diabetes from January to July 2011. Data were collected from 109 gestational diabetes mothers attending Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) hospital for delivery. Study revealed that gestational diabetes was more common among mothers aged >25 years old and multiparaous women. Mean gestational age of diagnosis was 16.82±9.54 weeks. Sixty eight (68%) mothers were diagnosed before 20 weeks of gestation and more than 90% mothers with gestational diabetes delivered by caesarean section. Mean pregnancy weight gain was 6.8±1.18kg. Adverse maternal outcome observed in 24% cases and adverse fetal outcome was present in 34% cases. In univariate analysis weeks of delivery and fasting blood sugar were statistically significantly associated with adverse pregnancy outcome. Babies born to mothers with only diet restriction had less birth weight than mothers with insulin therapy. Pregnancy thought to be the most vulnerable stage of women's life and protecting her health along with her fetus during this period yields a positive impact on the health of future generation. Particular attention should be given during antenatal period to initiate screening programme and treatment protocol for gestational diabetic mothers.

  2. Mortality of mothers from cardiovascular and non-cardiovascular causes following pregnancy complications in first delivery

    DEFF Research Database (Denmark)

    Lykke, Jacob Alexander; Langhoff-Roos, Jens; Lockwood, Charles J;

    2010-01-01

    The combined effects of preterm delivery, small-for-gestational-age offspring, hypertensive disorders of pregnancy, placental abruption and stillbirth on early maternal death from cardiovascular causes have not previously been described in a large cohort. We investigated the effects of pregnancy...... cardiovascular and non-cardiovascular causes following preterm delivery, small-for-gestational-age offspring and hypertensive disorders of pregnancy. We found that preterm delivery and small-for-gestational-age were both associated with subsequent death of mothers from cardiovascular and non...... cardiovascular and non-cardiovascular causes, while hypertensive disorders of pregnancy are markers of early death of mothers from cardiovascular causes....

  3. Neonatal pain-related stress, functional cortical activity and visual-perceptual abilities in school-age children born at extremely low gestational age.

    Science.gov (United States)

    Doesburg, Sam M; Chau, Cecil M; Cheung, Teresa P L; Moiseev, Alexander; Ribary, Urs; Herdman, Anthony T; Miller, Steven P; Cepeda, Ivan L; Synnes, Anne; Grunau, Ruth E

    2013-10-01

    Children born very prematurely (neonatal experience and neurodevelopment, remain poorly understood. Repeated procedural pain-related stress during neonatal intensive care has been proposed to contribute to altered neurocognitive development in these children. Due to critical periods in the development of thalamocortical systems, the immature brain of infants born at extremely low gestational age (ELGA; neonatal pain. In a cohort of school-age children followed since birth we assessed relations between functional brain activity measured using magnetoencephalogragy (MEG), visual-perceptual abilities and cumulative neonatal pain. We demonstrated alterations in the spectral structure of spontaneous cortical oscillatory activity in ELGA children at school-age. Cumulative neonatal pain-related stress was associated with changes in background cortical rhythmicity in these children, and these alterations in spontaneous brain oscillations were negatively correlated with visual-perceptual abilities at school-age, and were not driven by potentially confounding neonatal variables. These findings provide the first evidence linking neonatal pain-related stress, the development of functional brain activity, and school-age cognitive outcome in these vulnerable children.

  4. Fatores relacionados à presença de recém-nascidos grandes para a idade gestacional em gestantes com diabetes mellitus gestacional Factors related to the presence of large for gestational age newborns in pregnant women with gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Jean Carl Silva

    2009-01-01

    -Student test was used for the analysis of equality hypothesis between the averages of the two groups, and chi-square test, to check the groups' homogeneity concerning ratios. RESULTS: the groups did not show any significant difference concerning the gestational age, body mass index, weight gain along the gestation, number of previous pregnancies, fast glycemia in the oral glucose tolerance test after the ingestion of 75 g (TOTG 75 g, gestational age at delivery, glycemic values during the treatment, and the type of treatment used (p>0.05. In the group with neonatal macrosomia, there was a higher two-hour-glycemia in the TOTG 75 g (p=0.02, higher gestational age at the treatment onset (p=0.02, and a lower number of appointments at the health service (p<0.01. When adjusted to a logistic regression model, the most important factor (p<0.01 found to predict neonatal macrosomia was the two-hour-glycemia in the TOTG 75 g. CONCLUSIONS: the factors more frequently related to neonatal macrosomia were late treatment onset and, consequently, lower number of appointments and chiefly, high two-hour-glycemia in the TOTG 75 g.

  5. 足月小样儿气质的研究%Study on temperament of full-term small for gestational age infant

    Institute of Scientific and Technical Information of China (English)

    邹红梅; 宋燕燕; 李桦; 刘倩筠; 董海鹏; 吴志华

    2012-01-01

    目的 研究足月小样儿在气质维度及分型方面的特征.探讨足月小样儿对婴儿气质特征的影响,为足月小样儿的早期医疗干预提供理论依据.方法 应用Carey的RITQ对39名1~4个月的足月小样儿及40名正常婴儿进行测试比较.结果 足月小样儿组仅在活动水平1个维度分值显著低于正常组(χ2=7.607,P0.05).结论 足月小样儿具有一定的气质特征,在一定程度上对婴儿的心理行为发育产生了不良影响,应引起重视,并根据其气质特征进行早期干预.%Objective To study the temperament dimensionality and classification of full-term small for gestational age infants and explore the influence of full-term small for gestational age infants on temperament of infants, so as to provide some theoretical basis for early medical intervention for them. Methods RITQ developed by Carey was administered to 39 full-term small for gestational age infants aged 1-4 months and 40 normal infants. Results Full-term small for gestational age infants were significantly poorer in active level than normal infants (^ -1. 607, P 0. 05 ). Conclusion Full-term small for gestational age infants have certain temperament characteristics, which has negative effects on psychological and behavioral development of infants to a certain extent. Attention should be paid to that and early intervention is needed according to their temperament characteristics.

  6. Serum insulin-like growth factor-binding protein-2 levels and metabolic and cardiovascular risk factors in young adults and children born small for gestational age

    NARCIS (Netherlands)

    S.W.K. de Kort (Sandra); J. van Doorn (Jaap); A.G.M. van de Sande (Ad); R.W.J. Leunissen (Ralph); A.C.S. Hokken-Koelega (Anita)

    2010-01-01

    textabstractBackground: IGF binding protein (IGFBP)-2 might protect against cardiovascular disease. Small for gestational age (SGA) birth could be associated with a higher risk for type 2 diabetes mellitus and cardiovascular disease in later life. No data are available on the relationship between

  7. Earlier Age of Onset of Chronic Hypertension and Type 2 Diabetes Mellitus After a Hypertensive Disorder of Pregnancy or Gestational Diabetes Mellitus

    NARCIS (Netherlands)

    Heida, Karst Y.; Franx, Arie; Van Rijn, Bas B.; Eijkemans, Marinus J C; Boer, Jolanda M A; Verschuren, W.M. Monique; Oudijk, Martijn A.; Bots, Michiel L.; Van Der Schouw, Yvonne T.

    2015-01-01

    A prospective cohort study was conducted to assess the impact of a history of hypertensive disorder of pregnancy (HDP) or gestational diabetes mellitus (GDM) on the risk and age of onset of hypertension, type 2 diabetes mellitus (T2D), and cardiovascular disease (CVD) later in life, independent of

  8. Children and young adults born small for gestational age (SGA) : GH-IGF-IGFBP axis, insulin sensitivity, adipocytokines and body composition during and after growth hormone treatment

    NARCIS (Netherlands)

    M. van Dijk (Marije)

    2007-01-01

    textabstractThis doctoral thesis gives a detailed account of various studies, performed in short children born small for gestational age (SGA) participating in the third Dutch GH trial (IUGR-3 study), and in young SGA adults previously treated with GH in the first Dutch GH trial (SGA follow-up study

  9. Genetic and Environmental Factors in Pre- and Postnatal Growth Disorders: Studies in children born small for gestational age (SGA), with and without postnatal short stature

    NARCIS (Netherlands)

    W.A. Ester (Wietske)

    2009-01-01

    textabstractTh is thesis describes genetic and environmental factors which are important in pre- and postnatal growth disorders and specifi cally focuses on children born small for gestational age (SGA) with or without postnatal catch-up growth. It also presents a subclassifi cation of short SGA sub

  10. A randomised controlled trial evaluating IGF1 titration in contrast to current GH dosing strategies in children born small for gestational age

    DEFF Research Database (Denmark)

    Jensen, Rikke Beck; Thankamony, Ajay; O'Connell, Susan M

    2014-01-01

    BACKGROUND: Short children born small for gestational age (SGA) are treated with a GH dose based on body size, but treatment may lead to high levels of IGF1. The objective was to evaluate IGF1 titration of GH dose in contrast to current dosing strategies. METHODS: In the North European Small-for-...

  11. Longitudinal changes in insulin sensitivity and body composition of small-for-gestational-age adolescents after cessation of growth hormone treatment

    NARCIS (Netherlands)

    R.H. Willemsen (Ruben); A.C.S. Hokken-Koelega (Anita)

    2008-01-01

    textabstractContext: GH treatment reduces insulin sensitivity (Si). For small-for-gestational-age (SGA) subjects, who might have an increased risk to develop cardiovascular disease and type 2 diabetes, it is still uncertain how Si, β-cell function, and body composition change over time after stoppin

  12. Metabolic Health in Short Children Born Small for Gestational Age Treated With Growth Hormone and Gonadotropin-Releasing Hormone Analog : Results of a Randomized, Dose-Response Trial

    NARCIS (Netherlands)

    van der Steen, Manouk; Lem, Annemieke J.; van der Kaay, Danielle C. M.; Bakker-van Waarde, Willie M.; van der Hulst, Flip J. P. C. M.; Neijens, Floor S.; Noordam, Cees; Odink, Roelof J.; Oostdijk, Wilma; Schroor, Eelco J.; Westerlaken, Ciska; Hokken-Koelega, Anita C. S.

    2015-01-01

    Context: Previously we showed that pubertal children born small for gestational age (SGA) with a poor adult height (AH) expectation can benefit from treatment with GH1 mg/m(2) per day (similar to 0.033 mg/kg/d) in combination with 2 years of GnRH analog (GnRHa) and even more so with a double GH

  13. Growth in Small-for-Gestational-Age Preterm-Born Children from 0 to 4 Years : The Role of both Prematurity and SGA Status

    NARCIS (Netherlands)

    Bocca-Tjeertes, Inger F. A.; Reijneveld, Sijmen A.; Kerstjens, Jorien M.; de Winter, Andrea F.; Bos, Arend F.

    2013-01-01

    Background: Fullterm small-for-gestational-age children (SGAs) are known for their ability to catch up on growth. Nevertheless, increased risk of growth restriction remains. Evidence on preterm SGA children's growth is lacking. Objective: To determine absolute gains in height and weight, relative gr

  14. National and regional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010

    DEFF Research Database (Denmark)

    Lee, Anne C C; Katz, Joanne; Blencowe, Hannah

    2013-01-01

    BACKGROUND: National estimates for the numbers of babies born small for gestational age and the comorbidity with preterm birth are unavailable. We aimed to estimate the prevalence of term and preterm babies born small for gestational age (term-SGA and preterm-SGA), and the relation to low......-income countries (27% of livebirths), of whom 10·6 million infants were born at term and low birthweight. The prevalence of term-SGA babies ranged from 5·3% of livebirths in east Asia to 41·5% in south Asia, and the prevalence of preterm-SGA infants ranged from 1·2% in north Africa to 3·0% in southeast Asia. Of 18...... million low-birthweight babies, 59% were term-SGA and 41% were preterm-SGA. Two-thirds of small-for-gestational-age infants were born in Asia (17·4 million in south Asia). Preterm-SGA babies totalled 2·8 million births in low-income and middle-income countries. Most small-for-gestational-age infants were...

  15. Dependence of maternal serum [AFP]/[hCG] median ratios on age of gestation: comparison of trisomy 21 to euploid pregnancies.

    Science.gov (United States)

    Marcus-Braun, N; Birk, O; Manor, E; Segal, D; Harari, G; Toma, I; Shalev, S; Borochowitz, Z U; Yaron, Y; Sharony, R; Itzhaky, D; Shtoyerman, R; Appelman, Z; Braun, G

    2009-12-01

    Current risk calculations for trisomy 21, which are based on multiples of median (MoM), do not take into account possible differences between euploid and trisomy 21 pregnancies that may develop with gestational age. In order to optimize the predictive value of screening tests, we calculated the ratio between maternal serum concentration of alpha-fetoprotein (AFP) and that of human chorionic gonadotropin (hCG) in euploid and in trisomy 21 pregnancies. The medians of the concentration ratios, [AFP]/[hCG] at 16-21 weeks of gestation, were plotted as a function of gestational age for 307 cases of trisomy 21 and were compared with the medians of 30 549 normal karyotype cases. [AFP]/[hCG] ratio medians were independent of body weight and maternal age. There was a significant difference in the [AFP]/[hCG] ratio when comparing trisomy 21 and euploid pregnancies at each week. This difference became greater with advancing gestational age (P hCG] between euploid and trisomy 21 pregnancies, which may be used to improve detection rates of Down syndrome screening.

  16. Serum YKL-40 and uterine artery Doppler – a prospective cohort study, with focus on preeclampsia and small-for-gestational-age

    DEFF Research Database (Denmark)

    Gybel-Brask, Dorte; Høgdall, Estrid; Johansen, Julia

    2014-01-01

    OBJECTIVE: To test if serum YKL-40 is increased in women developing preeclampsia or small-for-gestational age fetuses. We also assessed the association between uterine artery pulsatility index, notching and serum YKL-40 levels. DESIGN: Prospective cohort study. SETTING: A primary referral unit fo...

  17. The PPAR-γ Pro12Ala polymorphism associates with weight gain during GH-treatment in short children born small for gestational age

    NARCIS (Netherlands)

    S.W.K. de Kort (Sandra); A.C.S. Hokken-Koelega (Anita)

    2010-01-01

    textabstractContext: Short children born small for gestational age (SGA) have a lean phenotype with lower insulin sensitivity and higher blood pressure. GH treatment results in weight gain, and a decrease in blood pressure and insulin sensitivity. However, not all children respond in the same way.

  18. In rats gestational iron deficiency does not change body fat or hepatic mitochondria in the aged offspring.

    Science.gov (United States)

    Rees, W D; Hay, S M; Hayes, H E; Birgovan, C; McArdle, H J

    2017-09-05

    Mitochondrial dysfunction and resulting changes in adiposity have been observed in the offspring of animals fed a high fat (HF) diet. As iron is an important component of the mitochondria, we have studied the offspring of female rats fed complete (Con) or iron-deficient (FeD) rations for the duration of gestation to test for similar effects. The FeD offspring were ~12% smaller at weaning and remained so because of a persistent reduction in lean tissue mass. The offspring were fed a complete (stock) diet until 52 weeks of age after which some animals from each litter were fed a HF diet for a further 12 weeks. The HF diet increased body fat when compared with animals fed the stock diet, however, prenatal iron deficiency did not change the ratio of fat:lean in either the stock or HF diet groups. The HF diet caused triglyceride to accumulate in the liver, however, there was no effect of prenatal iron deficiency. The activity of the mitochondrial electron transport complexes was similar in all groups including those challenged with a HF diet. HF feeding increased the number of copies of mitochondrial DNA and the prevalence of the D-loop mutation, however, neither parameter was affected by prenatal iron deficiency. This study shows that the effects of prenatal iron deficiency differ from other models in that there is no persistent effect on hepatic mitochondria in aged animals exposed to an increased metabolic load.

  19. Depression during gestation in adolescent mothers interferes with neonatal neurobehavior

    Directory of Open Access Journals (Sweden)

    Marina Carvalho de Moraes Barros

    2013-12-01

    Full Text Available Objective: To compare the neurobehavior of neonates born to adolescent mothers with and without depression during gestation. Methods: This prospective cross-sectional study included healthy term neonates born to adolescent mothers with untreated depression during gestation, without exposure to legal or illicit drugs, and compared them with infants born to adolescent mothers without psychiatric disorders. Maternal psychiatric diagnoses were assessed by the Composite International Diagnostic Interview (CIDI 2.1 and neonatal neurobehavior by the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS at 24 to 72 hours of life. Neurobehavioral outcomes were analyzed by ANOVA adjusted for confounders. Results: 37 infants born to mothers with depression during gestation were compared to 332 infants born to mothers without psychiatric disorders. Infants of mothers with depression had smaller head circumferences. Significant interactions of maternal depression and male gender, gestational age > 40 weeks, regional anesthesia during delivery, vaginal delivery, and infant head circumference ≥ 34 cm were found. Worse performance was noted in the following neonatal neurobehavioral parameters: arousal, excitability, lethargy, hypotonicity, and signs of stress and abstinence. Conclusion: Infants born to adolescent mothers with depression exhibit some behavioral changes in the first days of life. These changes are associated with infant sex, gestational age, type of anesthesia, mode of delivery, and head circumference.

  20. Intrahepatic cholestasis of pregnancy and timing of delivery.

    Science.gov (United States)

    Lo, Jamie O; Shaffer, Brian L; Allen, Allison J; Little, Sarah E; Cheng, Yvonne W; Caughey, Aaron B

    2015-01-01

    We examined the morbidities from delivery at earlier gestational ages versus intrauterine fetal demise (IUFD) for women with intrahepatic cholestasis of pregnancy (ICP) to determine the optimal gestational age for delivery. A decision-analytic model was created to compare delivery at 35 through 38 weeks gestation for different delivery strategies: (1) empiric steroids; (2) steroids if fetal lung maturity (FLM) negative; (3) wait a week and retest if FLM negative; or (4) deliver immediately. Literature review identified 18 studies that estimated IUFD in ICP; we used the mean rate, 1.74%, and assumed a uniform distribution from 34 to 40 weeks gestation. Large cohort data was used to calculate neonatal morbidity rates at each gestational age. Maternal and neonatal quality-adjusted life years (QALYs) were combined. Univariate sensitivity and Monte Carlo analyses were performed to test for robustness. Immediate delivery at 36 weeks without FLM testing and steroid administration was the optimal strategy as compared to delivery at 36 weeks with steroids (+47 QALYs) and as compared to immediate delivery at 35 weeks (+210 QALYs). Our results were robust up to a 30% increase in the rate of IUFD. Immediate delivery at 36 weeks in women with ICP is the optimal delivery strategy.

