Development of external genitalia during mini-puberty: is it related to somatic growth or reproductive hormones?

Although hypothalamo-pituitary-gonadal axis is active during mini-puberty, its relationship with somatic growth and the role on the development of external genitalia has not been fully elucidated. We aimed to evaluate the effects of somatic growth and reproductive hormones on the development of external genitalia during mini-puberty. Anthropometric data, pubertal assesment, serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), dehydroepiandrosterone sulfate (DHEAS), androstenedione (A4), sex-hormone binding globulin (SHBG), estradiol (E2) and inhibin-B, testosterone (T), and anti-Mullerian Hormone (AMH) of healthy infants aged 1-4 months were evaluated. Free sex hormone index was calculated as T/SHBG for boys and E2/SHBG for girls. The mean age of 148 (74 female) infants included in the study was 2.31 ± 0.76 months. Tanner stage 2-3 sex steroid and gonadotropin levels were observed. A statistically significant difference was found between the weight, height, BMI, weight gain and serum FSH, LH, and A4 measurements of girls and boys (p < 0.05). Penile length was associated with weight (r = 0.24, p = 0.03), height (r = 0.25, p = 0.02), and AMH (r = 0.3, p = 0.01), but not with testosterone (p = 0.56 respectively). A negative correlation was found between weight and serum LH (r =  - 0.26, p = 0.2) and T/SHBG levels in males (r =  - 0.38, p = 0.015 respectively). Weight-SDS was negatively correlated with testosterone in males (r =  - 0.25, p = 0.02). Testicular size and breast stage did not correlate with any of the hormonal and anthropometric parameters.  Conclusions: External genitalia in males during mini-puberty is related more to somatic growth rather than reproductive hormones. Similar to pubertal developmental stages, both total and free testosterone are negatively associated with higher weight during mini-puberty. What is Known: • Mini-puberty allows early assessment of HPG axis function in infancy. • There is an inverse relationship between the amount of adipose tissue and circulating testosterone levels in males during puberty and adulthood. • The potential effect of somatic growth and reproductive hormones on external genital development during mini-puberty remains unclear. What is New: • During mini-puberty, males' external genitalia is more related to somatic growth than to reproductive hormones, but this relationship is not observed in girls. • Both total and free testosterone are negatively associated with higher weight during mini-puberty, similar to the pubertal developmental stages.

Biomass smoke exposure and somatic growth among children: The RESPIRE and CRECER prospective cohort studies in rural Guatemala

BACKGROUND

Cooking-related biomass smoke is a major source of household air pollution (HAP) and an important health hazard. Prior studies identified associations between HAP exposure and childhood stunting; less is known for underweight and wasting. Few studies had personal HAP measurements.

METHODS

557 households in rural Guatemala were enrolled in the CRECER study, the follow-up study of the RESPIRE randomized intervention trial. They were assigned to three groups that received chimney stoves at different ages of the study children. Multiple personal carbon monoxide (CO) exposure measurements were used as proxies for HAP exposures. Children's heights and weights were measured from 24 to 60 months of age. Height-for-age z-score (HAZ), weight-for-age z-score (WAZ), and weight-for-height z-score (WHZ) were calculated based on the World Health Organization's Multicentre Growth Reference Study. HAZ, WAZ, and WHZ below -2 were classified as stunting, underweight, and wasting, respectively. Generalized linear models and mixed effects models were applied.

RESULTS

541 children had valid anthropometric data, among whom 488 (90.2 %) were stunted, 192 (35.5 %) were underweight, and 2 (0.3 %) were wasted. A 1 ppm higher average CO exposure was associated with a 0.21 lower HAZ (95 % CI: 0.17-0.25), a 0.13 lower WAZ (95 % CI: 0.10-0.17) and a 0.06 lower WHZ (95 % CI: 0.02-0.10).The associations for HAZ were stronger among boys (coefficient = -0.29, 95 % CI: -0.35 - -0.22) than among girls (coefficient = -0.15, 95 % CI: -0.20 - -0.10). A 1 ppm-year higher cumulative CO exposure was associated with a higher risk of moderate stunting among boys (OR = 1.27, 95 % CI: 1.05-1.59), but not among girls.

DISCUSSION

In this rural Guatemalan population, higher HAP exposure was associated with lower HAZ and WAZ. The associations between HAP and HAZ/stunting were stronger among boys. Reducing HAP might benefit childhood somatic growth in rural populations of low-income countries.

