Birth Body Weight Research Articles

Intestinal Dysbiosis Featuring Abundance of Ruminococcus gnavus Associates With Allergic Diseases in Infants

Dysbiosis of the intestinal microbiota has been associated with development of allergies in infants. However, it is not clear what microbes might contribute to this process. We investigated what microbe(s) might be involved in analyses of infant twins and mice. We studied fecal specimens prospectively in a twin cohort (n= 30) and age-matched singletons (n= 14) born at National Taiwan University Children's Hospital, Taipei, Taiwan, from April 2011 to March 2013. Clinical parameters (gestational age, birth body weight, mode of delivery and feeding, immunizations, and medical events) were recorded. Fecal samples were collected beginning immediately after birth and for 1 year; the children were followed until 3 years of age and allergic symptoms (repetitive and continuous for at least 6 months) were noted. A skin prick test was used to ascertain atopy. Bacterial communities in fecal samples were profiled by 16S ribosomal RNA-based polymerase chain reaction-temporal temperature gradient gel electrophoresis and next-generation sequencing. BALB/c mice without and with ovalbumin sensitization/challenge were infected with candidate bacteria by oral gauge intragastric intubation. Fecal, serum, lung, and colon tissue samples were collected from mice and analyzed for mechanisms of allergy development. During the investigation period, 20 children (45.5%) developed allergic diseases, including respiratory (allergic rhinitis and asthma) and skin (atopic dermatitis and eczema) allergies. Lachnospiraceae were detected at significantly higher frequency in allergic infants than nonallergic infants (P < .004); the high fecal count of Lachnospiraceae in allergic subjects appeared at 2 months of age and persisted until 12 months of age. The enrichment of Lachnospiraceae in allergic infants was attributed to the overgrowth of Ruminococcus gnavus, whichtended to have a low frequency in nonallergic subjects (P= .0004). Increased R gnavus was observed before the onset of allergic manifestations, and was associated with respiratory allergies (P < .002) or respiratory allergies coexistent with atopic eczema (P<.001). In mice, endogenous R gnavus grew rapidly after sensitization and challenge with ovalbumin. Mice gavaged with purified R gnavus developed airway hyper-responsiveness and had histologic evidence of airway inflammation (asthma). Expansion of R gnavus in mice stimulated secretion of cytokines (interleukin [IL] 25, IL33, and thymic stromal lymphopoietin) by colon tissues, which activated type 2 innate lymphoid cells and dendritic cells to promote differentiation of T-helper 2 cells and production of their cytokines (IL4, IL5, and IL13). This led to infiltration of the colon and lung parenchyma by eosinophils and mast cells. In a study of a twin cohort (some infants with,some without allergies), we associated development of allergies, particularly respiratory allergies, with increased fecal abundance of R gnavus. Mice fed R gnavus developed airway inflammation, characterized by expansion of T-helper 2 cells in the colon and lung, and infiltration of colon and lung parenchyma by eosinophils and mast cells.

Association of maternal serum homocysteine concentration levels in late stage of pregnancy with preterm births: a nested case–control study

Purpose: To investigate the relationship between maternal serum homocysteine (Hcy) levels in the late stage of pregnancy and preterm birth. Other relevant biochemical parameters were measured to establish the normal reference interval of serum Hcy in both women in the late stage of pregnancy and neonates.Materials and methods: The nested case–control study included 300 singleton pregnant women with preterm births between June 2013 and May 2015 and their premature delivered babies as a preterm group. Blood sample within three days before delivery was collected. Simultaneously, 300 healthy pregnant women admitted during the same time, and singleton mature neonates who had gestational week-matched blood sample were age-matched as a control group.Results: Maternal serum levels of Hcy, total triglycerides, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), uric acid (UA), free fatty acids (FAA) and superoxide dismutase (SOD) were all higher in the preterm group than in the control group except high-density lipoprotein cholesterol (HDL-C). Serum levels of Hcy, TC, LDL-C, UA, FAA and SOD were higher in prematurely delivered neonates than in the control group except for HDL-C. The body weight of prematurely delivered neonates was negatively correlated with the maternal serum levels of Hcy and UA before delivery.Conclusions: Higher maternal serum Hcy levels were associated with preterm birth and neonatal body weight. Elevated maternal serum levels of Hcy might serve as a biomarker for preterm birth prediction.

