Birth Weight Categories Research Articles

Surviving prematurity: retrospective longitudinal study of multisystem consequences in preterm-born individuals from infancy to adolescence

BackgroundPrematurity is linked to diverse and significant health outcomes, but a comprehensive understanding of its long-term multisystem impacts remains limited.MethodsRetrospective longitudinal cohort study on 417 preterm children born between 2000 and 2015 explores the incidence, dynamics, and interrelationships of health conditions from infancy to adolescence. Data on 1818 diagnoses, categorised by birth weight (BW) and gestational age (GA) and documented according to ICD-10, were analysed using non-parametric tests and negative binomial regression models.ResultsMost diagnoses occurred by age 7, with eye diseases, congenital malformations, and infections most prevalent, but the greatest disparities with the general population were in blood, nervous system, mental, and neoplastic diseases. Lower BW significantly correlated with higher mean disease counts and greater diversity of health conditions across various ICD-10 chapters, while GA showed less pronounced associations. Children in "Extremely and very low," "Low," and "Sub-optimal" BW categories exhibited 1.77, 1.50, and 1.34 times more diseases, respectively, than those in the "Normal" BW category. Unique and highly individual patterns of disease co-occurrence were observed, increasing in complexity as BW decreased.ConclusionsThe highest disease burden for preterm-born individuals occurred by age 7, with lower BW linked to greater health complexity and unique comorbidities.

Description of Nutritional Knowledge of Mothers Who Give Birth to Low Birth Weight Babies and Non-Low Birth Weight Babies at Tidar Hospital, Magelang

Background: The impact of babies with the Low Birth Weight (LBW) category in the long term can have a risk of experiencing respiratory disorders, infections, and even death. The incidence of LBW can be influenced by gestational age of less than 37 weeks, maternal age of less than 20 years or more than 35 years, pregnancy spacing, maternal occupation, and maternal nutritional knowledge. Purpose: Describe the nutritional knowledge of mothers who give birth to LBW and non-LBW babies at Tidar Hospital Magelang Methods: This type of research is descriptive with a Cross Sectional research design. The study population was mothers who gave birth in April 2022 at Tidar Hospital, Magelang. The sampling method was carried out using the total sampling technique with a total of 20 respondents. Primary data collection techniques include filling out questionnaires and interviewing respondents directly. Results: The number of mothers who are included in the category of having LBW babies is 3 people (15%) and mothers with the category of Non-LBW Babies are 17 people (85%). The nutritional knowledge of mothers with the category of LBW babies has a good, sufficient, and less score which is evenly distributed, namely 1 respondent each. While those who are Non-LBW have a good score of 13 respondents, a sufficient score of 1 respondent, and a less score of 3 respondents. Conclusion: Mothers who give birth to babies in the non-LBW category have better nutritional knowledge than mothers who give birth to babies in the LBW category.

Circadian clock activity in human umbilical vein endothelial cells of preterm and term neonates.

During mammalian gestation, fetal circadian rhythms are thought to be mainly controlled by maternal signals. In humans, the initiation and activity of central and peripheral circadian clocks is largely unknown. This study aimed to elucidate the developmental clock properties in human umbilical vein endothelial cells (HUVECs). HUVECs were obtained from (a) preterm infants, subgrouped according to birth weight or gestational age classification, and (b) term infants (in total: n = 60). In vitro clock activity was determined by using live bioluminescence recording of a luciferase reporter gene under circadian control over 120 h. In addition, core clock and clock-associated gene expression were quantified using NanoString technology. Peripheral clock activity was detected, regardless of prematurity and birth weight classification. The mean period, amplitude, and phase of circadian oscillations were not significantly associated with gestational age or birth weight classification. Peripheral clock activity can be demonstrated in HUVECs from both preterm and term infants without significant developmental differences in the period, amplitude, and phase of oscillations. This model may be useful to identify perturbation factors of proper development and entrainment of neonatal circadian clock activity. We established a model system for analyzing the peripheral clock in preterm and term HUVECs. In HUVECs, the peripheral clock exhibits functional in vitro activity independent of gestational age or birth weight categories. In this model system, neither significant developmental differences exist in the period, amplitude, and phase, nor in the expression of circadian core clock and clock-associated genes. Entrainment and proper function of the circadian clock deserve attention in neonatal intensive care.