Ontogenetic differences in the response of the cold-water coral Caryophyllia huinayensis to ocean acidification, warming and food availability

Cold-water corals (CWCs) are considered vulnerable to environmental changes. However, previous studies have focused on adult CWCs and mainly investigated the short-term effects of single stressors. So far, the effects of environmental changes on different CWC life stages are unknown, both for single and multiple stressors and over long time periods. Therefore, we conducted a six-month aquarium experiment with three life stages of Caryophyllia huinayensis to study their physiological response (survival, somatic growth, calcification and respiration) to the interactive effects of aragonite saturation (0.8 and 2.5), temperature (11 and 15 °C) and food availability (8 and 87 μg C L-1). The response clearly differed between life stages and measured traits. Elevated temperature and reduced feeding had the greatest effects, pushing the corals to their physiological limits. Highest mortality was observed in adult corals, while calcification rates decreased the most in juveniles. We observed a three-month delay in response, presumably because energy reserves declined, suggesting that short-term experiments overestimate coral resilience. Elevated summer temperatures and reduced food supply are likely to have the greatest impact on live CWCs in the future, leading to reduced coral growth and population shifts due to delayed juvenile maturation and high adult mortality.

Follow-up aortic dilatation in patients with repaired tetralogy of Fallot using cardiovascular magnetic resonance

Purpose

The study sought to determine the rate of aortic expansion and correlation with somatic growth in patients with repaired tetralogy of Fallot (rTOF), and predictors for determining the annual growth rate of the aorta (Ao-AGR).

Methods

Ninety-four rTOF patients (mean age 14.5 ± 4.4 years) with two cardiac magnetic resonance tests (CMR) (median duration 52 months, interquartile range, IQR 24-71) were analyzed for aortic diameter (AoD) at the annulus, the sinus of Valsalva (SoV), the sinotubular junction, and the ascending aorta (AAo), and compared with the normal limit AoD (NL-AoD) values. The median age-at-repair was 60 months (IQR 36-84). Ao-AGR and its index (Ao-AGRI) were derived from changes of the AoD and AoD-index, respectively, divided by the duration between the two studies. Three potential predictors (baseline AoD, sex, and age-at-repair) for the progression of Ao-AGR were analyzed.

Results

There was a significant larger AoD than NL-AoD (p < 0.001). Slow aortic growth was encountered in 78-85 % of patients. The Ao-AGR was slow, the median AGR ranged from 0.37 mm (IQR 0.13-0.72) at annulus to 0.56 mm (IQR 0.22-0.91) at AAo. There was a regression in Ao-AGRI, ranged from -1.41 mm (IQR -1.94, -0.87) at annulus to -2.36 mm (IQR -3.09, -1.63) at SoV. The three predictors were not correlated with severity of Ao-AGR.

Conclusion

Most adolescents with rTOF show significant aortic dilatation. There is a slow Ao-AGR with regression of Ao-AGRI, which may suggest that the rate of aortic growth is slower than the somatic growth. There are no significant predictors of the progression of Ao-AGR.

Somatic growth in children with congenital heart disease at 10 years of age: Risk factors and longitudinal growth

BACKGROUND

Children with congenital heart disease (CHD) are at risk of impaired growth.

AIMS

To describe height, weight, head circumference (HC), and body mass index (BMI) at 10 years and identify risk factors for altered longitudinal growth in children with CHD.

STUDY DESIGN

Growth parameters were evaluated from birth until 10 years using z-scores. The impact of cardiac and noncardiac factors on longitudinal growth was investigated.

SUBJECTS

A total of 135 children with different types of CHD who underwent cardiopulmonary bypass surgery, no genetic disorder.

OUTCOME MEASURES

Head circumference, weight, height and BMI.

RESULTS

At 10 years, z-scores for height and BMI did not differ from the Swiss population (P > 0.1). Z-scores for weight and HC were significantly below the norm (-0.38 and - 0.71, P < 0.01). From 1 to 10 years, all growth parameters except BMI increased significantly (P ≤ 0.001, BMI: P = 0.14). Lower gestational age and longer length of hospitalization were associated with either impaired head circumference or length at 10 years, while lower socioeconomic status was associated with higher BMI and weight at 10 years (all P < 0.05).

CONCLUSION

Despite partial catch-up, somatic growth remains impaired in children with CHD with weight and HC below the norm at 10 years. The only cardiac factor associated with impaired longitudinal growth was duration of hospital stay. Furthermore, lower socioeconomic background may pose a risk of overweight at older age. Close monitoring of growth parameters and parental counselling in all CHD children is advisable beyond early childhood to ensure optimal somatic growth.