Early life indicators predict mortality, illness, reduced welfare and carcass characteristics in finisher pigs

The objective of this study was to investigate associations between early life indicators, lactation management factors and subsequent mortality, health, welfare and carcass traits of offspring. A total of 1016 pigs from a batch born during one week were used. During lactation, number of liveborn piglets, stillborn and mummies, sow parity, number of times cross-fostered, weaning age, birth and weaning body weight (BW) were collected. Mortality was recorded throughout the offspring production cycle. Prior to slaughter, pigs were scored for lameness (1=non-lame to 3=severely lame). At slaughter, tail lesions were scored (0=no lesion to 4=severe lesion) and cold carcass weight (CCW), lean meat%, presence of pericarditis and heart condemnations were recorded. Additionally, lungs were scored for pleurisy (0=no lesions to 4=severely extended lesions) and enzootic pneumonia (EP) like lesions. There was an increased risk of lameness prior to slaughter for pigs born to first parity sows (P<0.05) compared with pigs born to older sows. Sow parity was a source of variation for cold carcass weight (P<0.05) and lean meat% (P<0.05). Pigs born in litters with more liveborn pigs were at greater risk of death and to be lame prior to slaughter (P<0.05). Pigs that were cross-fostered once were 11.69 times, and those that were cross-fostered ≥2 times were 7.28, times more likely to die compared with pigs that were not cross-fostered (P<0.05). Further, pigs that were cross-fostered once were at greater risk of pericarditis and heart condemnations compared with pigs that were not cross-fostered (P<0.05). Pigs with a birth BW of <0.95kg were at higher mortality risk throughout the production cycle. There was an increased risk of lameness, pleurisy, pericarditis and heart condemnations (P<0.05) for pigs with lower weaning weights. Additionally, heavier pigs at weaning also had higher carcass weights (P<0.05). There was an increased risk of lameness for pigs weaned at a younger age (P<0.05). Males were 2.27 times less likely to receive a score of zero for tail biting compared with female pigs. Results from this study highlight the complex relationship between management, performance and disease in pigs. They confirm that special attention should be given to lighter weight pigs and pigs born to first parity sows and that cross-fostering should be minimised.

The analgesic effect of non-pharmacological interventions to reduce procedural pain in preterm neonates

Painful procedures are unavoidable in the medical care of preterm babies. The unpleasant experience during the neonatal period may contribute to hyperalgesia and poor neurodevelopment outcome later. Seeking effective interventions to reduce pain are strongly indicated for these very small premature babies. The aim of this study is to investigate if instilling breast milk (BM) or dextrose water into oral cavity can reduce the procedural pain of heel stick for preterm babies. This is a prospective study; 20 premature neonates are enrolled. Each study case received heel stick 4 times. BM, 10% dextrose water (D10W), distilled water (placebo) and nothing (control group) were given one after the other in random order to the same patient before heel stick. Premature infant pain profile (PIPP) was used to assess the pain scores. The whole process consisted of 4 sections: a baseline period for 1min, intervention period for 1min, heel stick period for 20s, and recovery period for 5min. The primary outcome is to compare the PIPP scores in the 4 groups. Totally 20 babies completed this study. Median gestational age was 32 weeks 2 days (26 weeks 4 days-35 weeks 6 days) and median birth body weight was 1596g (766-2435g). The median PIPP scores and interquartile range at each time period were listed in the context. There are significant differences between BM/control group at all time periods, between BM/placebo group at 30-60s, 1-2min, and 2-3min, and between D10W/control group at 0-30s, 30-60s, 3-4min, and 4-5min. There are no significant differences between BM/D10W, D10W/placebo, and placebo/control groups at any time periods. Giving something with taste such as BM or D10W is safe and effective in reducing the procedural pain of heel stick in preterm neonates; BM is the priority.

Parenteral nutrition in childhood and consequences for dentition and gingivae.