Space scan statistics to identify clusters of neonatal mortality associated with bacterial sepsis.

Our study aim was to identify high-risk areas of neonatal mortality associated with bacterial sepsis in the state of São Paulo, Southeast Brazil. We used a population-based study applying retrospective spatial scan statistics with data extracted from birth certificates linked to death certificates. All live births from mothers residing in São Paulo State from 2004 to 2020 were included. Spatial analysis using the Poisson model was adopted to scan high-rate clusters of neonatal mortality associated with bacterial sepsis (WHO-ICD10 A32.7, A40, A41, P36, P37.2 in any line of the death certificate). We found a prevalence of neonatal death associated with bacterial sepsis of 2.3/1000 live births. Clusters of high neonatal mortality associated with bacterial sepsis were identified mainly in the southeast region of the state, with four of them appearing as cluster areas for all birth weight categories (<1500g, 1500 to <2500g and≥2500g). The spatial analysis according to the birth weight showed some overlapping in the detected clusters, suggesting shared risk factors that need to be explored. Our study highlights the ongoing challenge of neonatal sepsis in the most developed state of a middle-income country and the importance of employing statistical techniques, including spatial methods, for enhancing surveillance and intervention strategies.

Differences in BMI trajectory for infants in different birth weight classes

Deviations from normal postnatal growth patterns in infancy and early childhood are indicators to predict future negative health outcomes and to direct early interventions, such as changes in feeding regimens. The objective of our study was to examine potential differences in BMI trajectory during the first year of life between infants of different birth weight categories. A pooled, fully anonymized dataset was constructed based on individual subject data of 4,777 participants from 12 clinical studies in which infant growth outcome measurements were collected at several timepoints during their first year of life. A BMI model was constructed using a joint bivariate growth model for weight and height (and their deterministic relationship). A Bayesian approach was used to explore birthweight category-specific differences in BMI development. Our main finding is that the BMI trajectories of the birthweight categories (particularly the small vs large groups) continue to show differences over time, although these differences become less apparent after the first months of age. Both weight and length continue to show consistent differences between categories across the first year of life. A more detailed analysis including the effect of region and gender, showed differential BMI patterns among the three birthweight categories over time across the different subgroups (combinations of region and gender).

HUBUNGAN PEMBERIAN JENIS ASUPAN NUTRISI DAN PEMILIHAN TERAPI DENGAN LAMA PERAWATAN PADA BBLR DENGAN IKTERUS NEONATORUM DI RSUD KANJURUHAN MALANG

Infants born weighing less than 2500 grams can be classified into the Low Birth Weight (LBW) category. This classification is not based on gestational age, which makes LBW infants particularly vulnerable because their bodies are not fully prepared to face the extrauterine environment. There are several impacts associated with LBW, one of which is the incidence of neonatal jaundice. This condition occurs especially in LBW infants, leading to longer hospital stays. During the treatment period, the reduction in serum bilirubin levels must be supported by adequate nutritional intake and appropriate therapy. Nutritional intake may include exclusive breastfeeding, predominant breastfeeding, or a combination of both, while therapies include phototherapy, exchange transfusion, and pharmacological treatments. Providing nutrition as early as possible can help reduce bilirubin levels more quickly. Therefore, the purpose of this study was to determine the relationship between types of nutritional intake, therapy selection, and the length of stay in LBW infants with neonatal jaundice at Kanjuruhan Kepanjen Hospital, Malang Regency. The study used an observational analytic design with a cross-sectional approach and included 56 samples selected through purposive sampling. Data were collected using a form based on secondary data and analyzed using the Eta Test, with a correlation value of η = 0.438. The results indicate a moderate relationship between the type of nutritional intake and the length of stay in LBW infants with neonatal jaundice. This study also reported a significant difference in the average length of stay based on the type of nutritional intake, with an ANOVA test yielding a p-value of 0.004. This suggests a significant difference in the length of stay based on nutritional intake. These findings should be of particular concern to healthcare workers when providing nutritional care for LBW infants with neonatal jaundice. Keywords: LBW, neonatal jaundice, infant nutrition, therapy selection, hospitalization.

