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Morkuniene R, Cole TJ, Levuliene R, Suchomlinov A, Tutkuviene J. The associations of preterm birth and low birth weight with childhood growth curves between birth and 12 years: a SITAR-based longitudinal analysis. Ann Hum Biol 2025; 52:2472757. [PMID: 40094297 DOI: 10.1080/03014460.2025.2472757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2024] [Revised: 02/11/2025] [Accepted: 02/21/2025] [Indexed: 03/19/2025]
Abstract
BACKGROUND Children born preterm grow differently from those born at term. AIM To compare growth in length/height, weight, and BMI of preterm- and term-born children, grouped by birth weight (BW) and gestational age (GA). SUBJECTS AND METHODS Longitudinal data of 950 children (birth to 12 years) were collected retrospectively. Growth trajectories were modelled using SITAR (Superimposition by Translation and Rotation) by sex, with three groups each for GA and BW. RESULTS SITAR summarised growth patterns from birth to 12 years and explained 76-79% of height variance, 90-92% for weight, and 72-75% for BMI. Early preterm and low BW groups were shorter, lighter and thinner on average than their term or normal BW peers, with late preterm and low-normal BW groups intermediate. Effects were larger for BW than GA, e.g. early preterm girls/boys were 0.3/0.8 kg lighter, 0.9/0.9 cm shorter and 0.8/0.8 kg/m2 thinner, while low BW girls/boys were 0.5/1.0 kg lighter, 1.5/1.4 cm shorter and 0.8/0.9 kg/m2 thinner. Moreover, faster growth rates were associated with lower BW. CONCLUSION Both BW and GA significantly impacted growth, but low BW more so than early preterm birth. This underscores the need for targeted interventions for low BW children to address potential long-term growth challenges.
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Affiliation(s)
- Ruta Morkuniene
- Department of Anatomy, Histology and Anthropology, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Tim J Cole
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Ruta Levuliene
- Institute of Applied Mathematics, Vilnius University, Vilnius, Lithuania
| | - Andrej Suchomlinov
- Department of Anatomy, Histology and Anthropology, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Janina Tutkuviene
- Department of Anatomy, Histology and Anthropology, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Martha VML, Masquio DCL, dos Santos LS, Martha JML, Martha PML, Colares Neto GDP. Impact of the COVID-19 pandemic on growth determinants in premature neonates: observational study in a secondary health service in Carapicuíba, São Paulo (2020-2023). Front Pediatr 2024; 12:1431402. [PMID: 39698472 PMCID: PMC11652131 DOI: 10.3389/fped.2024.1431402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Accepted: 11/18/2024] [Indexed: 12/20/2024] Open
Abstract
Introduction Prematurity is a factor that contributes to the increase in infant morbidity and mortality and is associated with factors determining child growth, such as nutritional deficits, mainly during the COVID-19 pandemic. Objective To evaluate the factors determining the growth of premature neonates treated at a secondary health service during the COVID-19 pandemic. Method Observational retrospective and prospective cohort study of premature patients followed at the follow-up clinic in the municipality of Carapicuíba from February 2020 to December 2023. Through a review of medical records, anthropometric data were collected from birth to corrected gestational age, approximately six months, and nutritional and non-nutritional data with direct or indirect influence on growth. Statistical analysis with tests for quantitative and qualitative variables was carried out with the SPSS Statistics software version 27.0 (SPSS et al., USA). Result The study analyzed a sample of 302 newborns, predominantly male (51.7%) and classified as moderately preterm (47.4%), with an average gestational age of 32.4 ± 2.8 weeks. Prenatal complications occurred in 59.3% of cases, while neonatal complications, such as extrauterine growth restriction (EUGR, 30.8%) and use of parenteral nutrition (36.1%), were common, with an average hospital stay of 30.2 ± 26.1 days. Most newborns were artificially fed (51%) Moreover, they received multivitamins (71.9%). At six months, the newborns showed healthy growth with an average weight of 6.718.2 ± 1.346.5 g. Multiple linear regression analysis revealed significant associations between EUGR and negative Z scores for weight, length, and head circumference at six months. Complications such as anemia and congenital abnormalities also negatively impacted these scores. Comparatively, the newborns in the group pre-vaccination against COVID-19 had more significant growth at six months and more prevalence of newborns born large for gestational age (LGA), while complications such as gastroesophageal reflux disease and viral bronchiolitis was more common in the post-vaccination group. Conclusion During the COVID-19 pandemic, non-nutritional factors, especially EUGR, significantly influenced the anthropometry of premature babies. This condition highlighted the need for more effective therapeutic strategies and public health measures to improve the growth and development of premature infants.
