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Introduction: Anticipating which babies are in danger of experiencing poor outcomes during the perinatal period in uncomplicated appropriate for gestational age (AGA) pregnancies at term is difficult in obstetric practice. Cerebroplacental ratio (CPR) is emerging as a significant indicator of negative perinatal results. The current study sought to establish how effective CPR is in predicting negative perinatal outcomes in term uncomplicated AGA pregnancies. Materials and Methods: This study was a hospital-based prospective observational cohort study conducted at a single center. Patients were chosen depending on different criteria for inclusion and exclusion. A prenatal ultrasound with a color Doppler scan was carried out to calculate CPR. Patients were grouped according to their last CPR measurement before delivery into either normal CPR or pathological CPR categories. Doppler results did not impact clinical decisions and delivery followed institutional protocols. After childbirth, data on the outcome of the perinatal period were obtained from the patients’ medical records. Negative perinatal outcomes were assessed through the delivery method, APGAR score, perinatal morbidity, and perinatal mortality. These outcomes were correlated with CPR. Results: The research included 605 women, separated into normal and pathological CPR groups. Of these, 153 (25.3%) were classified in the pathological CPR category, whereas 452 (74.7%) exhibited normal CPR. In our study, there were 138 patients who experienced adverse perinatal outcomes in the pathological CPR group, whereas 44 patients had such outcomes in the normal CPR group. The diagnostic accuracy of pathological CPR to predict any negative perinatal result was 90.25%. Conclusions: CPR shows potential in detecting fetuses at risk in full-term uncomplicated AGA pregnancies.

mean birth weight and incidence of LBW babies in this area are influenced by various maternal factors, and many of them are preventable. Method: It is a hospital based cross sectional study done by Simple random sampling consisting of 200 newborns and their respective mothers delivered 15 months. Ballard score will be used to calculate the gestational age New Bellard’ Score. Post-delivery methods of determining gestational age in premature infants have been developed and validated. The New Ballard Exam allows for gestational assessment in infants as early as 20 weeks' gestation and utilizes parameters of physical (6 criteria) and neurological (6 criteria) maturity to reach a score that correlates with gestational age. Results: LBW babies include preterm babies (17.5%) and term and post-term SGA babies (18.2%). Neonatal and IMR in these babies is very high. In the present study LBW rate was 22%. Regarding IUGR babies much work can be done to reduce the rate. It was found that 13.5% of mothers were below 20 years.1% of mothers were illiterate. Mean birth weight in primi was less and LBW rate was high. 12% of mothers were anemic. Mean maternal hemoglobin was 11.0%. Maternal anemia strongly influences mean birth weight and LBW rate. Mother receiving minimum 4 ANC visits was 99%, and still 12% of mothers were anemic. Incidence of macrosomia was high in diabetic group compared to non-diabetic group. Neonatal mortality is high in LGA babies. Conclusion: In the present study 15.5% of babies were SGA babies. Symmetric IUGR babies contribute >95% of total IUGR in this study. Birth weight was more in symmetric IUGR babies by 100 gm. Along with birth weight all other parameters under study were high in asymmetric IUGR babies. [ABSTRACT FROM AUTHOR]

Abstract Background Controversy surrounds the impact of persistent organic pollutants (POPs) on fetal development. This study aimed to investigate levels of polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) in umbilical cord blood from Şanlıurfa mothers in Turkey, exploring associations with gestational age and birth weight. Methods Participants included voluntary mothers pregnant with a single fetus, providing details on maternal factors. Cord blood samples were collected immediately after delivery. Samples were extracted with a modified QuEChERS method, and OCPs (17 pesticides) and PCBs (11 congeners) compound levels were analyzed with a gas chromatograph/mass spectrometry. Detection frequencies and levels of POPs by single pollutant type and pollutant groups were calculated and compared according to gestational duration and birth weight. We used partial least squares discriminant analysis to identify the key chemicals and distinguish their respective statuses. Results Among 120 infants, 35 were preterm but appropriate for gestational age, 35 were term but small for gestational age (SGA), and 50 were term and appropriate for gestational age (AGA). Beta HCH, Oxy-Chlordan, and PCB 28, were not detected in cord blood samples. Half of the samples contained at least 4 types of OCPs, with a median OCP level of 38.44 ng/g. Among the DDT, 2,4’-DDE was found at the highest concentration in cord plasma samples. The PCB congeners with a frequency exceeding 50% were ranked in the following order: 151, 149, 138, 146. The median level of ∑PCBs was 5.93 ng/g. Male infants born at term with SGA status exhibited lower levels of ∑DDTs, ∑OCPs compared to male infants born preterm or at term with AGA status. Di-ortho-substituted PCBs and hexachlorinated PCBs were higher in male infants born at term with SGA status than male infants born preterm with AGA status. Conclusion Overall, exposure to DDT and PCBs demonstrates varying effects depending on gestational duration and birth weight, with exposure levels also differing by gender. This underscores the necessity for studies across diverse populations that investigate the combined effects of multiple pollutant exposures on gestational age, birth weight, and gender simultaneously.

Background: Controversy surrounds the impact of persistent organic pollutants (POPs) on fetal development. This study aimed to investigate levels of polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) in umbilical cord blood from Şanlıurfa mothers in Turkey, exploring associations with gestational age and birth weight. Methods: Participants included voluntary mothers pregnant with a single fetus, providing details on maternal factors. Cord blood samples were collected immediately after delivery. Samples were extracted with a modified QuEChERS method, and OCPs (17 pesticides) and PCBs (11 congeners) compound levels were analyzed with a gas chromatograph/mass spectrometry. Detection frequencies and levels of POPs by single pollutant type and pollutant groups were calculated and compared according to gestational duration and birth weight. We used partial least squares discriminant analysis to identify the key chemicals and distinguish their respective statuses. Results: Among 120 infants, 35 were preterm but appropriate for gestational age, 35 were term but small for gestational age (SGA), and 50 were term and appropriate for gestational age (AGA). Beta HCH, Oxy-Chlordan, and PCB 28, were not detected in cord blood samples. Half of the samples contained at least 4 types of OCPs, with a median OCP level of 38.44 ng/g. Among the DDT, 2,4'-DDE was found at the highest concentration in cord plasma samples. The PCB congeners with a frequency exceeding 50% were ranked in the following order: 151, 149, 138, 146. The median level of ∑PCBs was 5.93 ng/g. Male infants born at term with SGA status exhibited lower levels of ∑DDTs, ∑OCPs compared to male infants born preterm or at term with AGA status. Di-ortho-substituted PCBs and hexachlorinated PCBs were higher in male infants born at term with SGA status than male infants born preterm with AGA status. Conclusion: Overall, exposure to DDT and PCBs demonstrates varying effects depending on gestational duration and birth weight, with exposure levels also differing by gender. This underscores the necessity for studies across diverse populations that investigate the combined effects of multiple pollutant exposures on gestational age, birth weight, and gender simultaneously. [ABSTRACT FROM AUTHOR]

Abstract Introduction Infants born small for gestational age (SGA) have an increased risk of developing various cardiovascular complications. While many influencing factors can be adjusted or adapt over time, congenital factors also have a significant role. This study, therefore, seeks to explore the effect of perinatal factors on the left ventricular (LV) parameters in SGA infants, as assessed immediately after birth. Methods and materials This single-center prospective cohort study, conducted between 2014 and 2018, involved healthy SGA newborns born > 35 weeks’ gestation, delivered at New York-Presbyterian Brooklyn Methodist Hospital, and a gestational age (GA)-matched control group of appropriate for gestational age (AGA) infants. Data analysis was performed using multivariate linear regression in STATA. Results The study enrolled 528 neonates, 114 SGA and 414 AGA. SGA infants exhibited a mean GA of 38.05 weeks (vs. 38.54), higher male representation (69.3% vs. 51.5%), lower birth weight (BW) (2318g vs 3381g), lower Apgar scores at birth, and a higher rate of neonatal intensive care unit admission compared to AGA infants (41.2% vs.18.9%; p

