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Ginsburg AS, Jehan F, Ariff S, Nisar MI, Schaefer E, Flaherman V, Shrestha A, Dongol S, Laleau V, de Sa AB, Co R, Nankabirwa V. Newborn weight nomograms in selected low and middle-income countries. Sci Rep 2023; 13:14128. [PMID: 37644038 PMCID: PMC10465556 DOI: 10.1038/s41598-023-39773-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 07/31/2023] [Indexed: 08/31/2023] Open
Abstract
Growth impairment is common in low- and middle-income countries (LMIC) and may begin during early infancy, increasing morbidity and mortality. To ensure healthy infant growth, healthcare providers in high-income countries (HIC) track newborn weight change using tools developed and validated in HIC. To understand the utility of these tools for LMIC, we conducted a secondary analysis to compare weight trajectories in the first 5 days of life among newborns born in our LMIC cohort to an existing HIC newborn weight tool designed to track early weight change. Between April 2019 and March 2020, a convenience sample of 741 singleton healthy breastfeeding newborns who weighed ≥ 2000 g at birth were enrolled at selected health facilities in Guinea-Bissau, Nepal, Pakistan, and Uganda. Using a standardized protocol, newborn weights were obtained within 6 h of birth and at 1, 2, 3, 4, and 5 days, and nomograms depicting newborn weight change were generated. The trajectories of early newborn weight change in our cohort were largely similar to published norms derived from HIC infants, with the exceptions that initial newborn weight loss in Guinea-Bissau was more pronounced than HIC norms and newborn weight gain following weight nadir was more pronounced in Guinea-Bissau, Pakistan, and Uganda than HIC norms. These data demonstrate that HIC newborn weight change tools may have utility in LMIC settings.
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Affiliation(s)
| | | | | | | | | | - Valerie Flaherman
- University of California, San Francisco, 3333 California St., Box 0503, San Francisco, CA, 94118, USA.
| | - Akina Shrestha
- Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Srijana Dongol
- Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Victoria Laleau
- University of California, San Francisco, 3333 California St., Box 0503, San Francisco, CA, 94118, USA
| | | | - Raimundo Co
- International Partnership for Human Development, Bissau, Guinea-Bissau
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Tagi N, Ergin A, Bilgen HS, Ozek E. The Use of the "Early Weight Loss Nomograms" as Compared to a Standard Weight Loss Percentage Protocol Will Decrease Postnatal Formula Supplementation. Breastfeed Med 2022; 17:137-142. [PMID: 34936479 DOI: 10.1089/bfm.2021.0042] [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] [Indexed: 11/13/2022]
Abstract
Introduction: We compared the number of babies who needed formula supplementation, based on the "Early Weight Loss Nomograms," with the hypothetical outcomes that would have occurred in the same cohort if they had been managed according to a "weight loss percentage" protocol. Subjects and Methods: This study included 308 newborns. Supplemental formula was provided to babies whose weight loss was more than the 95th percentile according to the "Early Weight Loss Nomograms." Pathological weight loss was defined as when a weight loss was >5% at the 24th hour or >8% at the 48th hour. The number of babies who would have needed formula supplementation according to those two strategies were compared. Results: The mean postnatal first-second day weight losses for vaginal and cesarean deliveries were 3.06% versus 4.7% and 4.5%, versus 5.8%, respectively, and were significantly higher for babies born by cesarean section (p = 0.001). We found that 89.4% of vaginal deliveries and 89.2% of babies born by cesarean section were exclusively breastfed when the nomograms were in use. If the daily weight loss strategy would be applied instead of the nomograms to the study cohort, the rate of exclusive breastfeeding would be significantly lower for babies born by cesarean section (64.2% versus 89.2%) (p = 0.001). Conclusions: The use of the Early Weight Loss Nomograms will decrease the rate of formula supplementation.