Assessment of dentition in children under parenteral nutrition, risk factors for caries, and dental developmental abnormalities. The study involved 63 patients (aged 2.25-16.6 years), i.e. 32 subjects receiving parenteral nutrition for a mean period of 5.6&#177;2.94 years, and 31 healthy control subjects. Oral hygiene (OHI-S, PL-I), gingival (GI), and dentition status (caries, DMFT/dmft, enamel defects, shape alterations), frequency of oral meals and frequency of cariogenic snacks consumption were evaluated. Medical records provided information on parenteral meals per week, age parenteral nutrition started, birth body mass, Apgar score, weight deficiency, and antibiotic therapy until aged 1 year. The Mann-Whitney test, chi-squared test, and Spearman rank correlation coefficient were used (p&#8804;0.05). Dental developmental abnormalities occurred more often in PN subjects (71.87% vs. 25.80%). The prevalence of caries in PN (56.25% vs. 90.32%) and dmft (2.00&#177;3.30 vs. 4.21&#177;3.33) and DMFT (2.47&#177;4.08 vs. 3.33&#177;3.50) were lower. Positive caries Spearman's rank correlation coefficients: frequency of oral meals and frequency of cariogenic snacks consumption, and GI. Negative correlation coefficients: low birth body mass, antibiotic therapy, and low body mass in the first year of life. Positive dental developmental abnormality Spearman's coefficients: low birth body mass, Apgar score < 7, parenteral nutrition duration, low body mass and antibiotic therapy in the first year of life. Beta- lactam, aminoglycoside, glycopeptide and nitroimidazole treatments were related to enamel hypoplasia. Parenteral nutrition in childhood is related to the risk of dental developmental abnormalities, promoted by malnutrition and antibiotic therapy in infancy. Limiting the number of meals and cariogenic snacks, and most probably administration of antibiotics, decreases the risk of caries.

Evolving Cesarean Scar Pregnancy into Morbidity Adherent Placenta—Evidence from Serial Ultrasound Examination

ObjectiveTo present the complete history of a case with placenta accreta and demonstrate the special clues of ultrasonography finding during whole trimesters from early pregnancy to delivery. Case ReportA multiparous 28-year-old female with a history of multiple cesarean deliveries was found with suspected precesarean section scar pregnancy at 6 weeks of gestation. We performed a series of ultrasonography scans, which revealed placenta previa totalis and placenta accreta at 15 and 32 weeks of gestation, respectively. A well-planned cesarean section with hysterectomy was performed at the 35th week of gestation with massive blood transfusion support, and an alive female baby—with a birth body weight of 2485 g, and Apgar score of 9 at the 1st minute and 10 at the 5th minute—was born. The intraoperative blood loss was 7000 mL, and no postoperative hemorrhage or other complication occurred. ConclusionUltrasonography remains the main tool for diagnosis of morbid adherent placenta with several typical clues, including abnormal vasculature, increased size and numbers of vascular sinus, absence of uterovesicle border or retroplacental hypoechoic zone, and invaded placenta insertion on myometrium. Proper planning prior to the operation and detailed counseling may be necessary, as well as hysterectomy; massive bleeding with transfusion remained the most seen complication.

Study of perinatal factors in children with developmental delay

Background: Birth history gives important information in children with developmental delay. Developmental challenge in children is an emerging problem across the globe, which is largely associated with improved neonatal survival. The present study highlights the importance of birth history in children with developmental delay in our hospital. The objective of this study was to study the perinatal events in children with developmental delay.Methods: Observational descriptive study was conducted on children between 6 months to 5 years who were admitted in Pediatric wards with suspected history of developmental delay. DDST II scale was performed on these children and children who failed on Denver II scale were recruited into the study. Birth history was noted in detail, if available, documentation of birth events was asked for and noted. Developmental history with developmental quotient (DQ), were noted in detail.Results: 135 children had developmental delay, 113 (83.70%) were born by vaginal delivery and 22 (16.30%) were born by caesarian section, 46 (34.18%) had no cry at birth and remaining 89 (65.92%) had normal cry at birth. 104 (77.04%) were born by term gestation and 31 (22.96%) were born preterm. Birth weight was normal in 78 (57.7%) children, LBW was seen 47 (34.81%) and 5 children each with VLBW and ELBW and 35 (25.93%) were IUGR. On comparing the children born gestational age and birth body weight with all four domains, there was no significant difference.Conclusions: Global developmental delay was more common in children born at preterm, low birth weight, IUGR and children who had birth asphyxia. Birth weight and gestational age did not significantly affect any particular domain of development.

Behaviors and body weight of suckling piglets in different social environments.