  1. Screening for aneuploidies by maternal age, fetal nuchal translucency and maternal serum biochemistry at 11-13+6 gestational weeks

    Directory of Open Access Journals (Sweden)

    Karadžov-Orlić Nataša

    2012-01-01

    Full Text Available Introduction. Aneuploidies are the major cause of perinatal death and early psychophysical disorders. Objective. In this study, we analyzed detection and false-positive rates of screening for aneuploidies in the first trimester by the combination of maternal age, fetal nuchal translucency (NT thickness and maternal serum free beta-human chorionic gonadotrophin (β-hCG, and pregnancy-associated plasma protein-A (PAPP-A at 11-13+6 weeks of gestation, using the appropriate software developed by the Fetal Medicine Foundation. Methods. Our screening study for aneuploidies analyzed 4172 singleton pregnancies from January 2006 to December 2010. The sensitivities and false-positive rates using the combined aneuploidies determination for the risk cut-off of 1:275 were evaluated. Results. In the trisomy 21 pregnancies, the fetal NT was higher than 95th centile, in 72.8%, serum free b-hCG concentration it was above the 95th centile in 55% and serum PAPP-A was below the 5th centile in 47% of the cases. In the trisomy 18 and 13, the fetal NT was above 95th centile in 66.6% and 44.4% of the cases, respectively. The serum free b-hCG concentration was above the 95th centile in 0 and 10%, but serum PAPP-A was below 5th centile in 80.9% and 88.8% of pregnancies. In the trisomy 21 pregnancies the median free beta-hCG was 2.3 MoM and the median PAPP-A was 0.45 MoM. Chromosomal abnormalities were detected in 169 fetuses: trisomy 21 (97, Turner syndrome (19, trisomy 18 (28, trisomy 13 (11 and others (14. Detection rate of combined screening for aneuploides were 86.0% with false positive rate of 5.3% (mean age 33±4.9 years, >35 years in 35% of pregnancies. Conclusion. Our study suggests that the strategy of first-trimester combined screening of biochemical values and ultrasonographic parameters at 12 gestational weeks identifies higher percentage of aneuploidies with a lower false-positive rate than a single parameter strategy.

  2. Screening for aneuploidies by maternal age, fetal nuchal translucency and maternal serum biochemistry at 11-13+6 gestational weeks.

    Science.gov (United States)

    Karadzov-Orlić, Natasa; Egić, Amira; Filimonović, Dejan; Marinković, Maja; Damnjanović-Pazin, Barbara; Milovanović, Zagorka; Joksić, Ivana; Branković, Snezana; Lukić, Relja; Mandić, Vesna; Cerović, Nikola; Mojović, Donka; Plamenac, Sanja; Stanković, Minja; Maglić, Dragana; Mikovć, Zeljko

    2012-01-01

    Aneuploidies are the major cause of perinatal death and early psychophysical disorders. In this study, we analyzed detection and false-positive rates of screening for aneuploidies in the first trimester by the combination of maternal age, fetal nuchal translucency (NT) thickness and maternal serum free beta-human chorionic gonadotrophin (beta-hCG), and pregnancy-associated plasma protein-A (PAPP-A) at 11-13+6 weeks of gestation, using the appropriate software developed by the Fetal Medicine Foundation. Our screening study for aneuploidies analyzed 4172 singleton pregnancies from January 2006 to December 2010. The sensitivities and false-positive rates using the combined aneuploidies determination for the risk cut-off of 1:275 were evaluated. In the trisomy 21 pregnancies, the fetal NT was higher than 95th centile, in 72.8%, serum free b-hCG concentration it was above the 95th centile in 55% and serum PAPP-A was below the 5th centile in 47% of the cases. In the trisomy 18 and 13, the fetal NT was above 95th centile in 66.6% and 44.4% of the cases, respectively.The serum free b-hCG concentration was above the 95th centile in 0 and 10%, but serum PAPP-A was below 5th centile in 80.9% and 88.8% of pregnancies. In the trisomy 21 pregnancies the median free beta-hCG was 2.3 MoM and the median PAPP-A was 0.45 MoM. Chromosomal abnormalities were detected in 169 fetuses: trisomy 21 (97), Turner syndrome (19), trisomy 18 (28), trisomy 13 (11) and others (14). Detection rate of combined screening for aneuploides were 86.0% with false positive rate of 5.3% (mean age 33 +/- 4.9 years, > 35 years in 35% of pregnancies). Our study suggests that the strategy of first-trimester combined screening of biochemical values and ultrasonographic parameters at 12 gestational weeks identifies higher percentage of aneuploidies with a lower false-positive rate than a single parameter strategy.

  3. There is an association between disease location and gestational age at birth in newborns submitted to surgery due to necrotizing enterocolitis.

    Science.gov (United States)

    Feldens, Letícia; Souza, João C K de; Fraga, José C

    2017-08-30

    To evaluate if there are differences regarding disease location and mortality of necrotizing enterocolitis, according to the gestational age at birth, in newborns submitted to surgery due to enterocolite. A historical cohort study of 198 newborns submitted to surgery due to necrotizing enterecolitis in a tertiary hospital, from November 1991 to December 2012. The newborns were divided into different categories according to gestational age (<30 weeks, 30-33 weeks and 6 days, 34-36 weeks and 6 days, and ≥37 weeks), and were followed for 60 days after surgery. The inclusion criterion was the presence of histological findings of necrotizing enterocolitis in the pathology. Patients with single intestinal perforation were excluded. The jejunum was the most commonly affected site in extremely premature infants (p=0.01), whereas the ileum was the most commonly affected site in premature infants (p=0.002), and the colon in infants born at term (p<0.001). With the increasing gestational age, it was observed that intestinal involvement decreased for the ileum and the jejunum (decreasing from 45% to 0% and from 5% to 0%, respectively), with a progressive increase in colon involvement (0% to 84%). Total mortality rate was 45.5%, and no statistical difference was observed in the mortality at different gestational ages (p=0.287). In newborns submitted to surgery due to necrotizing enterocolitis, the disease in extremely preterm infants was more common in the jejunum, whereas in preterm infants, the most affected site was the ileum, and in newborns born close to term, it was the colon. No difference in mortality was observed according to the gestational age at birth. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  4. Maternal Antioxidant Levels in Pregnancy and Risk of Preeclampsia and Small for Gestational Age Birth: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Cohen, Jacqueline M; Beddaoui, Margaret; Kramer, Michael S; Platt, Robert W; Basso, Olga; Kahn, Susan R

    2015-01-01

    Oxidative stress in preeclampsia and small for gestational age (SGA) birth suggests antioxidant supplementation could prevent these conditions. However, it remains unclear whether maternal antioxidant levels are systematically lower in these pregnancies. To conduct a systematic review of the association between maternal antioxidant levels during pregnancy and preeclampsia or SGA. We searched PubMed, Embase, and several other databases from 1970-2013 for observational studies that measured maternal blood levels of non-enzymatic antioxidants (vitamins A, C, E, and carotenoids) during pregnancy or within 72 hours of delivery. The entire review process was done in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale and additional questions. We pooled the standardized mean difference (SMD) across studies, stratified by outcome and pregnancy trimester, and investigated heterogeneity using meta-regression. We reviewed 1,882 unique citations and 64 studies were included. Most studies were small with important risk of bias. Among studies that addressed preeclampsia (n = 58) and SGA (n = 9), 16% and 66%, respectively, measured levels prior to diagnosis. The SMDs for vitamins A, C, and E were significantly negative for overall preeclampsia, but not for mild or severe preeclampsia subtypes. Significant heterogeneity was observed in all meta-analyses and most could not be explained. Evidence for lower carotenoid antioxidants in preeclampsia and SGA was limited and inconclusive. Publication bias appears likely. Small, low-quality studies limit conclusions that can be drawn from the available literature. Observational studies inconsistently show that vitamins C and E or other antioxidants are lower in women who develop preeclampsia or SGA. Reverse causality remains a possible explanation for associations observed. New clinical trials are not warranted in light of this evidence; however, additional rigorous observational studies measuring antioxidant levels

  5. Maternal Antioxidant Levels in Pregnancy and Risk of Preeclampsia and Small for Gestational Age Birth: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Jacqueline M Cohen

    Full Text Available Oxidative stress in preeclampsia and small for gestational age (SGA birth suggests antioxidant supplementation could prevent these conditions. However, it remains unclear whether maternal antioxidant levels are systematically lower in these pregnancies.To conduct a systematic review of the association between maternal antioxidant levels during pregnancy and preeclampsia or SGA.We searched PubMed, Embase, and several other databases from 1970-2013 for observational studies that measured maternal blood levels of non-enzymatic antioxidants (vitamins A, C, E, and carotenoids during pregnancy or within 72 hours of delivery. The entire review process was done in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale and additional questions. We pooled the standardized mean difference (SMD across studies, stratified by outcome and pregnancy trimester, and investigated heterogeneity using meta-regression.We reviewed 1,882 unique citations and 64 studies were included. Most studies were small with important risk of bias. Among studies that addressed preeclampsia (n = 58 and SGA (n = 9, 16% and 66%, respectively, measured levels prior to diagnosis. The SMDs for vitamins A, C, and E were significantly negative for overall preeclampsia, but not for mild or severe preeclampsia subtypes. Significant heterogeneity was observed in all meta-analyses and most could not be explained. Evidence for lower carotenoid antioxidants in preeclampsia and SGA was limited and inconclusive. Publication bias appears likely.Small, low-quality studies limit conclusions that can be drawn from the available literature. Observational studies inconsistently show that vitamins C and E or other antioxidants are lower in women who develop preeclampsia or SGA. Reverse causality remains a possible explanation for associations observed. New clinical trials are not warranted in light of this evidence; however, additional rigorous observational studies measuring antioxidant

  6. Maternal protein intake in pregnancy and offspring metabolic health at age 9-16 y: results from a Danish cohort of gestational diabetes mellitus pregnancies and controls

    DEFF Research Database (Denmark)

    Maslova, Ekaterina; Hansen, Susanne; Grunnet, Louise Groth

    2017-01-01

    in free-living populations remains limited.Objective: We examined the association of protein intake in pregnancy with offspring metabolic health at age 9-16 y in a longitudinal cohort that oversampled pregnancies with gestational diabetes mellitus (GDM).Design: Six hundred eight women with an index...... pregnancy affected by gestational diabetes mellitus and 626 controls enrolled in the Danish National Birth Cohort were used for the analysis. Protein (total, animal, vegetable) intake was assessed by using a food frequency questionnaire in gestational week 25. The offspring underwent a clinical examination...... including fasting blood samples and a dual-energy X-ray absorptiometry scan (subset of 650) from which metabolic outcomes were derived. Multivariable analyses were conducted applying a 1: 1 substitution of carbohydrates for protein.Results: The mean +/- SD protein intake in pregnancy was 93 +/- 15 g/d (16...

  7. The Association between Birth Weight and Gestational Age and Asthma in 6-7- and 13-14-Year-Old Children.

    Science.gov (United States)

    Raheleh, Zamani; Ahmad, Alikhani; Abtin, Heydarzadeh; Roghaye, Zare; Sara, Hashemain; Siavash, Rahimi

    2016-01-01

    Background. Previous studies that assessed the role of birth weight and gestational age in the risk of asthma have been conflicting. Objectives. To examine the association between birth weight and gestational age and symptoms of asthma. Patients and Methods. Subjects were 6656 school children of ages 6-7 and 13-14 years from urban districts of Mazandaran, Iran. ISAAC questionnaires were used. Results. There was an increased risk of "wheeze ever" in both age groups with birth weight under 2.5 kg and in all subgroups of low birth weight (LBW). Birth weight more than 3.5 kg was associated with lower risk of "severe asthma" in age group 6-7 years. With respect to gestational age, higher risks of "wheeze ever," "asthma ever," and "night cough in the past 12 months" were found in age group 13-14 years born before 37 weeks and the risk of "severe asthma" was higher in younger group (6-7 years). A lower risk of "asthma ever" was also found in 6-7-year-old children and 13-14-year-old girls who were born after 40 weeks. Conclusions. This study showed that there is a direct relation between "wheeze ever" and LBW and an inverse relation between risk of "severe asthma" and birth weight more than 3.5 kg.

  8. Bespoke program design for school-aged therapy disability service delivery.

    Science.gov (United States)

    Weatherill, Pamela; Bahn, Susanne; Cooper, Trudi

    2012-01-01

    This article uses the evaluation of a school-aged therapy service for children with disabilities in Western Australia to investigate models of service delivery. The current literature on family-centered practice, multidisciplinary and transdisciplinary approaches, and 4 models of service are reviewed. The models include the life needs model, the relational goal-orientated model of optimal service delivery to children and families, the quality of life model, and the collaborative model of service delivery. Analysis of the data is presented together with a bespoke model of service delivery for children with disabilities, arguing that local contexts benefit from custom-made service design.

  9. Effect of surfactant and partial liquid ventilation treatment on gas exchange and lung mechanics in immature lambs: influence of gestational age.

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    Carmen Rey-Santano

    Full Text Available OBJECTIVES: Surfactant (SF and partial liquid ventilation (PLV improve gas exchange and lung mechanics in neonatal RDS. However, variations in the effects of SF and PLV with degree of lung immaturity have not been thoroughly explored. SETTING: Experimental Neonatal Respiratory Physiology Research Unit, Cruces University Hospital. DESIGN: Prospective, randomized study using sealed envelopes. SUBJECTS: 36 preterm lambs were exposed (at 125 or 133-days of gestational age by laparotomy and intubated. Catheters were placed in the jugular vein and carotid artery. INTERVENTIONS: All the lambs were assigned to one of three subgroups given: 20 mL/Kg perfluorocarbon and managed with partial liquid ventilation (PLV, surfactant (Curosurf®, 200 mg/kg or (3 no pulmonary treatment (Controls for 3 h. MEASUREMENTS AND MAIN RESULTS: Cardiovascular parameters, blood gases and pulmonary mechanics were measured. In 125-day gestation lambs, SF treatment partially improved gas exchange and lung mechanics, while PLV produced significant rapid improvements in these parameters. In 133-day lambs, treatments with SF or PLV achieved similarly good responses. Neither surfactant nor PLV significantly affected the cardiovascular parameters. CONCLUSION: SF therapy response was more effective in the older gestational age group whereas the effectiveness of PLV therapy was not gestational age dependent.

  10. Baseline IGF-I Levels Determine Insulin Secretion and Insulin Sensitivity during the First Year on Growth Hormone Therapy in Children Born Small for Gestational Age. Results from a North European Multicentre Study (NESGAS)

    DEFF Research Database (Denmark)

    Jensen, Rikke Beck; Thankamony, Ajay; O'Connell, Susan M

    2013-01-01

    Objective: Developmental programming alters growth and metabolic outcome in children born small for gestational age (SGA). We explored insulin and glucose metabolism in SGA children treated with a fixed GH dose over 1 year. Methods: In the North European Small for Gestational Age Study (NESGAS), ...

  11. Review of metformin and glyburide in the management of gestational diabetes

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    Carroll DG

    2015-01-01

    Full Text Available Background: Worldwide, gestational diabetes affects 15% of pregnancies. It is recommended in patients with gestational diabetes to initiate diet therapy and if this is not adequate, insulin is the next treatment modality. While insulin is the preferred drug therapy to manage gestational diabetes in the majority of women, it may not always be the best option for all women. Objective: The purpose of this review is to assess the efficacy and safety of oral agents for treatment of gestational diabetes. Methods: A literature search of the MEDLINE, Ovid databases and Google Scholar was performed using the search term “gestational diabetes” combined with each “metformin” and “glyburide”. The time frame for the search was inception through August 2014. Randomized controlled trials and cohort (both prospective and retrospective trials, published in English, with human participants were included. Studies included only pregnant women diagnosed with gestational diabetes. Results: There were no significant differences in preterm deliveries, delivery modes, macrosomia, and birth weights and large for gestational age when utilizing glyburide vs insulin for gestational diabetes management. There were significantly higher neonatal intensive care unit admissions as well as longer lengths of stay for hypoglycemia and respiratory distress in babies whose mothers were treated with glyburide versus insulin. For the studies comparing metformin to insulin, there are no significant differences reported for birth weight, gestational age, delivery mode, prematurity and perinatal deaths. Women taking metformin may require supplemental insulin more frequently than those taking glyburide. Conclusion: Glyburide and metformin appear to be safe and effective to manage blood glucose in patients with gestational diabetes who prefer to not utilize insulin or who cannot afford insulin therapy. All other oral therapies to manage blood glucose levels during gestational

  12. Parallel-Machine Scheduling Problems with Past-Sequence-Dependent Delivery Times and Aging Maintenance

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    Wei-min Ma

    2015-01-01

    Full Text Available We consider parallel-machine scheduling problems with past-sequence-dependent (psd delivery times and aging maintenance. The delivery time is proportional to the waiting time in the system. Each machine has an aging maintenance activity. We develop polynomial algorithms to three versions of the problem to minimize the total absolute deviation of job completion times, the total load, and the total completion time.

