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2.
Arch. argent. pediatr ; 121(3): e202202661, jun. 2023. tab, graf, mapas
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1435623

ABSTRACT

Introducción. El feto que no alcanza el potencial de crecimiento esperado en el útero se considera pequeño para la edad gestacional (PEG). Esta restricción depende de factores genéticos y/o ambientales; la altura geográfica es uno muy relevante. Este trabajo analiza la distribución espacial de las prevalencias de PEG y su tendencia secular en Jujuy (1991-2014). Materiales y métodos. Se analizaron los registros de 308 469 nacidos vivos de Jujuy (Dirección de Estadísticas e Información de Salud). Se estimaron prevalencias de PEG (peso/edad gestacional

Introduction. A fetus that does not reach the expected growth potential in utero is considered small for gestational age (SGA). Such restriction depends on genetic and/or environmental factors, being altitude a very relevant factor. This study analyzes the spatial distribution of the prevalence of SGA and its secular trend in Jujuy (1991­2014). Materials and methods. The records of 308 469 live births in Jujuy (Health Statistics and Information Department) were analyzed. The prevalence of SGA (weight/gestational age < P10 and < P3) was estimated for sex according to the INTERGROWTH-21 st standard in the ecoregions of Jujuy (Valle and Ramal ­less than 2000 MASL­, Puna, and Quebrada) across 3 periods (1991­2000, 2001­2009, 2010­2014) and proportions were compared. The secular trend was assessed using the Joinpoint regression analysis. Results. The overall prevalence of SGA was 2.3% (< P3) and 7% (< P10). Significantly higher values were observed in Puna and Quebrada in both SGA categories and across all periods. Only in Valle, significant differences were observed between sexes across all periods. The prevalence of SGA showed a significant downward secular trend at a provincial and regional level, and this was greater in Quebrada (5.2% < P3 and 3.5% < P10). Conclusions. A consistent and significant decrease in the prevalence of SGA has been observed since the 1990s in Jujuy, where altitude is itself a determining factor of size at birth, since the Puna and Quebrada regions showed the highest prevalence of SGA during the entire period.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infant , Infant, Small for Gestational Age , Parturition , Prevalence , Cross-Sectional Studies , Retrospective Studies , Gestational Age , Altitude
3.
Chinese Journal of Obstetrics and Gynecology ; (12): 334-342, 2023.
Article in Chinese | WPRIM | ID: wpr-985656

ABSTRACT

Objective: To establish neonatal birthweight percentile curves based on single-center cohort database using different methods, compare them with the current national birthweight curves and discuss the appropriateness and significance of single-center birthweight standard. Methods: Based on a prospective first-trimester screening cohort at Nanjing Drum Tower Hospital from January 2017 to February 2022, the generalized additive models for location, scale and shape (GAMLSS) and semi-customized method were applied to generate local birthweight percentile curves (hereinafter referred to as the local GAMLSS curves, semi-customized curves) for 3 894 cases who were at low risk of small for gestation age (SGA) and large for gestation age (LGA). Infants were categorized as SGA (birth weight<10th centile) by both semi-customized and local GAMLSS curves, semi-customized curves only, or not SGA (met neither criteria). The incidence of adverse perinatal outcome between different groups was compared. The same method was used to compare the semi-customized curves with the Chinese national birthweight curves (established by GAMLSS method as well, hereinafter referred to as the national GAMLSS curves). Results: (1) Among the 7 044 live births, 404 (5.74%, 404/7 044), 774 (10.99%, 774/7 044) and 868 (12.32%, 868/7 044) cases were diagnosed as SGA according to the national GAMLSS curves, the local GAMLSS curves and the semi-customized curves respectively. The birth weight of the 10th percentile of the semi-customized curves was higher than that of the local GAMLSS curves and the national GAMLSS curves at all gestational age. (2) When comparing semi-customized curves and the local GAMLSS curves, the incidence of admission to neonatal intensive care unit (NICU) for more than 24 hours of infants identified as SGA by semi-customized curves only (94 cases) and both semi-customized and local GAMLSS curves (774 cases) was 10.64% (10/94) and 5.68% (44/774) respectively, both significantly higher than that in non SGA group [6 176 cases, 1.34% (83/6 176); P<0.001]. The incidence of preeclampsia, pregnancy<34 weeks, and pregnancy<37 weeks of infants identified as SGA by the semi-customized curves only and both semi-customized and local GAMLSS curves was 12.77% (12/94) and 9.43% (73/774), 9.57% (9/94) and 2.71% (21/774), 24.47% (23/94) and 7.24% (56/774) respectively, which were significantly higher than those of the non SGA group [4.37% (270/6 176), 0.83% (51/6 176), 4.23% (261/6 176); all P<0.001]. (3) When comparing semi-customized curves and the national GAMLSS curves, the incidence of admission to NICU for more than 24 hours of infants identified as SGA by semi-customized curves only (464 cases) and both semi-customized and national GAMLSS curves (404 cases) was 5.60% (26/464) and 6.93% (28/404) respectively, both significantly higher than that in non SGA group [6 176 cases, 1.34% (83/6 176); all P<0.001]. The incidence of emergency cesarean section or forceps delivery for non-reassuring fetal status (NRFS) in infants identified as SGA by semi-customized curves only and both semi-customized and national GAMLSS curves was 4.96% (23/464) and 12.38% (50/404), both significantly higher than that in the non SGA group [2.57% (159/6 176); all P<0.001]. The incidence of preeclampsia, pregnancy<34 weeks, and pregnancy<37 weeks in the semi-customized curves only group and both semi-customized and national GAMLSS curves group was 8.84% (41/464) and 10.89% (44/404), 4.31% (20/464) and 2.48% (10/404), 10.56% (49/464) and 7.43% (30/404) respectively, all significantly higher than those in the non SGA group [4.37% (270/6 176), 0.83% (51/6 176), 4.23% (261/6 176); all P<0.001]. Conclusion: Compared with the national GAMLSS birthweight curves and the local GAMLSS curves, the birth weight curves established by semi-customized method based on our single center database is in line with our center' SGA screening, which is helpful to identify and strengthen the management of high-risk infants.


Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Birth Weight , Cesarean Section , Gestational Age , Infant, Small for Gestational Age , Pre-Eclampsia/epidemiology , Prospective Studies
4.
Chinese Journal of Preventive Medicine ; (12): 935-940, 2023.
Article in Chinese | WPRIM | ID: wpr-985499

ABSTRACT

The incidence of perinatal disease and perinatal mortality in small for gestational age infants increased significantly. This group of people is prone to a variety of long-term metabolic diseases and cardiovascular diseases, and is also prone to growth retardation and neurodevelopmental delay, which will seriously affect the long-term quality of life of children. The article studies the neurodevelopmental outcomes of small-for-gestational-age infants. By reviewing and sorting out previous literature, the neurodevelopmental disorders of small-for-gestational-age infants are analyzed according to five aspects: intellectual development, motor development, language development, sensory development, and mental illness. The classification and summary were carried out, and the influencing factors of neurodevelopmental disorders of SGA were also evaluated, so as to provide reference for promoting the improvement of neurodevelopmental outcomes of small-for-gestational-age infants.


Subject(s)
Infant, Newborn , Pregnancy , Female , Child , Infant , Humans , Gestational Age , Quality of Life , Infant, Small for Gestational Age , Fetal Growth Retardation/epidemiology
5.
Chinese Journal of Contemporary Pediatrics ; (12): 104-108, 2023.
Article in Chinese | WPRIM | ID: wpr-971047

ABSTRACT

About 3% of pregnant women suffer from chronic kidney disease (CKD). This article reviews the literature on the outcomes of neonates born to mothers with CKD (including those undergoing dialysis and kidney transplantation), and the results show that CKD during pregnancy may increase the risk of preterm birth, low birth weight, and small for gestational age infant, but it does not increase the risk of congenital anomalies. As for long-term outcomes, CKD during pregnancy has no significant impact on offspring's physical development and immune function. Neurodevelopmental outcome of offspring is associated with preterm birth and low birth weight, rather than intrauterine drug exposure. However, further research and follow-up are needed to investigate the outcome of neonates born to mothers with CKD.


Subject(s)
Infant , Infant, Newborn , Pregnancy , Female , Humans , Birth Weight , Premature Birth , Mothers , Renal Insufficiency, Chronic/therapy , Infant, Small for Gestational Age
6.
Clin. biomed. res ; 43(1): 39-46, 2023.
Article in English | LILACS | ID: biblio-1435949

ABSTRACT

Introduction: To analyze the factors (socio-demographic, clinical, prenatal care, delivery, postpartum data and anthropometric measures) associated with the birth of small for gestational age newborns.Methods: A cross-sectional study was performed with 15 years old or younger postpartum adolescents divided into small-for-gestational-age newborn (SGA) and non-small-for-gestational age newborn groups (NSGA). Socio-demographic, clinical, prenatal care, delivery, postpartum data and anthropometric measures (triceps skinfold (TS), and mid-arm circumference, (MAC)) were collected.Results: 8,153 women gave birth at the obstetric ward and 364 (4.46%) ≤ 15 years old adolescents were enrolled in the study. The proportion of SGA newborns was 34.61%. The SGA group attended fewer prenatal visits (p = 0.037), had a higher prevalence of nutritional status classified as "very low weight" (p < 0.001) and vaginal delivery (p = 0.023), compared to the NSGA group. The nutritional status and vaginal delivery remained significant even after adjustment for confounders. The prevalence risk for SGA birth was 30% higher in the group of mothers with nutritional status classified as "very low weight" (odds ratio 1.30, 95% confidence interval 1.13 to 1.50) (p < 0.001).Conclusions: 15.4% of adolescents ≤ 15 years of age had an arm circumference compatible with the "very low weight" condition, demonstrating the high prevalence of poor maternal nutritional status in this group. The birth of SGA among adolescents ≤ 15 years of age is independently associated with maternal nutritional status classified as "very low weight" by the mid-arm circumference measures (MAC).