ObjectiveThis study was conducted to characterize the behaviors and the body weight of suckling piglets in different social environments.MethodsTwo groups of sows and suckling piglets housed either in individual farrowing crates in separate pens (1.8×2.4 m, the control group) or in groups of three sows with their piglets in farrowing crates in a large common enclosure (5.4×2.2 m, the treatment group) were observed with the aid of video technology for 9 consecutive hours on days 1, 2, and 3, after mixing.ResultsSuckling, agonistic, and elimination behaviors of suckling piglets were significantly higher in the control group than in the treatment group. Inactive behavior was higher in the treatment group than in the control group. Most of the effects of the social environment on the suckling piglets seem to be the result of large reductions in behaviors and body weight for piglets switching from high activity to low activity. Moreover, suckling behavior and birth body weight were highly correlated with body weight at the end of the test.ConclusionThe social environment that resulted from mixing, thus, had significant effects on the behavior and body weight of suckling piglets, and behavioral characteristics, therefore, should be considered when making improvements to the husbandry and care methods used in swine production.

Effects of intrauterine retention and postmortem interval on body weight following intrauterine death: implications for assessment of fetal growth restriction at autopsy.

According to the classification system used, 15-60% of stillbirths remain unexplained, despite undergoing recommended autopsy examination, with variable attribution of fetal growth restriction (FGR) as a cause of death. Distinguishing small-for-gestational age (SGA) from pathological FGR is a challenge at postmortem examination. This study uses data from a large, well-characterized series of intrauterine death autopsies to investigate the effects of secondary changes such as fetal maceration, intrauterine retention and postmortem interval on body weight. Autopsy findings from intrauterine death investigations (2005-2013 inclusive, from Great Ormond Street Hospital and St George's Hospital, London) were collated into a research database. Growth charts published by the World Health Organization were used to determine normal expected weight centiles for fetuses born ≥ 24 weeks' gestation, and the effects of intrauterine retention (maceration) and postmortem interval were calculated. There were 1064 intrauterine deaths, including 533 stillbirths ≥ 24 weeks' gestation with a recorded birth weight. Of these, 192 (36%) had an unadjusted birth weight below the 10th centile and were defined as SGA. The majority (86%) of stillborn SGA fetuses demonstrated some degree of maceration, indicating a significant period of intrauterine retention after death. A significantly greater proportion of macerated fetuses were present in the SGA population compared with the non-SGA population (P = 0.01). There was a significant relationship between increasing intrauterine retention interval and both more severe maceration and reduction in birth weight (P < 0.0001 for both), with an average artifactual reduction in birth weight of around -0.8 SD of expected weight. There was an average 12% reduction in fetal weight between delivery and autopsy and, as postmortem interval increased, fetal weight loss increased (P = 0.0001). Based on birth weight alone, 36% of stillbirths are classified as SGA. However, fetuses lose weight in utero with increasing intrauterine retention and continue to lose weight between delivery and autopsy, resulting in erroneous overestimation of FGR. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Inulin Supplementation Lowered the Metabolic Defects of Prolonged Exposure to Chlorpyrifos from Gestation to Young Adult Stage in Offspring Rats.

Increasing evidence indicates that chlorpyrifos (CPF), an organophosphorus insecticide, is involved in metabolic disorders. We assess the hypothesis whether supplementation with prebiotics from gestation to adulthood, through a modulation of microbiota composition and fermentative activity, alleviates CPF induced metabolic disorders of 60 days old offspring. 5 groups of Wistar rats, from gestation until weaning, received two doses of CPF pesticide: 1 mg/kg/day (CPF1) or 3.5 mg/kg/day (CPF3.5) with free access to inulin (10g/L in drinking water). Then male pups received the same treatment as dams. Metabolic profile, leptin sensitivity, insulin receptor (IR) expression in liver, gut microbiota composition and short chain fatty acid composition (SCFAs) in the colon, were analyzed at postnatal day 60 in the offspring (PND 60). CPF3.5 increased offspring’s birth body weight (BW) but decreased BW at PND60. Inulin supplementation restored the BW at PND 60 to control levels. Hyperinsulinemia and decrease in insulin receptor β in liver were seen in CPF1 exposed rats. In contrast, hyperglycemia and decrease in insulin level were found in CPF3.5 rats. Inulin restored the levels of some metabolic parameters in CPF groups to ranges comparable with the controls. The total bacterial population, short chain fatty acid (SCFA) production and butyrate levels were enhanced in CPF groups receiving inulin. Our data indicate that developmental exposure to CPF interferes with metabolism with dose related effects evident at adulthood. By modulating microbiota population and fermentative activity, inulin corrected adult metabolic disorders of rats exposed to CPF during development. Prebiotics supply may be thus considered as a novel nutritional strategy to counteract insulin resistance and diabetes induced by a continuous pesticide exposure.