  13. Association between delivery at an advanced maternal age and osteoporosis in elderly Korean women.

    Science.gov (United States)

    Ahn, Eunju; Lee, Jungkwon; Park, Yong Soon; Noh, Hye-Mi; Kim, Bo Ha

    2015-11-01

    Although several reproductive factors have been associated with low bone mineral density (BMD) in elderly women, few studies have evaluated the long-term effects of delivery at a high-risk maternal age on BMD. Using nationally representative survey data collected from 736 women aged 65 years or older, we evaluated the relationship between delivery during adolescence or at an age of 35 years or older and osteoporosis in elderly women. Data regarding demographic and socioeconomic characteristics, medical history, lifestyle risk factors, reproductive history, and history of osteoporosis and fracture were collected by administration of self-report questionnaires. Anthropometric data and BMD were measured in accordance with standardized guidelines. Independent determinants of BMD were identified by stepwise multiple linear regression analysis, and the resulting model was used to evaluate the risk of osteoporosis according to delivery during adolescence or at an advanced age. Of the 736 subjects, 426 (60.1 %) were found to have osteoporosis (T score ≤ -2.5), and 19.2 and 38.9 % reported delivery during adolescence and at an advanced age, respectively. The incidence of delivery during adolescence or at an advanced age was significantly higher in subjects with osteoporosis than in those without osteoporosis. After adjustment for covariates, multiple logistic regression analysis revealed that elderly women with a history of delivery at an advanced maternal age are at an increased (2.164-fold greater) risk of osteoporosis (95 % confidence interval 1.109-4.223) compared with elderly women without a history of delivery at an advanced age. However, a history of delivery during adolescence did not affect the risk.

  14. Spontaneous Uterine Rupture at 15 Weeks' Gestation in a Patient with a History of Cesarean Delivery after Removal of Shirodkar Cerclage

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    Serika Kanao

    2014-05-01

    Full Text Available A pregnant woman presented with acute upper abdominal pain and nausea at 15 weeks' gestation. She had a history of cesarean delivery for abruption after the removal of a Shirodkar cerclage that was placed because of cervical shortening caused by conization. She became pregnant again 14 months later. Ultrasonography revealed no significant findings, and a single intrauterine pregnancy with positive fetal heart activity was confirmed. An intestinal obstruction was suspected because abdominal radiography showed multiple air–fluid levels in the colon. Over the 3 hours following admission, her symptoms gradually worsened, and plain abdominal computed tomography (CT showed a large hemorrhage in the abdominal cavity, but the uterine wall appeared intact at this time. Subsequently, dynamic CT revealed discontinuity of the uterine muscle layer. During laparotomy, uterine rupture with complete opening of the uterine wall at the site of the previous transverse scar was identified. A dead fetus was located within the amniotic sac in a blood-filled abdominal cavity. She received a total of 10 units of packed red blood cells and 6 units of fresh frozen plasma for the resuscitation. She was discharged on the eighth postoperative day without any complications.

  15. A case-control study to examine the association between breastfeeding during late pregnancy and risk of a small-for-gestational-age birth in Lima, Peru.

    Science.gov (United States)

    Pareja, Rossina G; Marquis, Grace S; Penny, Mary E; Dixon, Philip M

    2015-04-01

    Excessive demands on maternal nutritional status may be a risk factor for poor birth outcomes. This study examined the association between breastfeeding during late pregnancy (≥ 28 weeks) and the risk of having a small-for-gestational-age (SGA) newborn, using a matched case-control design (78 SGA cases: birthweight <10th percentile for gestational age; 150 non-SGA controls: 50th percentile gestational age). Between March 2006 and April 2007, project midwives visited daily three government hospitals in Lima, Peru and identified cases and matched controls based on hospital, gestational age, and inter-gestational period. Mothers were interviewed and clinical chart extractions were completed. Factors associated with risk of SGA were assessed by their adjusted odds ratios (aOR) from conditional logistic regression. Exposure to an overlap of breastfeeding during late pregnancy was not associated with an increased risk of having a SGA newborn [aOR=0.58, 95% confidence interval (CI): 0.10-3.30]. However, increased risk was associated with having a previous low-birthweight birth (aOR=6.53; 95% CI: 1.43-29.70) and a low intake of animal source foods (<25th percentile; aOR=2.26; 95% CI: 1.01-5.04), and tended to be associated with being short (<150 cm; aOR=2.05; 95% CI: 0.92-4.54). This study found no evidence to support the hypothesis that breastfeeding during late pregnancy increases the risk for SGA; however, studies with greater statistical power are needed to definitively examine this possible association and clarify whether there are other risks to the new baby, the toddler and the pregnant woman. © 2012 Blackwell Publishing Ltd.

  16. The accuracy of using last menstrual period to determine gestational age for first trimester medication abortion: a systematic review.

    Science.gov (United States)

    Schonberg, Dana; Wang, Lin-Fan; Bennett, Ariana H; Gold, Marji; Jackson, Emily

    2014-11-01

    We sought to evaluate the accuracy of assessing gestational age (GA) prior to first trimester medication abortion using last menstrual period (LMP) compared to ultrasound (U/S). We searched Medline, Embase and Cochrane databases through October 2013 for peer-reviewed articles comparing LMP to U/S for GA dating in abortion care. Two teams of investigators independently evaluated data using standard abstraction forms. The US Preventive Services Task Force and Quality Assessment of Diagnostic Accuracy Studies guidelines were used to assess quality. Of 318 articles identified, 5 met inclusion criteria. Three studies reported that 2.5-11.8% of women were eligible for medication abortion by LMP and ineligible by U/S. The number of women who underestimated GA using LMP compared to U/S ranged from 1.8 to 14.8%, with lower rates found when the sample was limited to a GA abortion at GA abortion by LMP but ineligible by U/S is needed to confirm the safety and effectiveness of providing medication abortion using LMP alone to determine GA. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Fetal lung apparent diffusion coefficient measurement using diffusion-weighted MRI at 3 Tesla: Correlation with gestational age.

    Science.gov (United States)

    Afacan, Onur; Gholipour, Ali; Mulkern, Robert V; Barnewolt, Carol E; Estroff, Judy A; Connolly, Susan A; Parad, Richard B; Bairdain, Sigrid; Warfield, Simon K

    2016-12-01

    To evaluate the feasibility of using diffusion-weighted magnetic resonance imaging (DW-MRI) to assess the fetal lung apparent diffusion coefficient (ADC) at 3 Tesla (T). Seventy-one pregnant women (32 second trimester, 39 third trimester) were scanned with a twice-refocused Echo-planar diffusion-weighted imaging sequence with 6 different b-values in 3 orthogonal diffusion orientations at 3T. After each scan, a region-of-interest (ROI) mask was drawn to select a region in the fetal lung and an automated robust maximum likelihood estimation algorithm was used to compute the ADC parameter. The amount of motion in each scan was visually rated. When scans with unacceptable levels of motion were eliminated, the lung ADC values showed a strong association with gestational age (P < 0.01), increasing dramatically between 16 and 27 weeks and then achieving a plateau around 27 weeks. We show that to get reliable estimates of ADC values of fetal lungs, a multiple b-value acquisition, where motion is either corrected or considered, can be performed. J. Magn. Reson. Imaging 2016;44:1650-1655. © 2016 International Society for Magnetic Resonance in Medicine.

  18. Association between gestational age and birth weight on the language development of Brazilian children: a systematic review.

    Science.gov (United States)

    Zerbeto, Amanda B; Cortelo, Fernando M; C Filho, Élio B

    2015-01-01

    To review the literature that addresses the relationship between prematurity, birth weight, and development of language in Brazilian children. A systematic review of studies published between 2003 and 2012 in English and Portuguese and indexed in PubMed, LILACS, and SciELO. The following key words were used in the searches: Prematuro, Prematuridade, Linguagem, Prematurity, Language, Speech-Language Pathology. Fifty-seven articles were retrieved, 13 of which were included in the systematic review. The results showed an association between prematurity, low birth weight, and language development. In studies that made comparisons between preterm and term infants, there was evidence that preterm infants had poorer performance on indicators of language. It was also observed that children born with lower birth weight had a poorer performance on measures of language when compared to children with higher weight and closer to 37 weeks of gestational age. Regarding the type of language assessed, expression proved to be more impaired than reception. Higher parental education and family income were indicated as protective factors for the development of language. Conversely, lower birth weight and higher degree of prematurity emerged as risk factors. Preterm birth and low birth weight poses risks for the language development of children, especially in the first years of life. Therefore, it is essential that pediatricians are aware of the language development of these children to ensure proper treatment. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  19. Smoking ban and small-for-gestational age births in Ireland.

    Science.gov (United States)

    Kabir, Zubair; Daly, Sean; Clarke, Vanessa; Keogan, Sheila; Clancy, Luke

    2013-01-01

    Ireland introduced a comprehensive workplace smoke-free legislation in March, 2004. Smoking-related adverse birth outcomes have both health care and societal cost implications. The main aim of this study was to determine the impact of the Irish smoke-free legislation on small-for-gestationa- age (SGA) births. We developed a population-based birthweight (BW) percentile curve based on a recent study to compute SGA (BW births born between January 1999 and December 2008 were analyzed linking with monthly maternal smoking rates from a large referral maternity university hospital. We ran individual control and CUSUM charts, with bootstrap simulations, to pinpoint the breakpoint for the impact of ban implementation ( = April 2004). Monthly SGA rates (%) before and after April 2004 was considered pre and post ban period births, respectively. Autocorrelation was tested using Durbin Watson (DW) statistic. Mixed models using a random intercept and a fixed effect were employed using SAS (v 9.2). A total of 588,997 singleton live-births born between January 1999 and December 2008 were analyzed. vSGA and SGA monthly rates declined from an average of 4.7% to 4.3% and from 6.9% to 6.6% before and after April 2004, respectively. No auto-correlation was detected (DW = ~2). Adjusted mixed models indicated a significant decline in both vSGA and SGA rates immediately after the ban [(-5.3%; 95% CI -5.43% to -5.17%, pbirth rates both immediately and sustained over the post-ban period, reinforces the mounting evidence of the positive health effect of a successful comprehensive smoke-free legislation in a vulnerable population group as pregnant women.

  20. Age of dam and sex of calf adjustments and genetic parameters for gestation length in Charolais cattle.

    Science.gov (United States)

    Crews, D H

    2006-01-01

    To estimate adjustment factors and genetic parameters for gestation length (GES), AI and calving date records (n = 40,356) were extracted from the Canadian Charolais Association field database. The average time from AI to calving date was 285.2 d (SD = 4.49 d) and ranged from 274 to 296 d. Fixed effects were sex of calf, age of dam (2, 3, 4, 5 to 10, > or = 11 yr), and gestation contemporary group (year of birth x herd of origin). Variance components were estimated using REML and 4 animal models (n = 84,332) containing from 0 to 3 random maternal effects. Model 1 (M1) contained only direct genetic effects. Model 2 (M2) was G1 plus maternal genetic effects with the direct x maternal genetic covariance constrained to zero, and model 3 (M3) was G2 without the covariance constraint. Model 4 (M4) extended G3 to include a random maternal permanent environmental effect. Direct heritability estimates were high and similar among all models (0.61 to 0.64), and maternal heritability estimates were low, ranging from 0.01 (M2) to 0.09 (M3). Likelihood ratio tests and parameter estimates suggested that M4 was the most appropriate (P or = 11-yr-old cows, respectively. Bivariate animal models were used to estimate genetic parameters for GES with birth and adjusted 205-d weaning weights, and postweaning gain. Direct GES was positively correlated with direct birth weight (BWT; 0.34 +/- 0.04) but negatively correlated with maternal BWT (-0.20 +/- 0.07). Maternal GES had a low, negative genetic correlation with direct BWT (-0.15 +/- 0.05) but a high and positive genetic correlation with maternal BWT (0.62 +/- 0.07). Generally, GES had near-zero genetic correlations with direct and maternal weaning weights. Results suggest that important genetic associations exist for GES with BWT, but genetic correlations with weaning weight and postweaning gain were less important.

  1. Outcomes after physical examination-indicated cerclage in twin gestations.

    Science.gov (United States)

    Miller, Emily S; Rajan, Priya V; Grobman, William A

    2014-07-01

    To compare outcomes of physical examination-indicated cerclage in women with twin gestations to those with singleton gestations and to identify whether risk factors for extremely preterm birth (before 28 weeks) differ between these 2 groups. This is a single institution retrospective cohort study of women who underwent a physical examination-indicated cerclage between Jan. 1, 1980, and Aug. 15, 2012. Differences in characteristics and outcomes were compared between women with twin and singleton gestations. A multivariable analysis was performed to examine whether twin gestation was independently associated with delivery before 28 weeks and whether any effect modification was present between risk factors for preterm birth and the presence of a twin gestation. Of the 442 women who underwent a cerclage during the period of study, 104 (23.5%) had twins. Mean gestational age and digital cervical length at placement did not differ by plurality. Although twins were more likely to deliver at a slightly earlier median gestation than singletons (31.9 weeks; interquartile range, 24.9-35.1 vs 32.7 weeks; interquartile range, 24.6-38.3; P = .015), the frequency of delivery before 28 weeks did not differ between these 2 groups (33.7% vs 35.8%, P = .69). Greater cervical dilation and prolapsing membranes were identified as risk factors for birth digital cervical length twin gestations. Women with a twin pregnancy who received a physical examination-indicated cerclage had similar risk factors for extreme preterm birth and may experience similar obstetric outcomes as women with singleton gestations. Copyright © 2014 Mosby, Inc. All rights reserved.

  2. Maternal periconceptional and gestational low protein diet affects mouse offspring growth, cardiovascular and adipose phenotype at 1 year of age.

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    Adam J Watkins

    Full Text Available Human and animal studies have revealed a strong association between periconceptional environmental factors, such as poor maternal diet, and an increased propensity for cardiovascular and metabolic disease in adult offspring. Previously, we reported cardiovascular and physiological effects of maternal low protein diet (LPD fed during discrete periods of periconceptional development on 6-month-old mouse offspring. Here, we extend the analysis in 1 year aging offspring, evaluating mechanisms regulating growth and adiposity. Isocaloric LPD (9% casein or normal protein diet (18% casein; NPD was fed to female MF-1 mice either exclusively during oocyte maturation (for 3.5 days prior to mating; Egg-LPD, Egg-NPD, respectively, throughout gestation (LPD, NPD or exclusively during preimplantation development (for 3.5 days post mating; Emb-LPD. LPD and Emb-LPD female offspring were significantly lighter and heavier than NPD females respectively for up to 52 weeks. Egg-LPD, LPD and Emb-LPD offspring displayed significantly elevated systolic blood pressure at 52 weeks compared to respective controls (Egg-NPD, NPD. LPD females had significantly reduced inguinal and retroperitoneal fat pad: body weight ratios compared to NPD females. Expression of the insulin receptor (Insr and insulin-like growth factor I receptor (Igf1r in retroperitoneal fat was significantly elevated in Emb-LPD females (P<0.05, whilst Emb-LPD males displayed significantly decreased expression of the mitochondrial uncoupling protein 1 (Ucp1 gene compared to NPD offspring. LPD females displayed significantly increased expression of Ucp1 in interscapular brown adipose tissue when compared to NPD offspring. Our results demonstrate that aging offspring body weight, cardiovascular and adiposity homeostasis can be programmed by maternal periconceptional nutrition. These adverse outcomes further exemplify the criticality of dietary behaviour around the time of conception on long-term offspring

  3. Gestational Age, Infant Birth Weight, and Subsequent Risk of Type 2 Diabetes in Mothers: Nurses' Health Study II

    Science.gov (United States)

    ... P, Shufelt C, et al. Hypertensive disorders in pregnancy predict cardiovascular events: how good is maternal recall of preeclampsia and gestational hypertension. Symposia V “Gender Disparities in Cardiology”; 2011 American ...

  4. Regional placental blood oxygen level dependent (BOLD) changes with gestational age in normally developing pregnancies using long duration R2* mapping in utero

    Science.gov (United States)

    Dighe, Manjiri; Kim, Yun Jung; Seshamani, Sharmishtaa; Blazejewska, Ania I.; Mckown, Susan; Caucutt, Jason; Gatenby, Christopher; Studholme, Colin

    2016-03-01

    The aim of this study was to examine the use of R2* mapping in maternal and fetal sub-regions of the placenta with the aim of providing a reference for blood oxygenation levels during normative development. There have been a number of MR relaxation studies of placental tissues in-utero, but none have reported R2* value changes with age, or examined differences in sub-regions of the placenta. Here specialized long-duration Multi-frame R2* imaging was used to create a stable estimate for R2* values in different placental regions in healthy pregnant volunteers not imaged for clinical reasons. 27 subjects were recruited and scanned up to 3 times during their pregnancy. A multi-slice dual echo EPI based BOLD acquisition was employed and repeated between 90 and 150 times over 3 to 5 minutes to provide a high accuracy estimate of the R2* signal level. Acquisitions were also repeated in 13 cases within a visit to evaluate reproducibility of the method in a given subject. Experimental results showed R2* measurements were highly repeatable within a visit with standard deviation of (0.76). Plots of all visits against gestational age indicated clear correlations showing decreases in R2* with age. This increase was consistent was also consistent over time in multiple visits of the same volunteer during their pregnancy. Maternal and fetal regional changes with gestational age followed the same trend with increase in R2* over the gestational age.

  5. Umbilical cord versus maternal serum leptin and adioponectin levels: a comparative study in small and appropriate for gestational age newborns

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    Zakeri HR

    2009-10-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: The mechanisms by which fetal weight are regulated during pregnancy are poorly understood. The relation between hormones such as leptin and adiponectin and intrautrine growth is still under investigation. The aim of this study was to ascertain whether fetal growth restriction is associated with alterations of leptin and adiponectin  concentrations in venous umbilical cord blood and maternal serum."n"nMethods: Maternal serum and venous umbilical cord blood leptin and adiponectin concentrations were determined by ELISA after 36 week of gestational age in 22 women with uncomplicated singleton pregnancies with AGA fetuses (group A and in 22 women with singleton pregnancies complicated by fetal growth restriction but without fetal distress (group B, all with normal body mass index and without history of diabetes, hypertention or maternal cardiac disease."n"nResults: Venous umbilical cord leptin levels were significantly lower in group B compared with group A (8.1±0.8ng/ml versus 39.45±6.8ng/ml; p=0.001. Venous umbilical cord adiponectin levels were also significantly lower in group B compared with group A (28.8±3.5μg/ml versus 43.6±3.7μg/ml; p=0.007. Maternal serum leptin and adiponectin did not differ

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

    Energy Technology Data Exchange (ETDEWEB)

    Skranes, Jon S.; Brubakk, Ann-Mari [Norwegian University of Science and Technology, Department of Laboratory Medicine, Children' s and Women' s Health, Trondheim (Norway); Martinussen, Marit; Smevik, Olaug; Myhr, Gunnar [Norwegian University of Science and Technology, Department of Circulation and Imaging, Trondheim (Norway); Indredavik, Marit [Norwegian University of Science and Technology, Department of Neuroscience, Trondheim (Norway); Vik, Torstein [Norwegian University of Science and Technology, Department of Community Medicine and General Practice, Trondheim (Norway)

    2005-08-01

    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.)