Maternal Nutritional Factors Enhance Birthweight Prediction: A Super Learner Ensemble Approach

Birthweight (BW) is a widely used indicator of neonatal health, with low birthweight (LBW) being linked to higher risks of morbidity and mortality. Timely and precise prediction of LBW is crucial for ensuring newborn health and well-being. Despite recent machine learning advancements in BW classification based on physiological traits in the mother and ultrasound outcomes, maternal status in essential micronutrients for fetal development is yet to be fully exploited for BW prediction. This study aims to evaluate the impact of maternal nutritional factors, specifically mid-pregnancy plasma concentrations of vitamin B12, folate, and anemia on BW prediction. This study analyzed data from 729 pregnant women in Tarragona, Spain, for early BW prediction and analyzed each factor’s impact and contribution using a partial dependency plot and feature importance. Using a super learner ensemble method with tenfold cross-validation, the model achieved a prediction accuracy of 96.19% and an AUC-ROC of 0.96, outperforming single-model approaches. Vitamin B12 and folate status were identified as significant predictors, underscoring their importance in reducing LBW risk. The findings highlight the critical role of maternal nutritional factors in BW prediction and suggest that monitoring vitamin B12 and folate levels during pregnancy could enhance prenatal care and mitigate neonatal complications associated with LBW.

Comparative analysis of INTERGROWTH-21st and Fenton growth charts for birthweight classification in a multiethnic Asian cohort: a cross-sectional study.

The objective of this study is to evaluate the impact of using International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) (IG-21) growth standards compared with Fenton growth charts on birthweight classification in a multiethnic newborn cohort in Singapore. Cross-sectional study. KK Women's and Children's Hospital, Singapore. Study population included 2541 babies born between 16 December 2019 and 16 March 2020. None. Birthweight classifications of small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA) were assessed using IG-21 and Fenton growth charts. The level of agreement between the two charts was measured using Cohen's kappa coefficient (K). Of 2541 neonates, 171 (6.7%) had discordant birthweight classifications. The kappa coefficient indicated moderate overall agreement (K=0.79) between the charts, with decreasing agreement from preterm (K=0.88) to full-term categories (K=0.71). The largest discordance was observed in 98 (60.5%) neonates classified as LGA by IG-21 but AGA by Fenton. In comparison, 60 (2.9%) neonates classified as AGA by IG-21 were SGA by Fenton, while 13 (4.6%) were SGA by IG-21 but AGA by Fenton. The study found discrepancies in birthweight classification between IG-21 and Fenton growth charts, with Fenton charts overclassifying SGA and underclassifying LGA in our study population. These findings suggest the potential need to integrate IG-21 growth standards into local practice to improve accuracy in neonatal growth assessment. Further research is necessary to evaluate the clinical implications of these discordant classifications on neonatal outcomes.

Gender, gestation, and birthweight-based differences in the timing of passage of first urine and meconium in neonates: A prospective observational study.

The cut-off for referral to a higher center and further investigations for the delayed passage of first urine and meconium by a neonate have been traditionally kept after 48 hours of birth. There are very few studies regarding this in Indian neonates, and previous studies have relied primarily on the mother's recall of the event which may have led to recall bias. Therefore, through this study, we wanted to use hospital intake/output records to identify the risk factors that affect the timing of passage of first urine and stool in neonates delivered at our center and to find out if the cut-off of 48 hours to call it a delay is justifiable. This was a single-center, prospective observational study conducted in Eastern India. After obtaining ethics committee approval, the eligible neonates delivered at the center were prospectively enrolled between June 2020 to December 2022. The timing of passage of first urine and meconium was noted using 3 hourly collected information from the input/output charts maintained by the nursing staff in the postnatal wards. The median time of passage of first urine and meconium was compared across gender, gestation, and birth weight. To find the factors associated independently with delayed passage of meconium, multivariable logistic regression was used. A total of 330 neonates were enrolled prospectively in the study. Approximately two-thirds of them passed first urine (69.7%) and meconium (62.7%) within 6 hours after delivery. The median and interquartile range (IQR) of the time of passage of the first urine was 4 (1-7) hours of life. This did not vary significantly for gender, gestation, and birthweight categories. The median (IQR) of time of passage of meconium was 4 (1-8) hours of life, which was significantly higher for male [5 (2-8.5), (P = 0.029)] and preterm neonates [6.3 (2.5-12), (P = 0.001)], but did not vary significantly for birthweight categories. On multivariable logistic regression, twin gestation [OR 4.15 (95% CI 1.09-15.76); P = 0.036] and preterm birth [OR 2.97 (95% CI 1.18-7.43); P = 0.02] increased the odds of passage of meconium beyond 12 hours' postnatal age. 99.39% and 98.77% of the neonates passed urine and meconium respectively within 24 hours. The median time of passage of first urine was not influenced by gender, gestation at birth, and birthweight categories. The median time of passage of meconium was significantly higher for male and preterm neonates. Also, with early initiation of direct breastfeeding and good feeding support most neonates pass their first urine and stool by 24 hours of life. So, maybe it's time to revise the cut-off for referrals or investigations from 48 hours to 24 hours of life. However, further studies with larger sample sizes will be required to confirm this cut-off.