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Kuwaye D, Cho HR. Anomaly Detection and Correction in Dense Functional Data Within Electronic Medical Records. Stat Med 2024; 43:4768-4777. [PMID: 39225196 DOI: 10.1002/sim.10209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 08/08/2024] [Accepted: 08/13/2024] [Indexed: 09/04/2024]
Abstract
In medical research, the accuracy of data from electronic medical records (EMRs) is critical, particularly when analyzing dense functional data, where anomalies can severely compromise research integrity. Anomalies in EMRs often arise from human errors in data measurement and entry, and increase in frequency with the volume of data. Despite the established methods in computer science, anomaly detection in medical applications remains underdeveloped. We address this deficiency by introducing a novel tool for identifying and correcting anomalies specifically in dense functional EMR data. Our approach utilizes studentized residuals from a mean-shift model, and therefore assumes that the data adheres to a smooth functional trajectory. Additionally, our method is tailored to be conservative, focusing on anomalies that signify actual errors in the data collection process while controlling for false discovery rates and type II errors. To support widespread implementation, we provide a comprehensive R package, ensuring that our methods can be applied in diverse settings. Our methodology's efficacy has been validated through rigorous simulation studies and real-world applications, confirming its ability to accurately identify and correct errors, thus enhancing the reliability and quality of medical data analysis.
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Affiliation(s)
- Daren Kuwaye
- Department of Biostatistics, University of Iowa, Iowa City, Iowa
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Monteith H, Mamakeesick M, Rae J, Galloway T, Harris SB, Birken C, Hamilton J, Maguire JL, Parkin P, Zinman B, Hanley AJG. Determinants of Anishinabeck infant and early childhood growth trajectories in Northwestern Ontario, Canada: a cohort study. BMC Pediatr 2023; 23:641. [PMID: 38115010 PMCID: PMC10729431 DOI: 10.1186/s12887-023-04449-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 11/29/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND The Developmental Origins of Health and Disease (DOHaD) paradigm emphasizes the significance of early life factors for the prevention of chronic health conditions, like type 2 diabetes (T2DM) and obesity, which disproportionately affect First Nations communities in Canada. Despite increasing DOHaD research related to maternal health during pregnancy, early childhood growth patterns, and infant feeding practices with many populations, data from First Nations communities in Canada are limited. In partnership with Sandy Lake First Nation, the aims of this project were to characterize birthweights and growth patterns of First Nations infants/children over the first 6 years of life and to study the impact of maternal and infant social and behavioral factors on birthweight and growth trajectories. METHODS We recruited 194 families through community announcements and clinic visits. Infant/child length/height and weight were measured at 1 and 2 weeks; 1, 2, 6, 12, and 18 months; and 2, 3, 4, 5 and 6 years. Maternal and infant/child questionnaires captured data about health, nutrition, and social support. Weight-for-Age z-score (WAZ), Height-for-Age z-score (HAZ), and BMI-for-Age z-score (BAZ) were calculated using WHO reference standards and trajectories were analyzed using generalized additive models. Generalized estimating equations and logistic regression were used to determine associations between exposures and outcomes. RESULTS WAZ and BAZ were above the WHO mean and increased with age until age 6 years. Generalized estimating equations indicated that WAZ was positively associated with age (0.152; 95% CI 0.014, 0.29), HAZ was positively associated with birthweight (0.155; 95% CI 0.035, 0.275), and BAZ was positively associated with caregiver's BMI (0.049; 95% CI 0.004, 0.090). There was an increased odds of rapid weight gain (RWG) with exposure to gestational diabetes (OR: 7.47, 95% CI 1.68, 46.22). Almost 70% of parents initiated breastfeeding, and breastfeeding initiation was modestly associated with lower WAZ (-0.18; 95% CI -0.64, 0.28) and BAZ (-0.23; 95% CI -0.79, 0.34). CONCLUSIONS This work highlights early life factors that may contribute to T2DM etiology and can be used to support community and Indigenous-led prevention strategies.
