Female Birth Weight Research Articles

Renal endowment in men and women: start from the beginning

The development of the human kidney leads to the establishment of nephron endowment through a process influenced by both genetic and environmental factors. There is individual variability regarding nephron endowment and factors including aging and pathological conditions contribute to the decline in the number of nephrons, impacting renal function. Genetic determinants, such as mutations in crucial developmental genes like Pax2, and epigenetic mechanisms mediated by key enzymes including sirtuin 3, play critical roles in the regulation of the number of nephrons, with implications for kidney disease susceptibility. Sexual dimorphism significantly influences kidney development and function, with the number of nephrons being significantly lower in females, consistent with lower female birth weight, which is considered a surrogate for nephron endowment. Also, although females have fewer nephrons, they experience a slower decline in GFR compared to males. Gender disparity in chronic kidney disease progression has been attributed to factors such as metabolism, oxidative stress, renal hemodynamics, and sex hormones. Understanding the complexities of nephron endowment variability, genetic determinants, and sexual dimorphism in kidney development and function is crucial for elucidating the mechanisms underlying individual kidney disease susceptibility and progression. Further research in this field holds promise for the development of personalized approaches to kidney disease prevention, management, and treatment.

Placental chronic inflammatory histopathology and fetal growth in a cohort with universal placental examination

IntroductionChronic placental inflammation is a routinely diagnosed group of placental lesions that reflect immunologic dysfunction of the mother, fetus, or both. MethodsComplete placental pathology examinations were performed for all term births at New York Presbyterian- Brooklyn Methodist Hospital from January 2010–August 2016. Diagnoses were blinded except to gestational age. CPI lesions were marked as chronic choriodeciduitis, decidual plasma cells, chronic inflammation of basal plate with anchoring villitis, and chronic villitis. ResultsIn this cohort of term pregnancies, 257 (11.6 %) males and 218 (9.8 %) females had ≥1 CPI lesions. Chronic villitis was the most common (319 or 14 %), with chronic choriodeciduitis, decidual plasma cells, and chronic inflammation of basal plate with anchoring villitis in 94 (4 %), 69 (3 %) and 170 (8 %), respectively. In males, chronic villitis was associated with lower gestational adjusted birthweight and had no association with placental weight. In females, chronic villitis was associated with lower gestational adjusted birthweight, but the effect became nonsignificant after adjustment for placental weight. DiscussionIn summary, CPI lesions’ incidence and association with birth weight vary by sex. Chronic villitis is associated with lower birthweight in females; this effect is completely mediated by placental weight. Chronic villitis showed a weak direct association of chronic villitis in males, but no association with lower placental weight in males. We suggest that differences between our results and previous publications reflect effects of sampling bias.

Chronic Undernutrition in Ovine Twin Pregnancies Abolishes Differences in Birth Weight Due to Sex: An Evaluation of the Role of Nutritional and Antioxidant Supplementation.

In twin pregnancies of discordant sex, the male fetus grows larger than the female co-twin. Our study aimed to determine the effect of the sex of co-twins on lambs' birth weight in ovine pregnancies developed under natural undernourishment. Additionally, we investigated whether the nutritional and/or antioxidant supplementation provided to ewes during pregnancy could modulate the potential effects associated with the sex of co-twins. Ninety-six birth records of twin pregnancies of sheep grazing the natural Patagonian prairies were analyzed. The animals were divided into four groups: control (no supplementation), N (concentrate supplementation, 100% NRC), A (antioxidant supplementation), and NA (concentrate + antioxidant supplementation). Supplementation occurred from day 35 of gestation onwards until lambing. There were no differences in female or male birth weight in the control undernourished group. However, in group N, females or males with sex-discordant co-twins had a higher birth weight than did those with co-twins of the same sex. Group A males with female co-twins had a higher birth weight compared to males whose co-twins were also males. In NA lambs, males had a higher birth weight compared to females, regardless of their co-twin's sex. Therefore, chronic undernutrition abolished the differences in birth weight due to fetal sex. Restoring maternal nutrition or antioxidant supplementation tends to normalize birth weight and restore the differences between females and males. This effect is enhanced with the combined supplementation of concentrated food and antioxidants.