Blood pressure and cardiovascular risk in relation to birth weight and urinary sodium: an individual-participant meta-analysis of European family-based population studies

Abstract Background While the relation of salt intake with blood pressure (BP) is linear, it is U-shaped for mortality and cardiovascular disease (CVD). Purpose This individual-participant meta-analysis explored whether the relation of hypertension, death or CVD with 24 h urinary sodium excretion (UVNA) or sodium-to-potassium (UNAK) ratio was modified by birth weight. Methods Families were randomly enrolled in the Flemish Study on Genes, Environment and Health Outcomes (1985-2004) and the European Project on Genes in Hypertension (1999-2001). Categories of birth weight, UVNA and UNAK (≤2500, &amp;gt;2500-4000, &amp;gt;4000 g; &amp;lt;2.3, 2.3-4.6 and &amp;gt;4.6 g; and &amp;lt;1, 1-2 , &amp;gt;2, respectively) were coded using deviation-from-mean coding and analyzed by Kaplan-Meier survival functions and linear and Cox regression. Results The study population was subdivided into the Outcome (n=1945), Hypertension (n=1460) and BP cohorts (n=1039) to analyze the incidence of mortality and cardiovascular endpoints, hypertension and BP changes as function of UVNA changes. The prevalence of low/medium/high birth weight in the Outcome Cohort was 5.8/84.5/9.7%. Over 16.7 years (median), rates were 4.9%, 8.0% and 27.1% for mortality, CVD and hypertension, respectively, but were not associated with birth weight. Multivariable-adjusted hazard ratios were not significant for any endpoint in any of the BW, UVNA and UNAK strata. Adult body weight tracked with birth weight (P&amp;lt;0.0001). The partial r in the low birth weight group associating changes from baseline to follow-up in UVNA and systolic BP was 0.68 (P=0.023), but not significant in other birth weight groups. Conclusion This study did not substantiate its prior hypothesis, but showed tracking of adult with birth weight and suggest that low birth weight increases salt sensitivity.Figure 1Figure 2

Maternal education and antenatal attendance in Georgia: A cohort study

Abstract Background Antenatal care (ANC) and maternal education are important determinants for maternal and newborn health outcomes. Understanding the impact of maternal education on ANC is crucial. Purpose To examine the association between maternal education and ANC attendance. Methods A retrospective cohort study utilized nationwide electronic medical birth registry data (2020-2022) in Georgia. the study includes pregnant women and their newborns. A randomized sample was selected, and extracted variables included maternal age, parity, body mass index, education, year of delivery, gestational age, infant sex, Apgar score, birth weight, delivery type, and newborn status. Statistical analysis via IBM SPSS v23 involved chi-square, t-tests, and logistic regression. Results The sample size contains 4976 mothers after excluding cases with missing data (n = 25). The mean maternal age was 30.5 years (SD = 5.4), with a mean BMI of 28.0(SD = 4.8), and the mean gestational week was 38.4(SD = 2.0), with a mean birth weight of 3263.0 (SD = 568.0) grams. Highly educated women had more than 3 times higher odds (OR = 3.636,95%CI:2.575-5.134) of having at least one ANC visit compared to those with Unknown education. primiparous women had significantly higher odds of having at least one ANC visit compared to Multiparous women, OR = 1.519, (95%CI:1.081-2.135). The chi-square test showed significant difference between ANC visits and the number of liveborn/stillborn (χ² = 53.026, p &amp;lt; .001). Moreover, there was a significant association between birth weight categories and ANC visits (χ² = 167.095, p &amp;lt; .001). Conclusions Our study emphasizes the role of education in improving access to ANC among women with low education levels. We can increase ANC visits and improve maternal and newborn health outcomes by focusing educational efforts on pregnant women. Additionally, focusing on high-risk populations, and using tailored interventions can further improve ANC attendance along with maternal and neonatal health. Key messages • Boosting ANC access and improving maternal and neonatal health by tailored community programs. • Conservative communities and underrepresented communities require additional resources to promote tailored healthcare. and extra effort in education about ANC.