Effect of parental physiological conditions and assisted reproductive technologies on the pregnancy and birth outcomes in infertile patients

Assisted reproductive technologies (ART) are widely used to treat infertility. Emerging evidence suggested that ART was associated with perinatal or neonatal problems, however, little is known about the ART related risk factors. Here using 21136 ART cases, we determined the impacts of parental physiological conditions in the ART mediated pregnancy outcomes. In addition, we further evaluated the effects of three different ART methods (frozen-thawed embryo transfer [FET], in vitro fertilization [IVF] and intracytoplasmic sperm injection [ICSI]) in the pregnancy and birth outcomes in ART mediated pregnancy. Our data revealed that older parental age increases the risks of abortion, preterm birth and low body weight birth. Higher maternal BMI (Body mass index) level correlates with higher abortion rate. Moreover, pregnancy with multiple fetuses has severer adverse outcomes compared to singleton pregnancy. Among the three ART methods, ICSI is associated with lower ratios of ectopic pregnancy, abortion and deformity compared to FET and IVF. Our study revealed new clinical insights into the ART related risk factors and suggested that both the parental physiological conditions and ART methods should be evaluated to develop better ART mediated infertility treatments.

Effects of dam parity and pre-weaning average daily gain of Holstein calves on future milk production.

This research communication describes relationships between pre-weaning average daily gain (ADG) and dam parity with future productivity of dairy calves. Higher ADG before weaning has been shown to be related to greater milk production in the first lactation of Holstein calves fed milk replacer. However, data is limited on the relationship between pre-weaning ADG and first lactation performance of Holstein calves fed whole milk. Data of three hundred and thirty-two Holstein calves from 35 primiparous and 297 multiparous cows was investigated to evaluate the relationship between the dam parity and pre-weaning ADG with the first lactation performance. Results indicated that birth (P < 0·01), and weaning body weight (P < 0·001) were greater in calves born from multiparous cows. Neither 305 d milk production nor pre-weaning ADG differed significantly between calves born to primiparous or multiparous cows, although milk yield tended to be higher in the former and ADG higher in the latter. Correlations between 305 d milk yield and pre-weaning ADG, dam parity and birth body weight were low and non-significant, although there was a tendency for a positive correlation between ADG and milk yield.

Toll-like 4 receptor /NFκB inflammatory/miR-146a pathway contributes to the ART-correlated preterm birth outcome.

Assisted reproductive technology (ART) is widely used for the women with infertility conditions to achieve pregnancy. However, the adverse effects of ART may lead to poor perinatal and neonatal outcomes, e.g., preterm birth and low body weight. In this study, we investigated the inflammatory molecular factors and microRNA that might be involved in ART related preterm birth. We found the elevation of Toll-like 4 receptor (TLR4), activation of NFκB pathway and down-regulation of microRNA-146a (miR-146a), a negative regulator of NFκB, in the placenta of preterm birth and ART, indicating preterm birth and ART were associated with inflammation signaling activation. In vitro experiments demonstrated that miR-146a suppressed NFκB pathway and shifted the balance of cytokines in the cord blood toward a repertoire of pro-inflammatory outcomes by down-regulating IRAK1 and TRAF6. The pro-inflammatory cytokines IL-6, IFNγ and TNFα in the cord blood were highly expressed in the preterm and ART, while anti-inflammatory cytokine IL-10 was the lower in the preterm and ART. In summary, we firstly uncovered that TLR4/NFκB mediated inflammation signaling and miR-146a participated in ART-related preterm birth patients, which suggests that importance of TLR4/NFκB/miR-146a signaling in clinical interventions and biomarkers of ART-related perinatal or neonatal outcomes.

Productive and reproductive performance and metabolic profiles of ewes supplemented with hydroponically grown green wheat (Triticum aestivum L.)