Altered methylation patterns of insulin-like growth factor (IGF)-axis genes in small for gestational age (SGA) have been reported in different populations. In the present study, we analyzed the methylation status of IGF-axis genes in the placenta of appropriate for gestational age (AGA) and SGA neonates of South Indian women. Placental samples were collected from AGA (n = 40) and SAG (n = 40) neonates. The methylation of IGF-axis genes promoter was analyzed using MS-PCR. IGF2, H19, IGF1, and IGFR1 genes promoter methylation was 2.5, 1.5, 5, and 7.5% lower in SGA compared to AGA, respectively. Co-methylation of IGF-axis genes promoter was 40% and 20% in AGA and SGA, respectively. IGF-axis gene promoter methylation significantly (p < 0.05) influenced the levels of IGFBP3 protein, birth weight, mitotic index, gestational weeks, and IGFR1 and IGFR2 gene expression. IGF-axis genes methylation was lower in SGA than in AGA, and the methylation significantly influenced the IGF-axis components. [ABSTRACT FROM AUTHOR]

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Introduction: Infants born small for gestational age (SGA) have an increased risk of developing various cardiovascular complications. While many influencing factors can be adjusted or adapt over time, congenital factors also have a significant role. This study, therefore, seeks to explore the effect of perinatal factors on the left ventricular (LV) parameters in SGA infants, as assessed immediately after birth. Methods and materials: This single-center prospective cohort study, conducted between 2014 and 2018, involved healthy SGA newborns born > 35 weeks' gestation, delivered at New York-Presbyterian Brooklyn Methodist Hospital, and a gestational age (GA)-matched control group of appropriate for gestational age (AGA) infants. Data analysis was performed using multivariate linear regression in STATA. Results: The study enrolled 528 neonates, 114 SGA and 414 AGA. SGA infants exhibited a mean GA of 38.05 weeks (vs. 38.54), higher male representation (69.3% vs. 51.5%), lower birth weight (BW) (2318g vs 3381g), lower Apgar scores at birth, and a higher rate of neonatal intensive care unit admission compared to AGA infants (41.2% vs.18.9%; p<0.001). Furthermore, SGA infants were more likely to be born to nulliparous women (63.16% vs. 38.16%; p<0.001), with lower body mass index (BMI) (29.8 vs. 31.7; p=0.004), a lower prevalence of gestational maternal diabetes (GDM) (14.9 % vs. 35.5%; p<0.001), and a higher prevalence of preeclampsia (18.4 % vs. 6.52%; p<0.001). BW was identified as the most significant predictor affecting most LV parameters in this study (p<0.001), except shortening fraction, asymmetric interventricular septal hypertrophy and Inter-ventricular septal thickness/LV posterior wall ratio (IVS/LVPW). Lower GA (coefficient = -0.09, p=0.002), insulin use in GDM (coefficient = 0.39, p=0.014), and low APGAR scores at 1 minute (coefficient = -0.07, p<0.001) were significant predictors of IVS during diastole (R-squared [R2]=0.24). High maternal BMI is marginally associated with LVPW during systole (R2=0.27, coefficient = 0.01, p=0.050), while male sex was a significant predictor of LV internal dimension during diastole (R2=0.29, p=0.033). Conclusion: This study highlights the significant influence of perinatal factors on LV parameters in SGA infants, with BW being the most influential factor. Although LV morphology alone may not predict future cardiovascular risk in the SGA population, further research is needed to develop effective strategies for long-term cardiovascular health management in this population. [ABSTRACT FROM AUTHOR]

The objective of this study was to compare the diurnal variations in cortisol and cortisone concentrations in serum and saliva among extremely preterm (EPT), very preterm (VPT), and full-term (FT) children, all born appropriate for gestational age (AGA). EPT, VPT, and FT children, all born AGA, were recruited from two healthcare centers. Cortisol and cortisone concentrations in serum and saliva were measured by liquid chromatography-mass spectrometry (LC‒MS). Statistical analysis was performed using nonparametric tests. A total of 101 children (5.0–8.9 years old) were included in this study: EPT=18, VPT=43 and FT=40. All groups had similar distributions in terms of age, birth weight standard deviation score (SDS) and BMI (SDS), showing no differences in serum ACTH, cortisol, or cortisone levels. Additionally, salivary cortisol and cortisone concentrations decreased significantly throughout the day (p-values<0.0001). Salivary cortisol concentrations were below the limit of detection (0.55 nmol/L) before dinner and before bedtime in approximately one-third and two-thirds of all children, respectively. Salivary cortisone was detectable in all but one sample. The diurnal cortisol rhythm was preserved in all preterm children, regardless of their gestational age, and no differences in cortisol concentrations among the groups were found. This may have significant implications for the clinical management and follow-up of preterm individuals. [ABSTRACT FROM AUTHOR]

Abstract Objective: To assess the maternal blood levels of fatty acids (FAs) in pregnancies with fetal growth restriction (FGR). Methods: This prospective cross-sectional study included pregnant women with gestational age between 26 and 37 + 6 weeks with FGR and appropriate for gestational age (AGA) fetuses. The levels of saturated, trans, monounsaturated, and polyunsaturated FAs were measured using centrifugation and liquid chromatography. The Student’s t-test, Mann-Whitney test, and general linear model, with gestational age and maternal weight as covariants, were used to compare FA levels and the FGR and AGA groups. The Chi-square was used to evaluate the association between groups and studied variables. Results: Maternal blood sample was collected from 64 pregnant women, being 24 FGR and 40 AGA. A weak positive correlation was found between the palmitoleic acid level and maternal weight (r = 0.285, p = 0.036). A weak negative correlation was found between the gamma-linoleic acid level and gestational age (r = −0.277, p = 0.026). The median of the elaidic acid level (2.3 vs. 4.7ng/ml, p = 0.045) and gamma-linoleic acid (6.3 vs. 6.6ng/ml, p = 0.024) was significantly lower in the FGR than the AGA group. The palmitoleic acid level was significantly higher in the FGR than AGA group (50.5 vs. 47.6ng/ml, p = 0.033). Conclusion: Pregnant women with FGR had lower elaidic acid and gamma-linoleic acid levels and higher palmitoleic acid levels than AGA fetuses.