Larval parasitic copepods affect early life history traits of a temperate clingfish

Larval copepods are frequent parasites that infest fish larvae along the Chilean coast. Because these parasites develop on fish during the early development, when their bodies are fragile and in a recent stage, they can affect the fishes' early life history traits (ELHT). The goal of this study was to determine the effect of parasitic copepods on the ELHT of the larvae of the clingfish Gobiesox marmoratus (Teleostei: Gobiesocidae) using otolith microstructure analysis. Ichthyoplankton samples were collected during austral winter (July and August 2012), in the inner shelf waters off Valparaiso Bay, central Chile. A total of 95 non-parasitized larvae (NPL) and 95 parasitized (PL) with copepods were randomly selected for subsequent analyses. Parasitized larvae of G. marmoratus were larger than NPL. The right otolith tended to be larger than the left otolith in the fish larvae, but with a higher asymmetry in PL. The PL showed larger otoliths-at-size than the NPL, particularly in smaller larvae (< 8 mm of standard length, SL). Nonetheless, parasitized larvae larger than 8 mm SL showed the opposite trend that is smaller-at-size otoliths than NPL. The Gompertz models indicated that the asymptotic length of NPL doubled the length of PL; this suggests that parasitic copepods affect the maximum size attained by the PL. In conclusion, parasitic copepods negatively affect the ELHT of G. marmoratus larvae and the greater asymmetry can be attributed to parasitism.

Serial assessment of somatic and cardiovascular development in patients with single ventricle undergoing Fontan procedure

BACKGROUND

The palliation of patients with single ventricle (SV) undergoing Fontan procedure led to improved long-term survival but is still limited due to cardiovascular complications. The aim of this study was to describe the somatic and cardiovascular development of Fontan patients until adolescence and to identify determining factors.

METHODS

We retrospectively assessed somatic growth, vascular growth of pulmonary arteries, and cardiac growth of the SV and systemic semilunar valve from 0 to 16 years of age using transthoracic echocardiography. The Doppler inflow pattern of the atrioventricular valve was quantified by E-, A-wave and E/A ratio. All data were converted to z-scores and analyzed using linear mixed effect models to identify associations with age at Fontan procedure, gender, and ventricular morphology.

RESULTS

134 patients undergoing Fontan procedure at a median age of 2.4 (IQR 2.12 to 2.8) years were analyzed. A catch-up of somatic growth after Fontan procedure until school age was found, with lower body height and weight z-scores in male patients and patients with systemic right ventricles. An early time of Fontan procedure was favorable for somatic growth, but not for vascular growth. Cardiac development indicated a decrease of SV end-diastolic diameter z-score until adolescence. Despite a trend towards normalization, E-wave and E/A ratio z-scores were diminished over the entire period.

CONCLUSIONS

There is a catch-up growth of somatic, vascular and cardiac parameters after Fontan procedure, which in our cohort depends on the time of Fontan procedure, ventricular morphology, and gender. Beside other factors, diastolic function of the SV remains altered.

Photoperiodic effects on somatic growth and gonadal maturation in Mickey Mouse platy, Xiphophorus maculatus (Gunther, 1866)

Photoperiod is important in initiation or suppression of reproductive timing and gonadal maturation which varies with species. The aim of the present study was to investigate the effect of two photoperiodic manipulating regimes, i.e., long (18L:6D) and short (10L:14D) photoperiods for a period of 60 days on somatic growth and gonadal maturation of a live-bearer ornamental fish, Mickey Mouse platy (Xiphophorus maculatus). The control fish were further kept under the laboratory environmental condition. The results showed a significant increase in weight gain, specific growth rate, and gonadosomatic index in fish under long photoperiod than those exposed to short photoperiod and control condition (P < 0.05). A condition factor showed significant variations between long photoperiod and control groups. Furthermore, a long photoperiod also induced a significant increase in the number of fish with mature embryo and middle-eyed embryo in the ovary. Similarly, histological analysis of testes of males showed an increase in the number of mature spermatid and spermatozoa under long photoperiod when compared to those of control and short photoperiod ones. Thus, it can be concluded that long-day photoperiodic manipulation may be applied for healthy growth and early gonadal maturation of live-bearer ornamental fishes.