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Affiliation(s)
- Nazmiye Tagi
- T.R. Ministry of Health İzmir Provincial Health Directorate Bakırçay University Çiğli Training and Research Hospital Yeni Mahalle, İzmir, Turkey
| | - Ayla Ergin
- Midwifery Department, Faculty of Health Sciences, Kocaeli University, Kocaeli, Turkey
| | - Hulya Selva Bilgen
- Division of Neonatology, Department of Pediatrics, Marmara University Medical School, Istanbul, Turkey
| | - Eren Ozek
- Division of Neonatology, Department of Pediatrics, Marmara University Medical School, Istanbul, Turkey
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Duan L, Gan S, Hu H. A single-center experience on exchange transfusion therapy in 123 full-term cases of severe neonatal hyperbilirubinemia in Wuhan. J Matern Fetal Neonatal Med 2020; 34:466-472. [PMID: 33225794 DOI: 10.1080/14767058.2020.1844659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To describe the clinical experience in application of exchange transfusion therapy (ETT) in the treatment of severe neonatal hyperbilirubinemia. METHODS The clinical data and examination results of severe neonatal hyperbilirubinemia full-term cases treated by ETT were analyzed retrospectively, the etiology and risk factors of severe neonatal hyperbilirubinemia were statistically analyzed, and the statistical characteristics of the children in each etiological group and the incidence of adverse events of ETT were analyzed. RESULTS The age of jaundice, peak total bilirubin after phototherapy and ETT in 123 full-term infants were 2.0 (1.0, 3.0) days, 4.0 (2.0, 7.0) days and 4.0 (2.0, 7.0) days, respectively, of which 68 were male and 55 were female. The main pathogeny of severe neonatal hyperbilirubinemia was blood group incompatibility hemolytic disease of newborn (HDN). Age of ETT, total bilirubin after ETT, gender and BAEP results were different between ABE and non-ABE infants. Weight loss can be used as a predictor of hospitalization length. The major adverse events related to ETT were hypocalcemia, hypomagnesemia, hyponatremia and thrombocytopenia. CONCLUSIONS ETT can rapidly reduce the level of total bilirubin to prevent ABE and play an important role in the treatment of neonatal hyperbilirubinemia, but the whole process of ETT needs to be closely monitored.
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Affiliation(s)
- Ling Duan
- Department of Blood Transfusion, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shan Gan
- Department of Blood Transfusion, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongbing Hu
- Department of Blood Transfusion, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Morton J. Hands-On or Hands-Off When First Milk Matters Most? Breastfeed Med 2019; 14:295-297. [PMID: 30897006 DOI: 10.1089/bfm.2018.0253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Jane Morton
- Department of Pediatrics, Stanford University Medical Center, Palo Alto, California
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Kair LR, Flaherman V, Colaizy T. Effect of Donor Milk Supplementation on Breastfeeding Outcomes in Term Newborns: A Randomized Controlled Trial. Clin Pediatr (Phila) 2019; 58:534-540. [PMID: 30688082 PMCID: PMC6456417 DOI: 10.1177/0009922819826105] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Pasteurized donor human milk (DHM) use for healthy newborns is increasing; however, no studies have explored its effect on breastfeeding outcomes. PATIENTS AND METHODS We enrolled 60 healthy, term breastfeeding newborns with ≥4.5% weight loss in the first 36 hours in a randomized controlled trial. Thirty newborns were randomly assigned to early limited-volume DHM supplementation and 30 newborns to exclusive breastfeeding. Mothers were surveyed at 1 week and 1, 2, and 3 months regarding the mode of infant feeding. Comparing infants randomized to DHM supplementation with those exclusively breastfeeding, there was no significant difference in the proportion using formula at 1 week (21% vs 7%, P = .15), nor in the proportion of any breastfeeding (79% vs 90%, P = .30) or breastfeeding without formula at 3 months (62% vs 77%, P = .27). Conclusion For newborns with ≥4.5% weight loss in the first 36 hours, early limited-volume supplementation with DHM is unlikely to have a significant favorable impact on breastfeeding outcomes.