Purpose: The purpose of this prospective observational study was to assess the effect of the nutritional status of pregnant mothers on the birth weight of their new-borns. Material and methods: This study was a prospective observational study of 500 pregnant women registering at an antenatal clinic in GMH Rewa from January 2021 to June 2022. The study participants were followed up at their 2nd visit between 24th and 28th weeks and at their 3rd visit at the time of delivery. Anthropometric, dietary, and haematological parameters were obtained at each visit. Results: Among the 203 women, 140 (68.93%) gave birth to babies whose weight was appropriate for gestational age (AGA) babies, and 63 (31.03%) gave birth to babies whose weight was less than expected for gestational age (SGA) babies. The present study has shown an association between low maternal BMI, low weight gain, inadequate IFA intake, inadequate nutrient intake, inadequate protein intake, inadequate calorie intake, low haemoglobin count during pregnancy, and low birth weight babies. Conclusion: This study emphasizes the significance of a healthy diet and nutrition throughout pregnancy because they directly and favourably affect the newborn’s weight and overall health. Birth weight is statistically significant and positively correlated with maternal iron and folic acid supplementation, particularly blood iron levels. The potential benefits of nutrition and iron-folic acid supplementation, as well as the identification of their inadequacies, can support low-cost treatments intended to lower the incidence of SGA. The study suggests providing proper awareness and health education about pregnancy, timely ANC visits, nutrition, and institutional delivery for a better foetal outcome. [ABSTRACT FROM AUTHOR]

(1) Intrauterine growth restriction (IUGR) is associated with multiple morbidities including growth restriction and impaired neurodevelopment. Small for gestational age (SGA) is defined as a birth weight <10th percentile, regardless of the etiology. The term is commonly used as a proxy for IUGR, but it may represent a healthy constitutionally small infant. Differentiating between IUGR and constitutionally small infants is essential for the nutritional management. (2) Infants born at <37 weeks of gestation between 2017 and 2022, who underwent body composition measurement (FFM: fat-free mass; FM: fat mass) at term-equivalent age, were included in this study. Infants with IUGR and constitutionally small infants (SGA) were compared to infants appropriate for gestational age (AGA). (3) A total of 300 infants (AGA: n = 249; IUGR: n = 40; SGA: n = 11) were analyzed. FFM (p < 0.001) and weight growth velocity (p = 0.022) were significantly lower in IUGR compared to AGA infants, but equal in SGA and AGA infants. FM was not significantly different between all groups. (4) The FFM Z-score was significantly lower in IUGR compared to AGA infants (p = 0.017). Being born constitutionally small compared to AGA had no impact on growth and body composition. These data showed that early aggressive nutritional management is essential in IUGR infants to avoid impaired growth and loss of FFM. [ABSTRACT FROM AUTHOR]

ObjectivesThis study analyzed the physical growth of small for gestational age (SGA) and appropriate for gestational age (AGA) twins up to one year after birth.MethodsWeight, length, and head circumference data of 0–1 year-old twins were collected from the Child Health Care System from 2010 to 2019. Physical data were presented as Z-scores. Five parameters – growth level of weight, body length, head circumference, growth velocity, and body proportion (weight for length) were compared in twins.ResultsA total of 3,909 cases were collected (22.61% SGA, 77.39% AGA). 1. In both groups, WAZ (Weight for age z-score), HCZ (Head circumference for age z-score), and LAZ (Length for age z-score) increased more rapidly in the first 6 months. By one year of age, WAZ, HCZ, and LAZ had reached the normal range, but none had reached the average level of normal singleton children. 2. The mean values of WAZ, HCZ, and LAZ in the AGA group were between −1 and 0, and between −2 and − 1 in the SGA group, in the first year after birth. The SGA group lagged significantly behind the AGA group. The LAZ score of SGA and AGA was lower than the WAZ and HCZ scores. 3. The proportion of preterm AGA was the largest in twins, and the growth rate of preterm AGA was the fastest. Preterm twins had greater growth potential than term twins. However, the growth level of preterm SGA was always low. 4. The WFLZ (Weight for length z-score) in each group was approximately close to 0. The WFLZ of SGA was smaller than that of AGA twins at most time points. After 4 months of age, the WFLZ of twins had a downward trend. The WFLZ of preterm SGA approached −1 at approximately 1 year old.ConclusionThe physical growth of SGA and AGA in twins in the first year can reach the normal range but cannot reach the average level of normal singleton children. More attention should be paid to SGA in twins, especially preterm SGA. We should give proper nutritional guidance after 4 months of age to ensure the appropriate body proportion (weight for length) of SGA in twins.Clinical trial registrationwww.chictr.org.cn, CTR2000034761.

IGF-axis and mitotic capacity of cells play a vital role in fetal growth. We compared IGF1, IGF2, and IGFBP3 protein levels, mitotic indices, IGFR1 and IGFR2 mRNA expression in appropriate for gestational age (AGA) and small for gestational age (SGA) neonates of Indian women. Cord blood (n = 80) and placental samples (n = 40) were collected from AGA and SGA neonates. Plasma IGF1, IGF2, and IGFBP3 proteins were measured by ELISA. IGFR1 and IGFR2 mRNA expression in the placenta were analyzed by qRT-PCR. Cord blood was cultured in vitro and mitotic index was obtained. IGF1 (p = 1), and IGF2 (p = 0.69) protein levels did not differ, whereas IGFBP3 (p = 0.02) was significantly less in SGA compared to AGA neonates. Down-regulation of IGFR1 (3.9-folds) and IGFR2 (2.8-folds) mRNA and reduced mitotic index of lymphocytes was observed in SGA (p = 0.001) compared to AGA neonates. Our results showed that, SGA neonates displayed down-regulated IGFR1 and IGFR2 mRNA, decreased IGFBP3 protein and mitotic index. [ABSTRACT FROM AUTHOR]

BackgroundThe improvement in perinatal medicine has promoted the increase of survival rate in very premature infants. Since growth and developmental delays will have a long-term impact on them, early catch-up growth is extremely important. However, there are few longitudinal studies on anthropometric parameters for assessing catch-up growth in such infants.ObjectiveTo investigate the increasing trend of body weight, body length and head circumference (HC) of very premature infants within 3 years old, providing evidence for promoting scientific catch-up growth in such infants.MethodsParticipants were selected from Northern Jiangsu People's Hospital during August 2017 to September 2018, including 120 ICU-treated very premature infants delivered at 28-32 weeks of gestation, who were divided into two group 〔small for gestational age (SGA) group (n=11) and appropriate for gestational age (AGA) group (n=109) 〕, and 121 full-term infants. Body weight and length as well as HC were measured at 40 weeks, 3, 6, 12, 24 months of corrected age and 36 months, respectively, and Z-scores and growth rates of these three parameters were calculated.ResultsThe Z-scores of body weight, body length and HC differed statistically across SGA, AGA and full-term infants within 12 months of corrected age (P

BackgroundPreterm birth (PTB) is associated with increased infant mortality, and neurodevelopmental abnormalities among survivors. The aim of this study is to investigate temporal trends, patterns, and predictors of PTB in California from 2007 to 2016, based on the obstetric estimate of gestational age (OA).MethodsA retrospective cohort study evaluated 435,280 PTBs from the 5,137,376 resident live births (8.5%) documented in the California Birth Statistical Master Files (BSMF) from 2007 to 2016. The outcome variable was PTB; the explanatory variables were birth year, maternal characteristics and health behaviors. Descriptive statistics and logistic regression analysis were used to identify subgroups with significant risk factors associated with PTB. Small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA) infants were identified employing gestational age based on obstetric estimates and further classified by term and preterm births, resulting in six categories of intrauterine growth.ResultsThe prevalence of PTB in California decreased from 9.0% in 2007 to 8.2% in 2014, but increased during the last 2 years, 8.4% in 2015 and 8.5% in 2016. Maternal age, education level, race and ethnicity, smoking during pregnancy, and parity were significant risk factors associated with PTB. The adjusted odds ratio (AOR) showed that women in the oldest age group (40-54 years) were almost twice as likely to experience PTB as women in the 20- to 24-year reference age group. The prevalence of PTB was 64% higher in African American women than in Caucasian women. Hispanic women showed less disparity in the prevalence of PTB based on education and socioeconomic level. The analysis of interactions between maternal characteristics and perinatal health behaviors showed that Asian women have the highest prevalence of PTB in the youngest age group (