Multigenerational plasticity of Daphnia magna under thermal stress across ten generations

The effects of increasing temperature owing to thermal discharge and global warming on zooplanktons such as Daphnia magna are a growing concern. The purpose of this study was to evaluate the effects of elevated temperature (25 °C) on oxidative stress responses, growth, and reproduction of D. magna across 10 generations. The number of offspring per female at 21 d was significantly increased and the rate of adult somatic growth (5-21 d) was decreased in the F0 generation at 25 °C compared with those at the reference temperature 20 °C. However, the F3 generation showed the lowest number of offspring and the highest adult somatic growth rate and oxidative stress responses (5 d) at 25 °C. Moreover, all life-history traits seemed to recover to the levels of the control group from the F6 generation at 20 °C. These findings suggest that D. magna under continuous thermal stress exhibits non-adaptive responses in the early generations (F0-F3) and changes to adaptive responses in the later generations (F6-F9). However, the underlying epigenetic mechanism should be identified in the future.

Did Malnutrition Affect Post-Operative Somatic Growth in Pediatric Patients Undergoing Surgical Procedures for Congenital Heart Disease?

OBJECTIVES

This study aims to investigate the impact of pre-operative malnutrition on nutritional outcome following congenital heart defects surgery.

DESIGN

This is a prospective cohort study.

SETTING

Pediatric Cardiac Intensive Care, Harapan Kita National Cardiovascular Center, Jakarta, Indonesia.

PATIENT

Pediatric patients, aged younger than 36 months old with Aristotle score of 6-10, undergoing congenital heart defects surgery with cardiopulmonary bypass were included in this study.

MEASUREMENT

The measured outcome was nutritional outcome based on body weight changes before and after corrective surgery. The measured variables were age, gender, Aristotle score, caloric intake (in pediatric cardiac intensive care unit and pediatric ward), length of stay, albumin level, and prealbumin level.

RESULTS

Among 185 patients, 6% increase of body weight was observed within 12 days of observation (p = 0.007). From bivariate analysis, post-operative nutritional status improvement was significantly associated with pre-operative Z-score for weight-for-age (p = 0.011), caloric intake in pediatric ward (p < 0.0001), and prealbumin level (p = 0.038). From multivariate analysis, caloric intake in pediatric ward remained as a factor which significantly determined post-operative nutritional status (p = 0.001, OR = 1.33, 95% CI 1.014-1.053).

CONCLUSION

Malnourished patients may have significant improvement in somatic growth following corrective surgery but no effect was observed on the post-operative body weight gain. Adequate nutritional support is important to ensure optimal recovery and better nutritional outcome.

Intermittent hypoxia suppression of growth hormone and insulin-like growth factor-I in the neonatal rat liver

OBJECTIVES

Extremely low gestational age neonates with chronic lung disease requiring oxygen therapy frequently experience fluctuations in arterial oxygen saturation or intermittent hypoxia (IH). These infants are at risk for multi-organ developmental delay, reduced growth, and short stature. The growth hormone (GH)/insulin-like growth factor-I (IGF-1) system, an important hormonal regulator of lipid and carbohydrate metabolism, promotes neonatal growth and development. We tested the hypothesis that increasing episodes of IH delay neonatal growth by influencing the GH/IGF-I axis.

DESIGN

Newborn rats were exposed to 2, 4, 6, 8, 10, or 12 hypoxic episodes (12% O₂) during hyperoxia (50% O₂) from P0-P7, P0-P14 (IH), or allowed to recover from P7-P21 or P14-P21 (IHR) in room air (RA). RA littermates at P7, P14, and P21 served as RA controls; and groups exposed to hyperoxia only (50% O₂) served as zero IH controls. Histopathology of the liver; hepatic levels of GH, GHBP, IGF-I, IGFBP-3, and leptin; and immunoreactivities of GH, GHR, IGF-I and IGF-IR were determined.

RESULTS

Pathological findings of the liver, including cellular swelling, steatosis, necrosis and focal sinusoid congestion were seen in IH, and were particularly severe in the P7 animals. Hepatic GH levels were significantly suppressed in the IH groups exposed to 6-12 hypoxic episodes per day and were not normalized during IHR. Deficits in the GH levels were associated with reduced body length and increase body weight during IHR suggesting increased adiposity and catchup fat. Catchup fat was also associated with elevations in GHBP, IGF-I, leptin.