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Affiliation(s)
- Laura R. Kair
- University of Iowa Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA 52242
- University of California Davis Medical Center, 2516 Stockton Blvd., Ticon II, Room 341, Sacramento, CA 95817, Phone: (916) 734-7308, Fax: (916) 456-2236,
| | - Valerie Flaherman
- University of California, San Francisco, 3333 California St., Box 0503, San Francisco, CA 94118, Phone: (415) 502-6266, Fax: (415) 476-6106
| | - Tarah Colaizy
- Division of Neonatology, Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, 8809 JPP, Iowa City, IA 52242, Phone: (319) 356-3508,
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Zia MTK, Golombek S, Lemon L, Nitkowski Keever S, Paudel U. The influence of time of birth and seasonal variations on weight loss in breastfeeding neonates. J Neonatal Perinatal Med 2019; 12:189-194. [PMID: 30714975 DOI: 10.3233/npm-17137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Breastfeeding (BF) neonates generally lose weight after birth. Neonatal factors like gestational age, birth weight and mode of delivery can affect the neonatal weight loss after birth. Similarly, maternal age, parity and illness may contribute to newborn weight loss. However, influence of the time of birth and season on changes in weight is not well elucidated. OBJECTIVE The aim of this study is to determine the effect of birth time and the seasonal variations on weight loss in BF newborns. METHODS In this retrospective study of a prospectively maintained database of two sets of groups, from January 2013 to October 2016, were evaluated- Birth time group and Seasonal group; Birth time of the groups was: night time 7pm to 7am and day time 7am to 7pm; and the seasonal variations groups studies were summer, fall, winter and spring. Weight loss of >5%, 7%, and 10% at <24 hours (h), 48 h and 72 h of birth, respectively, were considered as a significant weight loss. Preterm, exclusively formula fed and neonates admitted to NICU were excluded. RESULTS A total of 2044 newborns were analyzed. In the birth time group, babies born during the night time had significantly lost >5% of birth weight at <24 h (p < 0.01) and >7% birth weight at <48 h of life (p < 0.02). Weight loss >10% at <72 h was similar in both birth time cohorts. C-section, prolonged rupture of membrane, and maternal pre-delivery hospital stay for >12 h were significant contributing factors. Whereas, seasonal variations were not associated with weight loss in neonates. CONCLUSION BF babies born at night time lose significantly more weight during the first two days of life and seasonal association was not found to affect weight loss in the neonates.
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Affiliation(s)
- M T K Zia
- Department of Pediatrics, Maria Fareri Children's Hospital, New York Medical College, Valhalla, NY, USA
- Department of Pediatrics, New York-Presbyterian/Hudson Valley Hospital, Cortlandt Manor, NY, USA
| | - S Golombek
- Department of Pediatrics, Maria Fareri Children's Hospital, New York Medical College, Valhalla, NY, USA
| | - L Lemon
- Department of Pediatrics, New York-Presbyterian/Hudson Valley Hospital, Cortlandt Manor, NY, USA
| | - S Nitkowski Keever
- Department of Pediatrics, New York-Presbyterian/Hudson Valley Hospital, Cortlandt Manor, NY, USA
| | - U Paudel
- Department of Pediatrics, Maria Fareri Children's Hospital, New York Medical College, Valhalla, NY, USA
- Department of Pediatrics, New York-Presbyterian/Hudson Valley Hospital, Cortlandt Manor, NY, USA
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Genna CW, Notarangelo M. Differentiating Normal Newborn Weight Loss From Breastfeeding Failure. CLINICAL LACTATION 2018. [DOI: 10.1891/2158-0782.9.4.183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
There is increasing concern for the risk of hypernatremic dehydration in infants breastfeeding poorly. It is important to differentiate normal weight changes as infants adapt to extrauterine life from excessive weight loss from breastfeeding failure or mismanagement. We review recent data on normal weight changes in exclusively breastfeeding infants and those at risk for hypernatremic dehydration to help health professionals determine when infants require further scrutiny and supplementation. The data suggest that perinatal practices influence infant weight changes. Protecting normal birth and early initiation of breastfeeding should reduce the incidence of excessive weight loss and risk of hypernatremic dehydration