Objective  We examined the effects of maternal hypertensive disorders of pregnancy (HDP) on the mortality and neurodevelopmental outcomes in preterm very low birth weight (VLBW) infants (BW ≤1,500 g) based on their intrauterine growth status and gestational age (GA). Study Design  We included singleton VLBW infants born at <32 weeks' gestation registered in the Neonatal Research Network Japan database. The composite outcomes including death, cerebral palsy (CP), and developmental delay (DD) at 3 years of age were retrospectively compared among three groups: appropriate for GA (AGA) infants of mothers with and without HDP (H-AGA and N-AGA) and small for GA (SGA) infants of mothers with HDP (H-SGA). The adjusted odds ratios (AOR) and 95% confidence intervals (CI) stratified by the groups of every two gestational weeks were calculated after adjusting for the center, year of birth, sex, maternal age, maternal diabetes, antenatal steroid use, clinical chorioamnionitis, premature rupture of membranes, non-life-threatening congenital anomalies, and GA. Results  Of 19,323 eligible infants, outcomes were evaluated in 10,192 infants: 683 were H-AGA, 1,719 were H-SGA, and 7,790 were N-AGA. Between H-AGA and N-AGA, no significant difference was observed in the risk for death, CP, or DD in any GA groups. H-AGA had a lower risk for death, CP, or DD than H-SGA in the 24 to 25 weeks group (AOR: 0.434, 95% CI: 0.202–0.930). The odds for death, CP, or DD of H-SGA against N-AGA were found to be higher in the 24 to 25 weeks (AOR: 2.558, 95% CI: 1.558–3.272) and 26 to 27 weeks (AOR: 1.898, 95% CI: 1.427–2.526) groups, but lower in the 30 to 31 weeks group (AOR: 0.518, 95% CI: 0.335–0.800). Conclusion  There was a lack of follow-up data; however, the outcomes of liveborn preterm VLBW infants of mothers with HDP depended on their intrauterine growth status and GA at birth. Key Points The effects of HDP on preterm low birth weight infants need to be further examined. The outcomes were not different between AGA infants with and without maternal HDP. The outcomes of SGA infants with maternal HDP were dependent on their GA. [ABSTRACT FROM AUTHOR]

We examined the long-term health outcomes associated with being born small for gestational age (SGA) or large for gestational age (LGA). A total of 632 young adults aged ≈20.6 years were recruited from a longitudinal study (Chiang Mai, Thailand) in 2010: 473 born appropriate for gestational age (AGA), 142 SGA, and 17 LGA. The clinical assessments included anthropometry, blood pressure (BP), lipid profile, and an oral glucose tolerance test (OGTT). Young adults born SGA were 1.8 and 3.2 cm shorter than AGA (p = 0.0006) and LGA (p = 0.019) participants, respectively. The incidence of short stature was 8% among SGA compared with 3% in AGA and no cases among LGA participants, with the adjusted relative risk (aRR) of short stature among SGA 2.70 times higher than that of AGA counterparts (p = 0.013). SGA participants also had a 2 h glucose 7% higher than that of the AGA group (105 vs. 99 mg/dL; p = 0.006). Young adults born LGA had a BMI greater by 2.42 kg/m2 (p = 0.025) and 2.11 kg/m2 (p = 0.040) than those of SGA and AGA, respectively. Thus, the rate of overweight/obesity was 35% in the LGA group compared with 14.2% and 16.6% of SGA and AGA groups, respectively, with corresponding aRR of overweight/obesity of 2.95 (p = 0.011) and 2.50 (p = 0.017), respectively. LGA participants had markedly higher rates of BP abnormalities (prehypertension and/or hypertension) with an aRR of systolic BP abnormalities of 2.30 (p = 0.023) and 2.79 (p = 0.003) compared with SGA and AGA groups, respectively. Thai young adults born SGA had an increased risk of short stature and displayed some impairment in glucose metabolism. In contrast, those born LGA were at an increased risk of overweight/obesity and elevated blood pressure. The long-term follow-up of this cohort is important to ascertain whether these early abnormalities accentuate over time, leading to overt cardiometabolic conditions. [ABSTRACT FROM AUTHOR]

The maternal renin-angiotensin system is involved in blood pressure control and plays a crucial role in fetoplacental nutrition. Pre-gestational type 1 diabetes (PGDM) leads to serious pregnancy complications. We thus performed a longitudinal study to analyse the association of maternal angiotensin-converting enzyme (ACE) serum levels and placental mRNA expression with fetal newborns gestational weight in type 1 diabetes mellitus (T1DM) women. We recruited 65 singleton pregnant women with T1DM. Placental mRNA ACE gene expression was examined using quantitative real-time PCR. Serum ACE levels were measured in the first, second and third trimesters of pregnancy by ELISA commercial kits. Placental expression of ACE mRNA was significantly lower in small for gestational age (SGA) than appropriate for gestational age (AGA) and large for gestational age (LGA) mothers (0.55±0.06 vs 0.78±0.06 and 0.85±0.07 respectively, p=0.003). In the SGA group, the mRNA expression of ACE positively correlated with maternal body mass index (BMI) in the third trimester (r=0.49; p=0.04). In all study groups maternal ACE level was significantly higher in the third trimester (mean 139.91±SD 69.64) compared to the first and second trimesters of pregnancy (13.57±4.32 and 15.69±15.92 respectively). Our data suggest that lower placental ACE gene mRNA expression may have a vital role in the etiology of SGA babies. [ABSTRACT FROM AUTHOR]

Background: Despite the limited evidence, accelerated early postnatal growth (EPG) is commonly believed to benefit neurodevelopment for term-born infants, especially those small for gestational age.Objectives: To investigate the existence of critical time windows in the association of EPG with neurodevelopment, considering birth size groups.Study Design: In the French ELFE birth cohort, 12,854 term-born neonates were classified as small, appropriate or large for gestational age (SGA, AGA, LGA, respectively). Parents reported their child's development by using the Child Development Inventory (CDI-score) at age 12 months and the MacArthur-Bates Development Inventory (MAB-score; 100 score units) assessing language ability at age 24 months. Predictions of individual weight, body mass index (BMI), length, and head circumference (HC) from birth to age 24 months were obtained from repeated measurements fitted with the Jenss-Bayley mixed-effects model. For each infant, conditional gains (CG) in these growth parameters were generated at four-time points (3, 6, 12 and 24 months) representing specific variations in growth parameters during 0-3, 3-6, 6-12, 12-24 months, independent of previous measures. Using multivariable linear regression models, we provided the estimate differences of the neurodevelopmental scores according to variation of each growth parameter CG, by birth size group.Results: For SGA infants, the MAB-score differed by 5.8 (95% confidence interval [CI] -0.2, 11.8), 6.7 (95% CI -0.1, 13.3), and 9.7 (95% CI 1.9, 17.5) score units when CG in BMI, weight, and HC at 3 months varied from -2 to 1 standard deviation, respectively. For all infants, MAB-score was linearly and positively associated with length conditional gains at 12 months, with stronger magnitude for SGA infants. Results for the CDI-score were overall consistent with those for MAB-score.Conclusions: For term-born SGA infants, moderate catch-up in HC, BMI and weight within the first 3 months of life may benefit later neurodevelopment, which could guide clinicians to monitor EPG. [ABSTRACT FROM AUTHOR]