Subject(s)
Humans , Female , Adolescent , Nutritional Status , Adolescent Mothers/statistics & numerical data , Infant, Small for Gestational Age/growth & development , Fetal Growth Retardation/etiology
7.
Rio de Janeiro; s.n; 2023. 96 p. ilus.
Thesis in Portuguese | LILACS | ID: biblio-1551469

ABSTRACT

Introdução: Os recém-nascidos muito pré-termo e com muito baixo peso, apresentam na idade corrigida do termo, uma menor massa livre de gordura e maior adiposidade, em relação aos nascidos a termo. O aumento da gordura corporal na idade corrigida do termo pode ser fisiológico devido a uma adaptação do recém-nascido pré-termo a vida extrauterina. Entretanto, o déficit de massa livre de gordura pode persistir ao longo da vida e reflete uma capacidade metabólica reduzida e, portanto, o maior risco de doenças metabólicas no futuro. Os estudos sobre a composição corporal na idade pré-escolar e escolar de crianças nascidas pré-termo evidenciam resultados conflitantes na literatura. Objetivo: O objetivo deste estudo foi avaliar a composição corporal e o crescimento de crianças nascidas muito pré-termo ou muito baixo peso, entre 4 e 7 anos. Esta pesquisa apresenta como objetivos específicos comparar a composição corporal e o crescimento entre crianças que nasceram pequenas e adequadas para idade gestacional e avaliar associações entre a composição corporal nos primeiros 3 meses de vida com a massa livre de gordura e percentual de gordura entre 4 e 7 anos. Métodos: Estudo de coorte de recém-nascidos menores de 32 semanas de idade gestacional ou peso inferior a 1500 g, no Instituto Nacional em Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira/Fiocruz. Os dados antropométricos e da composição corporal, com o uso da pletismografia por deslocamento de ar, foram coletados nas idades corrigidas do termo e 3 meses, e na idade entre 4 e 7 anos. O teste t de Student e o teste qui-quadrado foram utilizados para comparar o crescimento e a composição corporal entre recém-nascidos pequenos, e adequados para idade gestacional, nas idades corrigidas do termo e 3 meses e na idade entre 4 e 7 anos. A análise de regressão linear múltipla foi realizada para avaliar as associações entre a composição corporal e o sexo masculino nos primeiros 3 meses de vida com a massa livre de gordura e o percentual de gordura na idade entre 4 e 7 anos. Para todas as análises foi considerado o nível de significância de 0,05. Resultados: Os recém-nascidos muito pré-termo, pequenos para idade gestacional, na idade corrigida do termo, apresentaram menor massa livre de gordura e massa de gordura (gramas, percentual e índices) e menor peso, comprimento e perímetro cefálico do que os nascidos adequados para idade gestacional. Aos 3 meses, a massa livre de gordura, índice de massa livre de gordura, peso e comprimento permaneceram menores no grupo dos nascidos pequenos para idade gestacional. Entre 4 e 7 anos a composição corporal e a antropometria foram similares entre os grupos. Na idade corrigida do termo, a massa livre de gordura apresentou associação positiva, e o percentual de gordura associação negativa com a massa livre de gordura aos 4 a 7 anos de idade. Aos 3 meses, a massa livre de gordura apresentou associação positiva com a massa livre de gordura na idade de 4 a 7 anos. O ganho de massa livre de gordura entre o período do termo e 3 meses também apresentou associação positiva com a massa livre de gordura aos 4 a 7 anos de idade. Conclusão: As diferenças na composição corporal observadas nos primeiros 3 meses de vida entre as crianças nascidas pré-termo pequenas e adequadas para idade gestacional, não se mantiveram entre 4 e 7 anos. A composição corporal na idade de 4 a 7 anos, apresentou associações com a massa livre de gordura nos primeiros 3 meses de idade corrigida, sendo este um período sensível para o risco de doenças metabólicas ao longo da vida. Os estudos longitudinais de longo prazo são necessários para melhor avaliar a trajetória da qualidade do crescimento das crianças nascidas muito pré-termo.


Introduction: Very preterm and very low birth weight infants have less fat-free mass and higher adiposity at term corrected age, than those born at term. The increase in fat mass may be physiological due to an adaptation of the preterm newborn to extrauterine life. However, the deficit of fat-free mass may persist throughout life and reflects a reduced metabolic capacity and therefore, increasing the risk of metabolic diseases in the future. Studies on body composition at preschool and school ages of children born preterm show conflicting results in the literature. Objective: The aim of the present study was to evaluate the body composition and growth of children born very preterm and/or very low birth weight, between 4 and 7 years of age. This research presents as specific objectives the comparison of body composition and growth between children born small and adequate for gestational age and to evaluate associations between body composition in the first 3 months of life with fat-free mass and fat percentage between 4 and 7 years of age. Methods: Cohort study of infants younger than 32 weeks of gestational age or less than 1500 g, at the Instituto Nacional em Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira / Fiocruz. Anthropometric and body composition data, using air displacement plethysmography, were collected at term and 3-month corrected ages, and at 4 to 7 years of age. Student's t test and chi-square test were used to compare growth and body composition between small and appropriate for gestational age infants at term and 3-month corrected ages, and at 4 to 7 years of age. A multiple linear regression analysis was performed to evaluate the associations between body composition and male sex in the first 3 months of life with fat-free mass and fat percentage at 4 to 7 years of age. For all analyses, a significance level of 0.05 was considered. Results: The very preterm, small for gestational age infants had had lower fat-free mass and fat mass (grams, percentual and indexes), and lower weight, length, and head circumference than the appropriate for gestational age infants. At 3 months, fat-free mass, fat-free mass index, weight and length remained lower in the small for gestational age group. Between 4 and 7 years, body composition and anthropometry were similar between the groups. At term corrected age, the fat-free mass showed a positive association and the percentage of fat mass a negative association with fat-free mass at 4 to 7 years. At 3 months, fat-free mass showed a positive association with fat-free mass at ages 4 to 7 years. Also, the gain in fat-free mass between term to 3 months was positively associated with fat-free mass ate 4 to 7 years at age. Conclusion: The differences in body composition and anthropometry observed in the first 3 months of life between children born very preterm small and appropriate for gestational age, were not maintained at 4 to 7 years of age. Body composition at preschool and school age shows associations with fat-free mass and % fat mass in the first 3 months of corrected age, and this is a sensitive period for the risk of metabolic diseases. Long-term longitudinal studies are needed to better assess the trajectory of growth quality in children born very preterm.


