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1.
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
2.
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 , Gestational Age , Humans , Hypertension, Pregnancy-Induced , Infant , Infant, Newborn , Infant, Premature , Infant, Small for Gestational Age , Platelet Count , Pregnancy
3.
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
4.
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
5.
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
6.
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)
Cesarean Section , Child , Female , Humans , Infant, Newborn , Infant, Newborn, Diseases , Infant, Small for Gestational Age , Pregnancy , Pregnancy Complications , Retrospective Studies
7.
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)
Brain , Electroencephalography , Gestational Age , Humans , Infant , Infant, Newborn , Infant, Premature , Infant, Small for Gestational Age
8.
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)
Cephalometry , Child, Preschool , Female , Gestational Age , Humans , Infant , Infant, Extremely Low Birth Weight , Infant, Newborn , Infant, Premature , Infant, Small for Gestational Age , Pregnancy
9.
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)
Brain , Child , Female , Fetal Growth Retardation , Gestational Age , Humans , Infant , Infant, Newborn , Infant, Premature , Infant, Small for Gestational Age , Pregnancy
10.
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
11.
Audiol., Commun. res ; 25: e2251, 2020. tab, graf
Article in Portuguese | LILACS | ID: biblio-1131800

ABSTRACT

RESUMO Objetivo Monitorar o sistema auditivo central de crianças nascidas pequenas para a idade gestacional, por meio da avaliação eletrofisiológica da audição, para verificar a ocorrência de eventuais disfunções neurais nesse sistema. Métodos Estudo longitudinal, cuja casuística foi composta por 23 crianças distribuídas em quatro grupos: 1) grupo de quatro crianças nascidas pequenas para a idade gestacional e a termo; 2) grupo de sete crianças nascidas pequenas para a idade gestacional e pré-termo; 3) grupo de quatro crianças nascidas com peso adequado para a idade gestacional e a termo; 4) grupo de oito crianças nascidas adequadas para a idade gestacional e pré-termo, cuja idade ao final da pesquisa foi de 3 anos (variação entre 34 e 39 meses). O critério de inclusão foi presença bilateral de emissões otoacústicas transientes. Todas as crianças foram submetidas ao potencial evocado auditivo de tronco encefálico ao nascimento, aos 6 meses e aos 3 anos de idade e à pesquisa do potencial evocado auditivo de longa latência aos 3 anos. Resultados crianças nascidas pequenas para a idade gestacional e a termo tiveram maior ocorrência de alterações, em relação aos demais grupos, com aumento da latência das ondas III e V e interpicos I-III e I-V. Todas apresentaram resultados normais no potencial evocado auditivo de longa latência. Conclusão Crianças nascidas pequenas para a idade gestacional e a termo apresentam disfunções na condução neural no tronco encefálico e devem ser consideradas de risco para alterações do desenvolvimento das habilidades auditivas necessárias para garantir qualidade de processamento da informação acústica.


ABSTRACT Purpose To follow up the central auditory system of children born small for gestational age, through electrophysiological evaluation of hearing, in order to verify the occurrence of possible neural dysfunctions in this system. Methods A longitudinal study was carried out with 23 children divided into four groups: Term-born group, subdivided into small for gestational age (four children) and four children born with appropriate weight for gestational age, whose age at the end of the research was three years old. Preterm group subdivided into small for gestational age (seven children), and appropriate for gestational age (eight children), whose corrected age, at the end of the research was three years old. All children were subjected to assessment of auditory brainstem auditory evoked potentials at birth, at six months and at three years of age, and Long-Latency Auditory Evoked Potential at three years. Results children born at term and small for gestational age had a higher occurrence of hearing alterations in relation to the other groups, with increased latency of waves III and V and interpeaks I-III and I-V. All children presented normal evaluation in the Long-Latency Auditory Evoked Potential. Conclusion Children born term and small for gestational age present dysfunctions in neural conduction in the brainstem and should be considered at risk for alterations in the development of the auditory skills that are necessary to guarantee quality of acoustic information processing.