Multicentre external validation of the Neonatal Healthcare-associated infectiOn Prediction (NeoHoP) score: a retrospective case–control study

Background and objectivesNeonatal mortality due to severe bacterial infections is a pressing global issue, especially in low-middle-income countries (LMICs) with constrained healthcare resources. This study aims to validate the Neonatal...

Bayesian Spatial Analysis of Risk Factors Affecting Low Birth Weight in Nigeria

Low birth weight (LBW), defined by the World Health Organization as a birth weight of less than 2.5 kilograms, is a major public health concern with significant implications for neonatal morbidity, mortality, and long-term health outcomes. LBW prevalence is particularly high in developing countries, contributing to substantial healthcare challenges and socio-economic burdens. This study examines the determinants of LBW in Nigeria, focusing on socio-demographic, economic, and health-related factors. This cross-sectional study utilizes data from the 2018 Nigeria Demographic and Health Survey (NDHS). A stratified two-stage cluster sampling method was employed, and data were collected through structured interviews. The analysis included socio-demographic characteristics, economic status, health factors, and birth weights, which were classified into LBW and normal birth weight categories. Ethical approval was obtained, and informed consent ensured participant confidentiality. The analysis revealed significant associations between LBW and several factors. Higher maternal education levels were linked to lower odds of LBW. Religious affiliation also impacted LBW, with Muslim mothers having a lower likelihood of LBW compared to Christian mothers. Ethnicity influenced LBW outcomes, with Igbo mothers showing higher odds of LBW compared to Yoruba mothers. Economic stability and urban residency were associated with reduced LBW risk. Health factors such as maternal BMI and frequent antenatal visits were protective against LBW. Geographic disparities indicated higher risks in northern Nigeria. The study underscores the multifactorial nature of LBW, highlighting the importance of maternal education, socio-economic support, and healthcare access. Tailored interventions addressing ethnic and religious contexts, along with region-specific strategies, are essential. The Bayesian STAR model&amp;apos;s superior performance suggests that spatial and non-parametric considerations provide deeper insights into LBW risk factors. Comprehensive, multifaceted strategies and policies are needed to address the determinants of LBW, focusing on vulnerable populations and regional disparities.

Placental abruption and the risk of necrotizing enterocolitis in neonates with birth weight ≥1500 grams; US national database study.

The pathogenesis of necrotizing enterocolitis (NEC) is multifactorial, placental abruption is associated with serious neonatal complications attributed to disruption of the maternal-fetal vascular interface. This study aimed to investigate the association between placental abruption and NEC. We analyzed the United States (US) National Inpatient Sample (NIS) dataset for the years 2016-2018. Using the logistic regression model, the adjusted odds ratios (aOR) were calculated to assess the risk of NEC in infants born to mothers with placental abruption after controlling for significant confounders. Analyses were repeated after stratifying the population into two birth weight (BW) categories: <1500 g and ≥1500 g. The study included 11,597,756 newborns. Placental abruption occurred in 0.16% of the population. NEC was diagnosed in 0.18% of infants, with a higher incidence (2.5%) in those born to mothers with placental abruption (aOR = 1.2, 95% CI: 1.1-1.3, p < 0.001). Placental abruption was associated with NEC only in infants with BW ≥ 1500 g (aOR = 1.34, 95% CI: 1.11-1.62, p 0.003). Placental abruption is associated with an increased risk of NEC in neonates with BW ≥ 1500 g. Research is needed to explore the mechanisms behind this association and to develop targeted interventions to mitigate NEC risks in this population. Placental abruption is associated with an increased risk of developing necrotizing enterocolitis (NEC) in neonates with a birth weight ≥1500 grams. This effect could be via direct in utero bowel injury or due to indirect postnatal compromise that occurs in these infants. This is the first study to specifically address the association between placental abruption and NEC in neonates ≥1500 g. The study used a national dataset that included all neonates delivered in the US, thereby allowing for the generalization of the findings after adjustment for multiple confounding factors. This study lays the groundwork for subsequent studies aimed at modifying feeding strategies and other neonatal management for the prevention of NEC in infants delivered after placental abruption.