Introduction: To assess the impact of gestational age at term on the association between cerebroplacental ratio (CPR) and operative delivery for intrapartum fetal compromise (IFC) and prognostic performance of CPR to predict operative delivery for IFC. Material and methods: This was a retrospective cohort study including 2052 singleton pregnancies delivered between 37+0 and 41+6 weeks of gestation in a single tertiary referral center over an 8‐year period. CPR was measured within 1 week of delivery. IFC was defined as the presence of persistent pathological cardiotocography pattern or the combination of pathological cardiotocography pattern and fetal scalp pH < 7.20. Operative delivery included instrumental vaginal delivery and cesarean section. Pregnancies were grouped according to birthweight (small for gestational age [SGA, birthweight <10th centile] and appropriate for gestational age [AGA, birthweight 10th–90th centile]) and gestational age by week at delivery. Rates of operative delivery were compared between the subgroups. Prognostic value of CPR was assessed using receiver operating characteristic curve. Results: Of the study cohort, 308 (15%) had a CPR <10th centile, 374 (18%) operative delivery for IFC, and 298 (15%) were SGA at birth. Overall, the rates of operative delivery for IFC were higher in the low CPR group both in SGA (35% vs. 22%; p = 0.023) and in AGA (23% vs. 16%; p = 0.007). According to gestational age by week at delivery, fetuses with low CPR showed higher rates of operative delivery for IFC with advancing gestational age, mainly in pregnancies delivered at 40 weeks (54% vs. 23%; p = 0.004) and at 41 weeks (60% vs. 19%; p = 0.010) for SGA and at 41 weeks (39% vs. 20%; p = 0.001) for AGA. The predictive value of CPR remained stable throughout term and was poor both in SGA and in AGA. Conclusions: Both SGA and AGA fetuses with low CPR showed higher rates of operative delivery for IFC at term with advancing gestational age. Prognostic value of CPR throughout term was poor. [ABSTRACT FROM AUTHOR]

Background & objectives: A etiologically symmetric and asymmetric small for gestational age (SGA) infants are two distinct entities. In view of absence of longitudinal information on growth pattern of skinfold thicknesses (SFTs) among Indian infants, this study was conducted to assess the auxological dynamics of SFTs (sub-cutaneous fat) of symmetric and asymmetric SGA infants. Methods: Triceps, sub-scapular, biceps, mid-axillary and anterior thigh SFTs among full-term, 100 symmetric SGA, 100 asymmetric SGA and 100 appropriate for gestational age (AGA) infants were measured at one, three, six, nine and 12 months. Ponderal Index (PI) was used to categorize infants into symmetric SGA (PI ≥2.2 g/cm3) and asymmetric SGA (PI <2.2 g/cm³). Intra-group (symmetric vs. asymmetric), inter-group (SGA vs. AGA) and gender differences were quantified. Results: SFTs among symmetric, asymmetric SGA infants increased to attain peak by six months. Maximum fat deposition in SGA infants was noticed for triceps, minimum for mid-axillary SFT. Mean triceps and sub-scapular skinfolds were measured higher in symmetric SGA than in asymmetric infants. SGA infants had significantly (P≤0.05) thinner SFTs than AGA. Growth velocity for SFTs, among symmetric and asymmetric SGA, was measured maximum between one and three months, threreafter it declined and relatively, steepness of fall was maximum for mid-axillary SFT followed by sub-scapular SFT. Interpretation & conclusions: Thinner SFTs obtained for symmetric and asymmetric SGA as compared to AGA infants reveal their compromised adiposity and nutritional status. Comparatively, higher SFTs in symmetric than in asymmetric SGA infants appear to suggest that the former have a tendency to accumulate more fat, than the latter during infancy. [ABSTRACT FROM AUTHOR]

Introduction: This study investigated whether fetal growth deceleration in term, appropriate-for-gestational-age (AGA) fetuses is associated with placental insufficiency and nonreassuring fetal heart rate (NRFHR) at birth. Methods: In this prospective study, 246 low-risk, singleton pregnancies at term with AGA fetuses were recruited. Correlation between decreased growth velocity (decline in estimated fetal weight [EFW] percentile), low EFW (EFWQ1 = latest EFW between 11 and 25% percentiles), umbilical artery (UA) pulsatility index (PI), middle cerebral artery (MCA) PI, and cerebro-placental ratio (CPR) with cesarean and instrumental deliveries due to NRFHR were tested. Results: The median change between fetal weight estimates (percentiles/week) was +0.49% (95% CI: −4 to +5%). Ten percent had decreased EFW percentile >3.5%/week. Fetal growth velocity/week was associated with MCA (r = 0.21, p < 0.001) and CPR (r = 0.24, p < 0.001) and inversely correlated with UA PI (r = −0.28, p < 0.001). NRFHR and cesarean section (CS) rates due to NRFHR were associated with decreased growth velocity, EFWQ1, and low CPR. The combination of abnormal CPR with decreased growth velocity occurred in 12 pregnancies, of which 5 (42%) had urgent CS due to NRFHR. The combination of abnormal CPR with EFWQ1 occurred in 9 pregnancies, of which 4 (44%) had urgent CS due to NRFHR. These combinations increased the likelihood ratio of CS due to NRFHR two-fold (8.41; 2.54–24.5) but did not significantly alter the number needed to treat by elective CS (3.78–4.68). Conclusion: Fetal growth velocity, EFW between 10 and 25th percentiles (EFWQ1), and abnormal CPR improves prediction of unplanned CS due to NRFHR among term AGA fetuses. This should be considered when counseling about the delivery method. [ABSTRACT FROM AUTHOR]

Introduction: Zinc deficiency is very much prevalent among pregnant women in developing countries. Zinc is required to maintain normal structure and function of multiple enzymes including those that are involved in foetal growth. Zinc deficiency increases risk of baby being born preterm, low birth weight, small for gestational age (SGA). Aims and Objectives: To compare serum zinc levels in small for gestational age babies with respect to appropriate for gestational age (AGA). Material and Methods: Out of total 200 newborn, hundred SGA newborn comprised the study group and hundred AGA newborn comprised the control group. Cord blood sample was collected immediately after birth and zinc levels were determined by atomic absorption spectrophotometry method. Results: The mean (±SD) serum zinc levels of study and control groups were 56.8 ± 40.6 μg/dl and 107.4 ± 72 μg/dl respectively and difference between two groups were found to be statistically significant. The mean serum zinc levels of preterm SGA group and term SGA group were 46.26 ± 22.54 μg/dl and 63.35 ± 47.47μg/dl respectively. Statistically significant difference was found in mean serum zinc levels between the two groups. Conclusion: SGA neonates have significant zinc deficiency as compared to AGA neonates. This zinc deficiency is even more pronounced in SGA newborns that are born preterm. This warrants the future investigation and necessary intervention on zinc supplementation during pregnancy and to preterm and SGA babies for better maternal and child health outcomes.

