1
|
Elmrayed S, Pinto J, Tough SC, McDonald SW, Scime NV, Wollny K, Lee Y, Kramer MS, Ospina MB, Lorenzetti DL, Madubueze A, Leung AA, Kumar M, Fenton TR. Small for gestational age preterm infants and later adiposity and height: A systematic review and meta-analysis. Paediatr Perinat Epidemiol 2023; 37:652-668. [PMID: 37580882 DOI: 10.1111/ppe.13002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 07/21/2023] [Accepted: 07/29/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND Overweight and obesity and their consequent morbidities are important worldwide health problems. Some research suggests excess adiposity origins may begin in fetal life, but unknown is whether this applies to infants born preterm. OBJECTIVE The objective of the study was to assess the association between small for gestational age (SGA) birth and later adiposity and height among those born preterm. DATA SOURCES MEDLINE, EMBASE and CINAHL until October 2022. STUDY SELECTION AND DATA EXTRACTION Studies were included if they reported anthropometric (adiposity measures and height) outcomes for participants born preterm with SGA versus non-SGA. Screening, data extraction and risks of bias assessments were conducted in duplicate by two reviewers. SYNTHESIS We meta-analysed across studies using random-effects models and explored potential heterogeneity sources. RESULTS Thirty-nine studies met the inclusion criteria. In later life, preterm SGA infants had a lower body mass index (-0.66 kg/m2 , 95% CI -0.79, -0.53; 32 studies, I2 = 16.7, n = 30,346), waist circumference (-1.20 cm, 95% CI -2.17, -0.23; 13 studies, I2 = 19.4, n = 2061), lean mass (-2.62 kg, 95% CI -3.45, 1.80; 7 studies, I2 = 0, n = 205) and height (-3.85 cm, 95% CI -4.73, -2.96; 26 studies, I2 = 52.6, n = 4174) compared with those preterm infants born non-SGA. There were no differences between preterm SGA and preterm non-SGA groups in waist/hip ratio, body fat, body fat per cent, truncal fat per cent, fat mass index or lean mass index, although power was limited for some analyses. Studies were rated at high risk of bias due to potential residual confounding and low risk of bias in other domains. CONCLUSIONS Compared to their preterm non-SGA peers, preterm infants born SGA have lower BMI, waist circumference, lean body mass and height in later life. No differences in adiposity were observed between SGA preterm infants and non-SGA preterm infants.
Collapse
Affiliation(s)
- Seham Elmrayed
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Institute of Global Health and Human Ecology, American University in Cairo, Cairo, Egypt
- Virginia Mason Franciscan Health, Seattle, Washington, USA
| | - Jahaira Pinto
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - Suzanne C Tough
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sheila W McDonald
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Natalie V Scime
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Krista Wollny
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Senior Persons Living Connected, Toronto, Ontario, Canada
| | - Yoonshin Lee
- Senior Persons Living Connected, Toronto, Ontario, Canada
| | - Michael S Kramer
- Departments of Pediatrics and of Epidemiology and Biostatistics, McGill University Faculty of Medicine, Montreal, Quebec, Canada
| | - Maria B Ospina
- Department of Public Health Sciences, Faculty of Health Sciences, Queen's University, Kingston, Canada
| | - Diane L Lorenzetti
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Health Sciences Library and Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Ada Madubueze
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Alexander A Leung
- Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Manoj Kumar
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Tanis R Fenton
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
2
|
White MR, Yates DT. Dousing the flame: reviewing the mechanisms of inflammatory programming during stress-induced intrauterine growth restriction and the potential for ω-3 polyunsaturated fatty acid intervention. Front Physiol 2023; 14:1250134. [PMID: 37727657 PMCID: PMC10505810 DOI: 10.3389/fphys.2023.1250134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 08/14/2023] [Indexed: 09/21/2023] Open
Abstract
Intrauterine growth restriction (IUGR) arises when maternal stressors coincide with peak placental development, leading to placental insufficiency. When the expanding nutrient demands of the growing fetus subsequently exceed the capacity of the stunted placenta, fetal hypoxemia and hypoglycemia result. Poor fetal nutrient status stimulates greater release of inflammatory cytokines and catecholamines, which in turn lead to thrifty growth and metabolic programming that benefits fetal survival but is maladaptive after birth. Specifically, some IUGR fetal tissues develop enriched expression of inflammatory cytokine receptors and other signaling cascade components, which increases inflammatory sensitivity even when circulating inflammatory cytokines are no longer elevated after birth. Recent evidence indicates that greater inflammatory tone contributes to deficits in skeletal muscle growth and metabolism that are characteristic of IUGR offspring. These deficits underlie the metabolic dysfunction that markedly increases risk for metabolic diseases in IUGR-born individuals. The same programming mechanisms yield reduced metabolic efficiency, poor body composition, and inferior carcass quality in IUGR-born livestock. The ω-3 polyunsaturated fatty acids (PUFA) are diet-derived nutraceuticals with anti-inflammatory effects that have been used to improve conditions of chronic systemic inflammation, including intrauterine stress. In this review, we highlight the role of sustained systemic inflammation in the development of IUGR pathologies. We then discuss the potential for ω-3 PUFA supplementation to improve inflammation-mediated growth and metabolic deficits in IUGR offspring, along with potential barriers that must be considered when developing a supplementation strategy.