  7. Comparison of Growth Parameters, Apgar score, the Blood Zinc, Magnesium, Calcium and Phosphor between Gestational Diabetic and Non-Gestational Diabetic Pregnant Women: a Prospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Mohammad Keshvari-Delavar

    2016-05-01

    Full Text Available Background: Due to little attention to the combined effect of diabetes and pregnancy on mother an infant’s microelements in literatures. This study aimed to compare newborns growth parameters, Apgar score, the cord blood zinc, magnesium, calcium and phosphor between pregnant women with and without gestational diabetes mellitus. Materials and Methods: This prospective cohort study was conducted in Hamadan city, Iran, during 2013-14. Gestational diabetes considered as exposure and 20 women with gestational diabetes were individually matched with the 20 non-diabetic pregnant women in terms of the variables age, number of pregnancies, and type of delivery were included in this study. The cord blood and mother vein blood samples were taken immediately after delivery. Results: The mean of newborn's head circumference was 34.85±0.9 cm and 33.90±0.97 cm in mothers with gestational diabetes and non- diabetic mothers respectively (P

  8. Mortality of mothers from cardiovascular and non-cardiovascular causes following pregnancy complications in first delivery

    DEFF Research Database (Denmark)

    Lykke, Jacob Alexander; Langhoff-Roos, Jens; Lockwood, Charles J

    2010-01-01

    The combined effects of preterm delivery, small-for-gestational-age offspring, hypertensive disorders of pregnancy, placental abruption and stillbirth on early maternal death from cardiovascular causes have not previously been described in a large cohort. We investigated the effects of pregnancy...... complications on early maternal death in a registry-based retrospective cohort study of 782 287 women with a first singleton delivery in Denmark 1978-2007, followed for a median of 14.8 years (range 0.25-30.2) accruing 11.6 million person-years. We employed Cox proportional hazard models of early death from...... and small-for-gestational-age offspring 3.30 [2.25, 4.84]; preterm delivery, small-for-gestational-age offspring and pre-eclampsia 3.85 [2.07, 7.19]. Thus, we conclude that, separately and combined, preterm delivery and small-for-gestational-age are strong markers of early maternal death from both...

  9. Reduced fetal telomere length in gestational diabetes.

    Directory of Open Access Journals (Sweden)

    Jian Xu

    Full Text Available Gestational diabetes mellitus (GDM is an important complication of pregnancy that poses significant threats to women and their offspring. Telomere length shortens as cellular damage increases and is associated with metabolic diseases. Telomere length in fetal leucocytes was determined in 82 infants of women with GDM (N = 82 and 65 normal pregnant women (N = 65. Women with preeclampsia (N = 45 and gestational hypertension (N = 23 were also studied. In the GDM group, telomere length was significantly shorter than normal pregnancy (P = 0.028, but there were no significant differences in fetal telomere length between preeclampsia and normal pregnancy (P = 0.841 and between gestational hypertension and normal pregnancy (P = 0.561. Regression analysis revealed that fetal telomere length was significantly associated with intrauterine exposure to GDM (P = 0.027 after adjustment for maternal age, gestational age at delivery, birth weight and fetal gender. Shortened telomere length may increase the risk of metabolic diseases in adulthood of GDM offspring.

  10. Peroxisome proliferator-activated receptor gamma modulation and lipogenic response in adipocytes of small-for-gestational age offspring

    Directory of Open Access Journals (Sweden)

    Yee Jennifer K

    2012-06-01

    Full Text Available Abstract Background Small-for-gestational age (SGA at birth increases risk of development of adult obesity and insulin resistance. A model of SGA rat offspring has been shown to exhibit increased adipose tissue expression of a key adipogenic transcription factor, peroxisome proliferator-activated receptor gamma (PPARγ, and increased fatty acid de novo synthesis during the nursing period, prior to onset of obesity. PPARγ agonists have been studied for potential use in the prevention of insulin resistance. Moreover, SGA adipocytes exhibit age-dependent differences in lipogenesis as mediated by PPARγ. The effects of PPARγ modulators on lipogenic gene expression and de novo lipogenesis on the age-dependent changes in SGA adipocytes are not known. The objectives of this study were: 1 to determine the adipogenic and lipogenic potential in SGA adipocytes at postnatal day 1 (p1 and day 21 (p21, 2 to determine how the PPARγ activator- and repressor-ligands affect the lipogenic potential, and 3 to determine the fatty acid metabolic response to PPARγ activator-ligand treatment. Methods Primary adipocyte cultures from p1 and p21 SGA and Control male offspring were established from a known maternal food-restriction model of SGA. Cell proliferation and Oil Red O (ORO staining were quantified. Adipocytes were treated with increasing doses of rosiglitazone or bisphenol-A diglycidyl ether (BADGE. PPARγ and SREBP1 protein expression were determined. De novo lipogenesis with rosiglitazone treatment at p21 was studied using 50% U13C-glucose and gas chromatography/mass spectrometry. Results At p1 and p21, SGA demonstrated increased cell proliferation and increased ORO staining. At p21, SGA demonstrated increased lipogenic gene expression and increased glucose-mediated fatty acid de novo synthesis compared with Controls. In response to rosiglitazone, SGA adipocytes further increased glucose utilization for fatty acid synthesis. SGA lipogenic gene expression

  11. 深圳不同胎龄初生儿生长发育与母亲分娩年龄的相关性分析%Correlation Analysis of Newborn Growth with Different Gestational Age and Maternal Childbirth Age

    Institute of Scientific and Technical Information of China (English)

    李优聪; 何凤梅; 黄素兰

    2015-01-01

    Objective To analyze the different gestational age newborn growth development and maternal age and correlation , and to explore the relationship between neonatal physical and other mothers ,feeding patterns .Methods Selected hospital delivery of 219 cases of new -born infants as the object of study .According to the gestational age were divided into 93 preterm infants and full-term infants in the observation group ,126 cases were recorded as control group .Contrast two groups of growing condition .Re‐sults The observation group's weight ,height ,sitting height and head circumference were significantly lower than the control group , less than 25 of the proportion of gestation age was higher than that of control group ,age > 30 was lower than the control group , mother education level below junior middle school ,six months before the artificial feeding and the proportion of various complications were significantly higher than that of the control group .The differences were statistically significant (P < 0 .05) .The correlation a‐nalysis showed that higher maternal age ,mother cultural degree in junior high school and above ,six month before the breast feeding mother and complication rate ,the lower the neonatal growth and development of better .At last ,the weight and height of the obser‐vation group were less than those of the control group by the same nursing method ,in 3 ,6 months of age ,the body weight and height data of the observation group were less than the control group ,there was no significant differences between the two groups of newborns in 12 months of age .Conclusion The growth and development of Shenzhen in different gestational age showed dif‐ferent trends ,which significantly better physique in full-term infants ,mother's age and culture degree relatively high point , the breastfeeding and maternal complications of pregnancy ,the lower the percentage of neonatal growth and development better .And after the birth of the newborn ,the use of

  12. Angiogenic factors at diagnosis of late-onset small-for-gestational age and histological placental underperfusion.

    Science.gov (United States)

    Triunfo, S; Lobmaier, S; Parra-Saavedra, M; Crovetto, F; Peguero, A; Nadal, A; Gratacos, E; Figueras, F

    2014-06-01

    This study was designed to explore the association between angiogenic factors levels at diagnosis of small-for-gestational age (SGA) and placental underperfusion (PUP). In a cohort of SGA singleton pregnancies, each delivered at >34 weeks, uterine (UtA), umbilical (UA), and middle cerebral (MCA) arteries were evaluated by Doppler upon diagnosis of SGA status. In addition, maternal circulating concentrations of placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) were assayed by ELISA, and each placenta was evaluated for histologic signs of PUP using a hierarchical and standardized classification system. Logistic regression was applied to analyze independent relationships (at diagnosis) between angiogenic factors and Doppler parameters. A total of 122 suspected SGA pregnancies were studied, 70 (57.4%) of which ultimately met PUP criteria. In this group, 85 placental findings qualified as PUP. Both mean UtA pulsatility index z-values (1.26 vs. 0.84; p = 0.038) and PlGF multiples of normal median (0.21 vs. 0.55; p = 0.002) differed significantly in pregnancies with and without PUP, respectively. By logistic regression, PlGF alone was independently predictive of PUP (OR = 0.11 [95% CI 0.025-0.57]; p = 0.008). Histologic placental abnormalities in term SGA neonates reflect latent insufficiency in uteroplacental blood supply. The heightened risk of adverse perinatal outcomes in this context underscores a need for new Doppler or biochemical prenatal markers of placental disease. Angiogenic factors may be pivotal identifying SGA neonates. Diminished circulating levels of placental growth factor, determined upon discovery of SGA status, are associated with histologic evidence of PUP. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Intrauterine transmission and clinical outcome of 248 pregnancies with primary cytomegalovirus infection in relation to gestational age.

    Science.gov (United States)

    Enders, Gisela; Daiminger, Anja; Bäder, Ursula; Exler, Simone; Enders, Martin

    2011-11-01

    The risk of intrauterine cytomegalovirus (CMV) infection and disease in the fetus or newborn largely depends on time of primary maternal infection during pregnancy. Prospective cohort study of pregnancy outcome in relation to gestational age at primary maternal CMV infection. In a total of 248 pregnancies with primary infection the onset of infection was determined by IgG seroconversion, IgG avidity and/or onset of clinical symptoms. Congenital infection was diagnosed by CMV detection in amniotic fluid, fetal tissue or urine of the neonate in the first 2 weeks of life. Clinical symptoms were retrieved from ultrasound and medical records. The intrauterine transmission rates following primary CMV infection in the pre- and periconceptional period were 16.7% (4/24) and 34.5% (10/29), respectively. For the first, second and third trimester of pregnancy transmission rates were 30.1% (25/83), 38.2% (29/76) and 72.2% (26/36), respectively. The rate of symptomatically infected fetuses or newborns at birth was 22.8% for any symptoms and 10.3% for severe manifestations. No symptoms were observed in infected newborns of mothers with primary infection in the preconceptional period and in the third trimester. The risk of intrauterine transmission following primary maternal infection in the third trimester is high, but the risk of neonatal disease is low. The highest risk of severe symptoms in the fetus and newborn exists around conception and in the first trimester of pregnancy. Copyright © 2011 Elsevier B.V. All rights reserved.

  14. The joint influence of marital status, interpregnancy interval, and neighborhood on small for gestational age birth: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Wu Yuquan

    2008-02-01

    Full Text Available Abstract Background Interpregnancy interval (IPI, marital status, and neighborhood are independently associated with birth outcomes. The joint contribution of these exposures has not been evaluated. We tested for effect modification between IPI and marriage, controlling for neighborhood. Methods We analyzed a cohort of 98,330 live births in Montréal, Canada from 1997–2001 to assess IPI and marital status in relation to small for gestational age (SGA birth. Births were categorized as subsequent-born with short (intermediate (12–35 months, or long (36+ months IPI, or as firstborn. The data had a 2-level hierarchical structure, with births nested in 49 neighborhoods. We used multilevel logistic regression to obtain adjusted effect estimates. Results Marital status modified the association between IPI and SGA birth. Being unmarried relative to married was associated with SGA birth for all IPI categories, particularly for subsequent births with short (odds ratio [OR] 1.60, 95% confidence interval [CI] 1.31–1.95 and intermediate (OR 1.48, 95% CI 1.26–1.74 IPIs. Subsequent births had a lower likelihood of SGA birth than firstborns. Intermediate IPIs were more protective for married (OR 0.50, 95% CI 0.47–0.54 than unmarried mothers (OR 0.65, 95% CI 0.56–0.76. Conclusion Being unmarried increases the likelihood of SGA birth as the IPI shortens, and the protective effect of intermediate IPIs is reduced in unmarried mothers. Marital status should be considered in recommending particular IPIs as an intervention to improve birth outcomes.

  15. Renewal and preliminary study of expressed sequence tags database on human fetal liver aged 22 wk of gestation

    Institute of Scientific and Technical Information of China (English)

    CHEN TingGui; WU SongFeng; ZHOU GangQiao; ZHU YunPing; HE FuChu

    2008-01-01

    With the developments of international human transcriptome data and our ESTs of human fetal liver aged 22 weeks (wk) of gestation (HFL22w), the former research must be renewed. In this work, the EST data were firstly clustered by blasting against the ESTs of HFL22w, UniGene, DOTS, MGC and Twin-scan-predicted human transcriptome. Then, after EST assembly and gene identification, the known genes were classified by GO (gene ontology), and the unknown genes were predicted by Pfam and ScanProsite to clarify their functions. In the end, the relations of 5 tissues including fetal liver, adult liver, bone marrow, thymus and lymph node that possess hemopoiesis or can indicate fetal liver char-acteristics were analyzed by hierarchical clustering. The results show that: (i) By comparing the 5 newest human transcriptome databases, we can largely reduce the probability that the ESTS belonging to unconnected parts of one gene were probably divided into different clusters, so it is recommended to blast against the newest databases when clustering EST data; (ii) some previous unknown ESTs had been identified as function-known genes, and 1379 genes were identified as fully new sequences pos-sessed in our lab; (iii) through GO classification, we got a rough understanding of HFL22w, and ob-tained 6 cell migration genes and 6 hemopoiesis genes; (iv) prediction of gene function had enabled us to obtain 277 profiles, among them, there are 5 categories distributed in more than 10 genes; (v) five tissue relations analyzed by hierarchical clustering are related to their functions; (vi) We have built the world's largest EST database on HFL22w. Renewal and preliminary analysis of EST database on HFL22w will help to understand hemopoiesis and cell migration mechanism, and promote future re-search on human fetal liver.

  16. Psychomotor and intellectual development (Neurocognitive Function) of children born small for gestational age (SGA). Transversal and longitudinal study.

    Science.gov (United States)

    Puga, Beatriz; Puga, Paloma Gil; de Arriba, Antonio; Armendariz, Yolanda; Labarta, Jose I; Longas, Angel Ferrandez

    2009-02-01

    Although much is now known about the effects of intrauterine growth retardation (IUGR) on children born SGA with regard to anthropometric and biochemical parameters and their treatment, there are still many gaps associated with its impact on neurocognitive functions. In our experience published several years ago, IUGR has a negative effect on neurocognitive development, regardless of whether these children showed evidence of catch-up growth or not or of the socio-economic conditions that might contribute to the situation. We have now accumulated a large number of cases, many of whom have been followed longitudinally, some for up to 7 years, many having been treated with GH from the time when this therapy was first approved by the EMA. Apart from the cases mentioned, other confounding factors such as gestational age, Apgar score, neonatal comorbidity and the possible effects of GH treatment have also been included. In addition and using our own reference standards, we now present our experience, which confirms what we had already noted in the past, that IUGR is in itself a condition that often causes psychomotorintellectual impairment, may be extremely severe and tends to worsen. This negative impact of IUGR on neurocognitive development does not depend on how the child grows,spontaneous growth is better and when growth is not altered by GH therapy. Later studies will be able to confirm whether early treatment with GH throughout the 2nd year of life, or an early specific stimulation programme, or the sum of both, can improve the neurocognitive development of these children. IUGR prevention, acting on causal factors that are partly avoidable such as smoking, working conditions and stress during pregnancy (see the corresponding article in this supplement) proves once again to be the best way to stop this negative impact on the IQ of many children born SGA.

  17. Small for gestational age and adulthood risk of disability pension: the contribution of childhood and adulthood conditions.

    Science.gov (United States)

    Helgertz, Jonas; Vågerö, Denny

    2014-10-01

    Early exiting from the labor force and into disability pension (DP) represents a major social problem in Sweden and elsewhere. We examined how being asymmetric (A-SGA) or symmetric (S-SGA) small for gestational age predicts transitioning into DP. We analyzed a longitudinal sample of 8125 men and women from the Stockholm Birth Cohort (SBC), born in 1953 and not on DP in 1990. The SBC consists of data from various sources, including self-reported information and data from administrative registers. The follow-up period was from 1991 to 2009. Yearly information on the receipt of DP benefits from register data was operationalized as a dichotomous variable. 13 percent of the sample moved into DP during follow-up. Cox proportional hazards regression was used to examine whether disadvantageous fetal growth--A-SGA and S-SGA--predicted DP. Men and women born A-SGA had a substantially increased hazard of DP. The full model suggested a hazard ratio of 1.68 (CI: 1.11-2.54), only being affected slightly by adulthood conditions. Several childhood conditions were also associated with DP. Such factors, however, mainly affected DP risk through adulthood conditions. The effect of SGA on DP appeared particularly strong among individuals from socioeconomically disadvantaged backgrounds. The evidence presented suggests that being A-SGA influences the risk of DP, independent of childhood and adulthood conditions, and similarly for men and women. Due to A-SGA being rather infrequent, reducing the occurrence of A-SGA would, however, only have a marginal impact on the stock of DP pensioners. For the individual affected, the elevation in the risk of DP was nevertheless substantial. Other childhood conditions exercised a larger influence on the stock of DP recipients, but they mostly operated through adulthood attainment. The importance of socioeconomic resources in childhood for the long term health consequences of SGA is interesting from a policy perspective and warrants further research.