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Flaherman V, Schaefer EW, Kuzniewicz MW, Li SX, Walsh EM, Paul IM. Health Care Utilization in the First Month After Birth and Its Relationship to Newborn Weight Loss and Method of Feeding. Acad Pediatr 2018; 18:677-684. [PMID: 29191700 DOI: 10.1016/j.acap.2017.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 11/16/2017] [Accepted: 11/19/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Guidelines recommend closer outpatient follow-up for exclusively breastfed newborns, especially those with pronounced weight loss, because of increased risk of hyperbilirubinemia and dehydration that might require readmission. Our objective was to determine how feeding method and weight loss are associated with neonatal health care utilization. METHODS A retrospective cohort study conducted at Northern California Kaiser Permanente hospitals in 2009-2013 assessed 143,889 neonates to study the inpatient method of feeding as well as inpatient and outpatient weights. The main outcome measures were inpatient and outpatient health care utilization in the 30 days after birth. RESULTS Newborn weight loss and feeding method were both associated with utilization. Exclusively breastfed newborns had higher readmission rates than those exclusively formula fed for both vaginal (4.3% compared to 2.1%) (P < .001) and cesarean deliveries (2.1% compared to 1.5%) (P = .025). Those exclusively breastfed also had more neonatal outpatient visits compared to those exclusively formula fed for both vaginal (means of 3.0 and 2.3, P < .001) and cesarean deliveries (means of 2.8 and 2.2, P < .001). Among vaginally delivered newborns of all feeding types, newborns with weight loss >10% at discharge had a relative risk of readmission of 1.10 (95% confidence interval [CI],1.00, 1.20) compared to those with <8% weight loss at discharge; among the subset weighed as inpatients or outpatients between 48 and 72 hours, those with >10% weight loss between 48-72 hours had a relative risk of readmission of 2.11 (95% CI, 1.95, 2.26) compared to those with <8% weight loss at 48-72 hours. CONCLUSIONS Exclusive breastfeeding and weight loss are associated with increased neonatal health care utilization. Improving clinical management of exclusively breastfed neonates with pronounced weight loss might reduce health care utilization.
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Affiliation(s)
- Valerie Flaherman
- Department of Pediatrics, University of California-San Francisco, San Francisco, Calif.
| | - Eric W Schaefer
- Department of Pediatrics, University of California-San Francisco, San Francisco, Calif
| | - Michael W Kuzniewicz
- Department of Pediatrics, University of California-San Francisco, San Francisco, Calif
| | - Sherian X Li
- Department of Pediatrics, University of California-San Francisco, San Francisco, Calif
| | - Eileen M Walsh
- Department of Pediatrics, University of California-San Francisco, San Francisco, Calif
| | - Ian M Paul
- Department of Pediatrics, University of California-San Francisco, San Francisco, Calif
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Verd S, de Sotto D, Fernández C, Gutiérrez A. Impact of in-hospital birth weight loss on short and medium term breastfeeding outcomes. Int Breastfeed J 2018; 13:25. [PMID: 29988668 PMCID: PMC6029158 DOI: 10.1186/s13006-018-0169-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 06/11/2018] [Indexed: 01/24/2023] Open
Abstract
Background The definition for lower limit of safe birthweight loss among exclusively breastfed neonates is arbitrary. Despite this, in cases of great in-hospital weight loss, breastfeeding adequacy is immediately questioned. The aim of this study was to examine the relationship between weight loss at discharge from hospital, when babies are ready to go home, and eventual cessation of exclusive breastfeeding since birth. Methods This is a secondary analysis of a cohort study. Study participants were 788 full term, breastfed and stable babies, born in 2007–2012 consecutively enrolled to primary care pediatric clinics in Majorca, Spain. Data were collected by chart review. The main predictor was birthweight loss at discharge. Extreme weight loss was defined as the 90th and 95th centiles of birthweight loss for babies who were delivered by vaginal delivery and by cesarean section. Main outcomes were cessation of exclusive breastfeeding by 7, 15, 30 and 100 days of life. Multivariate regression analysis was performed to study the relationship of selected variables with exclusive breastfeeding cessation since birth. Results We observed a median weight loss of 6%. In bivariate analysis, quartiles of birthweight loss at discharge were predictive of exclusive breastfeeding cessation at 15, 30 and 100 days postpartum. In multivariate analysis: in-hospital weight loss above the median did predict exclusive breastfeeding cessation by 15, 30 and 100 days of life, Adjusted Odds Ratios (AORs) (95% Confidence Intervals [CIs]): 1.57 (1.12, 2.19), 1.73 (1.26, 2.38) and 1.69 (1.25, 2.29), respectively. In contrast, we did not find that newborn extreme weight losses were associated with exclusive breastfeeding cessation. Conclusions We report that extreme birthweight loss does not trigger immediate formula supplementation. We do not identify any cut-off values to be used as predictors for the initiation of supplementary feeding, this research question remains unanswered.