Subject(s)
Humans , Infant, Newborn , Child, Preschool , Child , Body Composition , Infant, Premature , Infant, Small for Gestational Age , Anthropometry , Cohort Studies , Infant, Very Low Birth Weight , Metabolic Syndrome , Brazil
8.
Ibom Medical Journal ; 15(2): 132-140, 2022. tables
Article in English | AIM | ID: biblio-1379812

ABSTRACT

Background: Early initiation of breast feeding and feeding exclusively for six months have great implication for the survival, well-being and growth of new borne. Factors such as maternal age, occupation, religion, spouse age, spouse occupation, parity, antenatal care (ANC) attendance, mode of delivery (MOD) and birth order are significantly associated with exclusive breast feeding (EBF) Methodology: The study is a descriptive cross-sectional study conducted among nursing mothers attending child health clinic in General Hospital Bonny, in Bonny Island, Rivers State, Nigeria. All eligible nursing mother who presented at the clinic were enlisted for the study. Enlistment of eligible participants was done on every child welfare clinic day. Data was collected using a pretested, interviewer administered, structured questionnaire which was adapted and prepared in English Language. Categorical data was analyzed using multinomial logistic regression model with statistical significance set at 0.05. Result: Results from this study identified significant association between EBF and some maternal variables such as age, occupation and religion. Spouse age and occupation were significantly associated with EBF. ANC attendance, gestational age, MOD, parity and birth order were also significant variables associated with EBF. Conclusion: Maternal variables such as age, occupation, religion, parity, MOD, ANC attendance including spouse age and occupation significantly influence EBF of new borne.


Subject(s)
Breast Feeding , Occupations , Parity , Infant, Small for Gestational Age , Child Health , Breastfeeding and Complementary Feeding , Mothers
9.
Niger. j. paediatr ; 49(3): 261-265, 2022. tables
Article in English | AIM | ID: biblio-1399083

ABSTRACT

In the absence of acute phase reaction, ferritin concentration has been used as a standard measurement of iron stores. Low birth weight babies are at risk of developing iron lack because ferritin concentration at birth is influenced by duration of gestation, maternal iron status and conditions altering maternal­foetal iron exchange. Aim: The aim of this study was to determine the ferritin concentrations of low birth weight babies in comparison with that of normal birth weight babies. Materials and methods: Fortyfour normal birth weight (NBW) babies and 40 low birth weight (LBW) babies were recruited for the study. About 1.0ml of venous blood was drawn aseptically from each subject into a micro EDTA tube, centrifuged at 5000rpm for 5 minutes, the plasma separated into cryotubes and stored at-20oC until ready for quantitative determination of ferritin concentrations using direct immunoenzymatic colorimetric method.Data obtained was analysed statistically using the Statistical Package for Social Sciences (SPSS,version 23, Chicago, IL, USA). Results: Gestational age correlated positively with ferritin concentrations in LBW neonates (p<0.05)while APGAR score correlatepositively with ferritin concentrations in normal birth weight babies (r=0.398; p<0.05). Thoug not statistically significant (p=0.214), median values for ferritin concentrations were 188.5µg/ dl and 373µg/dl for LBW and NBW neonates respectively. Conclusion: Gestational age correlated positively with ferritin concentrations in LBW neonates


Subject(s)
Humans , Apgar Score , Apoferritins , Infant, Low Birth Weight , Infant, Small for Gestational Age , Gestational Age
10.
Chinese Journal of Contemporary Pediatrics ; (12): 60-64, 2022.
Article in English | WPRIM | ID: wpr-928567

ABSTRACT

OBJECTIVES@#To study the effect of hypertensive disorders of pregnancy on peripheral venous blood cell count in preterm infants with a gestational age of 28-34 weeks.@*METHODS@#A total of 227 preterm infants with a gestational age of 28-34 weeks who were admitted to the Department of Pediatrics, the First Hospital Affiliated to Kunming Medical University, from January to December 2020, and whose mothers had hypertensive disorders of pregnancy were enrolled as the study group. A total of 227 preterm infants with a gestational age of 28-34 weeks who were admitted during the same period and whose mothers did not have hypertensive disorders of pregnancy were enrolled as the control group. According to maternal blood pressure during pregnancy, the study group was divided into three subgroups: gestational hypertension (n=75), mild preeclampsia (n=81), and severe preeclampsia (n=71). According to the birth weight of the preterm infants, the study group was divided into two subgroups: small for gestational age (SGA) (n=113) and appropriate for gestational age (AGA) (n=114). Peripheral blood cell count on day 1 after birth was compared between the study and control groups, as well as between the subgroups of the study group.@*RESULTS@#Compared with the control group, the study group had significantly lower white blood cell count, absolute neutrophil count, and blood platelet count (P<0.05) and significantly higher incidence rates of leucopenia and neutropenia (P<0.05). The subgroup analysis showed that the mild preeclampsia and severe preeclampsia subgroups had significantly lower white blood cell count, absolute neutrophil count, and blood platelet count than the gestational hypertension subgroup (P<0.05), and that the SGA subgroup had significantly lower white blood cell count, absolute neutrophil count, and blood platelet count than the AGA subgroup (P<0.05).@*CONCLUSIONS@#Hypertensive disorders of pregnancy can affect the peripheral venous blood cell count of preterm infants, which is more significant in infants with maternal preeclampsia and SGA infants.