  18. STUDY OF VISUAL EVOKED POTENTIAL IN TERM, APPROPRIATE FOR GESTATIONAL AGE NEWBORNS IN A TERTIARY HEALTH CARE FACILITY OF KOLKATA

    Directory of Open Access Journals (Sweden)

    Koushik

    2016-02-01

    Full Text Available INTRODUCTION Evoked potentials are small magnitude electrical potentials that originate within neural tissues in response to a variety of stimuli which are depicted as a wave or a series of waves. Changes in the wave latencies and amplitudes have been shown to reflect disturbances in neuronal growth rates & myelination of the developing nervous system. Among the different evoked potentials, the Visual Evoked Potentials (VEP, have been shown to be a significantly accurate tool for assessing the degree of neurological handicap among survivors of perinatal asphyxia, especially in the full-term neonates. Thus, the development of a normative database of VEP parameters like wave latencies and amplitudes for term, appropriate-for-gestational age neonates in an Indian NICU set-up was the primary objective of our study as such data can be of great use for future clinical use. The study was a prospective observational study carried out jointly by the Departments of Neonatology and Physiology, of IPGME & R and SSKM Hospital, Kolkata from June’ 2012 to September’ 2013. Normative statistics like ‘mean±2SD’ values for N1, P1 & N2 wave latencies of both right & left eyes & also for inter-peak amplitudes (i.e. N1-P1 & P1-N2 of both the eyes was obtained by studying 40 healthy, term newborns. It was also observed that the ‘latencies’ of VEP waves do not vary significantly between normal male & female newborn babies and the latencies of both the eyes are comparable. The ‘inter-peak amplitudes’ on the other hand showed much more variability. Hence establishing a normative database of VEP parameters can be of much use and further studies with much larger sample size is highly recommended.

  19. Small-for-Gestational-Age Births in Pregnant Women with HIV, due to Severity of HIV Disease, Not Antiretroviral Therapy

    Directory of Open Access Journals (Sweden)

    Erika Aaron

    2012-01-01

    Full Text Available Objectives. To determine rate and factors associated with small-for-gestational-age (SGA births to women with HIV. Methods. Prospective data were collected from 183 pregnant women with HIV in an urban HIV prenatal clinic, 2000–2011. An SGA birth was defined as less than the 10th or 3rd percentile of birth weight distribution based upon cut points developed using national vital record data. Bivariate analysis utilized chi-squared and t-tests, and multiple logistic regression analyses were used. Results. The prevalence of SGA was 31.2% at the 10th and 12.6% at the 3rd percentile. SGA at the 10th (OR 2.77; 95% CI, 1.28–5.97 and 3rd (OR 3.64; 95% CI, 1.12–11.76 percentiles was associated with cigarette smoking. Women with CD4 count >200 cells/mm3 at the first prenatal visit were less likely to have an SGA birth at the 3rd percentile (OR 0.29; 95% CI, 0.10–0.86. Women taking NNRTI were less likely to have an SGA infant at the 10th (OR 0.28; 95% CI, 0.10–0.75 and 3rd (OR 0.16; 95% CI, 0.03–0.91 percentiles compared to those women on PIs. Conclusions. In this cohort with high rates of SGA, severity of HIV disease, not ART, was associated with SGA births after adjusting for sociodemographic, medication, and disease severity.

  20. Gestational diabetes mellitus diagnosed in different periods of gestation and neonatal outcome

    Directory of Open Access Journals (Sweden)

    Aqueela Ayaz

    2009-01-01

    Full Text Available Objective: To evaluate the maternal and neonatal out-comes in women diagnosed as gestational diabetes mel-litus (GDM in different periods of pregnancy.Materials and Methods: This descriptive observational study was carried out from 1st January 2007 to 31th De-cember 2007 in the department of Obstetrics and Gyne-cology of a 1300 bedded tertiary care hospital "Bahawal Victoria Hospital" in Bahawalpur, Pakistan. Seventy six pregnant women met the inclusion criteria of diabetes diagnosed on the basis of the Oral glucose tolerance test (OGTT according to the National Diabetic Data Group. The study subjects were divided on the basis of gestational age at the first time diagnosis of GDM in the current pregnancy into group A (gestational age 13-23 weeks, group B (24-30 weeks and group C (31-36 weeks.Results: Out of total study subjects, 19 (25% were di-agnosed as GDM between 13-23 weeks of gestation (early-onset, 25 (32.9% between 24-30 weeks while 32 (42.1% diagnosed in the gestational age of 31-35 weeks (late-onset. Pregnancy-induced hypertension 5 (26.3%, polyhydramnios 5 (26.3% and insulin treat-ment 13 (68.4% were higher in women with earlier GDM diagnosis (p<0.05. APGAR score at 5-min below seven was seen in 3 (15.8%, large for gestational age in 5 (26.3%, respiratory distress in 6 (31.5% and pre-term delivery in 5 (26.3% of the early GDM group. These complications were seen more frequently in the early group compared with late-onset GDM group (p<0.05. Conclusion: Earlier diagnosis of GDM was seem to be associated with less favorable newborn outcome.

  1. Polymorphisms in the IGF1 and IGF1R genes and children born small for gestational age: results of large population studies.

    Science.gov (United States)

    Ester, W A; Hokken-Koelega, A C S

    2008-06-01

    Small for gestational age (SGA) is the term used to describe a group of children born with a birth weight and/or birth length below the normal range of a reference population, corrected for their gestational age. Although animal models have shown that insulin-like growth factor 1 (IGF1) and insulin-like growth factor 1 receptor (IGF1R) genes are important candidates for reduced pre- and postnatal growth, only limited case reports have been published describing mutations. This might suggest that IGF1 and IGF1R are such crucial growth factors that only common genetic polymorphisms are allowed to survive. Common IGF1 and IGF1R gene polymorphisms, such as single nucleotide polymorphisms and variable number of tandem repeats, have been investigated with conflicting results with respect to SGA-related outcomes. The exact contribution of these polymorphisms to clinical practice remains to be elucidated.

  2. [Relationship of plasma ghrelin, IGF-1 and insulin with the growth and development of 2 -7 year-old children with small for gestational age at birth].

    Science.gov (United States)

    Cheng, Yaying; Song, Guangyao; Zhou, Lixia; Cai, Baoping; Zhao, Xiumian; Yin, Jianying

    2012-01-01

    To explore the relationship of Ghrelin, insulin-like growth factor-1 (IGF-1) and insulin with the growth and development of 2 -7 year-old children with small for gestational age (SGA) at birth. The levels of ghrelin, IGF-1, IGFBP-3, insulin and glucose were measured in the children with preterm SGA and term SGA and compared with the children with preterm appropriate for gestational age (AGA) and term AGA. The correlation of ghrelin with IGF-1, IGFBP-3 and insulin was analyzed. Plasma ghrelin in preterm SGA was higher than that in term SGA (P 0.05). Plasma ghrelin in preterm AGA and term SGA was higher than that in term AGA (P development of preterm and SGA children, regardless of the magnitude of their catch up growth. As a re-regulatory factor to insulin, ghrelin regulates the energy metabolism in a form of negative feedback.

  3. Short Maternal Stature Increases Risk of Small-for-Gestational-Age and Preterm Births in Low- and Middle-Income Countries

    DEFF Research Database (Denmark)

    Kozuki, Naoko; Katz, Joanne; Lee, Anne Cc

    2015-01-01

    population-based cohort studies and the WHO Global Survey on Maternal and Perinatal Health (13 of 24 available data sets used) from low- and middle-income countries (LMIC). We included those with weight taken within 72 h of birth, gestational age, and maternal height data (n = 177,000). For each....../or preterm births in LMIC may be associated with short maternal stature annually. A reduction in this burden requires primary prevention of SGA, improvement in postnatal growth through early childhood, and possibly further intervention in late childhood and adolescence. It is vital for researchers to broaden......BACKGROUND: Small-for-gestational-age (SGA) and preterm births are associated with adverse health consequences, including neonatal and infant mortality, childhood undernutrition, and adulthood chronic disease. OBJECTIVES: The specific aims of this study were to estimate the association between...

  4. Mode of Delivery and Asthma at School Age in 9 European Birth Cohorts

    DEFF Research Database (Denmark)

    Rusconi, Franca; Zugna, Daniela; Annesi-Maesano, Isabella

    2017-01-01

    risk ratios for asthma at ages 5–9 years were calculated using Poisson regression models and pooled. A sensitivity analysis was carried out in children born at term to reduce confounding due to perinatal factors. The study included 67,613 participants. Cohort-specific rates of cesarean delivery varied.......75) for elective cesarean delivery, 1.07 (95% CI: 0.94, 1.22) for emergency cesarean delivery, and 0.97 (95% CI: 0.84, 1.12) for operative vaginal delivery. In children born at term, the associations were strengthened only for elective cesarean delivery (aRR = 1.49, 95% CI: 1.13, 1.97). The large sample size...... allowed analysis of the associations between specific modes of delivery and asthma at school age. The increased risk of asthma associated with elective cesarean delivery, especially among children born at term, is relevant in counteracting the increasing use of this procedure, which is often performed...

  5. High-field magnetic resonance imaging of the developing human brain from the 10th to the 16th week of gestational Age.

    Science.gov (United States)

    Sbarbati, A; Marzola, P; Simonati, A; Nicolato, E; Osculati, F

    1998-01-01

    In the present work, high-field magnetic resonance imaging (HF-MRI) was applied to study the developing human brain paying particular attention to the structures of interest in pathology of malformation. The aim of the work was to evaluate the possible application of HF-MRI to the analysis of brain development in the absence of some limits of conventional histological technique. Seven formalin-fixed human fetuses of 50, 65, 70, 85, 110, 116 and 125 mm crown/ rump length (corresponding to a gestational age ranging from 10 to 16 weeks) were examined in an imager-spectrometer equipped with a 4. 7-tesla horizontal magnet with a 33-cm bore. In the brain of all the fetuses the telencephalic, mesencephalic and rhombencephalic vesicles were recognizable and an easy quantitative evaluation of the brain curvatures in the absence of distortion due to dissection was possible. Comparing fetuses at different gestational ages, the spatial modification of the different vesicles was evident. In fetuses at 16 weeks of gestational age, stratified compartments of the telencephalic wall were evident. The germinal zone and the cortical plate were visible: the germinal layer was identifiable as a hypointensity in the periventricular area. The subplate zone and the intermediate zone emitted a strong intensity signal. Our study demonstrates that HF-MRI can contribute to the study of the complex developmental events in the human brain from the 10th to 16th week of gestational age in a submillimetric scale of resolution. This technique can provide information about the morphology of the encephalic vesicles and their relations with the bone cavity that cannot be obtained with conventional methods and may be a useful adjunct to histological techniques.

  6. Socioeconomic inequality in birth weight and gestational age in Denmark 1996-2007: using a family-based approach to explore alternative explanations.

    Science.gov (United States)

    Mortensen, Laust H

    2013-01-01

    A large body of literature has reported associations between socioeconomic position and adverse pregnancy outcomes even in affluent egalitarian welfare states. This study explored the nature of this relationship by examining women who changed socioeconomic position between pregnancies and women who were siblings but were different in terms of socioeconomic position. Data consisted of 471,215 live born singletons born in Denmark 1997-2007 with at least one sibling or one first cousin. We examined parental educational attainment and household income in relation to preterm birth and small for gestational age using Cox regression. Household income was only weakly related to these outcomes. Paternal education was strongly associated with the outcomes only in the cohort analyses. Maternal education was inversely associated with preterm birth only in the cohort analyses, where the least educated women had the highest risk. Maternal education was inversely associated with the risk of small for gestational age in cohort analyses, attenuated between mothers who were siblings, and not present between children who were siblings. For example, the hazard ratio of preterm birth of women with a college/university degree when compared to women with only mandatory education was 0.64 (95% confidence interval: 0.60-0.67) in the cohort analysis, 0.90 (0.78-1.04) between mothers who were siblings, and 1.01 (0.82-1.24) between children who were siblings. The corresponding hazard ratios of small for gestational age were 0.54 (0.52-0.56), 0.72 (0.63-0.83), and 1.02 (0.84-1.24). This suggests that the associations were partly explained by factors shared between mothers who are siblings. In conclusion, the early life circumstances of mothers appear to be important in understanding the association between education, preterm birth and small for gestational age.

  7. Longitudinal changes in insulin sensitivity and body composition of small-for-gestational-age adolescents after cessation of growth hormone treatment

    OpenAIRE

    Willemsen, Ruben; Hokken-Koelega, Anita

    2008-01-01

    textabstractContext: GH treatment reduces insulin sensitivity (Si). For small-for-gestational-age (SGA) subjects, who might have an increased risk to develop cardiovascular disease and type 2 diabetes, it is still uncertain how Si, β-cell function, and body composition change over time after stopping GH treatment. Objective: Our objective was to investigate longitudinal changes in Si, β-cell function, and body composition after cessation of long-term GH treatment. Design and Patients: We cond...

  8. TWIN GESTATION : A CHALLENGING TASK

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    Vrunda V.

    2015-03-01

    Full Text Available INTRODUCTION In the era of modern obstetrics when multiple pregnancies are on increase it is very important to know the incidence and obstetric outcomes of twin deliveries. Twin pregnancy is still associated with increased maternal and perinatal morbidity and mortality as well as healthcare costs . ( 1 , 2 , 3 MATERIALS AND METHODS : This is a r etrospective study of twin deliveries done in the rural medical college teaching hospital over a period of 3 years. RESULTS : During the study period , incidence of twin delivery was 19.37 per 1000 deliveries. Majority cases of twins were young primies in ag e group (20 - 30 years . Preterm delivery occurred in 68% cases and was therefore , the most common morbidity followed by anaemia (38% and PIH (28%. Most common presentation was vertex (66% and malpresentation were present in 44% of cases. 54% were deliver ed by caesarean section. In 88% second baby delivered within 15 minutes. Uterine inertia , PROM , fetal distress , PPH , cord prolapse and abruption were complications during labour. There was no maternal mortality in present study. Average weight of first baby was 1679.63 gms and 2 nd baby was 1586.94 gms. Perinatal mortality of 1 st baby was 27.55 for 1 st baby and 37.25% for 2 nd baby . Average gestational age for patients in whom cervical encirclage was done was 34 weeks. CONCLUSION: P reterm delivery and low birth weight babies are main challenges to the obstetrician. Incidence of LSCS is quite high with malpresentation of leading (twin A baby is a major indication for LSCS . The use of antenatal care services and good intrapartum mana gement will help improve outcome in twin pregnancies.

  9. Evaluation of strategies regarding management of imminent preterm delivery before 32 weeks of gestation : a regional cohort study among 1375 women in the Netherlands

    NARCIS (Netherlands)

    Boesveld, Merel; Oudijk, Martijn A.|info:eu-repo/dai/nl/246958898; Koenen, Steven V.|info:eu-repo/dai/nl/239456742; Brouwers, Hens A|info:eu-repo/dai/nl/073463795; Van Beek, Erik; Boon, Janine; Drogtrop, Addy; Euser, Robert; Evers, Inge M.; Fiedeldeij, Cora A.; Heida, Karst Y.; Huisjes, Anjoke J M; Muijsers, Guido J J M; Schierbeek, Jaap M.; Kwee, Anneke|info:eu-repo/dai/nl/290465648

    STUDY DESIGN: A retrospective cohort study existing of 1 perinatal center and 9 referring hospitals. All women who received their first dose of ACS in 1 of the 10 hospitals between 24+0 and 32+0 weeks of gestation and/or delivered before 32 weeks of gestation from 2005 until 2010. Patients were

  10. JGZ-richtlijn 'Te vroeg en/of small for gestational age (SGA) geboren kinderen [Dutch Preventive Youth Health Care Service guideline on children born too early and/or too small for gestational age

    NARCIS (Netherlands)

    Pal-de Bruin, K.M. van der; Heerdink, N.; Kamphuis, M.; Pols, M.A.

    2014-01-01

    Bij kinderen die te vroeg geboren worden of met een te laag geboortegewicht voor de zwangerschapsduur (‘small for gestational age’ (SGA)) is intensieve zorg en nazorg gewenst. Knelpunten hierbij zijn de vaak gedeelde zorg door kinderartsen, huisartsen, jeugdgezondheidszorg (jgz) en andere profession

  11. [Effects of growth hormone treatment on anthropometrics, metabolic risk, and body composition variables in small for gestational age patients].

    Science.gov (United States)

    Aurensanz Clemente, Esther; Samper Villagrasa, Pilar; Ayerza Casas, Ariadna; Ruiz Frontera, Pablo; Bueno Lozano, Olga; Moreno Aznar, Luis Alberto; Bueno Lozano, Gloria

    2017-05-01

    Small for gestational age (SGA) children without catch-up growth can benefit from treatment with growth hormone (rhGH). However, they should be monitored very closely because they are at increased risk of metabolic syndrome. A group of 28 SGA children with a mean age of 8.79 years and undergoing treatment with rhGH were selected for evaluation. Over the course of 4 years, an annual evaluation was performed on the anthropometric variables (weight, height, body mass index [BMI], growth rate, blood pressure and waist perimeter), metabolic risk variables (glycaemia, glycosylated haemoglobin, cholesterol ratio, insulinaemia, insulin-like growth factor 1[IGF1], IGF binding protein-3 [IGFBP-3], IGF1/IGFBP3 ratio, and HOMA index), and body composition variables. Treatment with rhGH was associated with a significant increase in height (-2.76±.11 SD to -1.53±.17 SD, P=.000), weight (-1.50±.09 SD to -1.21±.13 SD; P=.016), and growth rate (-1.43±.35 SD to .41±.41 SD; P=.009), without a corresponding change in the BMI. Insulinaemia (9.33±1.93mU/ml to 16.55±1.72mU/ml; P=.044) and the HOMA index (3.63±.76 to 6.43±.67; P=.042) increased, approaching insulin resistance levels. No changes were observed in the lipid profile. Body composition changes were observed, with a significant increase in lean mass (73.19±1.26 to 78.74±1.31; P=.037), and a reduction of fat mass (26.81±1.26 to 21.26±1.31; P=.021). Treatment with rhGH is effective for improving anthropometric variables in SGA patients who have not experienced a catch-up growth. It also produces changes in body composition, which may lead to a reduction in risk of metabolic syndrome. However, some insulin resistance was observed. It is important to follow up this patient group in order to find out whether these changes persist into adulthood. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Metals exposure and risk of small-for-gestational age birth in a Canadian birth cohort: The MIREC study

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, Shari [Department of Public Health Sciences, Queen’s University, Kingston, Ontario (Canada); Arbuckle, Tye E., E-mail: Tye.Arbuckle@hc-sc.gc.ca [Population Studies Division, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa (Canada); Fisher, Mandy [Population Studies Division, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa (Canada); Fraser, William D. [Sainte Justine University Hospital Research Center, University of Montreal, Montreal (Canada); Ettinger, Adrienne [Center for Perinatal, Pediatric & Environmental Epidemiology, Yale School of Public Health, New Haven, CT (United States); King, Will [Department of Public Health Sciences, Queen’s University, Kingston, Ontario (Canada)

    2015-07-15

    Background: Lead, mercury, cadmium and arsenic are some of the most common toxic metals to which Canadians are exposed. The effect of exposure to current low levels of toxic metals on fetal growth restriction is unknown. Objective: The aim of this study was to examine relationships between exposure to lead, mercury, cadmium and arsenic during pregnancy, and risk of small for gestational age (SGA) birth. Methods: Lead, mercury, cadmium and arsenic levels were measured in blood samples from the first and third trimesters in 1835 pregnant women from across Canada. Arsenic species in first trimester urine were also assessed. Relative risks and 95% confidence intervals were estimated using log binomial multivariate regression. Important covariates including maternal age, parity, pre-pregnancy BMI, and smoking, were considered in the analysis. An exploratory analysis was performed to examine potential effect modification of these relationships by single nucleotide polymorphisms (SNPs) in GSTP1 and GSTO1 genes. Results: No association was found between blood lead, cadmium or arsenic and risk for SGA. We observed an increased risk for SGA for the highest compared to the lowest tertile of exposure for mercury (>1.6 µg/L, RR=1.56.; 95% CI=1.04–2.58) and arsenobetaine (>2.25 µg/L, RR=1.65; 95% CI=1.10–2.47) after adjustment for the effects of parity and smoking. A statistically significant interaction was observed in the relationship between dimethylarsinic acid (DMA) levels in urinary arsenic and SGA between strata of GSTO1 A104A (p for interaction=0.02). A marginally significant interaction was observed in the relationship between blood lead and SGA between strata of GSTP1 A114V (p for interaction=0.06). Conclusions: These results suggest a small increase in risk for SGA in infants born to women exposed to mercury and arsenic. Given the conflicting evidence in the literature this warrants further investigation in other pregnant populations. - Highlights: • Metals

  13. The ontogeny of scarless healing II: EGF and PDGF-B gene expression in fetal rat skin and fibroblasts as a function of gestational age.