Twenty six Katahdin ewes (i.e., female lambs from breeding to 2 mo of their 1st lactation) were used in a completely randomized design (13/treatment) to evaluate effects of replacement of dietary dry-rolled corn grain (DRC) and cottonseed meal (CSM) with hydroponically grown whole plant green wheat (HGW; Triticum aestivum L.) on productive parameters and blood metabolites during mating, gestation and lactation, and on body weight (BW) gain of their lambs in their 1st 60days of age. The gestation diet contained 70% oat hay, 20% rolled corn grain and 10% cottonseed meal, while the lactation diet contained 50% oat hay, 20% DRC and 30% CSM. Treatments consisted of total replacement of DRC and CSM with HGW in the gestation diet, while in the lactation diet HGW replaced 100% of the DRC and 33% of the CSM. There were no diet effects on reproductive parameters, and substitution of DRC and CSM with HGW did not affect dry matter intake during gestation and lactation. The BW gain of the lambs that were fed HGW did not differ from controls in the first 2 months of gestation, while it was lower (P<0.05) at the last 3 months of gestation. Feeding HGW did not affect birth BW of lambs or subsequent BW gains through 60days of age. Plasma non-esterified fatty acids (NEFA) were not affected by the diets fed during gestation, but were 56% lower (P<0.05) at day 60 of lactation. Plasma glucose was only lower (P<0.05) at day 90 of gestation, and blood urea nitrogen was only lower (P<0.05) at day 30 of lactation. There were no effects of diets on plasma insulin, cortisol or progesterone during gestation and lactation. Hydroponically grown green wheat is a suitable substitute for a portion of the DRC and CSM in ewes diets during gestation and lactation without negative effects.

Impacts of cow body condition score during gestation on weaning performance of the offspring

This experiment evaluated the impacts of cow body condition score (BCS) during gestation on productive parameters of the offspring. Three hundred multiparous, lactating, non-pregnant Angus × Hereford cows were assigned to a fixed-time artificial insemination (AI) protocol using semen from a single sire (d 0). Forty days after AI, cows were evaluated for pregnancy status via transrectal ultrasonography and BCS, and 100 pregnant cows (543±6kg of BW, 6.6±0.3yr of age, 4.83±0.06 of BCS, and 115±2 d postpartum) were selected for the experiment. Within these 100 cows, 20 cows had BCS ≥5.50 but ≤6.50 and were classified as adequate BCS (5.85±0.06; HBCS). The remaining cows had BCS ≤4.75 (4.52±0.03), and were divided into 4 groups (20 cows/group): LBCS (4.60±0.07), BCSG1 (4.43±0.07), BCSG2 (4.63±0.07), and BCSG3 (4.63±0.07). The HBCS and LBCS cows were managed to maintain their initial BCS throughout gestation. The BCSG1, BCSG2, and BCSG3 cows were managed to gain 1.50 BCS during the first, second, and third trimester of gestation, respectively, and maintain the resultant BCS until calving. Cow BCS was assessed again on d 102, 182, and 265. During the calving season (d 272-291), calf body weight (BW) was recorded within 3h after birth. Only cows that met the BCS maintenance (within 0.50 of BCS change) and change (≥1.25 and ≤1.75 of BCS increase within the trimester) criteria were maintained in the experiment (HBCS, n =14; LBCS, n =14; BCSG1, n =14; BCSG2, n =15, BCSG3, n =15). On d 344, cow milk production was estimated by the weigh-suckle-weigh method, and calves were weaned on d 475. No differences were detected (P≥0.42) for calving rate, calf birth BW, and cow milk production. Weaning rate and calf age at weaning were also similar among BCS groups (P≥0.15). However, calf weaning BW was greater (P≤0.05) for BCSG2 and BCSG3 cows (265 and 262kg, respectively; SEM =4) compared with HBCS and LBCS cows (248 and 249kg, respectively; SEM =4), and similar (P≥0.20) among all other comparisons. These results suggest that offspring weaning BW is directly influenced by BCS gain of beef cows during the second and third trimesters of gestation.

Relationships between leptin, the KiSS-1/GPR54 system and thyrotropic axis activity in ewe lambs predisposed to the delayed puberty