Subject(s)
Child , Female , Humans , Infant , Infant, Newborn , Pregnancy , Gestational Age , Hypertension, Pregnancy-Induced , Infant, Premature , Infant, Small for Gestational Age , Platelet Count
11.
Article in Portuguese | LILACS, CONASS, ColecionaSUS, SES-GO | ID: biblio-1401207

ABSTRACT

Tecnologia: Somatropina. Indicação: Transtorno de crescimento em crianças nascidas pequenas para a idade gestacional (PIG). Pergunta: A somatropina é eficaz e segura para promover aumento da curva de crescimento em crianças nascidas PIG? Métodos: Levantamento bibliográfico foi realizado na base de dados PUBMED, seguindo estratégias de buscas predefinidas. Foi feita avaliação da qualidade metodológica das revisões sistemáticas com a ferramenta AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews version 2). Resultados: Foi selecionada uma revisão sistemática que atendeu aos critérios de inclusão. Conclusão: evidências de moderada certeza indicam que somatropina é eficaz e segura para tratamento de crianças nascidas PIG, pois promove recuperação do crescimento e não há relatos de eventos adversos graves na literatura científica


Technology: Somatropin. Indication: Growth disorder in children born small for gestational age (SGA). Question: Is somatropin effective, safe and cost effective for promoting height gain in children born SGA? Methods: A bibliographic search was done in PUBMED database, following predefined search strategies. The methodological quality of systematic reviews was evaluated using the AMSTAR-2 tool (A MeaSurement Tool to Assess systematic Reviews version 2). Results: Only a systematic review met the inclusion criteria and was selected. Conclusion: Evidence of moderate certainty indicates that somatropin is effective and safe for the treatment of children born SGA, because the treatment improve the growth and there are no reports of serious adverse events in the scientific literature


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Infant, Small for Gestational Age , Human Growth Hormone/therapeutic use , Growth Disorders/drug therapy , Treatment Outcome , Systematic Reviews as Topic
12.
Rev. bras. ginecol. obstet ; 43(10): 743-748, Oct. 2021. tab, graf
Article in English | LILACS | ID: biblio-1357058

ABSTRACT

Abstract Objective To assess maternal serum levels of vitamin D in fetuses appropriate for gestational age (AGA), small for gestational age (SGA), and with fetal growth restriction (FGR) according to estimated fetal weight (EFW). Methods This cross-sectional study included 87 pregnant women between 26 and 36 weeks of gestation: 38 in the AGA group, 24 in the SGA group, and 25 in the FGR group. Maternal serum vitamin D levels were assessed using the chemiluminescence method. The Fisher exact test was used to compare the results between the groups. Results The mean ± standard deviation (SD) of maternal age (years) and body mass index (kg/m2) in the AGA, SGA, and FGR groups were 25.26 8.40 / 26.57 ± 4.37; 25.04 ± 8.44 / 26.09 ± 3.94; and 25.48 ± 7.52 / 26.24 ± 4.66, respectively (p > 0.05). The maternal serum vitamin D levels (mean ± SD) of the AGA, SGA, and FGR groups were 22.47 ± 8.35 ng/mL, 24.80 ± 10.76 ng/mL, and 23.61 ± 9.98 ng/mL, respectively, but without significant differences between the groups (p = 0.672). Conclusion Maternal serum vitamin D levels did not present significant differences among pregnant women with AGA, SGA, or FGR fetuses between 26 and 36 weeks of gestation according to EFW.


Resumo Objetivo Avaliar o nível sérico materno de vitamina D em fetos adequados para idade gestacional (AIG), pequenos para idade gestacional (PIG) e com restrição de crescimento (RCF) de acordo com a estimativa de peso fetal (EPF). Métodos Realizou-se um estudo transversal envolvendo 87 gestantes entre 26 e 36 semanas, sendo: 38 do grupo AIG, 24 do grupo PIG e 25 do grupo RCF. A dosagem sérica materna de vitamina D foi realizada pelo método de quimiluminescência. Para as comparações entre os grupos, utilizou-se o teste exato de Fisher. Resultados A média ± desvio-padrão (DP) da idade materna (anos) e do índice de massa corporal (kg/m2) nos grupos AIG, PIG e RCF foram 25,26 ± 8,40 / 26,57 ± 4,37; 25,04 ± 8,44 / 26,09 ± 3,94; e 25,48 ± 7,52 / 26,24 ± 4,66, respectivamente (p>0,05). A concentração sérica materna de vitamina D (médias ± desvios-padrão) dos grupos AIG, PG e RCF foram 22,47±8,35 ng/ml; 24,80_10,76 ng/ml; e 23,61 ± 9,98 ng/ml, respectivamente, contudo, sem diferenças significativas entre os grupos (p=0,672). Conclusão A concentração sérica materna de vitamina D não apresentou diferenças significantes entre gestantes com fetos AIG, PIG ou RCF entre 26 e 36 semanas de acordo com a EPF.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Pregnant Women , Fetal Growth Retardation , Vitamin D , Infant, Small for Gestational Age , Cross-Sectional Studies , Ultrasonography, Prenatal , Gestational Age
13.
Chinese Journal of Contemporary Pediatrics ; (12): 1200-1207, 2021.
Article in English | WPRIM | ID: wpr-922410