    Science.gov (United States)

    Peled, Z M; Rhee, S J; Hsu, M; Chang, J; Krummel, T M; Longaker, M T

    2001-10-01

    Twenty years ago, surgeons noted the ability of early-gestation fetal skin to heal in a scarless manner. Since that time, numerous investigators have attempted to elucidate the mechanisms behind this phenomenon. As a result of this effort, it is now well established that many animals undergo a transition late in development from scarless cutaneous healing to a scar-forming, adultlike phenotype. The authors have been interested in the role played by cytokines known to be involved in the adult wound-healing process and how they relate to scarless repair. They therefore asked the following question: Are genes for epidermal growth factor (EGF) and platelet-derived growth factor-B (PDGF-B) expressed differentially as a function of gestational age in fetal rat skin and dermal fibroblasts? To answer this question, skin from fetal Sprague-Dawley rats (N = 56) at time points that represented both the scarless and scar-forming periods of rat gestation was harvested. In addition, fibroblasts derived from fetal rat skin were cultured in vitro at similar times. These cells were expanded in culture and, when confluent, total ribonucleic acid from both fibroblasts and whole skin was extracted and subjected to Northern blot analysis with probes for EGF and PDGF-B. Results demonstrated that neither EGF nor PDGF-B gene expression changed markedly as a function of gestational age in fetal fibroblasts alone. In whole skin, however, both EGF and PDGF-B demonstrated a marked decrease in gene expression with increasing gestational age. Furthermore, the most striking decrease in gene expression for both cytokines came between 16 and 18 days of gestation-the transition point between scarless and scar-forming repair in the fetal rat. These data suggest that EGF and PDGF may play a role in the mechanism of scarless cutaneous repair. Moreover, it appears that fetal fibroblasts are not the cell type responsible for this differential gene expression. These results raise questions about the

  14. Angiogenic factors vs Doppler surveillance in the prediction of adverse outcome among late-pregnancy small-for- gestational-age fetuses.

    Science.gov (United States)

    Lobmaier, S M; Figueras, F; Mercade, I; Perello, M; Peguero, A; Crovetto, F; Ortiz, J U; Crispi, F; Gratacós, E

    2014-05-01

    To compare the value of Doppler surveillance with maternal blood angiogenic factors at diagnosis for the prediction of adverse outcome in late-pregnancy small-for-gestational-age (SGA) fetuses. In a cohort of 198 SGA fetuses we evaluated the association of Doppler indices (mean uterine artery pulsatility index (UtA-PI) and cerebroplacental ratio (CPR)) and angiogenic factors (maternal serum levels of soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF)) with the development of pre-eclampsia and adverse perinatal outcome (operative delivery for non-reassuring fetal status or neonatal metabolic acidosis). In SGA fetuses subsequently developing pre-eclampsia, mean UtA-PI (P < 0.001), sFlt-1 MoM (P < 0.001) and sFlt-1/PlGF MoM ratio (P < 0.001) were higher, while PlGF MoM was lower (P = 0.004). In SGA fetuses with adverse perinatal outcome, CPR (P < 0.002) and PlGF MoM (P < 0.001) were lower, and sFlt-1/PlGF MoM ratio was higher (P = 0.001). For predicting pre-eclampsia, the areas under the receiver-operating characteristics (ROC) curves for mean UtA-PI, sFlt-1 MoM and the combination of both were 0.852, 0.839 and 0.860, respectively. For adverse perinatal outcome, the areas under the ROC curves for CPR, PlGF MoM and the combination of both were 0.652, 0.656 and 0.684, respectively. The combination of Doppler indices and angiogenic factors did not significantly improve prediction of either pre-eclampsia (P = 0.851) or adverse outcome (P = 0.579). In SGA fetuses, angiogenic factors at diagnosis and follow-up with Doppler ultrasound both predict adverse outcome with a similar performance. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.

  15. Gestational weight gain and risk of gestational diabetes mellitus among Chinese women

    Institute of Scientific and Technical Information of China (English)

    Liu Zheng; Ao Deng; Yang Huixia; Wang Yan

    2014-01-01

    Background Gestational diabetes mellitus (GDM) is a common complication during pregnancy,and gestational weight gain is one of the major and modifiable risk factors.This study aims to estimate the relationship between the rate of gestational weight gain before diagnosis of GDM and the subsequent risk of GDM.Methods A case-control study was conducted with 90 GDM cases and 165 women in the control group from May 2012 to August 2012 at Peking University First Affiliated Hospital.GDM was diagnosed according to the standards issued by the Ministry of Health of China in 2011.The plasma glucose levels,weights,and covariate data of the women were obtained based on medical records.Univariate analysis and unconditional Logistic regression model were used to estimate the associations.Results After adjusting for age at delivery,parity,and pre-pregnancy body mass index,the risk of GDM increased with increasing rates of gestational weight gain.Compared with the lower rate of gestational weight gain (less than 0.28 kg per week),a rate of weight gain of 0.28 kg per week or more was associated with increased risk of GDM (odds ratio:2.03; 95% confidence interval:1.15 to 3.59).The association between the rate of gestational weight gain and GDM was primarily attributed to the increased weight gain in the first trimester.Conclusion High rates of gestational weight gain,particular during early pregnancy,may increase a woman's risk of GDM.

  16. Birthweight by gestational age and its effect on perinatal mortality in white and in Punjabi births: experience at a district general hospital in West London 1967-1975.

    Science.gov (United States)

    Dawson, I; Golder, R Y; Jonas, E G

    1982-11-01

    At Hillingdon Hospital in West London two main ethnic groups: 'UK' (i.e. white European) and 'Indian' (i.e. Punjabi) account for the bulk of obstetric work load. Birthweight by gestational age graphs were calculated for some 6000 Indian and 18000 UK infants born between 1967 and 1975 inclusive. A mean weight difference at term favoured UK male babies by 240 g and UK female babies by 230 g. Though the crude perinatal results in the two populations were not significantly different, the perinatal mortality of infants less than 2500 g in birthweight was lower in the Indian than the UK population, particularly in the 1500-2400 g group. This is attributed to a levelling off in intrauterine growth from 36 to 37 weeks gestation onwards in Indian compared with UK pregnancies, so that they were more mature than UK births of the same weight. However light-for-dates births, defined as birthweights below the 10th centile of weight-for-gestational age on their own ethnic and sex specific standards pose problems, irrespective of ethnic background.

  17. Early postnatal hypotension is not associated with indicators of white matter damage or cerebral palsy in extremely low gestational age newborns.

    Science.gov (United States)

    Logan, J W; O'Shea, T M; Allred, E N; Laughon, M M; Bose, C L; Dammann, O; Batton, D G; Kuban, K C; Paneth, N; Leviton, A

    2011-08-01

    To evaluate, in extremely low gestational age newborns (ELGANs), relationships between indicators of early postnatal hypotension and cranial ultrasound indicators of cerebral white matter damage imaged in the nursery and cerebral palsy diagnoses at 24 months follow-up. The 1041 infants in this prospective study were born at treatment with a vasopressor; and (3) blood pressure lability, defined as the upper quartile of the difference between each infant's lowest and highest MAP. Outcomes included indicators of cerebral white matter damage, that is, moderate/severe ventriculomegaly or an echolucent lesion on cranial ultrasound and cerebral palsy diagnoses at 24 months gestation. Logistic regression was used to evaluate relationships among hypotension indicators and outcomes, adjusting for potential confounders. Twenty-one percent of surviving infants had a lowest blood pressure in the lowest quartile for gestational age, 24% were treated with vasopressors and 24% had labile blood pressure. Among infants with these hypotension indicators, 10% percent developed ventriculomegaly and 7% developed an echolucent lesion. At 24 months follow-up, 6% had developed quadriparesis, 4% diparesis and 2% hemiparesis. After adjusting for confounders, we found no association between indicators of hypotension, and indicators of cerebral white matter damage or a cerebral palsy diagnosis. The absence of an association between indicators of hypotension and cerebral white matter damage and or cerebral palsy suggests that early hypotension may not be important in the pathogenesis of brain injury in ELGANs.

  18. Twin pregnancy childbirth way with gestational age of pregnancy outcome%双胎妊娠分娩方式与孕龄对妊娠结局的探讨

    Institute of Scientific and Technical Information of China (English)

    陈晓妮

    2014-01-01

    Twin pregnancy childbirth way and gestational age influence on pregnancy outcome.Methods:In twin pregnancy, 240 cases of maternal childbirth obstetrics and gynecology hospital as the research object.Through self-made form col ection of maternal clinical data were retrospectively analyzed. analyze the different gestational age and birth weight, the relationship between neonatal asphyxia, and different position and the way of delivery and neonatal asphyxia. Result: This group of neonatal asphyxia in 15.83% (76/480). Gestational age 28~34 weeks and of 39 weeks or a newborn, the incidence of asphyxia were significantly higher than that of 35~38 weeks gestational age neonates (al P<0.05). First position as head of the women, the vaginal trial production success of newborns, the incidence of first and second child suffocation were significantly higher than that of elective cesarean section newborn (3.67%, 6.42%vs0.00%, 3.67%), statistical y significant difference (P<0.05). Conclusion:Cesarean section can effectively reduce the incidence of postpartum hemorrhage, twin pregnancy maternal extend gestational age can effectively improve the newborn weight, reduce the incidence of neonatal asphyxia, the cutting head first recommended palace childbirth.%探讨双胎妊娠分娩方式和孕龄对妊娠结局的影响。方法:选择在我院妇产科分娩的双胎妊娠产妇240例为研究对象。通过自制的表格收集产妇的临床资料进行回顾性分析。分析不同的孕龄和新生儿体重、新生儿窒息的关系以及不同胎位和分娩方式与新生儿窒息发生的关系。结果:本组新生儿窒息共计15.83%(76/480)。孕龄28~34周和≥39周的新生儿,窒息的发生率均显著高于孕龄35~38周的新生儿(均P<0.05)。第一胎胎位为头位的产妇中,阴道试产成功的新生儿,第一胎和第二胎窒息的发生率均显著高于择期剖宫产的新生儿(3.67%、6.42%vs0.00%、0.92%),

  19. Gestational diabetes

    African Journals Online (AJOL)

    metabolism. In normal pregnancy fasting glucose declines to ... changes in lifestyle. The cause .... disease phenotype and requires interaction of environmental factors for ... lifestyle.'8. Gestational diabetes is a clinical event with conseque~ces.

  20. Neonatal milk supplementation in lambs has persistent effects on growth and metabolic function that differ by sex and gestational age.

    Science.gov (United States)

    Berry, Mary J; Jaquiery, Anne L; Oliver, Mark H; Harding, Jane E; Bloomfield, Frank H

    2016-12-01

    The perinatal environment has a major influence on long-term health and disease risk. Preterm birth alters early-life environment and is associated with altered metabolic function in adulthood. Whether preterm birth per se or the early nutritional interventions used to support growth in preterm infants underpins this association is unknown. Lambs born preterm, following dexamethasone induction of labour, or spontaneously at term were randomised to receive nutrient supplementation, analogous to the milk fortifier used clinically or water as a control for the first 2 weeks after birth. Thereafter, nutrition was not different between groups. Growth was monitored, and the glucose-insulin axis function was assessed in juvenile (4 months) and adult life (14 months). Early nutrition influenced adult metabolic function and body composition to a greater extent than preterm birth. In supplemented females, arginine-stimulated insulin secretion was increased in preterm but reduced in term-born juveniles compared with controls (repeated-measures ANOVA P<0·01). In supplemented preterm males, adult weight, ponderal index (PI) and fasting insulin concentrations were elevated compared with preterm controls (weight, 75 (sem 3) v. 69 (sem 2) kg; PI, 48·0 (sem 2·1) v. 43·7 (sem 1·7) kg/m3; fasting insulin, 0·19 (sem 0·02) v. 0·10 (sem 0·02) ng/ml). Conversely, supplemented term-born males had reduced adult weight, PI and fasting insulin concentrations compared with term-born controls (weight, 64 (sem 2) v. 70 (sem 2) kg; PI, 44·4 (sem 1·8) v. 48·2 (sem 1·7) kg/m3; fasting insulin, 0·09 (sem 0·02) v. 0·14 (sem 0·02) ng/ml; all group×supplement interactions P<0·05). Adult metabolic health may reflect both gestational age at birth and early nutrition. Human studies are urgently needed to investigate the adult sex-specific health implications of neonatal nutritional strategies.

  1. Individual exposures to drinking water trihalomethanes, low birth weight and small for gestational age risk: a prospective Kaunas cohort study

    Science.gov (United States)

    2011-01-01

    Background Evidence for an association between exposure during pregnancy to trihalomethanes (THMs) in drinking water and impaired fetal growth is still inconsistent and inconclusive, in particular, for various exposure routes. We examined the relationship of individual exposures to THMs in drinking water on low birth weight (LBW), small for gestational age (SGA), and birth weight (BW) in singleton births. Methods We conducted a cohort study of 4,161 pregnant women in Kaunas (Lithuania), using individual information on drinking water, ingestion, showering and bathing, and uptake factors of THMs in blood, to estimate an internal dose of THM. We used regression analysis to evaluate the relationship between internal THM dose and birth outcomes, adjusting for family status, education, smoking, alcohol consumption, body mass index, blood pressure, ethnic group, previous preterm, infant gender, and birth year. Results The estimated internal dose of THMs ranged from 0.0025 to 2.40 mg/d. We found dose-response relationships for the entire pregnancy and trimester-specific THM and chloroform internal dose and risk for LBW and a reduction in BW. The adjusted odds ratio for third tertile vs. first tertile chloroform internal dose of entire pregnancy was 2.17, 95% CI 1.19-3.98 for LBW; the OR per every 0.1 μg/d increase in chloroform internal dose was 1.10, 95% CI 1.01-1.19. Chloroform internal dose was associated with a slightly increased risk of SGA (OR 1.19, 95% CI 0.87-1.63 and OR 1.22, 95% CI 0.89-1.68, respectively, for second and third tertile of third trimester); the risk increased by 4% per every 0.1 μg/d increase in chloroform internal dose (OR 1.04, 95% CI 1.00-1.09). Conclusions THM internal dose in pregnancy varies substantially across individuals, and depends on both water THM levels and water use habits. Increased internal dose may affect fetal growth. PMID:21501533

  2. Risk factors and adverse perinatal outcomes among term and preterm infants born small-for-gestational-age: secondary analyses of the WHO Multi-Country Survey on Maternal and Newborn Health.

    Directory of Open Access Journals (Sweden)

    Erika Ota

    Full Text Available Small for gestational age (SGA is not only a major indicator of perinatal mortality and morbidity, but also the morbidity risks in later in life. We aim to estimate the association between the birth of SGA infants and the risk factors and adverse perinatal outcomes among twenty-nine countries in Africa, Latin America, the Middle East and Asia in 359 health facilities in 2010-11.We analysed facility-based, cross-sectional data from the WHO Multi-country Survey on Maternal and Newborn Health. We constructed multilevel logistic regression models with random effects for facilities and countries to estimate the risk factors for SGA infants using country-specific birthweight reference standards in preterm and term delivery, and SGA's association with adverse perinatal outcomes. We compared the risks and adverse perinatal outcomes with appropriate for gestational age (AGA infants categorized by preterm and term delivery.A total of 295,829 singleton infants delivered were analysed. The overall prevalence of SGA was highest in Cambodia (18.8%, Nepal (17.9%, the Occupied Palestinian Territory (16.1%, and Japan (16.0%, while the lowest was observed in Afghanistan (4.8%, Uganda (6.6% and Thailand (9.7%. The risk of preterm SGA infants was significantly higher among nulliparous mothers and mothers with chronic hypertension and preeclampsia/eclampsia (aOR: 2.89; 95% CI: 2.55-3.28 compared with AGA infants. Higher risks of term SGA were observed among sociodemographic factors and women with preeclampsia/eclampsia, anaemia and other medical conditions. Multiparity (> = 3 (AOR: 0.88; 95% CI: 0.83-0.92 was a protective factor for term SGA. The risk of perinatal mortality was significantly higher in preterm SGA deliveries in low to high HDI countries.Preterm SGA is associated with medical conditions related to preeclampsia, but not with sociodemographic status. Term SGA is associated with sociodemographic status and various medical conditions.