Subject(s)
Humans , Infant, Newborn , Infant , Infant, Small for Gestational Age , Evoked Potentials, Auditory, Brain Stem/physiology , Electrophysiology , Hearing Disorders/diagnosis , Hearing Disorders/physiopathology , Infant, Premature , Otoacoustic Emissions, Spontaneous/physiology , Language Development Disorders
12.
Article in English | LILACS | ID: biblio-1057228

ABSTRACT

ABSTRACT Objective: To determine maternal and fetal risk factors associated with the birth of late preterm infants in comparison to those born at term. Methods: A case-control study was carried out in a tertiary center for high-risk pregnancies. For the cases, the study enrolled post-partum mothers and their respective newborns with gestational ages equal or greater than 34 weeks and less than 37 weeks. As controls, the post-partum mothers and their newborns with gestational ages of 37 weeks or greater were selected. The sample was calculated with a ratio of two controls for each case, resulting in 423 patients. Association studies were performed using the chi-square test or Fisher's exact test and logistic regression analysis. Results: The variables associated with late prematurity were inadequate prenatal (Odds Ratio [OR] 1.23; confidence interval of 95% [95%CI] 1.12-1.34; p≤0.001), premature rupture of membranes (OR 4.98; 95%CI 2.66-9.31; p≤0.001), length of hospital stay ≥24 hours until birth (OR 0.18; 95%CI 0.06-0.52; p≤0.001), cesarean section (OR 2.74; 95%CI 1.69-4.44; p≤0.001) and small for gestational age newborn (OR 3.02; 95%CI 1.80-5.05; p≤0.001). Conclusions: Inadequate prenatal care and membranes' premature rupture were found as factors associated with the late preterm birth. It is important to identify the factors that allow intervention with adequate prenatal care in order to reduce poor outcomes due to late prematurity.


RESUMO Objetivo: Determinar fatores maternos e fetais associados ao nascimento de recém-nascidos prematuros tardios, quando comparados aos nascidos a termo. Métodos: Estudo caso-controle em um hospital terciário de referência para atendimento de gestações de alto risco. Foram considerados casos as puérperas e seus respectivos recém-nascidos com idade gestacional maior ou igual a 34 semanas e menor de 37 semanas. Para os controles foram selecionadas as puérperas e seus recém-nascidos com idade gestacional de 37 semanas completas ou mais. A amostra foi calculada com razão de dois controles para cada caso, resultando em um total de 423 pacientes. Estudos de associação foram efetuados utilizando-se o teste do qui-quadrado ou teste exato de Fisher e posterior regressão logística. Resultados: As variáveis associadas à prematuridade tardia foram a realização de pré-natal inadequado (Odds Ratio - OR 1,23; intervalo de confiança de 95% - IC95% 1,12-1,34; p≤0,001), a rotura prematura de membranas amnióticas (OR 4,98; IC95% 2,66-9,31; p≤0,001), o tempo de internação ≥24 horas até o nascimento (OR 0,18; IC95% 0,06-0,52; p≤0,001), o parto operatório (OR 2,74; IC95% 1,69-4,44; p≤0,001) e o recém-nascido pequeno para a idade gestacional (OR 3,02; IC95% 1,80-5,05; p≤0,001). Conclusões: Assistência pré-natal inadequada e rotura prematura de membranas destacaram-se como fatores associados ao nascimento de prematuros tardios. Ressalta-se a relevância da identificação de fatores passíveis de intervenção por meio de adequada assistência pré-natal, a fim de reduzir os desfechos desfavoráveis decorrentes da prematuridade tardia.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adolescent , Adult , Young Adult , Prenatal Care/methods , Fetal Membranes, Premature Rupture/epidemiology , Cesarean Section/statistics & numerical data , Premature Birth/epidemiology , Infant, Premature, Diseases/epidemiology , Prenatal Care/trends , Infant, Premature , Infant, Small for Gestational Age , Case-Control Studies , Risk Factors , Gestational Age , Pregnancy, High-Risk , Premature Birth/etiology , Tertiary Care Centers , Length of Stay/trends
13.
CoDAS ; 32(4): e20180275, 2020. tab
Article in Portuguese | LILACS | ID: biblio-1055909