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Affiliation(s)
- Sergio Verd
- Department of Primary Care, Balearic Health Authority, 07003 Palma de Mallorca, Spain
| | - Diego de Sotto
- 2Endocrinology Unit. Department of Paediatrics, Son Espases University Hospital, Valldemossa Road, 79, 07010 Palma de Mallorca, Spain
| | - Consuelo Fernández
- Department of Primary Care, Balearic Health Authority, 07003 Palma de Mallorca, Spain
| | - Antonio Gutiérrez
- 3Molecular Biology Unit, Division of Hematology, Son Espases University Hospital, Valldemossa Road, 79, 07010 Palma de Mallorca, Spain
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Yu C, Li H, Zhang Q, He H, Chen X, Hua Z. Report about term infants with severe hyperbilirubinemia undergoing exchange transfusion in Southwestern China during an 11-year period, from 2001 to 2011. PLoS One 2017; 12:e0179550. [PMID: 28662083 PMCID: PMC5491324 DOI: 10.1371/journal.pone.0179550] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 05/30/2017] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES This study was intended to explore the etiology and risk factors of severe neonatal hyperbilirubinemia and to analyze the adverse events associated with ECT (Exchange Transfusion), as well as to identify the factors related to the poor prognosis. METHODS All of the full-term neonates who had undergone ECT for hyperbilirubinemia at Children's Hospital of Chongqing Medical University from January 2001 to December 2011 were enrolled in this study. General demographic characteristics, comorbidities, pre- and post-exchange TSB(Total Serum Bilirubin) levels, duration and frequency of ECT, and clinical outcomes were recorded and analyzed anonymously. RESULTS Of 614 total infants, 368 patients (59.9%) with ABO incompatibility were identified, of whom 197 (53.5%) developed acute bilirubin encephalopathy (ABE) and 16 (4.3%) suffered a poor prognosis. The etiology was unidentified in 103 patients (16.8%), of whom 62 (60.1%) developed ABE and 9 (8.7%) had a poor prognosis. Identified adverse events secondary to ECT included thrombocytopenia (54.6%), hyperglycemia (42.8%), apnea (3.3%) and necrotizing enterocolitis (NEC) (1.3%). No ECT-related mortality was documented in this study. CONCLUSIONS The etiology, peak TSB level before ECT, and time of ECT had a significant impact on the outcome of severe neonatal hyperbilirubinemia. ABO incompatibility was the most common cause of extreme neonatal hyperbilirubinemia. Pathological weight loss could be involved in the development of extreme hyperbilirubinemia with an unidentified cause.