Maternal chorioamnionitis and the risk for necrotizing enterocolitis in the United States: A national cohort study

BackgroundNecrotizing enterocolitis (NEC) is a major cause for morbidity and mortality among newborn infants. Chorioamnionitis is a perinatal complication that is associated with preterm delivery. Few reports have studied chorioamnionitis as a possible risk factor for NEC. Further investigation is needed to fully understand this association. ObjectiveTo examine the association of chorioamnionitis with NEC in newborn infants. MethodsWe used National Inpatient Sample (NIS) datasets produced by the federal Healthcare Cost and Utilization Project (HCUP). We identified infants born to mothers diagnosed with chorioamnionitis and infants born to mothers who did not have chorioamnionitis. The odds ratios (OR) to develop NEC in infants born to mothers affected by chorioamnionitis were calculated using chi square and Fisher Exact tests in the overall sample and in subgroups of different birthweight (BW) categories. The association was re-evaluated using logistic regression models to control for confounding variables. ResultsThe study identified 18,973,800 newborn infants admitted during the years 2016–2020. Among infants born to mothers with chorioamnionitis, NEC occurred in 0.9 % compared to 0.1 % in infants born to mothers without chorioamnionitis, (adjusted OR = 1.12, CI:1.02–1.15, p = 0.01). The prevalence of NEC in infants born to mothers with chorioamnionitis varied by the birth weight category, mainly for BW category 2500-4499 g (aOR = 1.61, CI:1.44–1.80, p < 0.001). ConclusionMaternal chorioamnionitis is associated with increased incidence of NEC, particularly in the BW category 2500-4499 g. Further studies are needed to examine the pathophysiological factors underlying this association.

The association of birth weight and current BMI on the risk of hypertension: the Tohoku medical megabank community-based cohort study

This study aimed to investigate the association of combination of birth weight and current body mass index (BMI) with the risk of hypertension in adulthood. This cross-sectional study used data from the Tohoku Medical Megabank Community-based Cohort Study conducted in Japan. A total of 10,688 subjects aged ≥20 years were eligible. We calculated the least square (LS) means of systolic blood pressure (SBP) and trend tests were performed to evaluate the linear relationships between birth weight categories and SBP. We also used a multivariate logistic regression analysis to assess the risk of hypertension associated with the combination of birth weight and current BMI. There was a statistically inverse association between birth weight and SBP in the 20–64 age group, but no significant association in the ≥65 age group. Low birth weight (LBW) with normal BMI group had a higher risk of hypertension than the normal or high birth weight groups with normal BMI. Furthermore, the group with LBW and BMI ≥25.0 kg/m2 was the highest risk for hypertension (adjusted odds ratio: 2.73; 95% CI, 2.04–3.65) compared to the reference group (birth weight 2500–3499 g and BMI 18.5–24.9 kg/m2). There was a significant association between LBW and subsequent risk of hypertension. In addition, participants with lower birth weights had a higher risk of hypertension than those with higher birth weights. However, even in participants with a lower birth weight, the risk of hypertension could be reduced when they maintained an optimal BMI.

Effect of sex and birth weight on the performance, microbiome, immune response and colostrum intake of piglets

The objective of this study was to evaluate the effect of sex and birth weight classes (BWC) on the colostrum intake, performance, permanence in the production system, immune response and microbiome of piglets in the farrowing and nursery phases. A factorial design was used with two sex categories (female and male) and three BWC (low - 0.8 to 1.1 kg; medium - 1.101 to 1.4 kg; and high - 1.401 to 1.7 kg). A total of 757 piglets in the farrowing phase and 228 piglets in nursery phase were used. Serum glucose concentration at birth and 24 hours, colostrum intake, performance parameters, removal rates, mortality, medication, and serum concentrations of immunoglobulin G (IgG), interleukin 10 (IL-10) and tumor necrosis factor alpha (TNF-α) on the 4th day after weaning, and fecal microbiome on the 6th day of nursery were evaluated. The serum glucose levels were not changed (P > 0.05). Piglets with high birth weight ingested more colostrum (P < 0.001). Low birth weight piglets (P = 0.077) and males (P = 0.027) had a higher removal rate and mortality. A higher percentage of females with high birth weight required medication (P < 0.001). The body weights of piglets at all weighings were higher for those with high birth weight (P < 0.001). The daily weight gain and feed intake during the nursery phase were affected by the BWC (P < 0.001). Low birth weight piglets had a lower concentration of TNF-α (P = 0.009), and there was no difference in IL-10 concentration (P > 0.05). Males tended to have higher serum IgG concentrations (P = 0.067). Medium- and high-weight piglets, as well as males, showed a higher abundance of pathogenic bacterial species (Fusobacterium mortiferum, Campylobacter jejuni, Clostridium neonatale and Ruminococcus torques). In conclusion, females had a higher rate of permanence in the production system and a fecal microbiome with a lower abundance of pathogenic bacteria, and low birth weight piglets had lower colostrum intake with reduced zootechnical indices.