CONCLUSIONS

IH significantly impairs hepatic GH/IGF-1 signaling during the first few weeks of life, which is likely responsible for hepatic GH resistance, increased body fat, and hepatic steatosis. These hormonal perturbations may contribute to long-term organ and body growth impairment, and metabolic dysfunction in preterm infants experiencing frequent IH and/or apneic episodes.

Diethylstilbestrol arrested spermatogenesis and somatic growth in the juveniles of yellow catfish (Pelteobagrus fulvidraco), a fish with sexual dimorphic growth

In fish, spermatogenesis and somatic growth are mainly regulated by hypothalamic-pituitary-gonadal (HPG) and hypothalamic-pituitary-somatic (HPS) axes, respectively. Xenoestrogens have been reported to impair spermatogenesis in some fishes, and arrest somatic growth in some others, whereas, whether xenoestrogens are capable of disrupting spermatogenesis and somatic growth simultaneously in fish that exhibits sexual dimorphic growth is little known, and the underlying mechanisms remain poorly understood. In this study, male juveniles of yellow catfish (Pelteobagrus fulvidraco), which exhibits a sexual dimorphic growth that favors males, were exposed to diethylstilbestrol (DES) for 28 days. After exposure, DES significantly disrupted the spermatogenesis (decreased gonadal-somatic index (GSI) and germ cell number) and arrested the somatic growth (declined body weight) of the catfish juveniles. Gene expression and plasma steroid analyses demonstrated the suppressed mRNA levels of genes in HPG axis (gnrh-II, fshβ, and lhβ in the brain and dmrt1, sf1, fshr, cyp17a1, cyp19a1a, and cyp11b2 in the testis) and decreased 17β-estrodial (E2) and 11-ketotestosterone (11-KT) levels in plasma. Further analysis revealed the arrested germ cell proliferation (cyclin d1), meiosis (dmc1, sycp3), and enhanced apoptosis (decreased bcl-2 and elevated bax/bcl-2 ratio) in the testis. Besides, DES also suppressed the mRNA levels of genes in HPS axis (ghrh, gh, and prl in the brain and ghr, igf1, igf2a, and igf2b in the liver). The suppressed HPG and HPS axes were thus supposed to disturb spermatogenesis and arrest somatic growth in yellow catfish. The present study greatly extended our understanding on the mechanisms underlying the toxicity of DES on spermatogenesis and somatic growth of fish.

The effects of temperature and food availability on growth, flexibility in metabolic rates and their relationships in juvenile common carp

Flexibility in phenotypic traits can allow organisms to handle environmental changes. However, the ecological consequences of flexibility in metabolic rates are poorly understood. Here, we investigated whether the links between growth and flexibility in metabolic rates vary between two temperatures. Common carp Cyprinus carpio were raised in three temperature treatments [the 18°C, 28°C and 28°C-food control (28°C-FC)] and fed to satiation of receiving food either once or twice daily for 4weeks. The morphology and metabolic rates (standard metabolic rate, SMR; maximum metabolic rate, MMR) were measured at the beginning and end of the experiment. The mean total food ingested by fish in the 28°C-FC treatment was the same as that by fish in the 18°C treatment at each food availability. The final SMR (not MMR and aerobic scope, AS=MMR-SMR) increased more in the 28°C and 28°C-FC treatments with twice-daily feedings than once-daily feedings. Fish in the 28°C treatment had a higher specific growth rate (SGR) than fish in the 28°C-FC and 18°C treatments at both food availabilities. However, no differences in feeding efficiency (FE) were found among the three treatments in fish fed twice daily. The flexibility in SMR was related to individual differences in SGR, not with food intake and FE; individuals who increased their SMR more had a smaller growth performance with twice-daily feedings at 28°C, but it did not exist at 18°C. Flexibility in SMR provides a growth advantage in juvenile common carp experiencing changes in food availability and this link is temperature-dependent.