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Affiliation(s)
- Canfeng Yu
- Department of Neonatology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- Key Laboratory of Pediatrics in Chongqing, Chongqing, China
| | - Huifan Li
- Department of Neonatology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing, China
| | - Qiannan Zhang
- Department of Neonatology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Huayun He
- Department of Neonatology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Xinhong Chen
- Department of Neonatology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Ziyu Hua
- Department of Neonatology, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing, China
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Suchomlinov A, Tutkuviene J. The absence of physiological neonatal weight loss on the 1st-5th day is associated with decreased later physical indices. Ann Hum Biol 2016; 43:572-576. [PMID: 26560691 DOI: 10.3109/03014460.2015.1119310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM To investigate associations between physiological neonatal weight loss on the 1st-5th day and physical indices from birth up to the age of 17 years. METHODS Data were derived from the personal health records of healthy, full-term and breastfed children born in Vilnius in 1990 and 1996. Five hundred and thirty children (289 boys and 241 girls) who left a maternity unit on the 1st-5th day after birth were included in the analysis. RESULTS Infants left the maternity unit on day 4.62 ± 2.33. On the day of leaving a maternity unit, infants lost 105.06 ± 130.48 g (2.85 ± 3.65%) of birth weight. Girls who did not lose or gained weight after birth had already weighed less at birth (3163 ± 547 and 3490 ± 403 g, respectively, p < 0.01) and remained lighter up to the age of 17 years (54.3 ± 8.7 and 60.8 ± 10.1 kg at the age of 17 years respectively, p < 0.001). Girls who did not lose or gained weight after birth were also shorter than those who lost weight (164.3 ± 5.7 and 168.6 ± 5.4 cm at the age of 17 years, respectively, p < 0.001). CONCLUSION Girls who did not lose or gained weight immediately after birth tended to remain shorter and lighter during childhood and adolescence. Only a few statistically significant differences were obtained in boys.
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Affiliation(s)
- Andrej Suchomlinov
- a Department of Anatomy , Histology and Anthropology, Faculty of Medicine, Vilnius University , Vilnius , Lithuania
| | - Janina Tutkuviene
- a Department of Anatomy , Histology and Anthropology, Faculty of Medicine, Vilnius University , Vilnius , Lithuania
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12
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Wilbaux M, Kasser S, Wellmann S, Lapaire O, van den Anker JN, Pfister M. Characterizing and Forecasting Individual Weight Changes in Term Neonates. J Pediatr 2016; 173:101-107.e10. [PMID: 27039231 DOI: 10.1016/j.jpeds.2016.02.044] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 12/22/2015] [Accepted: 02/17/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To develop a mathematical, semimechanistic model characterizing physiological weight changes in term neonates, identify and quantify key maternal and neonatal factors influencing weight changes, and provide an online tool to forecast individual weight changes during the first week of life. STUDY DESIGN Longitudinal weight data from 1335 healthy term neonates exclusively breastfed up to 1 week of life were available. A semimechanistic model was developed to characterize weight changes applying nonlinear mixed-effects modeling. Covariate testing was performed by applying a standard stepwise forward selection-backward deletion approach. The developed model was externally evaluated on 300 additional neonates collected in the same center. RESULTS Weight changes during first week of life were described as a function of a changing net balance between time-dependent rates of weight gain and weight loss. Males had higher birth weights (WT0) than females. Gestational age had a positive effect on WT0 and weight gain rate, whereas mother's age had a positive effect on WT0 and a negative effect on weight gain rate. The developed model showed good predictive performance when externally validated (bias = 0.011%, precision = 0.52%) and was able to accurately forecast individual weight changes up to 1 week with only 3 initial weight measurements (bias = -0.74%, precision = 1.54%). CONCLUSIONS This semimechanistic model characterizes weight changes in healthy breastfed neonates during first week of life. We provide a user-friendly online tool allowing caregivers to forecast and monitor individual weight changes. We plan to validate this model with data from other centers and expand it with data from preterm neonates.