In the present study we compared body weight gains, some factors involved in the initiation of sexual maturation (pituitary expression of KiSS-1 and G protein-coupled receptors (GPR54), plasma concentrations of kisspeptin-10 (KiSS-10), leptin, thyroid-stimulating hormone (TSH), free thyroxin (fT4)) and the time of the first ovulation in ewe lambs predisposed to delayed puberty and control animals. The experiment was carried out on 114 ewes and 64 female lambs divided according to their birth type and body weight of their mothers. All ewe lambs were weighed at birth and every two weeks thereafter, until eight months of postnatal age. From four to eight months of postnatal age at monthly intervals, blood samples were collected from the jugular vein of all ewe lambs. Then, daily weight gains were recorded and plasma KiSS-10, leptin, TSH and fT4 concentrations were analysed by ELISA using species-specific antibodies. Starting from six months of age, the pituitary expression of KiSS-1/GPR54 mRNA was determined by Real Time-PCR. The activity of the ovaries was estimated using laparoscopy. The results obtained showed that the time of the onset of puberty in the ewe lambs depended on the mother’s body mass, the plasma leptin level, and the birth type (singleton/twin). It was observed that the elevation of leptin concentration up to 3.35±0.26–3.60±0.19ng/mL was associated with the initiation of puberty. Conversely, the hyperphysiological leptin levels found in ewe lambs, which were twin offspring of fatty sheep, were correlated with puberty delayed until the age of ten months. Moreover, it was found that a significant increase in pituitary KiSS-1 mRNA expression (1.40±0.12–1.63±0.22) (relative KiSS-1 mRNA expression level, ratio of KiSS-1 mRNA/GAPDH mRNA) and plasma KiSS-10 concentration (31.26±1.54ng/mL–32.24±2.25ng/mL) was connected with the occurrence of the first ovulation. On the other hand, GPR54 mRNA expression in the pituitary decreased around the time of the first ovulation. Also, the increase in thyroid gland activity was dependent on the mother’s body mass as well as birth type and occurred around the time of the first ovulation.

Childhood body mass index in adolescent-onset anorexia nervosa.

Although weight history is relevant in predicting eating disorder symptom severity, little is known about its role in the etiology of anorexia nervosa (AN). This study aimed to determine whether BMI or BMI trajectory differed between individuals who later developed adolescent-onset AN and a comparison group of HCs between school grades 1 through 6. This study was based on longitudinal data that identified 51 adolescents with AN and 51 matched HCs. Cases were identified through community screening in Sweden and included individuals born in 1969 through 1977. Measured weights and heights were retrieved and BMIs and weight trajectories of the AN and HC groups were compared using growth curve analysis. Main outcome measures included measured BMI and BMI trajectories from grades 1-6. Secondary outcomes examined included ponderal index at birth and maternal body weight. Individuals who later developed AN had higher BMIs than HCs between grades 1 and 6, by an average of 1.42 BMI-units. There was no difference in rate of weight gain between groups. Ponderal index at birth was higher for the AN as compared with HC group. Maternal weight did not differ significantly between groups. These findings, combined with those previously reported on the premorbid BMIs of those with bulimia nervosa, suggest that a predisposition toward elevated premorbid BMIs during childhood characterizes those who later develop anorexia or bulimia nervosa. These findings are consistent with a transdiagnostic perspective and suggest shared risk factors for AN and obesity. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1002-1009).

Comparison of structural outcome between intravitreal bevacizumab and laser treatment for type 1 retinopathy of prematurity after long-term follow-up

Background: To compare the structural outcome of intravitreal bevacizumab (IVB) and laser treatment for type 1 retinopathy of prematurity (ROP). Methods: This is a retrospective comparative study. From December 2002 to April 2009, patients with type 1 ROP according to criteria of Early Treatment of Retinopathy of Prematurity (ETROP) study were treated by peripheral retinal diode laser photocoagulation in nearly confluent pattern. From May 2009 to January 2015, we performed IVB for patients with type 1 ROP. The patients were closely followed until disappearance of retinal neovascularization in the laser group and regression of avascular zone in the bevacizumab group. The demographical data, postmenstrual age (PMA) for treatment, and fundus findings were recorded by chart review. The difference between laser and bevacizumab groups was compared by Student t-test and Fisher exact test. Results: We collected 43 patients (86 eyes) with type 1 ROP, including 30 male and 13 female infants. Their mean gestation age and birth body weight (BBW) were 27.5 weeks and 1,034 gm. Zone I and zone II disease were found in 8 and 35 patients. The mean PMA for treatment was 37.3 weeks. The mean follow-up period was 54.4 months. Laser treatment was administered in 26 patients, and bevacizumab injection for 17 infants. Single session of laser was performed in all patients of laser group without recurrence of retinal neovascularization. Complete regression of ROP was found in 15 infants of bevacizumab group following the first IVB. Four eyes in two patients (2/17, 11.7%) had recurrence of ROP and received additional injections and adjuvant laser treatment. There was no unfavorable anatomical results such as retinal detachment or macular ectopia or complications such as cataract or endophthalmitis in either bevacizumab or laser management. Conclusions: Laser therapy and IVB were both effective treatments for type 1 ROP to cause favorable anatomical outcomes. Single session of laser ablation in nearly confluent pattern was sufficient for complete regression of ROP in laser group. Single IVB was appropriate for managing most of cases with ROP in bevacizumab group, but a small proportion (nearly one tenth) of them had recurrent episodes requiring adjuvant therapies.