Collapse
Affiliation(s)
| | - Dustin T. Yates
- Stress Physiology Laboratory, Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE, United States
| |
Collapse
|
3
|
Costa Wiltgen A, Valentini NC, Beltram Marcelino T, Santos Pinto Guimarães L, Homrich Da Silva C, Rombaldi Bernardi J, Zubaran Goldani M. Different intrauterine environments and children motor development in the first 6 months of life: a prospective longitudinal cohort. Sci Rep 2023; 13:10325. [PMID: 37365232 PMCID: PMC10293270 DOI: 10.1038/s41598-023-36626-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 06/07/2023] [Indexed: 06/28/2023] Open
Abstract
This prospective cohort longitudinal study examines the risk factors associated with different intrauterine environments and the influence of different intrauterine environments on children's motor development at 3- and 6-months of life. Participants were 346 mother/newborn dyads enrolled in the first 24 to 48 h after delivery in public hospitals. Four groups with no concurrent condition composed the sample: mothers with a clinical diagnosis of diabetes, mothers with newborns small for gestational age due to idiopathic intrauterine growth restriction (IUGR), mothers who smoked tobacco during gestation, and a control group composed of mothers without clinical condition. Children were assessed at three- and six-months regarding motor development, weight, length, head circumference, and parents completed a socioeconomic questionnaire. The IUGR children had lower supine, sitting, and overall gross motor scores at 6 months than the other children's groups. Anthropometric and sociodemographic characteristics negatively influenced gross motor development. IUGR and anthropometric and sociodemographic characteristics negatively impact motor development. Intrauterine environment impact child neurodevelopment.
Collapse
Affiliation(s)
- Andressa Costa Wiltgen
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil.
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
| | - Nadia Cristina Valentini
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Programa de Pós-Graduação em Ciências do Movimento Humano, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Thiago Beltram Marcelino
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | | | - Clécio Homrich Da Silva
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil
- Faculdade de Medicina, Departamento de Pediatria, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Serviço de Pediatria, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Juliana Rombaldi Bernardi
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil
- Faculdade de Medicina, Departamento de Nutrição, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Serviço de Nutrição e Dietética, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Marcelo Zubaran Goldani
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil
- Faculdade de Medicina, Departamento de Pediatria, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Serviço de Pediatria, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| |
Collapse
|
4
|
Fenton TR, Elmrayed S, Scime NV, Tough SC, Pinto J, Sabet F, Wollny K, Lee Y, Harrison TG, Alladin-Karan B, Kramer MS, Ospina MB, Lorenzetti DL, Madubueze A, Leung AA, Kumar M. Small for date preterm infants and risk of higher blood pressure in later life: A systematic review and meta-analysis. Paediatr Perinat Epidemiol 2023. [PMID: 36688258 DOI: 10.1111/ppe.12955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 01/05/2023] [Accepted: 01/08/2023] [Indexed: 01/24/2023]
Abstract
BACKGROUND Historical reports suggest that infants born small for gestational age (SGA) are at increased risk for high blood pressure (BP) at older ages after adjustment for later age body size. Such adjustment may be inappropriate since adiposity is a known cause of cardiovascular and metabolic disease. OBJECTIVES To assess the association between SGA births and later BP among preterm births, considering potential background confounders and over-adjustment for later body size. METHODS A database search of studies up to October 2022 included MEDLINE, EMBASE and CINAHL. Studies were included if they reported BP (systolic [SBP] or diastolic [DBP]) (outcomes) for participants born preterm with SGA (exposure) or non-SGA births. All screening, extraction steps, and risk of bias (using the Risk of Bias In Non-randomised Studies of Interventions [ROBINS-I] tool) were conducted in duplicate by two reviewers. Data were pooled in meta-analysis using random-effects models. We explored potential sources of heterogeneity. RESULTS We found no meaningful difference in later BP between preterm infants with and without SGA status at birth. Meta-analysis of 25 studies showed that preterm SGA, compared to preterm non-SGA, was not associated with higher BP at age 2 and older with mean differences for SBP 0.01 mmHg (95% CI -0.10, 0.12, I2 = 59.8%, n = 20,462) and DBP 0.01 mm Hg (95% CI -0.10, 0.12), 22 studies, (I2 = 53.0%, n = 20,182). Adjustment for current weight did not alter the results, which could be due to the lack of differences in later weight status in most of the included studies. The included studies were rated to be at risk of bias due to potential residual confounding, with a low risk of bias in other domains. CONCLUSIONS Evidence indicates that preterm infants born SGA are not at increased risk of developing higher BP as children or as adults as compared to non-SGA preterm infants.