ABSTRACT

OBJECTIVES@#To assess the growth of preterm infants up to a corrected age of 24 months, and to understand the growth trend and pattern of preterm infants.@*METHODS@#A preterm infant follow-up database was established based on the Internet Plus follow-up system. A total of 3 188 preterm infants who were born from April 2018 to April 2021 were enrolled. Their length, weight, and head circumference were recorded at birth and at the corrected ages of 1, 3, 6, 12, 18, and 24 months. The preterm infants were grouped by perinatal factors. The growth curves of these infants were plotted and compared with the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) standard and World Health Organization (WHO) standard.@*RESULTS@#The weight, length, and head circumference curves of each group of preterm infants grouped by various perinatal factors all rose rapidly within the corrected age of 6 months, but the growth rate slowed down after the corrected age of 6 months. Based on the actual age for the groups of preterm infants with different gestational ages (<28 weeks, 28-31@*CONCLUSIONS@#The physical growth rate of preterm infants is faster within the corrected age of 6 months, and the growth rate slows down after the corrected age of 6 months. Preterm infants with a smaller gestational age need longer time to catch up in weight and head circumference. More attention should be paid to the physical growth of extremely preterm infants, extremely low birth weight infants, and small-for-gestational-age infants.


Subject(s)
Child, Preschool , Female , Humans , Infant , Infant, Newborn , Pregnancy , Cephalometry , Gestational Age , Infant, Extremely Low Birth Weight , Infant, Premature , Infant, Small for Gestational Age
14.
Chinese Journal of Contemporary Pediatrics ; (12): 1184-1189, 2021.
Article in English | WPRIM | ID: wpr-922408

ABSTRACT

Intrauterine growth restriction (IUGR) is caused by many factors, and most newborns with IUGR are small for gestational age (SGA). SGA infants have a relatively high risk of death and disease in the perinatal period, and the nervous system already has structural changes in the uterus, including the reduction of brain volume and gray matter volume, accompanied by abnormal imaging and pathological changes. IUGR fetuses undergo intrauterine blood flow redistribution to protect brain blood supply, and there are still controversies over the clinical effect of brain protection mechanism. SGA infants have a relatively high risk of abnormal cognitive, motor, language, and behavioral functions in the neonatal period and childhood, and preterm infants tend to have a higher degree of neurological impairment than full-term infants. Early intervention may help to improve the function of the nervous system.


Subject(s)
Child , Female , Humans , Infant , Infant, Newborn , Pregnancy , Brain , Fetal Growth Retardation , Gestational Age , Infant, Premature , Infant, Small for Gestational Age
15.
Chinese Journal of Contemporary Pediatrics ; (12): 494-498, 2021.
Article in Chinese | WPRIM | ID: wpr-879883

ABSTRACT

OBJECTIVE@#To study the influence of placental pathological chorangiosis in the mother on the mortality of neonates and the incidence rate of complications.@*METHODS@#A retrospective analysis was performed for the neonates who were hospitalized within 3 days after birth in the Department of Neonatology, Xiamen Maternal and Child Health Hospital, from July 2016 to February 2020. According to whether the placental pathology showed chorangiosis, the neonates were divided into an observation group and a control group (@*RESULTS@#Compared with the control group, the observation group had a significantly higher cesarean section rate (@*CONCLUSIONS@#Neonates born to mothers with placental pathological chorangiosis tend to have a higher morbidity rate and incidence rate of complications. It is important to improve the understanding of chorangiosis and provide intervention as soon as possible, in order to reduce complications and improve prognosis.


Subject(s)
Child , Female , Humans , Infant, Newborn , Pregnancy , Cesarean Section , Infant, Newborn, Diseases , Infant, Small for Gestational Age , Pregnancy Complications , Retrospective Studies
16.
Chinese Journal of Contemporary Pediatrics ; (12): 475-481, 2021.
Article in Chinese | WPRIM | ID: wpr-879880

ABSTRACT

OBJECTIVE@#To study the effect of oral motor intervention (OMI) on brain function development in preterm infants.@*METHODS@#A total of 112 preterm infants were stratified into small-gestational-age (30-31@*RESULTS@#On day 7 of OMI, the small-gestational-age intervention group had lower upper bounds of voltage and bandwidth and a higher aEEG score than the small-gestational-age control group (@*CONCLUSIONS@#OMI can promote the maturation of aEEG background activities, improve neurobehavioral manifestations, and accelerate brain function development in preterm infants.