  3. Gestational diabetes versus pregestational diabetes. Perinatal results.

    Directory of Open Access Journals (Sweden)

    Cristóbal Torres González

    2004-12-01

    Full Text Available Fundament: Diabetes Mellitus is one of the most affecting diseases in the development of pregnancy. This greatly depends on the metabolic control achieved, which has demanded several proyects of treatment, thus decreasing the risks that the gestational process carries out. Objective: to compare the perinatal results between the diabetic gestational women and pregestational ones admitted at Cienfuegos Hospital. Method: Comparative study developed at the Gynecological-Obstetric Universitary Hospital from Cienfuegos province, from January to december 2003, including 167 pregnant women with Diabetes mellitus during pregnancy. The variables under study were: type of Diabetes, Márquez Guillén classification about good or bad fetal-maternal prognosis , treatment used, type of delivery, gestational age at labor, newborn weight, prenatal and maternal complication. Results: There was a predominance of gestational diabetes (73, 6 % over the cases with pregestational diabetes (26,3 %. According to Marquez Guillén classification , the bad fetal-maternal prognosis (X=16.37, p

  4. "COMPARISON OF MATERNAL AND FETAL/NEONATAL COMPLICATIONS IN GESTATIONAL AND PRE-GESTATIONAL DIABETES MELLITUS "

    Directory of Open Access Journals (Sweden)

    F. Akhlaghi A. B. Hamedi

    2005-07-01

    Full Text Available Presence of maternal diabetes mellitus (DM during pregnancy has important consequences for both mother and child. To determine maternal and fetal/neonatal complications of gestational DM and compare them with pre-gestational DM, a prospective study was performed in 100 diabetic women delivered in our hospital from January 2001 to April 2002. Pregnancy outcome in 27 women with gestational DM and 73 women with pre-gestational DM and their offspring were studied and analyzed. The mean age of women was 28 years, women with gestational DM being slightly older than women with pre-gestational DM. Mothers with gestational DM were at increased risk of presenting with pre-eclampsia and preterm labor compared to pre-gestational DM. Frequency of Cesarean section was higher in mothers with pre-gestational DM. Frequencies of abortion and hypoglycemic episodes were similar in gestational DM and pre-gestational DM. Infants born to mothers with pre-gestational DM were at increased risk of suffering from respiratory distress syndrome and congenital malformations but rates of unexplained intrauterine fetal death and large for gestational age were higher in infant of mothers with gestational DM. Gestational and pre-gestational DM are associated with increased risk of maternal and neonatal morbidity. Pregnant women with gestational and pre-gestational DM and their offsprings should be monitored and managed carefully.

  5. Skin Delivery of Kojic Acid-Loaded Nanotechnology-Based Drug Delivery Systems for the Treatment of Skin Aging

    Directory of Open Access Journals (Sweden)

    M. L. Gonçalez

    2013-01-01

    Full Text Available The aging process causes a number of changes in the skin, including oxidative stress and dyschromia. The kojic acid (KA is iron chelator employed in treatment of skin aging, and inhibits tyrosinase, promotes depigmentation. Nanotechnology-based drug delivery systems, such as liquid crystalline systems (LCSs, can modulate drug permeation through the skin and improve the drug activity. This study is aimed at structurally developing and characterizing a kojic acid-loaded LCS, consists of water (W, cetostearyl isononanoate (oil—O and PPG-5-CETETH-20 (surfactant-S and evaluating its in vitro skin permeation and retention. Three regions of the diagram were selected for characterization: A (35% O, 50% S, 15% W, B (30% O, 50% S, 20% W and C (20% O, 50% S, 30% W, to which 2% KA was added. The formulations were subjected to polarized light microscopy, which indicated the presence of a hexagonal mesophase. Texture and bioadhesion assay showed that formulation B is suitable for topical application. According to the results from the in vitro permeation and retention of KA, the formulations developed can modulate the permeation of KA in the skin. The in vitro cytotoxic assays showed that KA-unloaded LCS and KA-loaded LCS didn't present cytotoxicity. PPG-5-CETETH-20-based systems may be a promising platform for KA skin delivery.

  6. Compliance With Legal Age Restrictions on Adolescent Alcohol Sales for Alcohol Home Delivery Services (AHDS)

    NARCIS (Netherlands)

    van Hoof, Joris Jasper; van den Wildenberg, Esther; de Bruijn, Dorien

    2014-01-01

    Purpose: Alcohol availability is an important predictor of alcohol use in adolescents and its negative consequences. Within this study, we zoomed in on availability through alcohol home delivery services (AHDS) by measuring compliance with the legal age limit in this sector. Methods: Two methods

  7. Compliance With Legal Age Restrictions on Adolescent Alcohol Sales for Alcohol Home Delivery Services (AHDS)

    NARCIS (Netherlands)

    Hoof, van Joris J.; Wildenberg, van den Esther; Bruijn, de Dorien

    2014-01-01

    Purpose: Alcohol availability is an important predictor of alcohol use in adolescents and its negative consequences. Within this study, we zoomed in on availability through alcohol home delivery services (AHDS) by measuring compliance with the legal age limit in this sector. Methods: Two methods wer

  8. Birth size, postnatal growth and growth during growth hormone treatment in small-for-gestational-age children: associations with IGF1 gene polymorphisms and haplotypes?

    Science.gov (United States)

    Ester, Wietske A; van Meurs, Joyce B; Arends, Nicolette J; Uitterlinden, André G; de Ridder, Maria A; Hokken-Koelega, Anita C

    2009-01-01

    Short small-for-gestational-age (SGA) children experience pre- and postnatal growth restriction, which might be influenced by polymorphisms in the IGF1 gene. The well-known -841(CA)(n)/192 bp polymorphism has been associated with birth size and cardiovascular disease. To determine whether birth size, postnatal growth and growth during growth hormone (GH) treatment, were associated with IGF1 gene polymorphisms and haplotypes. 201 short SGA children were investigated for four IGF1 gene polymorphisms in the promoter (-G1245A, -841(CA)(n)), intron 2 (+3703(CT)(n)) and 3UTR (+A1830G). Spontaneous growth and growth during GH treatment were studied. The -1245 A allele was identified as a marker-allele for the well-known -841(CA)(n)/non-192 bp allele, both part of haplotype 2. The -1245 A allele was not associated with head circumference at birth, but was associated with a postnatal 0.3 SDS smaller head circumference at age 1-3. The -1245 A allele was also associated with a 1-week shorter gestational age which explained the association with a smaller absolute birth size. No associations were found with gestational age-adjusted birth size, height and weight SDS during postnatal life and with growth during GH treatment. The -G1245A SNP appeared to be a marker for the well-known -841(CA)(n)/192 bp polymorphism. Haplotype 2, of which the -1245 A allele was the marker, was associated with a smaller head circumference SDS during spontaneous postnatal growth, but not during GH treatment. Copyright 2009 S. Karger AG, Basel.

  9. Association between maternal nutritional status of pre pregnancy, gestational weight gain and preterm birth.

    Science.gov (United States)

    Xinxo, Sonela; Bimbashi, Astrit; Z Kakarriqi, Eduard; Zaimi, Edmond

    2013-01-01

    Maternal nutritional status of pre pregnancy and gestational weight gain affects the preterm birth. The association between maternal nutritional status of pre pregnancy and preterm birth appears to be complex and varied by studies from different countries, thus this association between the gestational weight gain and preterm birth is more consolidated. The study aims to determine any association between the pre pregnancy maternal nutritional status, gestational weight gain and the preterm birth rate in the Albanian context. In case control study, we analyzed women who have delivered in obstetric institutions in Tirana during the year 2012. Body mass index and gestational weight gain of 150 women who had a preterm delivery were compared with those of 150 matched control women who had a normal delivery regarding the gestation age. The self-reported pre pregnancy weight, height, gestational weight gain, age, education and parity are collected through a structured questioner. The body mass index and gestational weight gain are categorized based on the Institute of Medicine recommendation. The multiple logistic regression is used to measure the association between the nutritional status of pre pregnancy and gestational weight gain and the preterm birth rate. The women which have a underweight status or obese of pre pregnancy are more likely to have a preterm birth compared to the women of a normal pre-pregnancy nutritional status (respectively OR =2.7 and 4.3 pnutritional status and gestational weight gain affects the risk for preterm birth. Pre-pregnancy and gestation nutritional assessments should be part of routine prenatal visits.

  10. Delivery outcomes for nulliparous women at the extremes of maternal age - a cohort study.

    LENUS (Irish Health Repository)

    Vaughan, DA

    2013-06-12

    OBJECTIVE: To examine the associations between extremes of maternal age (≤17 years or ≥40 years) and delivery outcomes. DESIGN: Retrospective cohort study. SETTING: Urban maternity hospital in Ireland. POPULATION: A total of 36 916 nulliparous women with singleton pregnancies who delivered between 2000 and 2011. METHODS: The study population was subdivided into five maternal age groups based on age at first booking visit: ≤17 years, 18-19 years, 20-34 years, 35-39 years and women aged ≥40 years. Logistic regression analyses were performed to examine the associations between extremes of maternal age and delivery outcomes, adjusting for potential confounding factors. MAIN OUTCOME MEASURES: Preterm birth, admission to the neonatal unit, congenital anomaly, caesarean section. RESULTS: Compared with maternal age 20-34 years, age ≤17 years was a risk factor for preterm birth (adjusted odds ratio [adjOR] 1.83, 95% confidence interval [95% CI] 1.33-2.52). Babies born to mothers ≥40 years were more likely to require admission to the neonatal unit (adjOR 1.35, 95% CI 1.06-1.72) and to have a congenital anomaly (adjOR 1.71, 95% CI 1.07-2.76). The overall caesarean section rate in nulliparous women was 23.9% with marked differences at the extremes of maternal age; 10.7% at age ≤17 years (adjOR 0.46, 95% CI 0.34-0.62) and 54.4% at age ≥40 years (adjOR 3.24, 95% CI 2.67-3.94). CONCLUSIONS: Extremes of maternal age need to be recognised as risk factors for adverse delivery outcomes. Low caesarean section rates in younger women suggest that a reduction in overall caesarean section rates may be possible.

  11. Maternal Obesity, Overweight and Gestational Diabetes Affect the Offspring Neurodevelopment at 6 and 18 Months of Age--A Follow Up from the PREOBE Cohort.

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    Francisco J Torres-Espinola

    Full Text Available Brain development in fetal life and early infancy is critical to determine lifelong performance in various neuropsychological domains. Metabolic pathologies such as overweight, obesity, and gestational diabetes in pregnant women are prevalent and increasing risk factors that may adversely affect long-term brain development in their offspring.The objective of this research was to investigate the influence of maternal metabolic pathologies on the neurodevelopment of the offspring at 6 and 18 months of life.This was a prospective case-control study of 331 mother- and child pairs from Granada, Spain. The mothers were included during pregnancy into four groups according to their pre-gestational body mass index and their gestational diabetes status; overweight (n:56, obese (n:64, gestational diabetic (n:79, and healthy normal weight controls (n:132. At 6 months and 18 months we assessed the children with the Bayley III scales of neurodevelopment.At 6 months (n=215, we found significant group differences in cognition composite language, and expressive language. Post hoc test revealed unexpectedly higher scores in the obese group compared to the normal weight group and a similar trend in overweight and diabetic group. The effects on language remained significant after adjusting for confounders with an adjusted odds ratio for a value above median in composite language score of 3.3 (95% CI: 1.1, 10.0; p=0.035 for children of obese mothers. At 18 month (n=197, the offspring born to obese mothers had lost five points in language composite scores and the previous differences in language and cognition was replaced by a suggestive trend of lower gross motor scores in the overweight, obese, and diabetic groups.Infants of obese mothers had a temporary accelerated development of cognition and language, followed by a rapid deceleration until 18 months of age, particularly of language scores. This novel observation prompts further confirmative studies to explore

  12. Breech deliveries in the Cantonal Hospital Zenica in the five-yearperiod(1999-2003

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    H. Karahasan,

    2005-02-01

    Full Text Available In this retrospective study we analysed the influence of gestation age,parity and the way of a delivery completion on postpartum vitality of new born infants in breech deliveries of singleton fetal pregnancies and none-malformed fetuses in the five-yearperiod.Out of the total number of 13431 deliveries, 502 ofthem(3.7%were completed by breech delivery in the period from 1999 to 2003. Breech deliveries are classified according to gestation age,parity and the way of delivery completion. Each delivery is further classified in one of the three groups of postpartum vitality, according to the method of Virginia Apgar (regular Apgar, mild and heavy hypoxia. Out of 502 breech deliveries, 211 (42% were delivered vaginally, and 291 (58% in sectio Caesarean. 98 (19,5% new born babies were delivered in mild hypoxia, and 33 (6.6% in heavier hypoxia. All infants with heavier hypoxia, 24 of them (72.7%, were delivered vaginally. Preterm born infants made 78,8% of children who were born in heavy hypoxia. Analysis based on parity does not show any significant difference in postpartum vitality of new born infants. Sectio Caesarea participated in significantly better postpartum vitality of newborn childrenin particular gestational age and parity groups. It should be preferred at term breech deliveries of the primiparas, and preterm breech deliveries of 33-37 weeks of gestational age regardless of parity.

  13. Glycemic Excursions in Type 1 Diabetes in Pregnancy: A Semiparametric Statistical Approach to Identify Sensitive Time Points during Gestation

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    Resmi Gupta

    2017-01-01

    Full Text Available Aim. To examine the gestational glycemic profile and identify specific times during pregnancy that variability in glucose levels, measured by change in velocity and acceleration/deceleration of blood glucose fluctuations, is associated with delivery of a large-for-gestational-age (LGA baby, in women with type 1 diabetes. Methods. Retrospective analysis of capillary blood glucose levels measured multiple times daily throughout gestation in women with type 1 diabetes was performed using semiparametric mixed models. Results. Velocity and acceleration/deceleration in glucose levels varied across gestation regardless of delivery outcome. Compared to women delivering LGA babies, those delivering babies appropriate for gestational age exhibited significantly smaller rates of change and less variation in glucose levels between 180 days of gestation and birth. Conclusions. Use of innovative statistical methods enabled detection of gestational intervals in which blood glucose fluctuation parameters might influence the likelihood of delivering LGA baby in mothers with type 1 diabetes. Understanding dynamics and being able to visualize gestational changes in blood glucose are a potentially useful tool to assist care providers in determining the optimal timing to initiate continuous glucose monitoring.

  14. Gestational diabetes: A clinical update

    DEFF Research Database (Denmark)

    Kampmann, Ulla; Madsen, Lene Ring; Skajaa, Gitte Oeskov

    2015-01-01

    Gestational diabetes mellitus (GDM) is increasing in prevalence in tandem with the dramatic increase in the prevalence of overweight and obesity in women of childbearing age. Much controversy surrounds the diagnosis and management of gestational diabetes, emphasizing the importance and relevance ...

  15. Maternal Continuing Folic Acid Supplementation after the First Trimester of Pregnancy Increased the Risk of Large-for-Gestational-Age Birth: A Population-Based Birth Cohort Study

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    Sufang Wang

    2016-08-01

    Full Text Available Supplementation with folic acid (FA was proven to prevent neural tube defects (NTDs and was recommended worldwide before and during early pregnancy. However, much less is known regarding the role of FA after the 12th gestational week (GW. This study aimed to investigate the related effects of continued FA supplementation after the first trimester of pregnancy on fetal growth. The study subjects came from the Ma’anshan-Anhui Birth Cohort Study (MABC that recruited 3474 pregnant women from the city of Ma’anshan in Anhui Province in China during the period of May 2013 to September 2014. The information on use of vitamin and mineral supplements was recorded in different periods (the first/second/third trimester of pregnancy. Small-for-gestational-age (SGA births were live-born infants that were <10th percentile of birth weight, and large-for-gestational-age (LGA births were live-born infants that were ≥90th percentile of birth weight according to nomograms based on gender and gestational age from the latest standards. We used multivariable logistic regression to evaluate the effects of FA supplement consumption in the second/third trimester of pregnancy on the risk of LGA and SGA. In addition, propensity score analysis was also performed to examine the effects. In this prospective birth cohort study conducted in Chinese women who had taken FA in the first trimester of pregnancy, we found that continued FA supplementation with 400 micrograms/day in the second and third trimesters of pregnancy significantly increased the risk of LGA (RR = 1.98 (1.29, 3.04. This relation was strong or monotonic after adjusting for maternal age, newborn’s gender, maternal pre-pregnancy BMI, maternal education level, smoking, alcohol consumption and calcium supplementation. We did not observe that continuing FA supplementation after the first trimester of pregnancy remarkably decreased the risk of SGA. The propensity score analysis showed similar results. To

  16. Associations of consumption of fruits and vegetables during pregnancy with infant birth weight or small for gestational age births: a systematic review of the literature

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    Murphy MM

    2014-10-01

    Full Text Available Mary M Murphy,1 Nicolas Stettler,1,2 Kimberly M Smith,1 Richard Reiss3 1Exponent, Inc., Center for Chemical Regulation and Food Safety, Washington, DC, USA; 2The Lewin Group, Falls Church, VA, USA; 3Exponent, Inc., Center for Chemical Regulation and Food Safety, Alexandria, VA, USA Abstract: Maternal nutrition is recognized as one of the determinants of fetal growth. Consumption of fruits and vegetables is promoted as part of a healthful diet; however, intakes are typically lower than recommended levels. The purpose of this study was to systematically review results from studies examining the relationship between maternal consumption of fruits and vegetables during pregnancy with infant birth weight or risk for delivering a small for gestational age baby. A comprehensive search of PubMed and EMBASE was conducted and abstracts were screened using predefined criteria. Eleven relevant studies were identified and systematically reviewed, including six prospective cohort studies, three retrospective cohort studies, and two case–control studies. Seven studies were conducted in cohorts from highly developed countries. One prospective study from a highly developed area reported increased risk for small for gestational age birth by women with low vegetable intakes (odds ratio 3.1; 95% confidence interval 1.4–6.9; P=0.01; another large prospective study reported a 10.4 g increase in birth weight per quintile increase in fruit intake (95% confidence interval 6.9–3.9; P<0.0001 and increases of 8.4 or 7.7 g per quintile intake of fruits and vegetables (combined or fruits, vegetables, and juice (combined, respectively. One retrospective study reported an association between low fruit intake and birth weight. In less developed countries, increased vegetable or fruit intake was associated with increased birth weight in two prospective studies. Overall, limited inconclusive evidence of a protective effect of increased consumption of vegetables and risk for

  17. Growth hormone treatment in children with short stature born small for gestational age: 5-year results of a randomized, double-blind, dose-response trial

    OpenAIRE

    Sas, Theo; Waal, Wouter; Houdijk, M.; Jansen, Maarten; Reeser, M.; Mulder, Paul; Hokken-Koelega, Anita

    1999-01-01

    textabstractThe growth-promoting effect of continuous GH treatment was evaluated over 5 yr in 79 children with short stature (height SD score, less than -1.88) born small for gestational age (SGA; birth length SD score, less than -1.88). Patients were randomly and blindly assigned to 1 of 2 GH dosage groups (3 vs. 6 IU/m2 body surface-day). GH deficiency was not an exclusion criterium. After 5 yr of GH treatment almost every child had reached a height well within the normal range for healthy ...