ABSTRACT

RESUMO Objetivo O estudo teve por objetivo identificar se o desenvolvimento das habilidades auditivas no primeiro ano de vida relaciona-se com o desenvolvimento de linguagem em neonatos pré-termo com idade cronológica entre 18 e 36 meses verificando se o desempenho de linguagem varia em função da relação peso/idade gestacional. Método Estudo retrospectivo e longitudinal aprovado pelo Comitê de Ética da Instituição. Amostra composta por 66 neonatos prematuros de ambos os sexos de 18 a 36 meses de idade, distribuídos conforme a adequação peso/idade gestacional em dois grupos: (a) GAIG: 39 neonatos com peso adequado à idade gestacional, sendo 26 com desenvolvimento auditivo normal e 13 com alterado; (b) GPIG: 27 neonatos pequenos para a idade gestacional, 18 com desenvolvimento auditivo normal e 9 com alterado. A partir das consultas aos prontuários do serviço de acompanhamento dos neonatos, verificaram-se os resultados do desenvolvimento das habilidades auditivas no primeiro ano de vida e avaliação da recepção, expressão e total de Linguagem (Menezes, 2003). Adotados como procedimentos estatísticos o ANOVA e o teste de Igualdade de Duas Proporções. Resultados O desempenho de linguagem não diferiu nos grupos GAIG e GPIG. Quando considerados o desenvolvimento auditivo normal e o alterado, em GAIG e GPIG, observou-se diferença significante na Recepção e Total de linguagem. As crianças com desenvolvimento auditivo normal apresentaram um maior percentual de adequação de linguagem. Conclusão A alteração das habilidades auditivas no primeiro ano de vida interferiu mais no desenvolvimento da linguagem do que a relação peso/idade gestacional.


ABSTRACT Purpose This study aimed to identify whether the development of hearing abilities in the first year of life is related to the development of language in preterm neonates with chronological age between 18 and 36 months, verifying if the language performance varies according to the weight/gestational age ratio. Methods Retrospective and longitudinal study approved by the Institution's Ethics Committee. The sample consisted of 66 preterm infants of both sexes, aged 18-36 months, divided into two groups: AIG Group 39 neonates with weight appropriate to the gestational age, 26 with normal hearing and 13 with altered hearing; and PIG group 27 neonates small for gestational age, 18 with normal and 9 with altered hearing. Results from the development of auditory skills in the first year of life and evaluation of the reception, expression and total of language (Menezes, 2003) were obtained from neonatal follow-up records. We used the ANOVA and the Equality Test of Two Proportions as statistical procedures. Results In each group, we observed a significant difference in the Reception and Total language in children with normal and altered auditory development. Children with normal hearing development presented a higher percentage of language adequacy. The language performance did not differ in relation to the weight / gestational age adequacy. Conclusion Changing auditory abilities in the first year of life interfered more in language development than the gestational age / weight ratio.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Speech Perception/physiology , Birth Weight/physiology , Longitudinal Studies , Infant, Premature , Infant, Small for Gestational Age , Multivariate Analysis , Retrospective Studies , Gestational Age , Language Development
14.
Article in Chinese | WPRIM | ID: wpr-828642

ABSTRACT

OBJECTIVE@#To investigate whether there is a difference in cerebellar development between appropriate -for-gestational-age (AGA) infants and small-for-gestational-age (SGA) infants.@*METHODS@#A total of 165 AGA infants and 105 SGA infants, with a gestational age of 26-40 weeks, were enrolled in this study. Within 24-48 hours after birth, ultrasound examination was performed to measure the transverse diameter of the cerebellum, the height of the vermis, the area of the vermis, the perimeter of the vermis, and the area and perimeter of the cerebellum on transverse section. A Pearson correlation analysis was used to investigate the correlation between cerebellar measurements and gestational age.@*RESULTS@#In both AGA and SGA infants, all cerebellar measurements were positively correlated with gestational age (r=0.50-0.81, P0.05), while in the 34-36 weeks and 37-40 weeks subgroups, the SGA infants had significantly lower measurements than the AGA infants (P<0.05).@*CONCLUSIONS@#The SGA infants with a gestational age of <34 weeks have intrauterine cerebellar development similar to AGA infants, but those with a gestational age of ≥34 weeks have poorer intrauterine cerebellar development than AGA infants.