Objective: The study aimed to determine the frequency of hypoglycemia in low birth weight neonates during the first 24 hours of life after birth. Materials and Methods: This cross-sectional study was conducted from 1st March 2016 to 31st August 2016 in the NICU and postnatal ward of POF Hospital, Wah Cantt. All the babies with birth weight less than 2.5 kg including preterm and term were included in the study. After the aseptic measure blood, sugar was checked and a value less than 45 mg/dl was labelled as hypoglycemia. Results: Out of 96 neonates, 51 (53%) were male and 45 (47%) were female. The minimum weight of the patient was 1.6kg and the maximum was 2.40 kg. Hypoglycemia was noted in 49 (51%) babies after 2 hours of birth whereas 36 (37.5%) had hypoglycemia at 4 hours and 13 (13.5 %) had at 24 hours. 68 (70.8%) babies included in the study were appropriate for gestational age (AGA) and 28 (29.1%) babies were small for gestational age (SGA). After 2 hours of birth, hypoglycemia was present more in SGA babies i.e.20 (71.4%) as compared to AGA babies i.e. 29 (42.6%) which had statistical significance also (p-value 0.01). Conclusion: Neonatal hypoglycemia is a well-recognized complication in newborns and low birth weight infants are more susceptible to hypoglycemia. Early identification of vulnerable infants and the use of preemptive measures can result in better outcomes. [ABSTRACT FROM AUTHOR]

Abstract Background Small for gestational age (SGA) is common among newborns in low‐income countries like Nepal and has higher immediate mortality and morbidities. Objectives To study the prevalence and prognostic factors of SGA babies in Western Nepal. Methods A cross‐sectional study (November 2016‐October 2017) was conducted in a tertiary care hospital in Western Nepal. Socio‐demographic, lifestyle factors including diet, and exposures including smoking and household air pollution in mothers who delivered newborns appropriate for gestational age (AGA), SGA and large for gestational age (LGA) were recorded. Logistic regression was carried out to find the odds ratio of prognostic factors after adjusting for potential confounders. Results Out of 4000 delivered babies, 77% (n = 3078) were AGA, 20.3% (n = 813) were SGA and 2.7% (n = 109) were LGA. The proportion of female‐SGA was greater in comparison to male‐SGA (n = 427, 52.5% vs n = 386, 47.5%). SGA babies were born to mothers who had term, preterm, and postterm delivery in the following proportions 70.1%, 19.3%, and 10.6%, respectively. The average weight gain (mean ± SD) by mothers in AGA pregnancies was 10.3 ± 2.4 kg, whereas in SGA were 9.3 ± 2.4 kg. In addition to low socioeconomic status (OR 1.9, 95% CI 1.1, 3.2), other prognostic factors associated with SGA were lifestyle factors such as low maternal sleep duration (OR 5.1, CI 3.6, 7.4) and monthly or less frequent meat intake (OR 5.0, CI 3.2, 7.8). Besides smoking (OR 8.8, CI 2.1, 36.3), the other major environmental factor associated with SGA was exposure to household air pollution (OR 5.4, 4.1, 6.9) during pregnancy. Similarly, some of the adverse health conditions associated with a significantly higher risk of SGA were anemia, oligohydramnios, and gestational diabetes. Conclusions SGA is common in Western Nepal and associated with several modifiable prognostic factors.

We examined the long-term health outcomes associated with being born small for gestational age (SGA) or large for gestational age (LGA). A total of 632 young adults aged ≈20.6 years were recruited from a longitudinal study (Chiang Mai, Thailand) in 2010: 473 born appropriate for gestational age (AGA), 142 SGA, and 17 LGA. The clinical assessments included anthropometry, blood pressure (BP), lipid profile, and an oral glucose tolerance test (OGTT). Young adults born SGA were 1.8 and 3.2 cm shorter than AGA (p = 0.0006) and LGA (p = 0.019) participants, respectively. The incidence of short stature was 8% among SGA compared with 3% in AGA and no cases among LGA participants, with the adjusted relative risk (aRR) of short stature among SGA 2.70 times higher than that of AGA counterparts (p = 0.013). SGA participants also had a 2 h glucose 7% higher than that of the AGA group (105 vs. 99 mg/dL; p = 0.006). Young adults born LGA had a BMI greater by 2.42 kg/m2 (p = 0.025) and 2.11 kg/m2 (p = 0.040) than those of SGA and AGA, respectively. Thus, the rate of overweight/obesity was 35% in the LGA group compared with 14.2% and 16.6% of SGA and AGA groups, respectively, with corresponding aRR of overweight/obesity of 2.95 (p = 0.011) and 2.50 (p = 0.017), respectively. LGA participants had markedly higher rates of BP abnormalities (prehypertension and/or hypertension) with an aRR of systolic BP abnormalities of 2.30 (p = 0.023) and 2.79 (p = 0.003) compared with SGA and AGA groups, respectively. Thai young adults born SGA had an increased risk of short stature and displayed some impairment in glucose metabolism. In contrast, those born LGA were at an increased risk of overweight/obesity and elevated blood pressure. The long-term follow-up of this cohort is important to ascertain whether these early abnormalities accentuate over time, leading to overt cardiometabolic conditions.

Background: Small for gestational age (SGA) is common among newborns in low‐income countries like Nepal and has higher immediate mortality and morbidities. Objectives: To study the prevalence and prognostic factors of SGA babies in Western Nepal. Methods: A cross‐sectional study (November 2016‐October 2017) was conducted in a tertiary care hospital in Western Nepal. Socio‐demographic, lifestyle factors including diet, and exposures including smoking and household air pollution in mothers who delivered newborns appropriate for gestational age (AGA), SGA and large for gestational age (LGA) were recorded. Logistic regression was carried out to find the odds ratio of prognostic factors after adjusting for potential confounders. Results: Out of 4000 delivered babies, 77% (n = 3078) were AGA, 20.3% (n = 813) were SGA and 2.7% (n = 109) were LGA. The proportion of female‐SGA was greater in comparison to male‐SGA (n = 427, 52.5% vs n = 386, 47.5%). SGA babies were born to mothers who had term, preterm, and postterm delivery in the following proportions 70.1%, 19.3%, and 10.6%, respectively. The average weight gain (mean ± SD) by mothers in AGA pregnancies was 10.3 ± 2.4 kg, whereas in SGA were 9.3 ± 2.4 kg. In addition to low socioeconomic status (OR 1.9, 95% CI 1.1, 3.2), other prognostic factors associated with SGA were lifestyle factors such as low maternal sleep duration (OR 5.1, CI 3.6, 7.4) and monthly or less frequent meat intake (OR 5.0, CI 3.2, 7.8). Besides smoking (OR 8.8, CI 2.1, 36.3), the other major environmental factor associated with SGA was exposure to household air pollution (OR 5.4, 4.1, 6.9) during pregnancy. Similarly, some of the adverse health conditions associated with a significantly higher risk of SGA were anemia, oligohydramnios, and gestational diabetes. Conclusions: SGA is common in Western Nepal and associated with several modifiable prognostic factors. [ABSTRACT FROM AUTHOR]

Abstract Background Preterm birth (PTB) is associated with increased infant mortality, and neurodevelopmental abnormalities among survivors. The aim of this study is to investigate temporal trends, patterns, and predictors of PTB in California from 2007 to 2016, based on the obstetric estimate of gestational age (OA). Methods A retrospective cohort study evaluated 435,280 PTBs from the 5,137,376 resident live births (8.5%) documented in the California Birth Statistical Master Files (BSMF) from 2007 to 2016. The outcome variable was PTB; the explanatory variables were birth year, maternal characteristics and health behaviors. Descriptive statistics and logistic regression analysis were used to identify subgroups with significant risk factors associated with PTB. Small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA) infants were identified employing gestational age based on obstetric estimates and further classified by term and preterm births, resulting in six categories of intrauterine growth. Results The prevalence of PTB in California decreased from 9.0% in 2007 to 8.2% in 2014, but increased during the last 2 years, 8.4% in 2015 and 8.5% in 2016. Maternal age, education level, race and ethnicity, smoking during pregnancy, and parity were significant risk factors associated with PTB. The adjusted odds ratio (AOR) showed that women in the oldest age group (40–54 years) were almost twice as likely to experience PTB as women in the 20- to 24-year reference age group. The prevalence of PTB was 64% higher in African American women than in Caucasian women. Hispanic women showed less disparity in the prevalence of PTB based on education and socioeconomic level. The analysis of interactions between maternal characteristics and perinatal health behaviors showed that Asian women have the highest prevalence of PTB in the youngest age group (