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Affiliation(s)
- Hiliary Monteith
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, University of Toronto Medical Sciences Building, 5Th Floor, Room 5253A, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | | | - Joan Rae
- Sandy Lake First Nation, Sandy Lake, ON, P0V 1V0, Canada
| | - Tracey Galloway
- Department of Anthropology, University of Toronto Mississauga Campus, Terrence Donnelly Health Sciences Complex, Room 354, 3359 Mississauga Rd, Mississauga, ON, L5L 1C6, Canada
| | - Stewart B Harris
- Schulich School of Medicine and Dentistry, Western Centre for Public Health & Family Medicine, Western University, 1465 Richmond St, London, N6G 2M1, ON, Canada
| | - Catherine Birken
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, University of Toronto Medical Sciences Building, 5Th Floor, Room 5271, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | - Jill Hamilton
- Division of Endocrinology, Hospital for Sick Children, Department of Nutritional Sciences, University of Toronto, 555 University Ave, Toronto, ON, M5S 1X8, Canada
| | - Jonathon L Maguire
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, University of Toronto Medical Sciences Building, 5Th Floor, Room 5271, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | - Patricia Parkin
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, University of Toronto Medical Sciences Building, 5Th Floor, Room 5271, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | - Bernard Zinman
- Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, 600 University Ave, Toronto, ON, M5G 1X5, Canada
| | - Anthony J G Hanley
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, University of Toronto Medical Sciences Building, 5Th Floor, Room 5253A, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
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Farias-Jofre M, Romero R, Galaz J, Xu Y, Miller D, Garcia-Flores V, Arenas-Hernandez M, Winters AD, Berkowitz BA, Podolsky RH, Shen Y, Kanninen T, Panaitescu B, Glazier CR, Pique-Regi R, Theis KR, Gomez-Lopez N. Blockade of IL-6R prevents preterm birth and adverse neonatal outcomes. EBioMedicine 2023; 98:104865. [PMID: 37944273 PMCID: PMC10665693 DOI: 10.1016/j.ebiom.2023.104865] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/11/2023] [Accepted: 10/19/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Preterm birth preceded by spontaneous preterm labour often occurs in the clinical setting of sterile intra-amniotic inflammation (SIAI), a condition that currently lacks treatment. METHODS Proteomic and scRNA-seq human data were analysed to evaluate the role of IL-6 and IL-1α in SIAI. A C57BL/6 murine model of SIAI-induced preterm birth was developed by the ultrasound-guided intra-amniotic injection of IL-1α. The blockade of IL-6R by using an aIL-6R was tested as prenatal treatment for preterm birth and adverse neonatal outcomes. QUEST-MRI evaluated brain oxidative stress in utero. Targeted transcriptomic profiling assessed maternal, foetal, and neonatal inflammation. Neonatal biometrics and neurodevelopment were tested. The neonatal gut immune-microbiome was evaluated using metagenomic sequencing and immunophenotyping. FINDINGS IL-6 plays a critical role in the human intra-amniotic inflammatory response, which is associated with elevated concentrations of the alarmin IL-1α. Intra-amniotic injection of IL-1α resembles SIAI, inducing preterm birth (7% vs. 50%, p = 0.03, Fisher's exact test) and neonatal mortality (18% vs. 56%, p = 0.02, Mann-Whitney U-test). QUEST-MRI revealed no foetal brain oxidative stress upon in utero IL-1α exposure (p > 0.05, mixed linear model). Prenatal treatment with aIL-6R abrogated IL-1α-induced preterm birth (50% vs. 7%, p = 0.03, Fisher's exact test) by dampening inflammatory processes associated with the common pathway of labour. Importantly, aIL-6R reduces neonatal mortality (56% vs. 22%, p = 0.03, Mann-Whitney U-test) by crossing from the mother to the amniotic cavity, dampening foetal organ inflammation and improving growth. Beneficial effects of prenatal IL-6R blockade carried over to neonatal life, improving survival, growth, neurodevelopment, and gut immune homeostasis. INTERPRETATION IL-6R blockade can serve as a strategy to treat SIAI, preventing preterm birth and adverse neonatal outcomes. FUNDING NICHD/NIH/DHHS, Contract HHSN275201300006C. WSU Perinatal Initiative in Maternal, Perinatal and Child Health.
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Affiliation(s)
- Marcelo Farias-Jofre
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA; Division of Obstetrics and Gynecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Roberto Romero
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, USA; Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA; Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.
| | - Jose Galaz
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA; Division of Obstetrics and Gynecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Yi Xu
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Derek Miller
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA; Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA
| | - Valeria Garcia-Flores
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA; Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA
| | - Marcia Arenas-Hernandez
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Andrew D Winters
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, USA; Department of Biochemistry, Microbiology, and Immunology, Wayne State University School of Medicine, Detroit, MO, USA
| | - Bruce A Berkowitz
- Department of Ophthalmology, Visual and Anatomical Sciences, Wayne State University School of Medicine; Detroit, MI, USA
| | - Robert H Podolsky
- Division of Biostatistics and Design Methodology, Center for Translational Research, Children's National Hospital, Silver Spring, MD, USA
| | - Yimin Shen
- Department of Radiology, School of Medicine, Wayne State University School of Medicine, Detroit, MI, USA
| | - Tomi Kanninen
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Bogdan Panaitescu
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Catherine R Glazier
- UCD School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Roger Pique-Regi
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA; Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, MI, USA
| | - Kevin R Theis
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA; Department of Biochemistry, Microbiology, and Immunology, Wayne State University School of Medicine, Detroit, MO, USA
| | - Nardhy Gomez-Lopez
- Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA; Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA; Department of Biochemistry, Microbiology, and Immunology, Wayne State University School of Medicine, Detroit, MO, USA; Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, MI, USA; Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA.