Subject(s)
Cerebellum , Gestational Age , Humans , Infant , Infant, Small for Gestational Age , Ultrasonography
15.
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)
Cesarean Section , Female , Gestational Age , Humans , Hypoglycemia/etiology , Infant , Infant, Newborn , Infant, Premature , Infant, Small for Gestational Age , Pregnancy , Retrospective Studies , Risk Factors
16.
Rev. bras. ginecol. obstet ; 41(12): 688-696, Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1057888

ABSTRACT

Abstract Objective To evaluate the association between early-onset fetal growth restriction (FGR), late-onset FGR, small for gestational age (SGA) and adequate for gestational age (AGA) fetuses and adverse perinatal outcomes. Methods This was a retrospective longitudinal study in which 4 groups were evaluated: 1 - early-onset FGR (before 32 weeks) (n=20), 2 - late-onset FGR (at or after 32 weeks) (n=113), 3 - SGA (n=59), 4 - AGA (n=476). The Kaplan-Meier curve was used to compare the time from the diagnosis of FGR to birth. Logistic regression was used to determine the best predictors of adverse perinatal outcomes in fetuses with FGR and SGA. Results A longer timebetween the diagnosis and birthwas observed forAGAthan for late FGR fetuses (p<0.001). The model including the type of FGR and the gestational age at birth was significant in predicting the risk of hospitalization in the neonatal intensive care unit (ICU) (p<0.001). The model including only the type of FGR predicted the risk of needing neonatal resuscitation (p<0.001), of respiratory distress (p<0.001), and of birth at<32, 34, and 37 weeks of gestation, respectively (p<0.001). Conclusion Fetal growth restriction and SGA were associated with adverse perinatal outcomes. The type of FGR at the moment of diagnosis was an independent variable to predict respiratory distress and the need for neonatal resuscitation. The model including both the type of FGR and the gestational age at birth predicted the risk of needing neonatal ICU hospitalization.


Resumo Objetivo Avaliar o efeito da restrição de crescimento fetal (RCF) precoce, RCF tardio, fetos pequenos constitucionais para idade gestacional (PIG) e fetos adequados para idade gestacional (AIG) sobre resultados adversos perinatais. Métodos Estudo longitudinal e retrospectivo, no qual foram avaliados quatro grupos: 1 - RCF precoce (< 32 semanas) (n=20), 2 - RCF tardio ( 32 semanas) (n=113), 3 - PIG (n=59), 4 - AIG (n=476). A curva de Kaplan-Meier foi utilizada para comparar o tempo entre o diagnóstico da RCF e o parto. Regressão logística foi utilizada para determinação dosmelhores previsores de resultados perinatais adversos entre os fetos com RCF e PIG. Resultados Os fetos AIGs apresentaram maior tempo entre o diagnóstico e parto, enquanto fetos RCF tardio apresentaram menor tempo (p<0,001). O modelo contendo tanto os tipos de RCF quanto a idade gestacional no momento do parto foi significativo em predizer o risco de internação na unidade de terapia intensiva (UTI) neonatal (p<0,001). O modelo incluindo apenas o tipo de FGR prediz o risco de ressuscitação neonatal (p<0,001), de desconforto respiratório (p<0,001) e de nascimento<32, 34 e 37 semanas de gestação, respectivamente (p<0,001). Conclusão Os desvios do crescimento, RCF e PIG, foram associados a resultados perinatais adversos. O tipo de RCF no momento do diagnóstico foi variável independente para predizer necessidade de reanimação neonatal e desconforto respiratório. O modelo que incluiu o tipo de FGR e idade gestacional no nascimento prediz o risco de necessitar de internação em UTI neonatal.