Collapse
Affiliation(s)
- Tanis R Fenton
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Seham Elmrayed
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Global Health and Human Ecology Institute, American University in Cairo, Cairo, Egypt
| | - Natalie V Scime
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Suzanne C Tough
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jahaira Pinto
- Virginia Mason Franciscan Health, Seattle, Washington, USA
| | - Fatemeh Sabet
- Interior Health Authority, Kelowna, British Columbia, Canada
| | - Krista Wollny
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - Yoonshin Lee
- Senior Persons Living Connected, Hong Fook Mental Health Association, Toronto, Ontario, Canada
| | - Tyrone G Harrison
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Bibi Alladin-Karan
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Michael S Kramer
- Departments of Pediatrics and of Epidemiology and Biostatistics, McGill University Faculty of Medicine, Montreal, Quebec, Canada
| | - Maria B Ospina
- Department of Public Health Sciences, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Diane L Lorenzetti
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Health Sciences Library and Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Ada Madubueze
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Alexander A Leung
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Manoj Kumar
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
5
|
Shoji H, Murano Y, Saitoh Y, Ikeda N, Ohkawa N, Nishizaki N, Hisata K, Kantake M, Obinata K, Yoneoka D, Shimizu T. Use of Head and Chest Circumference Ratio as an Index of Fetal Growth Retardation in Preterm Infants. Nutrients 2022; 14:nu14224942. [PMID: 36432628 PMCID: PMC9694309 DOI: 10.3390/nu14224942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/17/2022] [Accepted: 11/19/2022] [Indexed: 11/23/2022] Open
Abstract
We evaluated the relationship between fetal growth in preterm babies using the head circumference (HC)/chest circumference (CC) ratio and other anthropometric parameters at birth and at school age. Data were collected from 187 very low birth weight (VLBW) children born at less than 30 weeks of gestational age (GA) at birth and at 6 years. We assessed the correlation between the HC/CC ratio and body weight (BW), body length (BL), and HC z-scores at birth, and BW, body height (BH), and body mass index (BMI) z-scores at 6 years. Multiple regression analysis showed that BW z-score, BL z-score, and HC z-score at birth were significantly associated with HC/CC at birth. The BMI z-score at 6 years was also significantly associated with HC/CC at birth. The HC/CC ratio at birth is a reliable parameter for evaluating fetal growth restriction and a possible predictor of physical growth in VLBW children.