Background: The cerebroplacental ratio (CPR) is emerging as a predictor for adverse perinatal outcome in term pregnancies. Earlier, it has shown a role in small for gestational age (SGA) pregnancies, but a proportion of appropriate for gestational age foetuses (AGA) despite of good size have impaired growth velocity and are thereby at risk of adverse outcome. CPR has implication for assessment of well being of SGA and AGA foetuses close to term. Objective: To investigate the association between foetal CPR and adverse perinatal outcome in uncomplicated term AGA pregnancies. Methods: This was a prospective observational study done in Department of Obstetric and Gynaecology, King George Medical University, Lucknow, over a period of one year. Women > 37 week singleton pregnancy with no known risk factor who had Doppler USG done within a week of delivery were included. CPR was calculated by dividing the Doppler indices of middle cerebral artery (MCA) by umbilical artery (MCA PI/UA PI). CPR < 1 was taken as abnormal. These patients were followed up till delivery to look for various perinatal outcomes. Results Out of 127 low-risk AGA pregnancies who went for USG colour Doppler scan, 117 patients who met our inclusion criteria were analysed; out of 117 patients 23(i.e. 19.65 %) were having CPR < 1 and 94 patients (i.e. 80.34%) were having CPR>1. Among 23 patients with CPR < 1, 22 (91.30%) had adverse outcome as compared to only 20.21% patients with CPR > 1, and this is found to be statistically significant (p < 0.001). Conclusion: Our study found CPR measure to be a very promising tool for optimising the identification of at risk foetus in low-risk AGA pregnancies. [ABSTRACT FROM AUTHOR]

To characterize and compare sex hormone concentrations, and uterine and ovarian volumes in adolescent girls born small for gestational age (SGA) who had experienced catch-up growth and girls born at a size appropriate for gestational age (AGA), and to investigate the association between these parameters and glucose metabolism, perinatal factors, and early growth. A prospective, longitudinal, observational study from birth until adolescence. Mean age at final assessment was 12.7 ± 0.1 years. We followed 55 girls (20 SGA, 35 AGA). Sex hormone concentrations (gonadotropins, estradiol, testosterone, and sex hormone binding globulin) were analyzed, and the oral glucose tolerance test conducted. Uterine and ovarian sizes were assessed using pelvic ultrasound. Uterine and ovarian volumes were smaller in SGA-born compared with AGA-born girls (P =.013 and P =.039, respectively). SGA girls had lower sex hormone binding globulin levels (P =.039) and higher testosterone levels (P =.003), free androgen index (P <.001), and glycemia 2 hours post glucose load (P =.005) compared with AGA-born girls. Birth weight and early infancy height velocity explained 37.4% of variation in ovarian volume (P =.004), and body mass index at birth, increase in peripheral skinfold thickness during second year of life, and early childhood height velocity explained 43.2% of variation in testosterone levels in adolescence (P =.006). SGA-born girls who experienced catch-up growth remain at risk of biochemical hyperandrogenism in adolescence, and have reduced uterine and ovarian volumes, which might influence future reproductive function. Ovarian size and androgen levels in adolescence might be influenced by early growth and subcutaneous fat deposition. [ABSTRACT FROM AUTHOR]

Introduction: Zinc deficiency is very much prevalent among pregnant women in developing countries. Zinc is required to maintain normal structure and function of multiple enzymes including those that are involved in foetal growth. Zinc deficiency increases risk of baby being born preterm, low birth weight, small for gestational age (SGA). Aims and Objectives: To compare serum zinc levels in small for gestational age babies with respect to appropriate for gestational age (AGA). Material and Methods: Out of total 200 newborn, hundred SGA newborn comprised the study group and hundred AGA newborn comprised the control group. Cord blood sample was collected immediately after birth and zinc levels were determined by atomic absorption spectrophotometry method. Results: The mean (±SD) serum zinc levels of study and control groups were 56.8 ± 40.6 μg/dl and 107.4 ± 72 μg/dl respectively and difference between two groups were found to be statistically significant. The mean serum zinc levels of preterm SGA group and term SGA group were 46.26 ± 22.54 μg/dl and 63.35 ± 47.47μg/dl respectively. Statistically significant difference was found in mean serum zinc levels between the two groups. Conclusion: SGA neonates have significant zinc deficiency as compared to AGA neonates. This zinc deficiency is even more pronounced in SGA newborns that are born preterm. This warrants the future investigation and necessary intervention on zinc supplementation during pregnancy and to preterm and SGA babies for better maternal and child health outcomes. [ABSTRACT FROM AUTHOR]

Aim: This meta-analysis evaluates the use of cerebroplacental ratio (CPR) in predicting adverse perinatal outcome.Methods: An electronic search of PubMed, Embase, Google scholar, Cochrane Library and Up-to-Date was done using variations of 'cerebroplacental ratio' and 'cerebroumbilical ratio'. We included studies where CPR was measured and postpartum outcomes were available. Selected articles were evaluated for quality of study methodology using the Newcastle-Ottawa Scale, and aggregate statistics for relative risks, odds ratios and 95% confidence interval were calculated.Results: Data from 66,392 patients in 47 studies was extracted. There were 25 prospective, 17 retrospective and 5 case-control studies. Data on each obstetric or perinatal outcome was separately analysed. When analysing the prospective data, it showed abnormal CPR can predict the need for operative delivery due to foetal distress [RR: 2.52, 95%CI: 2.10-3.02; I2 = 65.78, P < 0.001], low pH [RR: 2.19, 95%CI: 1.01-4.75; I2 = 70.26, P = 0.005] and low Apgar score [RR: 2.05, 95%CI: 1.39-3.03; I2 = 37.15, P = 0.10], foetal or neonatal demise [RR: 2.49, 95%CI: 1.00-6.20], as well as NICU admission [RR: 2.23, 95%CI: 1.84-2.70; I2 48.53, P = 0.14].The retrospective data showed a statistically significant correlation in all outcomes but the low pH.Conclusion: Our meta-analysis shows that CPR can be used to identify foetuses with higher risk of operative delivery due to foetal distress, low Apgar score, NICU admission, neonatal morbidity as well as stillbirth and neonatal death rates. [ABSTRACT FROM AUTHOR]

Background: The current treatment approach in patent ductus arteriosus suggests the identification of high-risk infants that may benefit the most from treatment. Small for gestational age infants are a high-risk population in which the treatment approach to the patent ductus arteriosus and outcomes have not been described.Aim: To compare the patent ductus arteriosus treatment approach and outcomes in small for gestational age and appropriate for gestational age infants.Study Design: Retrospective analysis of infants born between January 1, 2011 and December 31, 2015 at <33 weeks' GA and admitted to neonatal intensive care units (NICU) part of the Canadian Neonatal Network.Results: 595 of 2507 small for gestational age infants (23.7%) and 4714 of 20,002 appropriate for gestational age infants (23.6%) had a patent ductus arteriosus. The patent ductus arteriosus treatment approach (conservative, medical, surgical) was similar in both groups. Small for gestational age infants with and without a patent ductus arteriosus had increased risk of the composite outcome of death or bronchopulmonary dysplasia (aOR 3.40; 95% CI 2.73, 4.24; and aOR 2.72; 95% CI 2.24, 3.31) respectively.Conclusions: Patent ductus arteriosus management did not differ between small for gestational age and appropriate for gestational age infants. Small for gestational age infants had increased risk of death or bronchopulmonary dysplasia regardless of their patent ductus arteriosus status. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to compare the incidence of retinopathy of prematurity (ROP) in small-for-gestational-age (SGA) infants with appropriate-for-gestational-age (AGA) infants. Materials and Methods: A hospital-based prospective descriptive study was conducted on all cases of preterm babies