Subject(s)
Humans , Female , Pregnancy , Infant, Small for Gestational Age , Gestational Age , Fetal Growth Retardation , Prognosis , Respiratory Distress Syndrome, Newborn/diagnosis , Respiratory Distress Syndrome, Newborn/therapy , Time Factors , Retrospective Studies , Risk Factors , Longitudinal Studies , Ultrasonography, Prenatal , Critical Care
17.
Rev. bras. ginecol. obstet ; 41(7): 454-462, July 2019. tab
Article in English | LILACS | ID: biblio-1020601

ABSTRACT

Abstract Fetal growth restriction (FGR) diagnosis is often made by fetal biometric ultrasound measurements orDoppler evaluation, but most babies are only diagnosed after birth, using the birth weight as a proxy for intrauterine development. The higher risks of neurodevelopmental delay, metabolic syndrome, and cardiovascular illness associated with FGR impose a shift on the focus during pregnancy. New methodological approaches, like metabolomics, can provide novel biomarkers for intrauterine fetal development. Recent evidence on metabolites involved with fetal growth and weight show a consistent role played by lipids (especially fatty acids), amino acids, vitamin D and folic acid. Fetal energy source andmetabolism, structural functions, and nervous system functioning need further evaluations in different populations. In the near future, the establishment of a core set of outcomes for FGR studies may improve the identification of the role of each metabolite in its development. Thus, we will concretely progress with the perspective of a translational capacity of metabolomics for this condition.


Resumo O diagnóstico da restrição do crescimento fetal (RCF) é frequentemente feito por medidas biométricas ultrassonográficas ou por avaliação pela Dopplervelocimetria, mas, na maioria dos casos, o diagnóstico é apenas pós-natal, usando o peso ao nascimento como um marcador para o desenvolvimento intrauterino. Riscos maiores de atraso do neurodesenvolvimento, síndrome metabólica e doenças cardiovasculares associadas com a RCF impõem uma mudança no foco durante a gestação. Novas abordagens metodológicas, como a metabolômica, podem fornecer novos biomarcadores para o desenvolvimento fetal intrauterino. As evidências recentes sobre os metabolitos envolvidos com o crescimento e peso fetalmostram um papel consistente desempenhado pelos lipídios (especialmente os ácidos graxos), aminoácidos, vitamina


Subject(s)
Humans , Female , Pregnancy , Prenatal Diagnosis , Fetal Growth Retardation/diagnosis , Infant, Small for Gestational Age/growth & development , Ultrasonography, Prenatal , Metabolomics , Fetal Growth Retardation/diagnostic imaging
18.
J. pediatr. (Rio J.) ; 95(3): 264-274, May-June 2019. tab, graf
Article in English | LILACS | ID: biblio-1012603

ABSTRACT

Abstract Objective: To systematically review evidence related to nutritional and cardiometabolic outcomes in children born at term and small for gestational age and the association with breastfeeding. Source of data: Two independent reviewers searched the MEDLINE, LILACS, SciELO, and Embase databases without time or language restrictions. The PRISMA tool was used, and studies that evaluated infants born at term and small for gestational age, breastfed, and with an evaluation of cardiometabolic outcomes were included. Studies with preterm infants, those that did not have information on breastfeeding, and those with lack of evaluation of the outcome variables were excluded. Also excluded were review articles, editorials, and series of cases. Summary of data: Only seven articles were found that met the abovementioned criteria. There was a great variability in the type of evaluation, as well as in the age of these children. It was demonstrated that breastfeeding promoted growth without body composition alteration and without increased insulin resistance in children with exclusive breastfeeding, when compared to children receiving a higher calorie formula, except for one article that observed an increase in fat mass in exclusively breastfed children. Conclusion: Breastfeeding seems to be a safe feeding practice for infants born at term and small for gestational age, showing no association with deleterious short-term outcomes. Breastfeeding stimulation in these populations seems to be a way of preventing the health problems associated with the high risk of chronic noncommunicable diseases and obesity.