  18. The Auxological and Biochemical Continuum of Short Children Born Small for Gestational Age (SGA or with Normal Birth Size (Idiopathic Short Stature

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    Ranke MichaelB

    2010-04-01

    Full Text Available Objective. Retrospective single-centre analysis of growth characteristics in 182 healthy short children born small for gestational age (SGA or appropriate for gestational age (idiopathic short stature, ISS. Methods. Birth size references from the USA and Sweden were compared, and for the classification as SGA or ISS the Swedish reference was chosen. Height, target height (TH, bone age (BA, predicted adult height (PAH, IGF-I and IGFBP-3 values were compared between SGA and ISS. Results. In the combined group, birth weight and length showed a symmetric Gaussian distribution. The American reference overestimates the percentage of short birth length and underestimates that of low birth weight. In childhood, SGA children were shorter than ISS (−3.1 versus −2.6 SDS, , also in comparison to TH (−2.6 versus −1.9 SDS, . TH, height SDS change over time, BA delay, and PAH were similar. IGF-I and IGFBP-3 were lower in ISS ( and .09. Conclusions. SGA children represent the left tail of the Gaussian distribution of birth size in short children. The distinction between SGA and ISS depends on birth size reference. Childhood height of SGA is lower than of ISS, but the other auxological features are similar.

  19. The Auxological and Biochemical Continuum of Short Children Born Small for Gestational Age (SGA or with Normal Birth Size (Idiopathic Short Stature

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    Jan M. Wit

    2010-01-01

    Full Text Available Objective. Retrospective single-centre analysis of growth characteristics in 182 healthy short children born small for gestational age (SGA or appropriate for gestational age (idiopathic short stature, ISS. Methods. Birth size references from the USA and Sweden were compared, and for the classification as SGA or ISS the Swedish reference was chosen. Height, target height (TH, bone age (BA, predicted adult height (PAH, IGF-I and IGFBP-3 values were compared between SGA and ISS. Results. In the combined group, birth weight and length showed a symmetric Gaussian distribution. The American reference overestimates the percentage of short birth length and underestimates that of low birth weight. In childhood, SGA children were shorter than ISS (−3.1 versus −2.6 SDS, P<.001, also in comparison to TH (−2.6 versus −1.9 SDS, P<.001. TH, height SDS change over time, BA delay, and PAH were similar. IGF-I and IGFBP-3 were lower in ISS (P=.03 and .09. Conclusions. SGA children represent the left tail of the Gaussian distribution of birth size in short children. The distinction between SGA and ISS depends on birth size reference. Childhood height of SGA is lower than of ISS, but the other auxological features are similar.

  20. A hyperoxic lung injury model in premature rabbits: the influence of different gestational ages and oxygen concentrations.

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    Roberta Munhoz Manzano

    Full Text Available BACKGROUND: Many animal models have been developed to study bronchopulmonary dysplasia (BPD. The preterm rabbit is a low-cost, easy-to-handle model, but it has a high mortality rate in response to the high oxygen concentrations used to induce lung injury. The aim of this study was to compare the mortality rates of two models of hyperoxia-induced lung injury in preterm rabbits. METHODS: Pregnant New Zealand white rabbits were subjected to caesarean section on gestational day 28 or 29 (full term  = 31 days. The premature rabbits in the 28-day gestation group were exposed to room air or FiO₂ ≥95%, and the rabbits in the 29-day gestation group were exposed to room air or FiO₂  = 80% for 11 days. The mean linear intercept (Lm, internal surface area (ISA, number of alveoli, septal thickness and proportion of elastic and collagen fibers were quantified. RESULTS: The survival rates in the 29-day groups were improved compared with the 28-day groups. Hyperoxia impaired the normal development of the lung, as demonstrated by an increase in the Lm, the septal thickness and the proportion of elastic fibers. Hyperoxia also decreased the ISA, the number of alveoli and the proportion of collagen fibers in the 28-day oxygen-exposed group compared with the control 28-day group. A reduced number of alveoli was found in the 29-day oxygen exposed animals compared with the control 29-day group. CONCLUSIONS: The 29-day preterm rabbits had a reduced mortality rate compared with the 28-day preterm rabbits and maintained a reduction in the alveoli number, which is comparable to BPD in humans.

  1. Lead versus bismuth-antimony shield for fetal dose reduction at different gestational ages at CT pulmonary angiography.

    Science.gov (United States)

    Chatterson, Leslie C; Leswick, David A; Fladeland, Derek A; Hunt, Megan M; Webster, Stephen T

    2011-08-01

    To compare the effective fetal dose reduction at different stages of gestation during maternal computed tomographic (CT) pulmonary angiography by using traditional lead apron and bismuth-antimony shields combined with limited z-axis and tube current. Phantom with gravid prosthesis, 0.5-mm lead, and two grades of bismuth-antimony shield was used. Thermoluminescent dosimeters (TLDs) measured radiation in the first- to third-trimester uterus. Fetal dose was determined for each gestation by using 100 kVp to the costophrenic angles (CPAs) with and without shielding for a total of 12 scans. Eight third-trimester scans were used to compare shields using 120 kVp to CPAs versus those using 100 kVp to the diaphragm. Average fetal dose increased with gestation with use of 100 kVp to CPAs, from 0.11 mGy in first trimester to 0.50 mGy in third trimester. Average third-trimester unshielded fetal dose was reduced from 0.82 mGy by using 120 kVp to CPAs to 0.17 mGy (79%, P Lead apron reduced dose more than either of the bismuth-antimony shields (72%-79% vs 57%-81%) with use of 100 kVp to CPAs. Shields reduced the dose by 73% (lead), 62% (90% attenuation bismuth-antimony), and 72% (95% attenuation bismuth-antimony) (P shields was demonstrated with 100 kVp to the diaphragm (P shields at reducing fetal dose. Shielding improves reduction with no significant difference between lead and bismuth-antimony shields when conservative scanning parameters are observed. © RSNA, 2011.

  2. Logistic regression analysis about the risk factors of small for gestational age%小于胎龄儿的高危因素Logistic回归分析

    Institute of Scientific and Technical Information of China (English)

    李盛强; 周守方; 袁贵龙

    2012-01-01

    目的:探讨小于胎龄儿的主要危险因素,为制定适宜的预防和干预措施提供科学依据.方法:选择2008~2009年单胎活产小于胎龄儿59例作为病例组,采用完全随机抽样方法选取出生体重在10%~90%分位的适于胎龄儿65例作为对照组.比较两组的胎龄、生长激素、胰岛素抵抗、镁离子浓度、孕妇体质指数、疾病情况、孕妇年龄、父亲吸烟、酗酒等,对上述资料先进行单因素分析,在此基础上选择有统计学差异的变量进行多因素非条件Logistic回归分析.结果:小于胎龄儿在生长激素、镁离子浓度、妊娠年龄方面明显低于适于胎龄儿,差异有统计学意义(P<0.05).小于胎龄儿在胰岛素抵抗水平、妊娠高血压、父亲酗酒率、父亲吸烟率方面明显高于适于胎龄儿,差异有统计学意义(P<0.05).Logistic回归分析表明,镁离子浓度、妊娠年龄、父亲酗酒可作为小于胎龄儿的独立相关因素.结论:镁离子可能是胎儿生长发育的重要调控因子;孕妇的妊娠年龄小和父亲的酗酒会使小于胎龄儿产生的几率大大增加.%Objective: To study the main risk factors of small for gestational age (SGA) infant and to provide scientific basis for appropriate prevention and intervention measure. Methods: The SGA group included 59 singleton alive SGA delivered in our hospital during January 2008 to December 2009, 65 cases were randomly selected by birth weight of 10% to 90% of its spaces appropriate for AGA and taken as a control group. Two groups were compared in gestation age, growth hormone, insulin resistance, density of magnesium ion, pregnant women's physique index, disease situation, pregnant women's age, father smoke, get drunk, etc. Simple logistic regression analysis was performed for all the risk factors, and variables with statistical significance were chosen for multivariate and unconditioned logistic regression analysis. Results: The levels of

  3. Genetic study of gestation length in Andalusian and Arabian mares.

    Science.gov (United States)

    Valera, M; Blesa, F; Dos Santos, R; Molina, A

    2006-09-01

    The length of gestation in Andalusian, or Spanish Purebred (SPB) and Arabian (AB) mares reared in Spain was analysed, based on 766 spontaneous full-term deliveries appertaining to 141 mares of SPB breed and 72 mares of AB breed in 31 breeding seasons. The data were obtained from the Yeguada Militar de Jerez de la Frontera stud farm in Cádiz, Spain. The mean length of gestation was of 336.8+/-0.48 days in the SPB mares and 340.3+/-0.63 days in AB mares. To assess the accurate prediction of time of birth the potential effect of a number of factors was investigated. The influences of the breed, mare, month and year of mating, age of the mother, number of births and sex of the foal were statistically significant. The factor have the greatest influence over the gestation length was the mare itself, with a correlation among consecutive births of around 0.4. The effect of inbreeding, both of the mare and foal, was negligible. Gestation length shortened as the breeding season progressed: in both breeds, a delay of 1 month in mating corresponded to a decrease of 3 days in the gestation length. According to our results, gestation length decrease as the mare gets older, with the shortest gestation periods when the mare is 10-12 years old, and from this point on, it slowly increases. The gestation period shortens as the 4th or 5th birth approaches, and then gets progressively longer. The range of variation in gestation length due to the number of births to the mare is of 2.9 days for the AB mares, and 2.2 days for SPB mares. The heritability for the gestation length for AB and the SPB breeds was 0.2, with a repeatability of 0.36 and 0.37, for SPB and AB breeds, respectively. With the data from both breeds, and using a classical approach, the response to selection was estimated if mares with extreme gestation lengths were culled, i.e. lengths which are under 310 days, or over 360 days. According to our results, in the case of SPB, a decrease of 14-45% would occur in the number

  4. Behavioural symptoms of attention deficit/hyperactivity disorder in preterm and term children born small and appropriate for gestational age: A longitudinal study

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    Kajantie Eero

    2010-12-01

    Full Text Available Abstract Background It remains unclear whether it is more detrimental to be born too early or too small in relation to symptoms of attention deficit/hyperactivity disorder (ADHD. Thus, we tested whether preterm birth and small body size at birth adjusted for gestational age are independently associated with symptoms of ADHD in children. Methods A longitudinal regional birth cohort study comprising 1535 live-born infants between 03/15/1985 and 03/14/1986 admitted to the neonatal wards and 658 randomly recruited non-admitted infants, in Finland. The present study sample comprised 828 children followed up to 56 months. The association between birth status and parent-rated ADHD symptoms of the child was analysed with multiple linear and logistic regression analyses. Results Neither prematurity (birth Conclusions Intrauterine growth restriction, reflected in SGA status and lower birth weight, rather than prematurity or lower gestational age per se, may increase risk for symptoms of ADHD in young children.

  5. Effect of maternal lipid profile, C-peptide, insulin, and HBA1c levels during late pregnancy on large-for-gestational age newborns

    Institute of Scientific and Technical Information of China (English)

    Ruo-Lin Hou; Huan-Huan Zhou; Xiao-Yang Chen; Xiu-Min Wang; Jie Shao; Zheng-Yan Zhao

    2014-01-01

    Background: Large-for-gestational age (LGA) newborns can increase the risk of metabolic syndrome. Previous studies have shown that the levels of maternal blood lipids, connecting peptide (C-peptide), insulin and glycosylated hemoglobin (HbA1c) were significantly different between LGA and appropriate-for-gestational age (AGA) newborns. This study aimed to determine the effect of the levels of maternal lipids, C-peptide, insulin, and HbA1c during late pregnancy on LGA newborns. Methods: This study comprised 2790 non-diabetic women in late pregnancy. Among their newborns, 2236 (80.1%) newborns were AGA, and 554 (19.9%) newborns were LGA. Maternal and neonatal characteristics were obtained from questionnaires and their case records. The levels of maternal fasting serum apolipoprotein A1 (ApoA1), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), C-peptide, insulin and blood HbA1c were measured. The chi-square and Mann-Whitney U test were used to analyze categorical variables and continuous variables between the AGA and LGA groups, respectively. Binary logistic regression analysis was made to determine the independent risk factors for LGA newborns. Results: Maternal TG, C-peptide, insulin and HbA1c levels were signifi cantly higher in the LGA group than in the AGA group (P Conclusion: High maternal TG level during late pregnancy is signifi cantly associated with LGA newborns.

  6. Maternal Plane of Nutrition during Late Gestation and Weaning Age Alter Angus × Simmental Offspring Longissimus Muscle Transcriptome and Intramuscular Fat.

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    Sonia J Moisá

    Full Text Available In model organisms both the nutrition of the mother and the young offspring could induce long-lasting transcriptional changes in tissues. In livestock, such changes could have important roles in determining nutrient use and meat quality. The main objective was to evaluate if plane of maternal nutrition during late-gestation and weaning age alter the offspring's Longissimus muscle (LM transcriptome, animal performance, and metabolic hormones. Whole-transcriptome microarray analysis was performed on LM samples of early (EW and normal weaned (NW Angus × Simmental calves born to grazing cows receiving no supplement [low plane of nutrition (LPN] or 2.3 kg high-grain mix/day [medium plane of nutrition (MPN] during the last 105 days of gestation. Biopsies of LM were harvested at 78 (EW, 187 (NW and 354 (before slaughter days of age. Despite greater feed intake in MPN offspring, blood insulin was greater in LPN offspring. Carcass intramuscular fat content was greater in EW offspring. Bioinformatics analysis of the transcriptome highlighted a modest overall response to maternal plane of nutrition, resulting in only 35 differentially expressed genes (DEG. However, weaning age and a high-grain diet (EW strongly impacted the transcriptome (DEG = 167, especially causing a lipogenic program activation. In addition, between 78 and 187 days of age, EW steers had an activation of the innate immune system due presumably to macrophage infiltration of intramuscular fat. Between 187 and 354 days of age (the "finishing" phase, NW steers had an activation of the lipogenic transcriptome machinery, while EW steers had a clear inhibition through the epigenetic control of histone acetylases. Results underscored the need to conduct further studies to understand better the functional outcome of transcriptome changes induced in the offspring by pre- and post-natal nutrition. Additional knowledge on molecular and functional outcomes would help produce more efficient beef

  7. Placental lipoprotein lipase DNA methylation alterations are associated with gestational diabetes and body composition at 5 years of age.

    Science.gov (United States)

    Gagné-Ouellet, Valérie; Houde, Andrée-Anne; Guay, Simon-Pierre; Perron, Patrice; Gaudet, Daniel; Guérin, Renée; Jean-Patrice, Baillargeon; Marie-France, Hivert; Brisson, Diane; Bouchard, Luigi

    2017-05-09

    Gestational diabetes mellitus (GDM) is associated with obesity in childhood. This suggests that consequences of in utero exposure to maternal hyperglycemia extend beyond the fetal development, possibly through epigenetic programming. The aims of this study were to assess whether placental DNA methylation (DNAm) marks were associated with maternal GDM status and to offspring body composition at 5 years old in a prospective birth cohort. DNAm levels were measured in the fetal side of the placenta in 66 samples (24 from GDM mothers) using bisDNA-pyrosequencing. Anthropometric and body composition (bioimpedance) were measured in children at 5 years of age. Mann-Whitney and Spearman tests were used to assess associations between GDM, placental DNAm levels at the lipoprotein lipase (LPL) locus and children's weight, height, body mass index (BMI), body fat, and lean masses at 5 years of age. Weight, height, and BMI z-scores were computed according to the World Health Organization growth chart. Analyses were adjusted for gestational age at birth, child sex, maternal age, and pre-pregnancy BMI. LPL DNAm levels were positively correlated with birth weight z-scores (r = 0.252, P = 0.04), and with mid-childhood weight z-scores (r = 0.314, P = 0.01) and fat mass (r = 0.275, P = 0.04), and negatively correlated with lean mass (r = -0.306, P = 0.02). We found a negative correlation between LPL DNAm and mRNA levels in placenta (r = -0.459; P fetal placental DNAm levels at the LPL gene locus are associated with the anthropometric profile in children at 5 years of age. These findings support the concept of fetal metabolic programming through epigenetic changes.

  8. Maternal Plane of Nutrition during Late Gestation and Weaning Age Alter Angus × Simmental Offspring Longissimus Muscle Transcriptome and Intramuscular Fat.

    Science.gov (United States)

    Moisá, Sonia J; Shike, Daniel W; Shoup, Lindsay; Rodriguez-Zas, Sandra L; Loor, Juan J

    2015-01-01

    In model organisms both the nutrition of the mother and the young offspring could i