Age-dependent physiological dynamics in acid-base balance, electrolytes, and blood metabolites in growing goats

There is a paucity of published data reporting acid-base equilibrium in goats, and no information is available on how the acid-base complexity changes when suckling goat kids become ruminants. The aims of this study were to evaluate young healthy goats for age-related changes in serum proteins, metabolites, and electrolytes; differences in results when the Henderson-Hasselbalch equation or strong ion approaches were used were also assessed. To assess biological variability and reproducibility, two consecutive long-term studies, each lasting from the 6th to 56th week of life (wl), were performed in 15 (Study 1) and 10 (Study 2) animals. Blood gas analysis, serum biochemical analysis, and electrophoresis were performed on venous blood, and acid-base information was obtained using the traditional Henderson-Hasselbalch approach, Stewart's strong ion model, and Constable's simplified strong ion model. In all goats within the first 4-5 months, serum concentrations of glucose, l-lactate, and inorganic phosphate decreased significantly, while serum concentrations of total protein, albumin, and gamma globulin increased. Consequently, nonvolatile weak acids (A_{tot Alb} and A_{tot TP}) increased. At the end of this 'adaptation period', i.e. when milk was replaced by purely plant-based food, significantly lower bicarbonate and base excess values were accompanied by blood pH that shifted towards acidosis. Electrolytes (Na⁺, K⁺, Ca²⁺, and Cl^-), anion gap, strong ion difference, and strong ion gap did not show age-dependent trends. In conclusion, somatic growth and development of gastro-intestinal fermentation in growing goats act as complex sources of physiological variability on acid-base equilibrium that was not reflected by the Henderson-Hasselbalch equation only.

Growth, Nutritional Status, and Pulmonary Function in Children with Chronic Recurrent Bronchitis

Bronchitis is a common health problem in children. Frequent bronchitis in infancy increases the risk of developing chronic respiratory diseases. The aim of the study was to assess the level of growth and the nutritional status in children and youths with special regard to the level of body fatness assessed by measuring skin-fold thickness. Relationships between somatic development, pulmonary function and the course of the disease were also explored. The study was carried out using anthropometric and spirometric measurements and also information on the severity and course of the disease in 141 children with chronic or recurrent bronchitis. All of the subjects were patients of the Pulmonary Medicine and Allergology Center in Karpacz, Poland. The mean body height did not differ significantly between the children examined and their healthy peers. However, the infection-prone children had excessive body fatness and muscle mass deficiency. The increased level of subcutaneous adipose tissue occurred especially in children with short duration of the disease, i.e. a maximum of 1 year. The functional lung parameters were generally normal. The presence of atopic diseases such as allergic rhinitis or atopic dermatitis did not impair the course of the children's somatic development. Also, long-term disease or the presence of additional allergic diseases did not impair lung function in the examined children. Taking appropriate preventive measures is recommended to achieve and maintain normal body weight in children who receive therapy due to bronchitis.

Perinatal and somatic growth properties of preterm babies born from spontaneous and in vitro fertilization multiple pregnancies

AIM

The objective of this study was to examine perinatal and neonatal properties of preterm infants with a corrected age of 24-36 months who were born as a result of spontaneous and in vitro fertilization multiple pregnancies, to interrogate somatic growth properties of these infants and evaluate the factors which had an impact by comparing groups.

MATERIAL AND METHODS

A total of 125 children with a birth weight below 2 500 g and a gestational age below the 37(th) gestational week 60 of whom were born as a result of in vitro fertilization multiple pregnancies and 65 of whom were born as a result of spontaneous multiple pregnancies were included in the study. Maternal age and morbidity, early rupture of membranes, birth weigth, gestational week, gender, APGAR score, hospitalization reasons in the neonatal period, requirement for intensive care, frequency of congenital anomaly, outpatient follow-up status, rehospitalization and socioeconomic levels were interrogated in the patients. Detailed physical examination and current height, weight and head circumference measurements were performed and the findings were placed in the growth curves of Neyzi et al. Ethics committee approval was received for this study from the ethics committee of Bakırköy Gynecology Obstetrics and Pediatrics Education and Research Hospital (12.10.2010; no:305).

RESULTS

The rate of cesarean section, mean maternal age, the rate of chronic disease in the mother and the rate of maternal disease which occured during pregnancy were significantly higher in the in vitro fertilization group (p<0.05). While no difference was found in mean gestational age, birth weight, rate of hospitalization, time of hospitalization, frequency of follow-up in the intensive care unit, rates of congenital anomaly and rehospitalization, APGAR score in the 5(th) minute was significantly higher in the in vitro fertilization group. The socioeconomical score was not different between the groups, but the in vitro fertilization group presented more regularly for outpatient follow-up visits. Height, head circumference measurements and mean current weight were found to be significantly higher in the in vitro fertilization group (p<0.05).

CONCLUSION

The fact that there was no difference in the rate of hospitalization, time of hospitalization, frequency of follow-up in the intensive care unit, rates of congenital anomaly and rehospitalization was attributed to the fact that the study and control groups were composed of only multiple pregnancies and preterms.