Breastfeeding and infant growth outcomes in the context of intensive peer counselling support in two communities in Bangladesh.

BackgroundExclusive breastfeeding and growth faltering during infancy remain challenges in Bangladesh. The Training & Assistance for Health & Nutrition Foundation has been working to address this gap through community-based peer counsellors since 2000. In this paper, we assessed the programme’s progress, particularly with respect to early initiation of breastfeeding and exclusive breastfeeding for normal birth weight, as well as for low birth weight (LBW) infants.MethodsThe peer counselling programme is continuing in rural and urban areas of Bangladesh, but only data collected between January 2013 and June 2015 is presented in this descriptive study. Intensive breastfeeding counselling was provided to women during the third trimester of pregnancy and 6 months postpartum by well-trained peer counsellors. They recorded data on infants’ birth weight, feeding practices and body weight every month and submitted these for computer entry. Weight measurements were converted to weight-for-age Z-scores (WAZ) and growth patterns assessed by comparing attained body weights with the World Health Organization (WHO) 2006 Child Growth Standards.ResultsA total of 994 infants were born during the study period; 94 % were normal birth weight and 6 % were LBW (<2.5 kg). Initiation of breastfeeding within one hour of birth was reported by 94 % of counselled mothers in both groups. The prevalence of exclusive breastfeeding at 6 months was 94 % in the normal birth weight infants and 92 % in the LBW infants, and their mean body weights were 7.5 ± 0.8 kg and 6.6 ± 0.7 kg respectively. There was no growth faltering in these infants during 6 months. Underweight rates in normal birth weight infants remained similar (2.2 % at 1 month and 2.5 % at 6 months), whereas underweight rates in LBW infants decreased from 42.1 % at 1 month to 21.1 % at 6 months.ConclusionsIn the context of a well-structured programme setting, and under the described circumstances, it seems likely that the well-trained and supervised community-based peer counsellors could assist in encouraging and helping mothers of both normal birth weight and LBW infants to initiate breastfeeding within one hour and to continue exclusive breastfeeding until 6 months of age. Our data suggest that they may also have contributed towards prevention of growth faltering in these infants.

Risk Factors for Extubation Failure in Extremely Low Birth Weight Infants

Although antenatal steroids and early use nasal continuous positive airway pressure (NCPAP) have significantly improved outcomes of neonatal respiratory distress syndrome, intubation with ventilator support is still commonly required in extremely low birth weight (ELBW) infants. The optimal timing of extubation in ELBW infants remains unclear. We retrospectively analyzed all ELBW preterm infants who were admitted to our neonatal intensive care unit (NICU) from January 2009 to December 2013. Demographic, ventilation, and arterial blood gas analysis results prior to and 2hours after extubation were collected. Extubation failure was defined as reintubation due to deterioration of respiratory condition within 7days after extubation. Risk factors for extubation failure were analyzed. In total, 173 ELBW infants were born and admitted to our NICU during these 5years. Among these 173 infants, 77 (44.5%) used NCPAP only during their hospitalization (20 diagnosed with chronic lung disease (CLD), 25.9%). Among the 95 patients that required intubation, 27 patients expired so extubation was not attempted. Sixteen of 68 (23.5%) survival cases required reintubation within 7days after extubation. We found that gestational age, birth body weight, and sex ratio did not differ between the successful extubation group and the failed extubation group. Univariate analysis showed that the failed extubation group had a lower arterial pH right before and 2hours after extubation, with a lower bicarbonate level after extubation. Further multivariate logistic regression analysis revealed an association between poor acid-base homeostasis 2hours after extubation (pH<7.3 and HCO3<18mM/L) and extubation failure (odds ratio 4.56 and 6.187 and 95% confidence interval: 1.263∼16.462 and 1.68∼22.791, respectively). This study shows that nearly half of ELBW infants do not require intubation. Among ELBW infants who require invasive ventilator support, those who have lower postextubation arterial pH and bicarbonate levels are at high risk of extubation failure.