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Panchal H, Athalye-Jape G, Rao S, Patole S. Growth and neuro-developmental outcomes of probiotic supplemented preterm infants-a systematic review and meta-analysis. Eur J Clin Nutr 2023; 77:855-871. [PMID: 36788356 PMCID: PMC10473962 DOI: 10.1038/s41430-023-01270-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 01/21/2023] [Accepted: 01/24/2023] [Indexed: 02/16/2023]
Abstract
Gut dysbiosis is associated with sepsis and necrotizing enterocolitis in preterm infants, which can adversely affect long-term growth and neurodevelopment. We aimed to synthesise evidence for the effect of probiotic supplementation on growth and neurodevelopmental outcomes in preterm infants. MEDLINE, EMBASE, EMCARE, Cochrane CENTRAL, and grey literature were searched in February 2022. Only randomized controlled trials (RCTs) were included. Meta-analysis was performed using random effects model. Effect sizes were expressed as standardized mean difference (SMD), mean difference (MD) or risk ratio (RR) and their corresponding 95% confidence intervals (CI). Risk of Bias (ROB) was assessed using the ROB-2 tool. Certainty of Evidence (CoE) was summarized using GRADE guidelines. Thirty RCTs (n = 4817) were included. Meta-analysis showed that probiotic supplementation was associated with better short-term weight gain [SMD 0.24 (95%CI 0.04, 0.44); 22 RCTs (n = 3721); p = 0.02; I2 = 88%; CoE: low]. However, length [SMD 0.12 (95%CI -0.13, 0.36); 7 RCTs, (n = 899); p = 0.35; I2 = 69%; CoE: low] and head circumference [SMD 0.09 (95%CI -0.15, 0.34); 8 RCTs (n = 1132); p = 0.46; I2 = 76%; CoE: low] were similar between the probiotic and placebo groups. Probiotic supplementation had no effect on neurodevelopmental impairment [RR 0.91 (95%CI 0.76, 1.08); 5 RCTs (n = 1556); p = 0.27; I2 = 0%; CoE: low]. Probiotic supplementation was associated with better short-term weight gain, but did not affect length, head circumference, long-term growth, and neurodevelopmental outcomes of preterm infants. Adequately powered RCTs are needed in this area. Prospero Registration: CRD42020064992.
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Affiliation(s)
- Harshad Panchal
- Neonatal Directorate, King Edward Memorial Hospital for Women, Perth, WA, Australia
| | - Gayatri Athalye-Jape
- Neonatal Directorate, King Edward Memorial Hospital for Women, Perth, WA, Australia.
- School of Medicine, University of Western Australia, Perth, WA, Australia.
| | - Shripada Rao
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Neonatal Directorate, Perth Children's Hospital, Perth, WA, Australia
| | - Sanjay Patole
- Neonatal Directorate, King Edward Memorial Hospital for Women, Perth, WA, Australia
- School of Medicine, University of Western Australia, Perth, WA, Australia
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Modjadji P, Mokgalaboni K, Nonterah EA, Lebelo SL, Mchiza ZJR, Madiba S, Kengne AP. A Systematic Review on Cardiometabolic Risks and Perinatal Outcomes among Pregnant Women Living with HIV in the Era of Antiretroviral Therapy. Viruses 2023; 15:1441. [PMID: 37515129 PMCID: PMC10385451 DOI: 10.3390/v15071441] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 07/30/2023] Open
Abstract
Antiretroviral therapy (ART) regimens have been shown to cause metabolic changes in people living with HIV (PLWH), predisposing them to cardiometabolic disease (CVMD). However, such evidence is less established in pregnant women living with HIV (pWLWH) on ART. Pregnancy-induced cardiometabolic risks (CMR) can predispose to unfavourable pregnancy outcomes and further persist in the postpartum period, resolve, and recur in subsequent pregnancies, or emerge as newly diagnosed chronic diseases of ageing. Therefore, this systematic review aimed at synthesizing evidence on CMR and perinatal outcomes among pWLWH in the era of ART. We considered prospective and retrospective cohorts, case-control, cross-sectional, and interventional studies published in English. Specific keywords were used to conduct a thorough literature search on PubMed-Medline and Scopus following the Preferred Reporting Items for Systematic Review and Meta-Analysis guideline. Two investigators independently screened the search outputs and reviewed full texts of potentially eligible articles. Data extraction was conducted by one investigator and verified by the second investigator. Thirty-one relevant studies conducted on 20,904 pWLWH on ART across Africa, Asia, Europe, and America were included. Studies demonstrate inconclusive findings, especially on perinatal outcomes, but significant risks of gestational hypertension and dyslipidemia were reported in pWLWH on ART compared to the control group. Therefore, future studies should focus more on these perinatal outcomes, and their impact on postpartum maternal health and growth trajectories of uninfected infants born from pWLWH who are either on ART or ART-naïve in comparison to infants born of HIV-negative mothers over the life course, especially in HIV-burdened African countries.