Resumo Objetivo: Revisar sistematicamente as evidências relacionadas aos desfechos nutricionais e cardiometabólicos em crianças nascidas a termo e pequenas para idade gestacional e a relação com o aleitamento materno. Fonte de dados: Dois revisores independentes fizeram buscas nas bases de dados MEDLINE,LILACS, SciELO, EMBASE sem restrições de tempo ou idioma. Foi usada a ferramenta PRISMA sendo incluídos estudos que avaliaram crianças nascidas a termo e pequenas para idade gestacional, amamentadas e com avaliação dos desfechos cardiometabólicos. Foram excluídos estudos com prematuros, aqueles que não trouxessem informação do aleitamento materno, ausência de avaliação das variáveis de desfecho. Também não foram incluídos artigos de revisão, editorial e série de casos. Síntese dos dados: Foram encontrados apenas sete artigos que preencheram os critérios citados acima. Houve uma grande variabilidade na forma de avaliação, assim como na idade dessas crianças. Foi evidenciado que o aleitamento materno promoveu crescimento sem alteração de composição corporal e sem resistência insulínica aumentada nas crianças com aleitamento materno exclusivo, quando comparadas com crianças que receberam fórmula láctea de maior teor calórico, exceto por um artigo que observou aumento de massa gorda nos amamentados exclusivamente. Conclusão: Aleitamento materno parece ser uma forma segura de alimentação para crianças nascidas a termo e pequenas para idade gestacional sem associação com desfechos deletérios em curto prazo. O estímulo ao aleitamento materno nessas populações parece ser um caminho de prevenção aos agravos à saúde associados ao alto risco de doenças crônicas não transmissíveis e à obesidade.


Subject(s)
Humans , Infant, Newborn , Infant , Child , Breast Feeding , Infant, Small for Gestational Age , Metabolic Syndrome , Obesity , Time Factors , Child Development , Feeding Behavior
19.
J. pediatr. (Rio J.) ; 95(3): 366-373, May-June 2019. tab
Article in English | LILACS | ID: biblio-1012601

ABSTRACT

Abstract Objective: To assess the prevalence and risks of underweight, stunting and wasting by gestational age in newborns of the Jujuy Province, Argentina at different altitude levels. Methods: Live newborns (n = 48,656) born from 2009-2014 in public facilities with a gestational age between 24+0 to 42+6 weeks. Phenotypes of underweight (<P3 weight/age), stunting (<P3 length/age) and wasting (<P3 body mass index/age) were calculated using Intergrowth-21st standards. Risk factors were maternal age, education, body mass index, parity, diabetes, hypertension, preeclampsia, tuberculosis, prematurity, and congenital malformations. Data were grouped by the geographic altitude: ≥2.000 or <2.000 m.a.s.l. Chi-squared test and a multivariate logistic regression analysis were performed to estimate the risk of the phenotypes associated with an altitudinal level ≥2.000 m.a.s.l. Results: The prevalence of underweight, stunting and wasting were 1.27%, 3.39% and 4.68%, respectively, and significantly higher at >2.000 m.a.s.l. Maternal age, body mass index >35 kg/m2, hypertension, congenital malformations, and prematurity were more strongly associated with underweight rather than stunting or wasting at ≥2.000 m.a.s.l. Conclusions: Underweight, stunting, and wasting risks were higher at a higher altitude, and were associated with recognized maternal and fetal conditions. The use of those three phenotypes will help prioritize preventive interventions and focus the management of fetal undernutrition.


Resumo Objetivo: Avaliar a prevalência e os riscos de recém-nascidos abaixo do peso, baixa estatura e emaciação por idade gestacional da Província de Jujuy, Argentina, em diferentes níveis de altitude. Métodos: Recém-nascidos vivos (n = 48.656) nascidos entre 2009 e 2014 em instalações públicas entre 24+0-42+6 semanas de idade gestacional. Os fenótipos de abaixo do peso (< P3 peso/idade), baixa estatura (< P3 comprimento/idade) e emaciação (< P3 índice de massa corporal/idade) foram calculados com os padrões do INTERGROWTH-21st. Os fatores de risco foram idade materna, escolaridade, índice de massa corporal, paridade, diabetes, hipertensão, pré-eclâmpsia, tuberculose, prematuridade e malformações congênitas. Os dados foram agrupados pela altitude geográfica: ≥ 2.000 ou < 2.000 m.a.s.l. O teste qui-quadrado e a análise de regressão logística multivariada foram feitos para estimar o risco dos fenótipos associados ao nível de altitude ≥ 2.000 m.a.s.l. Resultados: A prevalência de abaixo do peso, baixa estatura e emaciação foi de 1,27%, 3,39% e 4,68%, respectivamente, significativamente maiores em > 2.000 m.a.s.l. A idade materna, índice de massa corporal > 35 kg/m2, hipertensão, malformações congênitas e prematuridade foram mais fortemente associados a abaixo do peso e não a baixa estatura ou emaciação em ≥ 2.000 m.a.s.l. Conclusões: Os riscos de abaixo do peso, baixa estatura e emaciação foram maiores em altitude mais elevada e foram associados a condições maternas e fetais reconhecidas. O uso desses três fenótipos ajudará a priorizar as intervenções preventivas e focar no manejo da desnutrição fetal.