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Affiliation(s)
- Mélanie Wilbaux
- Division of Pediatric Pharmacology and Pharmacometrics, University of Basel Children's Hospital (UKBB), Basel, Switzerland
| | - Severin Kasser
- Division of Neonatology, University of Basel Children's Hospital (UKBB), Basel, Switzerland
| | - Sven Wellmann
- Division of Neonatology, University of Basel Children's Hospital (UKBB), Basel, Switzerland.
| | - Olav Lapaire
- Division of Obstetrics and Gynecology, University Hospital Basel, Basel, Switzerland
| | - Johannes N van den Anker
- Division of Pediatric Pharmacology and Pharmacometrics, University of Basel Children's Hospital (UKBB), Basel, Switzerland; Division of Pediatric Clinical Pharmacology, Children's National Health System, Washington, DC
| | - Marc Pfister
- Division of Pediatric Pharmacology and Pharmacometrics, University of Basel Children's Hospital (UKBB), Basel, Switzerland
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13
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Miller JR, Flaherman VJ, Schaefer EW, Kuzniewicz MW, Li SX, Walsh EM, Paul IM. Early weight loss nomograms for formula fed newborns. Hosp Pediatr 2015; 5:263-8. [PMID: 25934810 DOI: 10.1542/hpeds.2014-0143] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To develop nomograms depicting percentiles of weight loss by hour of age for both vaginal and cesarean-delivered newborns who are exclusively formula fed. METHODS Data regarding delivery mode, race/ethnicity, feeding type, and weights were extracted from electronic medical records of the birth hospitalization at 14 Kaiser Permanente Northern California hospitals between 2009 and 2013. Newborns whose first feeding was formula from a cohort of 161 471 healthy, term, singleton neonates born at ≥36 weeks' gestation between 2009 and 2013 were identified. Quantile regression was used to create nomograms stratified according to delivery mode; percentiles of weight loss were estimated as a function of time among formula-fed neonates. Weights measured subsequent to any breast milk feeding were excluded. Percentiles were determined through 48 and 72 hours of age for those born vaginally and via cesarean delivery, respectively. RESULTS A total of 7075 formula-fed newborns had weights recorded; 4525 were delivered vaginally, and 2550 were born via cesarean delivery. The median weight loss was 2.9% at 48 hours after vaginal delivery; weight loss>7% was rare. For cesarean-delivered neonates, median weight losses at 48 and 72 hours were 3.7% and 3.5%, respectively; weight loss>8% was rare. CONCLUSIONS For newborns who are formula fed, these results provide nomograms depicting percentiles of weight loss according to mode of delivery. These plots can be used to classify early weight loss according to percentile and may enable early identification of feeding difficulties or other neonatal morbidities.
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Affiliation(s)
| | - Valerie J Flaherman
- Departments of Pediatrics, and Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, California; and
| | - Eric W Schaefer
- Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - Michael W Kuzniewicz
- Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, California; and Division of Research, Kaiser Permanente, Oakland, California
| | - Sherian X Li
- Division of Research, Kaiser Permanente, Oakland, California
| | - Eileen M Walsh
- Division of Research, Kaiser Permanente, Oakland, California
| | - Ian M Paul
- Departments of Pediatrics, and Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
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Hull HR, Thornton J, Paley C, Navder K, Gallagher D. Maternal obesity influences the relationship between location of neonate fat mass and total fat mass. Pediatr Obes 2015; 10:245-51. [PMID: 25088238 PMCID: PMC4317390 DOI: 10.1111/ijpo.257] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 06/04/2014] [Accepted: 06/11/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND It is suggested that maternal obesity perpetuates offspring obesity to future generations. OBJECTIVE To determine whether location of neonate fat mass (FM: central vs. peripheral) is related to total neonate FM and whether maternal obesity influences this relationship. METHODS Neonate body composition and skin-fold thicknesses were assessed in healthy neonates (n = 371; 1-3 days old). Linear regression models examined the relationship between total FM and location of FM (central vs. peripheral). Location of FM was calculated by skin-folds: peripheral was the sum of (biceps and triceps)/2 and central was represented by the subscapular skin-fold. RESULTS A significant interaction was found for location of FM and maternal obesity. Holding all predictors constant, in offspring born to non-obese mothers, a 0.5 mm increase in central FM predicted a 15 g greater total FM, whereas a 0.5 mm increase in peripheral FM predicted a 66 g greater total FM. However, in offspring born to obese mothers, a 0.5 mm increase in central FM predicted a 56 g total FM, whereas a 0.5 mm increase in peripheral FM predicted a 14 g greater total FM. CONCLUSIONS The relationship between total FM and location of FM is influenced by maternal obesity.