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Affiliation(s)
- Perpetua Modjadji
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, Cape Town 7505, South Africa
| | - Kabelo Mokgalaboni
- Department of Life and Consumer Sciences, College of Agriculture and Environmental Sciences, University of South Africa, Florida Campus, Johannesburg 1709, South Africa
| | - Engelbert A Nonterah
- Navrongo Health Research Centre, Ghana Health Service, Navrongo P.O. Box 114, Ghana
| | - Sogolo Lucky Lebelo
- Department of Life and Consumer Sciences, College of Agriculture and Environmental Sciences, University of South Africa, Florida Campus, Johannesburg 1709, South Africa
| | - Zandile June-Rose Mchiza
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, Cape Town 7505, South Africa
| | - Sphiwe Madiba
- Faculty of Health Sciences, University of Limpopo, Polokwane 0700, South Africa
| | - Andre Pascal Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, Cape Town 7505, South Africa
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8
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Lee SM, Sie L, Liu J, Profit J, Main E, Lee HC. Racial and ethnic disparities in postnatal growth among very low birth weight infants in California. J Perinatol 2023; 43:371-377. [PMID: 36737570 PMCID: PMC9991910 DOI: 10.1038/s41372-023-01612-9] [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: 06/14/2022] [Revised: 01/09/2023] [Accepted: 01/13/2023] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To identify racial/ethnic disparities in postnatal growth by year and gestational age among very low birth weight infants. STUDY DESIGN Total 37,122 infants, with birth weight 500-1500 g or gestational age 23-34 weeks in the California Perinatal Quality Care Collaborative in 2008-2016. Postnatal growth failure (PGF) was defined as change in weight Z-score from birth to discharge below -1.28. Multivariable regression analysis with birth hospital as random effect was used to estimate odds ratios (OR). RESULTS Infants born to Hispanic mothers had highest risk of PGF at 30%, compared to white (24%, OR 1.33), Black (22%, OR 1.50), or Asian/Pacific Islander mothers (23%, OR 1.38). PGF incidence decreased from 2008 (27.4%) to 2016 (22.8%) with differences in trends by race. Each increasing gestational age week was associated with decreasing risk for PGF (OR 0.73, 95% confidence interval 0.72-0.74). CONCLUSION Targeted interventions addressing PGF are needed to address disparities.
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Affiliation(s)
- Soon Min Lee
- Department of Pediatrics, Division of Neonatal & Developmental Medicine, Stanford University, Stanford, CA, USA.,California Perinatal Quality Care Collaborative, Stanford, CA, USA.,Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Lillian Sie
- Department of Pediatrics, Division of Neonatal & Developmental Medicine, Stanford University, Stanford, CA, USA.,California Perinatal Quality Care Collaborative, Stanford, CA, USA
| | - Jessica Liu
- Department of Pediatrics, Division of Neonatal & Developmental Medicine, Stanford University, Stanford, CA, USA.,California Perinatal Quality Care Collaborative, Stanford, CA, USA
| | - Jochen Profit
- Department of Pediatrics, Division of Neonatal & Developmental Medicine, Stanford University, Stanford, CA, USA.,California Perinatal Quality Care Collaborative, Stanford, CA, USA
| | - Elliot Main
- Department of Obstetrics, Stanford University, Stanford, CA, USA.,California Maternal Quality Care Collaborative, Stanford, CA, USA
| | - Henry C Lee
- California Perinatal Quality Care Collaborative, Stanford, CA, USA. .,Department of Pediatrics, Division of Neonatology, University of California San Diego, San Diego, CA, USA.