Diarrhea outpatient and inpatient utilization and cost accumulation among children under five by birth weight category in Indonesia: an analysis of BPJS Kesehatan sample data

Diarrhea outpatient and inpatient utilization and cost accumulation among children under five by birth weight category in Indonesia: an analysis of BPJS Kesehatan sample data

Predicting postpartum hemorrhage in women undergoing planned cesarean section: A multicenter retrospective cohort study in Japan.

Given Japan's unique social background, it is critical to understand the current risk factors for postpartum hemorrhage (PPH) to effectively manage the condition, especially among specific groups. Therefore, this study aimed to identify the current risk factors for PPH during planned cesarean section (CS) in Japan. This multicenter retrospective cohort study was conducted in two tertiary maternal-fetal medicine units in Fukushima, Japan and included 1,069 women who underwent planned CS between January 1, 2013, and December 31, 2022. Risk factors for PPH (of > 1000 g and > 1500 g) were assessed using multivariate logistic regression analysis, considering variables such as maternal age, parity, assisted reproductive technology (ART) pregnancy, pre-pregnancy body mass index (BMI), uterine myoma, placenta previa, gestational age at delivery, birth weight categories, and hypertensive disorders of pregnancy (HDP). Multivariate linear regression analyses were conducted to predict estimated blood loss during planned CS. ART pregnancy, a pre-pregnancy BMI of 25.0-29.9 kg/m2, and uterine myoma increased PPH risk at various levels. Maternal smoking increased the risk of >1500 g PPH (adjusted odds ratio: 3.09, 95% confidence interval [CI]: 1.16-8.20). Multivariate linear analysis showed that advanced maternal age (B: 83 g; 95% CI: 27-139 g), ART pregnancy (B: 239 g; 95% CI: 121-357 g), pre-pregnancy BMI of 25.0-29.9 kg/m2 (B: 74 g; 95% CI: 22-167 g), uterine myoma (B: 151 g; 95% CI: 47-256 g), smoking (B: 107 g; 95% CI: 13-200 g), and birth weight > 3,500 g (B: 203 g; 95% CI: 67-338 g) were associated with blood loss during planned CS. Considering a patient's clinical characteristic may help predict bleeding in planned CSs and help improve patient safety.

Impact of compensatory growth on survival in newborn kittens.

In the feline species, the mortality of live-born kittens over the first 2 months of life is around 10%. Although some losses are inevitable, progress in veterinary medicine and improved knowledge of feline neonatalogy should make it possible to reduce them to a lower level. The objectives of this study were: (i) to describe early growth in kittens, and (ii) to assess whether low birth weight kittens develop compensatory growth during the first week of life and if so, whether compensatory growth is associated with increased chances of survival. Using data collected from 5,504 kittens born in 193 different French catteries, five growth rates were calculated to reflect the growth of kittens during the first week after birth. Low birth weight kittens had higher growth rates than normal birth weight kittens. In addition, low birth weight kittens whose early growth was in the lowest 25% had a significantly higher 0-2 months mortality rate than all the other groups. Weight loss (or lack of weight gain) between birth and Day 2 was identified as a risk factor for 0-2 months mortality whatever the birth weight category. Finally, critical early growth thresholds were determined separately for low and normal birth weight kittens. These figures could help caregivers to validate the adequacy or inadequacy of kitten early growth. They will be able to quickly identify and provide appropriate care for the kittens whose growth is deemed insufficient in order to improve their chances of survival.