Subject(s)
Humans , Infant , Infant, Newborn , Brain , Electroencephalography , Gestational Age , Infant, Premature , Infant, Small for Gestational Age
17.
São Paulo; s.n; 2021. 99 p.
Thesis in Portuguese | LILACS | ID: biblio-1342174

ABSTRACT

Introdução - As elevadas taxas de mortalidade neonatal e a prevalência de bebês nascidos pequenos para idade gestacional (PIG) ainda apresentadas por regiões de baixa e média renda indicam a necessidade de investigação sobre fatores que influenciam o crescimento fetal. Medidas biométricas fetais

Introduction Elevated rates of neonatal mortality and small-for-gestational-age (SGA) babies in low- and middle-income regions indicate the need to investigate factors associated with fetal growth. Fetal biometric measurements below the 10th percentile for gestational age (GA) reflect failure in achieving growth potential and provide opportunities for prenatal interventions. Objective To investigate factors associated with fetal biometric measurements below the 10th percentile assessed at early third trimester among pregnant women in the MINA-Brazil study. Methods This was a prospective analysis of pregnant women living in the urban area of Cruzeiro do Sul (AC), followed up since the antenatal period. Screening of participants took place from February 2015 to January 2016. A sociodemographic and health history interview was carried out along with two clinical assessments, scheduled between the second and third trimesters of pregnancy, to collect data on lifestyle factors and complications during pregnancy, anthropometric evaluation, blood collection, and ultrasound scan assessing fetal biometric measurements of head circumference (HC), abdominal circumference (AC) and femoral length (FL). Poisson regression models with hierarchical selection of variables were fitted for factors associated with occurrence of fetal measurements below the 10th percentile at early third trimester. Prevalence ratios (PR) and 95% confidence intervals (95%CI) were estimated. Results Among 426 participants (mean age 25 years (SD 6.4) and gestational age 27.8 weeks (SD 1.7)), 11.3%, 8.9% e 9.4% had fetuses with HC, AC, FL below the 10th percentile at early third trimester. Fetal biometric measurements below the 10th percentile were negatively associated with higher maternal education level, which denoted over 50% of protection (HC: PR 0.47, 95%CI 0.28; 0.81; AC: PR 0.48, 95%CI 0.26; 0.87; and FL: PR 0.48, 95%CI 0.27; 0.86). Adjusted for maternal education level, nulliparity (PR 1.94, 95%CI 1.10; 3.43), higher pre-gestational body mass index (BMI) (PR 1.06, 95%CI 1.01; 1.11), and pre-gestational alcohol consumption (PR 1.80, 95%CI 0.98; 3.30) were associated with HC measurements below the 10th percentile. Maternal height (p for trend 0.039) and pre-gestational alcohol consumption (PR 2.55, 95%CI 1.31; 4.96) were also associated with AC measurements below the 10th percentile. Association between higher average screen time per day during antenatal follow-up and FL measurements below the 10th percentile were observed as well (p for trend 0.031). Higher maternal education level, which may provide better material and non-material conditions, seems to protect fetal growth from failure to reach potential fetal size for GA. Positive associations observed with obstetric and antenatal conditions may be mediated by biological factors or gestational dysfunctions to incur in fetal measurements below the 10th percentile. Conclusion The occurrence of fetal biometric measurements below the 10th percentile for GA and their associated factors corroborate pre-pregnancy and antenatal care improvements anchored in equity policies, and for new strategies prior to birth that optimize the window of opportunity in the first thousand days of life.


Subject(s)
Infant, Small for Gestational Age , Cephalometry , Biometry , Abdominal Circumference , Femur/growth & development , Fetal Growth Retardation , Fetus
18.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 39: e2019245, 2021. tab, graf
Article in English, Portuguese | LILACS, SES-SP | ID: biblio-1136767

ABSTRACT

ABSTRACT Objective: To compare the incidence of small for gestational age infants among late preterm and term newborns, using the Fenton and Intergrowth-21st curves. Methods: Observational and retrospective study with newborns in a level II maternity. The study was approved by the Institution's Ethics Committee. Live births from July 2007 to February 2009 with a gestational age from 34 to 41 weeks and seven days were included. Neonates with incomplete data were excluded. Appropriate weight for gestational age was assessed by the Fenton and Intergrowth-21st intrauterine growth curves, considering birth weight <10th percentile as small for gestational age. The degree of agreement between the two curves was assessed by the Kappa coefficient. Numerical variables were compared using the Student t-test or the Mann-Whitney. Categorical variables were compared using the chi-square test. Statistical analyzes were performed using SPSS17® software, considering significant, p<0.05. Results: We included 2849 newborns with a birthweight of 3210±483 g, gestational age of 38.8±1.4 weeks; 51.1% male. The incidence of small for gestational age in the full sample was 13.0 vs. 8.7% (p<0.001, Kappa=0.667) by the Fenton and Intergrowth-21st curves, respectively. Among late preterm, the incidence of small neonates was 11.3 vs. 10.9% (p<0.001; Kappa=0.793) and among full-term infants it was 13.1% vs. 8.5% (p<0.001; Kappa=0.656), respectively for the Fenton and Intergrowth-21st curves. Conclusions: The incidence of small for gestational age newborns was significantly higher using the Fenton curve, with greater agreement between the Fenton and Intergrowth-21st curves among late preterm, compared to full term neonates.