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9
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Ramiro-Cortijo D, Singh P, Herranz Carrillo G, Gila-Díaz A, Martín-Cabrejas MA, Martin CR, Arribas SM. Association of maternal body composition and diet on breast milk hormones and neonatal growth during the first month of lactation. Front Endocrinol (Lausanne) 2023; 14:1090499. [PMID: 36936154 PMCID: PMC10018215 DOI: 10.3389/fendo.2023.1090499] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 02/17/2023] [Indexed: 03/06/2023] Open
Abstract
INTRODUCTION Preterm birth is associated with altered growth patterns and an increased risk of cardiometabolic diseases, with breast milk (BM) being a counteracting factor. Preterm infants also show alterations in adipokines and gut hormones influencing appetite and metabolism. Since these hormones are present in BM, it is possible that their levels may equilibrate deficiencies improving infant growth. We aimed to assess 1) the BM levels of ghrelin, resistin, leptin, insulin, peptide YY, and the gastrointestinal peptide in women with preterm and term labor; 2) the relationship between BM hormones and neonatal growth; and 3) the influence of maternal body composition and diet on these BM hormones. METHODS BM from 48 women (30 term and 18 preterm labor) was collected at days 7, 14, and 28 of lactation. Maternal body composition was evaluated by bioimpedance, and neonate anthropometric parameters were collected from medical records. The maternal dietary pattern was assessed by a 72-h dietary recall at days 7 and 28 of lactation. BM hormones were analyzed by the U-Plex Ultra-sensitive method. Data were analyzed using linear regression models. BM from women with preterm labor had lower ghrelin levels, with the other hormones being significantly higher compared to women with term delivery. RESULTS In premature infants, growth was positively associated with BM ghrelin, while, in term infants, it was positively associated with insulin and negatively with peptide YY. In the first week of lactation, women with preterm labor had higher body fat compared to women with term labor. In this group, ghrelin levels were positively associated with maternal body fat and with fiber and protein intake. In women with term labor, no associations between anthropometric parameters and BM hormones were found, and fiber intake was negatively associated with peptide YY. DISCUSSION Preterm labor is a factor influencing the levels of BM adipokines and gut hormones, with BM ghrelin being a relevant hormone for premature infant growth. Since ghrelin is lower in BM from women with preterm labor and the levels are associated with maternal fat storage and some dietary components, our data support the importance to monitor diet and body composition in women who gave birth prematurely to improve the BM hormonal status.
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Affiliation(s)
- David Ramiro-Cortijo
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
- Instituto Universitario de Estudios de la Mujer (IUEM), Universidad Autónoma de Madrid, Madrid, Spain
| | - Pratibha Singh
- Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
| | - Gloria Herranz Carrillo
- Division of Neonatology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Andrea Gila-Díaz
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - María A. Martín-Cabrejas
- Department of Agricultural Chemistry and Food Science, Institute of Food Science Research (CIAL), Universidad Autónoma de Madrid, Consejo Superior de Investigación Científica (CSIC), Madrid, Spain
| | - Camilia R. Martin
- Department of Neonatology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
- Division of Translational Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
| | - Silvia M. Arribas
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- Instituto Universitario de Estudios de la Mujer (IUEM), Universidad Autónoma de Madrid, Madrid, Spain
- *Correspondence: Silvia M. Arribas,
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10
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González-García L, Mantecón-Fernández L, Suárez-Rodríguez M, Arias-Llorente R, Lareu-Vidal S, Ibáñez-Fernández A, Caunedo-Jiménez M, González-López C, Fernández-Morán E, Fernández-Colomer B, Solís-Sánchez G. Postnatal Growth Faltering: Growth and Height Improvement at Two Years in Children with Very Low Birth Weight between 2002-2017. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121800. [PMID: 36553245 PMCID: PMC9777192 DOI: 10.3390/children9121800] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/08/2022] [Accepted: 11/22/2022] [Indexed: 11/25/2022]
Abstract
The prevalence of postnatal growth faltering (PGF) in preterm infants with very low birth weight (VLBW) (<1500 g) is a universal problem. Growth improvement is expected as neonatal care is optimized. Objectives: To determine if there has been a decrease in the prevalence of PGF and an improvement in height at 2 years in appropriate for gestational age VLBW children in the last two decades. Methods: Clinical descriptive retrospective analysis of neonatal somatometry at birth and at two-year corrected age in VLBW preterm infants. Small for gestational age were excluded. Two cohorts (2002−2006, n = 112; and 2013−2017, n = 92) were compared. Results. In the second five-year period, a decrease in prevalence of PGF was observed (36.6% vs. 22.8%, p = 0.033), an increase in growth rate in the first 28 days (5.22 (4.35−6.09) g/kg/day vs. 11.38 (10.61−12.15) g/kg/day, p < 0.0001) and an increase in height standard deviation (SD) at 2 years (−1.12 (−1.35−−0.91) vs. −0.74 (−0.99−−0.49) p = 0.023). Probability of short stature at 2 years was directly related to daily weight gain in the first 28 days. Conclusions: when comparing two five-year periods in the last two decades, growth in VLBW preterm infants has improved, both during neonatal period and at two years of age.