Subject(s)
Humans , Female , Infant, Newborn , Adult , Young Adult , Infant, Low Birth Weight , Infant, Small for Gestational Age , Altitude , Argentina/epidemiology , Socioeconomic Factors , Prevalence , Retrospective Studies , Risk Factors
20.
J. pediatr. (Rio J.) ; 95(supl.1): S23-S29, 2019. tab
Article in English | LILACS | ID: biblio-1002475

ABSTRACT

Abstract Objectives: To discuss the etiology and growth consequences of small size at birth and the indications, effects, and safety of biosynthetic growth hormone therapy in children born small for gestational age. Source of data: A comprehensive and non-systematic search was carried out in the PubMed, LILACS, and SciELO databases from 1980 to the present day, using the terms "small for gestational age," "intrauterine growth restriction," and "growth hormone". The publications were critically selected by the authors. Data synthesis: Although the majority of children born small for gestational age show spontaneous catch-up growth during the first two years of life, some of them remain with short stature during childhood, with high risk of short stature in adult life. Treatment with growth hormone might be indicated, preferably after 2-4 years of age, in those small for gestational age children who remain short, without catch-up growth. Treatment aims to increase growth velocity and to reach a normal height during childhood and an adult height within target height. Response to growth hormone treatment is variable, with better growth response during the pre-pubertal period. Conclusions: Treatment with growth hormone in short children born small for gestational age is safe and effective to improve adult height. Efforts should be done to identify the etiology of small size at birth before treatment.


Resumo Objetivos: Discutir a etiologia e as consequências para o crescimento e as indicações, os efeitos e a segurança da terapia com hormônio de crescimento biossintético em crianças pequenas para idade gestacional. Fonte dos dados: Uma busca abrangente e não sistemática foi feita nas bases de dados PubMed, LILACS e SciELO de 1980 até a presente data, com os termos "small for gestational age" (pequeno para a idade gestacional), "intrauterine growth restriction" (restrição de crescimento intrauterino) e "growth hormone" (hormônio do crescimento). As publicações foram selecionadas criticamente pelos autores. Síntese dos dados: Embora a maioria das crianças nascidas pequenas para idade gestacional apresente recuperação espontânea do crescimento durante os dois primeiros anos de vida, algumas delas permanecem com baixa estatura durante a infância, com alto risco de baixa estatura na vida adulta. O tratamento com hormônio de crescimento pode ser indicado, preferencialmente após os dois aos quatro anos, naquelas crianças sem recuperação espontânea do crescimento e com baixa estatura. Seus objetivos são aumentar a velocidade de crescimento e atingir uma altura normal durante a infância e uma altura adulta dentro da altura-alvo. A resposta ao tratamento com hormônio de crescimento é variável, com melhor resultado se iniciado durante o período pré-puberal. Conclusões: O tratamento com hormônio de crescimento em crianças baixas nascidas pequenas para idade gestacional é seguro e eficaz para melhorar a estatura adulta. Esforços devem ser feitos para identificar a etiologia do nascimento pequenas para idade gestacional antes do tratamento.


Subject(s)
Humans , Female , Infant, Newborn , Infant, Small for Gestational Age/growth & development , Growth Hormone/therapeutic use , Child Development/drug effects , Growth Disorders/drug therapy
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