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Affiliation(s)
- Holly R. Hull
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS,New York Obesity Nutrition Research Center at Columbia University, St. Luke's-Roosevelt Hosp., NY, NY
| | - John Thornton
- New York Obesity Nutrition Research Center at Columbia University, St. Luke's-Roosevelt Hosp., NY, NY
| | - Charles Paley
- Department of Pediatrics, St. Luke's-Roosevelt Hospital, NY, NY
| | | | - Dympna Gallagher
- New York Obesity Nutrition Research Center at Columbia University, St. Luke's-Roosevelt Hosp., NY, NY
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15
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Affiliation(s)
- Ranga Panagoda
- Department of Neonatal Registrar, Centenary Hospital for Women and Children, Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Natalie De Cure
- Department of Obstetric Registrar, Obstetrics and Gynaecology, Centenary Hospital for Women and Children, Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Ruth McCuaig
- Department of Obstetric Registrar, Obstetrics and Gynaecology, Centenary Hospital for Women and Children, Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Alison L Kent
- Department of Senior Staff Specialist, Neonatology, Centenary Hospital for Women and Children, Canberra Hospital, Canberra, Australian Capital Territory, Australia.,Department of Neonatology, Australian National University Medical School, Canberra, Australian Capital Territory, Australia
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16
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Flaherman VJ, Schaefer EW, Kuzniewicz MW, Li SX, Walsh EM, Paul IM. Early weight loss nomograms for exclusively breastfed newborns. Pediatrics 2015; 135:e16-23. [PMID: 25554815 PMCID: PMC4279066 DOI: 10.1542/peds.2014-1532] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/03/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The majority of newborns are exclusively breastfed during the birth hospitalization, and weight loss is nearly universal for these neonates. The amount of weight lost varies substantially among newborns with higher amounts of weight loss increasing risk for morbidity. No hour-by-hour newborn weight loss nomogram exists to assist in early identification of those on a trajectory for adverse outcomes. METHODS For 161 471 term, singleton neonates born at ≥36 weeks' gestation at Northern California Kaiser Permanente hospitals in 2009-2013, data were extracted from the birth hospitalization regarding delivery mode, race/ethnicity, feeding type, and weights from electronic records. Quantile regression was used to create nomograms stratified by delivery mode that estimated percentiles of weight loss as a function of time among exclusively breastfed neonates. Weights measured subsequent to any nonbreastmilk feeding were excluded. RESULTS Among this sample, 108 907 newborns had weights recorded while exclusively breastfeeding with 83 433 delivered vaginally and 25 474 delivered by cesarean. Differential weight loss by delivery mode was evident 6 hours after delivery and persisted over time. Almost 5% of vaginally delivered newborns and >10% of those delivered by cesarean had lost ≥10% of their birth weight 48 hours after delivery. By 72 hours, >25% of newborns delivered by cesarean had lost ≥10% of their birth weight. CONCLUSIONS These newborn weight loss nomograms demonstrate percentiles for weight loss by delivery mode for those who are exclusively breastfed. The nomograms can be used for early identification of neonates on a trajectory for greater weight loss and related morbidities.
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Affiliation(s)
- Valerie J Flaherman
- Departments of Pediatrics, and Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, California;
| | | | - Michael W Kuzniewicz
- Departments of Pediatrics, and Division of Research, Kaiser Permanente, Oakland, California
| | - Sherian X Li
- Division of Research, Kaiser Permanente, Oakland, California
| | - Eileen M Walsh
- Division of Research, Kaiser Permanente, Oakland, California
| | - Ian M Paul
- Departments of Public Health Sciences, and Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania; and
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