Collapse
Affiliation(s)
- Hiromichi Shoji
- Department of Pediatrics, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
- Correspondence: ; Tel.: +81-3-3813-3111; Fax: +81-3-5800-0216
| | - Yayoi Murano
- Department of Pediatrics, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Yukika Saitoh
- Department of Pediatrics, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Naho Ikeda
- Department of Pediatrics, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Natsuki Ohkawa
- Department of Neonatology, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni-shi, Shizuoka 410-2295, Japan
| | - Naoto Nishizaki
- Department of Pediatrics, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu-shi, Chiba 279-0021, Japan
| | - Ken Hisata
- Department of Pediatrics, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Masato Kantake
- Department of Neonatology, Juntendo University Nerima Hospital, 3-1-10 Koyadai, Nerima-ku, Tokyo 177-8521, Japan
| | - Kaoru Obinata
- Department of Pediatrics, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Daisuke Yoneoka
- Division of Biostatistics and Bioinformatics, Graduate School of Public Health St. Luke’s International University, 10-1 Akashi-cho, Chuo-ku, Tokyo 104-0044, Japan
| | - Toshiaki Shimizu
- Department of Pediatrics, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| |
Collapse
|
6
|
Growth Trajectories during the First 6 Years in Survivors Born at Less Than 25 Weeks of Gestation Compared with Those between 25 and 29 Weeks. J Clin Med 2022; 11:jcm11051418. [PMID: 35268509 PMCID: PMC8911231 DOI: 10.3390/jcm11051418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/01/2022] [Accepted: 03/03/2022] [Indexed: 11/30/2022] Open
Abstract
We aimed to determine the differences in the growth trajectories of the youngest gestational survivors (<25 weeks’ gestation) up to 6 years of age compared to those of older gestational ages. Preterm infants were divided into two groups: 22−24 weeks’ gestation (male (M) 16, female (F) 28) and 25−29 weeks’ gestation (M 84, F 59). Z-scores of body weight (BW), body length (BL), and body mass index (BMI) were derived from Japanese standards at 1, 1.5, 3, and 6 years of corrected age. Comparisons between the two groups by sex were made using the Wilcoxon test and linear regression analysis to examine the longitudinal and time-point associations of anthropometric z-scores, the presence of small for gestational age (SGA), and the two gestational groups. BW, BL, BMI, and z-scores were significantly lower in the 22−24 weeks group at almost all assessment points. However, there were no significant differences in BW, BL, BMI, and z-scores between the two female groups after 3 years. BMI z-scores were significantly associated with the youngest gestational age and the presence of SGA at all ages in males, but not in females. The youngest gestational age had a greater influence in males on the z-score of anthropometric parameters up to 6 years of age.
Collapse
|
7
|
Heisecke S, Alfaro EL, Martínez J, Figueroa M, Bronberg R, Ratowiecki J, López Camelo JS, Dipierri JE. Neonatal anthropometry of malformed newborns: A large South American population-based study. Paediatr Perinat Epidemiol 2022; 36:211-219. [PMID: 35188679 DOI: 10.1111/ppe.12843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 11/17/2021] [Accepted: 11/21/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Population-based anthropometric evaluation of malformed newborns is scarce. OBJECTIVES To evaluate malformed newborns' foetal growth using the ICD 10 malformations' classification. METHODS A study including 33,769 newborns (14,857 malformed and 18,912 nonmalformed), selected from 678,840 births from nine South American countries, period 2010-2018, was conducted. Prevalence of severe small and small for gestational age was calculated for malformed and nonmalformed newborns classified by preterm birth categories. Prevalence and relative risk (RR) with its 95% confidence interval (CI) were calculated. The associations between anthropometric phenotypes and congenital malformations were evaluated with generalized linear models. RESULTS Prevalence of preterm and term severe small and small for gestational age newborns was higher in malformed than that in nonmalformed neonates. For grouped ICD 10 malformations categories, the RR for severe small for gestational age was 2.88 (95% CI 2.51, 3.30) and 2.10 (95% CI 1.92, 2.30) for small for gestational age. For at-term and preterm malformed newborns, the RR for severe small for gestational age was 2.21 (95% CI 1.87, 2.61) and 3.21 (95% CI 2.52, 4.10), respectively; for small for gestational age, the RR was 2.31 (95% CI 2.11, 2.53) for at-term newborns and 2.58 (95% CI 2.16, 3.08) for preterm ones. CONCLUSIONS Prevalence and relative risk of severe small and small for gestational age vary according to the group of malformations and gestational age; they increase in congenital malformations of the nervous, respiratory and digestive systems, and in chromosomal abnormalities and are lower for malformations of eye, ear, face and neck and cleft lip and palate. Foetal growth considered together with malformed newborns' gestational age would allow for inferring different risks of morbidity and mortality.