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Affiliation(s)
| | - Laura Mantecón-Fernández
- Pediatrics Department, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
- Instituto Investigación Sanitaria Principado de Asturias, ISPA, 33011 Oviedo, Spain
| | - Marta Suárez-Rodríguez
- Pediatrics Department, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
- Instituto Investigación Sanitaria Principado de Asturias, ISPA, 33011 Oviedo, Spain
| | - Rosa Arias-Llorente
- Pediatrics Department, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
| | - Sonia Lareu-Vidal
- Pediatrics Department, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
| | | | - María Caunedo-Jiménez
- Pediatrics Department, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
| | - Clara González-López
- Pediatrics Department, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
| | - Eva Fernández-Morán
- Pediatrics Department, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
| | - Belén Fernández-Colomer
- Pediatrics Department, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
- Instituto Investigación Sanitaria Principado de Asturias, ISPA, 33011 Oviedo, Spain
| | - Gonzalo Solís-Sánchez
- Pediatrics Department, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
- Instituto Investigación Sanitaria Principado de Asturias, ISPA, 33011 Oviedo, Spain
- Medical Department, University of Oviedo, 33003 Oviedo, Spain
- Correspondence:
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11
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Vakil P, Henry A, Craig ME, Gow ML. A review of infant growth and psychomotor developmental outcomes after intrauterine exposure to preeclampsia. BMC Pediatr 2022; 22:513. [PMID: 36042465 PMCID: PMC9426217 DOI: 10.1186/s12887-022-03542-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 08/02/2022] [Indexed: 11/25/2022] Open
Abstract
Preeclampsia is a hypertensive disorder of pregnancy with serious health implications for mother and their offspring. The uteroplacental vascular insufficiency caused by preeclampsia is associated with epigenetic and pathological changes in the mother and fetus. However, the impact of preeclampsia in infancy (birth to 2 years), a time of rapid development influenced by pre- and postnatal factors that can predict future health outcomes, remains inconclusive. This narrative review of 23 epidemiological and basic science studies assessed the measurement and impact of preeclampsia exposure on infant growth and psychomotor developmental outcomes from birth to 2 years. Studies assessing infant growth report that preeclampsia-exposed infants have lower weight, length and BMI at 2 years than their normotensive controls, or that they instead experience accelerated weight gain to catch up in growth by 2 years, which may have long-term implications for their cardiometabolic health. In contrast, clear discrepancies remain as to whether preeclampsia exposure impairs infant motor and cognitive development, or instead has no impact. It is additionally unknown whether any impacts of preeclampsia are independent of confounders including shared genetic factors that predispose to both preeclampsia and childhood morbidity, perinatal factors including small for gestational age or preterm birth and their sequelae, and postnatal environmental factors such childhood nutrition. Further research is required to account for these variables in larger cohorts born at term, to help elucidate the independent pathophysiological impact of this clinically heterogenous and dangerous disease.
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Affiliation(s)
- Priya Vakil
- School of Women's and Children's Health, UNSW Medicine, Sydney, Australia
| | - Amanda Henry
- School of Women's and Children's Health, UNSW Medicine, Sydney, Australia.,Department of Women's and Children's Health, St George Hospital, Sydney, Australia.,The George Institute for Global Health, Sydney, Australia
| | - Maria E Craig
- School of Women's and Children's Health, UNSW Medicine, Sydney, Australia.,Department of Women's and Children's Health, St George Hospital, Sydney, Australia.,University of Sydney Children's Hospital Westmead Clinical School, Sydney, Australia
| | - Megan L Gow
- School of Women's and Children's Health, UNSW Medicine, Sydney, Australia. .,Department of Women's and Children's Health, St George Hospital, Sydney, Australia. .,University of Sydney Children's Hospital Westmead Clinical School, Sydney, Australia.