RESUMO Objetivo: Comparar a incidência de neonatos pequenos para idade gestacional entre nascidos vivos pré-termo tardios e a termo utilizando as curvas de Fenton e Intergrowth-21st. Métodos: Estudo observacional retrospectivo com recém-nascidos de uma maternidade pública de nível secundário. Foram incluídos nascidos vivos de julho/2007 a fevereiro/2009 com idade gestacional de 34 a 41 semanas e seis dias. O estudo foi aprovado pelo Comitê de Ética da instituição. Foram excluídos recém-nascidos com dados incompletos. Para adequação do peso/da idade gestacional, utilizaram-se as curvas de crescimento intrauterino de Fenton e Intergrowth-21st, considerando-se pequeno aquele com peso ao nascer <10º percentil. O grau de concordância entre as duas curvas foi avaliado pelo coeficiente Kappa. As variáveis numéricas foram comparadas pelo teste t de Student ou de Mann-Whitney, conforme distribuição, e as categóricas pelo teste χ2. As análises estatísticas foram realizadas no programa Statistical Package for the Social Sciences (SPSS) 17®, considerando-se significante p<0,05. Resultados: Foram incluídos 2.849 recém-nascidos com peso ao nascer de 3210±483 g, idade gestacional de 38,8±1,4 semanas, sendo 51,1% masculinos. A incidência de recém-nascidos pequenos para a idade gestacional pela curva de Fenton e Intergrowth-21st na amostra total foi, respectivamente, de 13 e 8,7% (p<0,001; Kappa=0,667). Entre os pré-termo tardios, a incidência foi de 11,3 e 10,9% (p<0,001; Kappa=0,793) e entre os nascidos a termo foi de 13,1 e 8,5%, (p<0,001; Kappa=0,656), respectivamente, para as curvas de Fenton e Intergrowth-21st. Conclusões: A incidência de recém-nascidos pequenos para idade gestacional foi significantemente maior pela curva de Fenton, com maior concordância entre as curvas de Fenton e Intergrowth-21st em recém-nascidos pré-termo tardios do que nos nascidos a termo.


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Adult , Birth Weight , Infant, Small for Gestational Age , Reference Values , Brazil/epidemiology , Infant, Premature , Incidence , Retrospective Studies , Gestational Age , Live Birth/epidemiology
19.
Arch. endocrinol. metab. (Online) ; 64(5): 567-574, Sept.-Oct. 2020. tab, graf
Article in English | LILACS | ID: biblio-1131125

ABSTRACT

ABSTRACT Objective Prematurity and low birth weight predispose preterm infants to cardiovascular disease in later life. Is the metabolic profile of these children impacted by the relation between birth weight and gestational age (GA)? This study aimed to evaluate whether the relationship between birth weight and GA of preterm infants has a positive correlation with the metabolic profile from birth to the sixth month of corrected age. Subjects and methods This is a longitudinal, prospective study with a cohort of 70 preterm and 54 term infants, who were enrolled in the study and shared into two groups: Appropriate for GA (AGA) and Small for GA (SGA), both classified at birth by Fenton and Kim curves. Longitudinal evaluation of anthropometry measures and blood samples of total cholesterol, glucose, triglycerides, and insulin were collected at birth, NICU discharge, and the sixth month of corrected age. Data were analyzed using descriptive and inferential statistical analysis (ANOVA, Fisher test, Shapiro-Wilk, and Cochran test). The effect size was 0.15, power was 0.92, and confidence interval 95%. Results No significant statistical differences were observed in relation to biochemical tests between AGA and SGA groups. However, a significant increase in triglyceride results above the reference values for age in the SGA group was observed throughout the follow-up. Conclusions Changes observed in the preterm infant metabolic profile show no correlation with adequacy of birth weight. Preterm lipid profile requires continuous evaluation at follow-up, due to the increased cardiovascular risk in later life.


Subject(s)
Humans , Infant, Newborn , Infant , Child , Metabolic Syndrome/diagnosis , Birth Weight , Infant, Premature , Infant, Small for Gestational Age , Prospective Studies , Gestational Age
20.
Chinese Journal of Contemporary Pediatrics ; (12): 1154-1158, 2020.
Article in Chinese | WPRIM | ID: wpr-879768

ABSTRACT

OBJECTIVE@#To investigate the risk factors for hypoglycemia after birth in preterm infants with a gestational age of ≤32 weeks.@*METHODS@#A retrospective analysis was performed for 86 neonates with hypoglycemia and a gestational age of ≤32 weeks who were admitted to the neonatal intensive care unit from January 2017 to June 2020 (hypoglycemia group). A total of 172 preterm infants with normal blood glucose who were hospitalized during the same period were randomly enrolled as the control group. Univariate analysis and multivariate logistic regression analysis were used to screen out the risk factors for hypoglycemia in preterm infants.@*RESULTS@#There were 515 preterm infants during the study, among whom 86 (16.7%) had hypoglycemia. Compared with the control group, the hypoglycemia group had significantly higher percentages of small for gestational age (SGA), cesarean section, maternal hypertension, and antenatal steroid administration (P<0.05), but significantly lower birth weight and rate of intravenous glucose use before blood glucose test (P<0.05). SGA (OR=4.311, 95%CI: 1.285-14.462, P<0.05), maternal hypertension (OR=2.469, 95%CI: 1.310-4.652, P<0.05), and antenatal steroid administration (OR=6.337, 95%CI: 1.430-28.095, P<0.05) were risk factors for hypoglycemia in preterm infants, while intravenous glucose use (OR=0.318, 95%CI: 0.171-0.591, P<0.05) was a protective factor against hypoglycemia in preterm infants.@*CONCLUSIONS@#SGA, maternal hypertension, and antenatal steroid administration may increase the risk of early hypoglycemia in preterm infants with a gestational age of ≤32 weeks, and intravenous glucose use is recommended as soon as possible after birth for preterm infants with a gestational age of ≤32 weeks to reduce the incidence rate of hypoglycemia.


Subject(s)
Female , Humans , Infant , Infant, Newborn , Pregnancy , Cesarean Section , Gestational Age , Hypoglycemia/etiology , Infant, Premature , Infant, Small for Gestational Age , Retrospective Studies , Risk Factors
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