Objective This study aimed to determine blood glucose levels of healthy, term, appropriate for gestational age (AGA), exclusively breastfed infants at the age of 6, 12, 24, 48, and 72 hours of life, and to investigate the incidence of hypoglycemia in those infants. Methods All healthy, term, AGA infants born in Cipto Mangunkusumo General Hospital, Jakarta, who were exclusively breastfed during the recruitment period of December 2003 until February 2004, were included in this study. These infants were subjected to blood glucose level determination at the age of 6, 12, 24, 48, or 72 hours of life, and the clinical signs of hypoglycemia were monitored. Results Two hundred and fifteen blood samples taken from 137 newborns were studied. There was no incidence of hypoglycemia observed, whether symptomatic or asymptomatic. The range of blood glucose levels was between 41 mg/dl and 115 mg/dl. The means and the standard deviations (SD) of the blood glucose lev- els of the 6-, 12-, 24-, 48- and 72-hour old infants were 59.7 (11.98) mg/dl, 64.1 (13.51) mg/dl, 65.9 (14.42) mg/dl, 67.0 (14.95) mg/dl, and 78.6 (16.51) mg/dl, respectively. Conclusions The current concern for hypoglycemia in the popu- lation of healthy, term, AGA, exclusively breastfed infants during the first few days of life was not proven to exist. Therefore, there is no reason to resort to prelacteal feeding in such infants

Objectives: To understand the growth and development status and differences between small for gestational age (SGA) and appropriate for gestational age (AGA) preterm infants during corrected ages 0-24 months, and to provide a basis for early health interventions for preterm infants., Methods: A retrospective study was conducted, selecting 824 preterm infants who received regular health care at the Guangzhou Women and Children's Medical Center from July 2019 to July 2022, including 144 SGA and 680 AGA infants. The growth data of SGA and AGA groups at birth and corrected ages 0-24 months were analyzed and compared., Results: The SGA group had significantly lower weight and length than the AGA group at corrected ages 0-18 months ( P <0.05), while there were no significant differences between the two groups at corrected age 24 months ( P >0.05). At corrected age 24 months, 85% (34/40) of SGA and 79% (74/94) of AGA preterm infants achieved catch-up growth. Stratified analysis by gestational age showed that there were significant differences in weight and length at corrected ages 0-9 months between the SGA subgroup with gestational age <34 weeks and the AGA subgroups with gestational age <34 weeks and 34 weeks ( P <0.05). In addition, the weight and length of the SGA subgroup with gestational age 34 weeks showed significant differences compared to the AGA subgroups with gestational age <34 weeks and 34 weeks at corrected ages 0-18 months and corrected ages 0-12 months, respectively ( P <0.05). Catch-up growth for SGA infants with gestational age <34 weeks and 34 weeks mainly occurred at corrected ages 0-12 months and corrected ages 0-18 months, respectively., Conclusions: SGA infants exhibit delayed early-life physical growth compared to AGA infants, but can achieve a higher proportion of catch-up growth by corrected age 24 months than AGA infants. Catch-up growth can be achieved earlier in SGA infants with a gestational age of <34 weeks compared to those with 34 weeks.

Aim: To elucidate the association between gut microbiota, short-chain fatty acids (SCFAs), and glucolipid metabolism in women with large for gestational age (LGA) infants., Methods and Results: A single-center, observational prospective cohort study was performed at a tertiary hospital in Wenzhou, China. Normal pregnant women were divided into LGA group and appropriate for gestational age (AGA) group according to the neonatal birth weight. Fecal samples were collected from each subject before delivery for the analysis of gut microbiota composition (GMC) and SCFAs. Blood samples were obtained at 24-28 weeks of gestation age to measure fasting blood glucose and fasting insulin levels, as well as just before delivery to assess serum triglycerides, total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein. The GMC exhibited differences at various taxonomic levels. Within the Firmicutes phylum, genus Lactobacillus, genus Clostridium, species Lactobacillus agil, and species Lactobacillus salivarius were enriched in the LGA group. Microbispora at genus level, Microbispora rosea at species level belonging to the Actinobacteria phylum, Neisseriales at order level, Bartonellaceae at family level, Paracoccus aminovorans, and Methylobacterium at genus level from the Proteobacteria phylum were more abundant in the LGA group. In contrast, within the Bacteroidetes phylum, Prevotella at genus level and Parabacteroides distasonis at species level were enriched in the AGA group. Although there were few differences observed in SCFA levels and most glucolipid metabolism indicators between the two groups, the serum HDL level was significantly lower in the LGA group compared to the AGA group. No significant relevance among GMC, SCFAs, and glucolipid metabolism indicators was found in the LGA group or in the AGA group., Conclusions: Multiple different taxa, especially phylum Firmicutes, genus Prevotella, and genus Clostridium, might play an important role in excessive fetal growth, and LGA might be associated with the lower serum HDL level., (© Crown copyright 2023.)

Objective: The aim of this study was to evaluate the performance of New Ballard Score (NBS) in small-for-gestational age (SGA) neonates.Methodology: Neonates born at 35-40 weeks of gestation were included if accurate obstetric gestation estimate was available and birth weight was <10th percentile for gestation. Gestation-matched appropriate-for-gestational-age neonates were enrolled as controls. Gestation derived from NBS was compared with gestation calculated from last menstrual period.Results: Gestational age estimated by NBS was significantly higher in SGA neonates (mean difference: 0.7 weeks). Neuromuscular component score was similar but physical component score was significantly higher in SGA neonates. Reanalysis after reducing score of 4 to 3 of SGA babies for skin and plantar crease physical parameters showed overestimation of gestational age decreased to 0.4 weeks.Conclusions: The physical parameters of NBS overestimate gestation in SGA neonates. Changing scores of skin and plantar creases in SGA neonates better estimates gestation age. [ABSTRACT FROM AUTHOR]

Purpose: To compare the incidence of type retinopathy of prematurity (ROP) in patients small for gestational age (SGA) and in patients appropriate for gestational age (AGA) in a developing country. Material and Method: We included in this study infants (n=162) with gestational age (GA) ≤34 weeks who were screened for ROP in a neonatal intensive care unit between June 2007 and December 2011 and were followed up until the retina was completely vascularized or ROP was regressed. Type 1 ROP was defined according to the ETROP study. To describe the incidence of type 1 ROP, data were analyzed in two main groups: (A) SGA-group and (B) AGA-group. SGA was defined as birth weight below the 10th percentile for gestational age. GA in weeks, birth weight (BW) in grams (g), ROP at any stage, type 1 ROP, and post menstrual age (PMA) at type 1 ROP were evaluated for the two groups. Retrospective review of records was performed. Results: BW (in mean±SD) was 832.45±131.74 g in group A and 962.97±351.47 g in group B; GA (in mean±SD) was 29.27±2.4 weeks in group A and 27.36±2.8 weeks in group B, with significant difference between the groups (p=0.001 vs. p