Collapse
Affiliation(s)
- Silvina Heisecke
- Dirección de Investigación, Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Argentina
| | - Emma L Alfaro
- Instituto de Ecorregiones Andinas (INECOA), Universidad Nacional de Jujuy-Consejo Nacional de Investigaciones Científicas y Técnicas (UNJu-CONICET), San Salvador de Jujuy, Argentina
| | - Jorge Martínez
- Instituto de Ecorregiones Andinas (INECOA), Universidad Nacional de Jujuy-Consejo Nacional de Investigaciones Científicas y Técnicas (UNJu-CONICET), San Salvador de Jujuy, Argentina.,Instituto de Biología de la Altura, Universidad Nacional de Jujuy, San Salvador de Jujuy, Argentina
| | - Marcelo Figueroa
- Instituto de Ecorregiones Andinas (INECOA), Universidad Nacional de Jujuy-Consejo Nacional de Investigaciones Científicas y Técnicas (UNJu-CONICET), San Salvador de Jujuy, Argentina.,Instituto de Estudios Celulares, Genéticos y Moleculares (ICeGeM), Universidad Nacional de Jujuy, San Salvador de Jujuy, Argentina
| | - Rubén Bronberg
- Área de Genética Médica y Poblacional, Hospital Ramos Mejía, Ciudad Autónoma de Buenos Aires, Argentina
| | - Julia Ratowiecki
- Laboratorio de Epidemiología Genética, Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Argentina.,Estudio Colaborativo Latino Americano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Argentina
| | - Jorge S López Camelo
- Laboratorio de Epidemiología Genética, Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Argentina.,Estudio Colaborativo Latino Americano de Malformaciones Congénitas (ECLAMC), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Argentina.,Instituto Nacional de Genética Médica Populacional (INAGEMP), Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Argentina
| | - José E Dipierri
- Instituto de Biología de la Altura, Universidad Nacional de Jujuy, San Salvador de Jujuy, Argentina
| |
Collapse
|
8
|
Jochum F, Nomayo A, Petersen H, Otten L. Krankheitsassoziierte Unterernährung bei Kindern und Jugendlichen in Deutschland. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-021-01411-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
9
|
Yu X, Yang X, Zhao Y, Luo XP, Liang Y, Wu W, Ying YQ, Ye F, Hou L. A comparison of the growth status, level of blood glucose, and lipid metabolism in small for gestational age and appropriate for gestational age girls with central precocious puberty: a retrospective study. Transl Pediatr 2021; 10:783-789. [PMID: 34012828 PMCID: PMC8107858 DOI: 10.21037/tp-20-366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND To compare the physical development status, level of blood glucose and lipid metabolism in small for gestational age (SGA) and appropriate for gestational age (AGA) groups with central precocious puberty (CPP). METHODS This was a retrospective study. Three hundred and twenty-two girls with CPP were divided into the AGA group (304 cases) and the SGA group (18 cases). Physical index such as height, weight, and body mass index (BMI), as well as sex hormones, adrenal androgens, blood lipid levels, fasting blood glucose, insulin levels, and homeostasis model assessment of insulin resistance (HOMA-IR) were compared between the two groups. RESULTS Height, weight, and BMI in the SGA group were lower than those in the AGA group (P<0.05). The level of LH/FSH, estradiol, testosterone, DHEA and androstenedione had no significant difference between the SGA group and AGA group (P>0.05). The fasting blood glucose, insulin level, HOMA-IR, high-density lipoprotein (HDL) and the average level of triglycerides were similar between these two groups (P>0.05). There was a statistically significant difference in total cholesterol and low-density lipoprotein (LDL) between the two groups (P<0.05). However, the blood lipids and blood glucose in both groups were within the normal range. CONCLUSIONS The height, weight, BMI, serum cholesterol and LDL of girls in SGA with CPP were significantly lower than that of those girls born AGA.
Collapse
Affiliation(s)
- Xiao Yu
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xi Yang
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yue Zhao
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao-Ping Luo
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Liang
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Wu
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan-Qin Ying
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Feng Ye
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ling Hou
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
10
|
|
11
|
Barreto CM, Pereira MAL, Rolim ACB, Abbas SA, Langhi Junior DM, Santos AMND. INCIDENCE OF SMALL FOR GESTATIONAL AGE NEONATES, ACCORDING TO THE FENTON AND INTERGROWTH-21ST CURVES IN A LEVEL II MATERNITY. ACTA ACUST UNITED AC 2020; 39:e2019245. [PMID: 32638944 PMCID: PMC7333938 DOI: 10.1590/1984-0462/2021/39/2019245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 10/11/2019] [Indexed: 11/21/2022]
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.
Collapse
|