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12
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Ofek Shlomai N, Reichman B, Zaslavsky‐Paltiel I, Lerner‐Geva L, Eventov‐Friedman S. Neonatal morbidities and postnatal growth failure in very low birth weight, very preterm infants. Acta Paediatr 2022; 111:1536-1545. [PMID: 35490375 DOI: 10.1111/apa.16380] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/17/2022] [Accepted: 04/27/2022] [Indexed: 11/29/2022]
Abstract
AIM To assess postnatal growth in infants with and without major neonatal morbidities. METHODS This study is based on analysis of data collected by the Israel Neonatal Network on VLBW infants (≤1500 g) born in Israel from 2009 to 2018. Postnatal growth was assessed in two 5 years epochs: 2009-2013 (n = 4583) and 2014-2018 (n = 4558). Outcome was considered as severe, mild and no postnatal growth failure (PNGF). Morbidities included respiratory distress syndrome, bronchopulmonary dysplasia, necrotising enterocolitis, patent ductus arteriosus and grades 3-4 intraventricular haemorrhage. Multinomial logistic regression analyses with the generalised estimating equation approach were applied. RESULTS The study population composed 9141 infants. Of them, 2089 had at least one major morbidity and 7052 infants had none. In infants with no morbidities, 2.1% had severe PNGF, 23.7% mild PNGF and 74.2% had no PNGF, as compared to 13.6%, 43.9% and 42.5%, respectively, in infants with any major neonatal morbidity (p < 0.0001). CONCLUSION Despite enormous advances in neonatal care, postnatal growth remains a challenge in VLBW infants, particularly in infants with major neonatal morbidities. Along with efforts to decrease morbidity, a more personalised plan and follow-up may be required in infants with major morbidities, given their high risk for diminished growth and potentially, adverse neurodevelopmental outcomes.
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Affiliation(s)
- Noa Ofek Shlomai
- Department of Neonatology Hadassah Medical Center Faculty of Medicine Hebrew University of Jerusalem Jerusalem Israel
| | - Brian Reichman
- Women and Children’s Health Research Unit Gertner Institute for Epidemiology and Health Policy Research Tel Hashomer Israel
- Sackler School of Medicine Tel‐Aviv University Tel‐Aviv Israel
| | - Inna Zaslavsky‐Paltiel
- Women and Children’s Health Research Unit Gertner Institute for Epidemiology and Health Policy Research Tel Hashomer Israel
| | - Liat Lerner‐Geva
- Women and Children’s Health Research Unit Gertner Institute for Epidemiology and Health Policy Research Tel Hashomer Israel
- Sackler School of Medicine Tel‐Aviv University Tel‐Aviv Israel
| | - Smadar Eventov‐Friedman
- Department of Neonatology Hadassah Medical Center Faculty of Medicine Hebrew University of Jerusalem Jerusalem Israel
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13
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Yitayew M, Chahin N, Rustom S, Thacker LR, Hendricks-Muñoz KD. Fenton vs. Intergrowth-21st: Postnatal Growth Assessment and Prediction of Neurodevelopment in Preterm Infants. Nutrients 2021; 13:nu13082841. [PMID: 34445001 PMCID: PMC8400500 DOI: 10.3390/nu13082841] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 11/17/2022] Open
Abstract
Although the survival rate of preterm infants has improved over the years, growth failure and associated impaired neurodevelopmental outcome remains a significant morbidity. Optimal nutrition plays an important role in achieving adequate postnatal growth. Accurate growth monitoring of preterm infants is critical in guiding nutritional protocols. Currently, there is no consensus regarding which growth assessment tool is suitable for monitoring postnatal growth of preterm infants to foster optimal neurodevelopmental outcomes while avoiding future consequences of aggressive nutritional approaches including increased risk for cardiovascular disease and metabolic syndrome. A retrospective single center cohort study was conducted to compare the performance of two growth-assessment tools, Fenton and Intergrowth-21st (IG-21st) in the classification of size at birth, identification of impaired growth and predicting neurodevelopment. A total of 340 infants with mean gestational age of 30 weeks were included. Proportion of agreement between the two tools for identification of small for gestational age (SGA) was high 0.94 (0.87, 0.1) however, agreement for classification of postnatal growth failure at discharge was moderate 0.6 (0.52, 0.69). Growth failure at discharge was less prevalent using IG-21st. There was significant association between weight-based growth failure and poor neurodevelopmental outcomes at 12 and 24 months of age.
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Affiliation(s)
- Miheret Yitayew
- Department of Pediatrics, Children’s Hospital of Richmond, Virginia Commonwealth University, Richmond, VA 23298, USA; (N.C.); (K.D.H.-M.)
- Division of Neonatal Medicine, Department of Pediatrics, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA
- Correspondence:
| | - Nayef Chahin
- Department of Pediatrics, Children’s Hospital of Richmond, Virginia Commonwealth University, Richmond, VA 23298, USA; (N.C.); (K.D.H.-M.)
| | - Salem Rustom
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA 23298, USA; (S.R.); (L.R.T.)
| | - Leroy R. Thacker
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA 23298, USA; (S.R.); (L.R.T.)
| | - Karen D. Hendricks-Muñoz
- Department of Pediatrics, Children’s Hospital of Richmond, Virginia Commonwealth University, Richmond, VA 23298, USA; (N.C.); (K.D.H.-M.)
- Division of Neonatal Medicine, Department of Pediatrics, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA
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