205 Level of Supplemental Fat in the Diet of Gestating Beef Cows: Effects on Cow and Calf Performance

Abstract This study evaluated the effects of feeding a canola seed-based (7.2% ether extract) pellet to gestating cows on cow performance, reproductive efficiency, milk yield and composition, and calf birth weight. Seventy-two pregnant, multiparous cows were allocated to 12 pens in a completely randomized block design. Body weight (BW; 605 ± 35 kg) was utilized as the blocking criteria. Diets were formulated to be isonitrogenous (CP: 8.20 ± 0.24% and 9.07 ± 0.05% second and third trimesters, respectively) and isocaloric (TDN: 58.29 ± 0.24% and 60.50 ± 0.04% second and third trimesters, respectively), and to meet NASEM (2016) nutrient requirements for pregnant beef cattle. Pens were randomly assigned to three replicated (n = 4) dietary treatments: 0 (CON), 150 (LOW), and 300 (HIGH) g of fat/d (DM basis). Dietary treatments were fed from 148 ± 8 d prepartum until at least 50% of all cows had calved, then switched to a common lactation diet. Body condition score (BCS), BW and subcutaneous fat thickness were measured at the start (SOT) and end of trial (EOT), and at 21 and 42 d postpartum. Orthogonal contrasts were used to assess linear and quadratic relationships between fat inclusion and dependent variables. At SOT, there were no differences (P ≥ 0.73) in conceptus corrected BW (597 ± 34 kg) or (P ≥ 0.13) BCS (2.85 ± 0.12, Canadian System: 1 to 5). After 84 d on trial (64 ± 8 d prepartum), conceptus corrected average daily gain (ADG) increased linearly (P = 0.04) as fat inclusion increased. After 151 d of supplementation (EOT), conceptus corrected ADG and subcutaneous fat thickness did not differ (P ≥ 0.71 and 0.63, respectively). BCS change from SOT to EOT increased, while EOT to 21 d postpartum decreased quadratically as fat inclusion increased (P = 0.02 and 0.01, respectively). Female calf birth weight decreased quadratically (P = 0.01) as fat inclusion increased, but there was no effect (P ≥ 0.75) on male calf birth weight. As fat inclusion increased, lactose concentration in milk decreased linearly (P = 0.04). As days in milk (DIM) increased, milk protein, total solids, and milk energy yield decreased (P ≤ 0.05). Milk urea-N tended to increase (P = 0.07), while 12 h milk yield (P = 0.05) tended to decrease as DIM increased. Milk fat and energy were not affected by fat inclusion, day, or the interaction between fat inclusion and day (P ≥ 0.16). There was a quadratic tendency for fat inclusion to affect pregnancy rate (P = 0.09), being maximized on LOW treatment. These results suggest that increasing fat inclusion during mid-to-late gestation tended to improve cow reproductive efficiency. Further investigation is required to determine the optimal level of fat inclusion from canola seed.

Prenatal Exposure to Heavy Metals and Adverse Birth Outcomes: Evidence From an E-Waste Area in China.

Electronic waste that has not been properly treated can lead to environmental contamination including of heavy metals, which can pose risks to human health. Infants, a sensitive group, are highly susceptible to heavy metals exposure. The aim of this study was to investigate the association between prenatal heavy metal exposure and infant birth outcomes in an e-waste recycling area in China. We analyzed cadmium (Cd), chromium (Cr), manganese (Mn), lead (Pb), copper (Cu), and arsenic (As) concentrations in 102 human milk samples collected 4weeks after delivery. The results showed that 34.3% of participants for Cr, which exceeds the World Health Organization (WHO) guidelines, as well as the mean exposure of Cr exceeded the WHO guidelines. We collected data on the birth weight (BW) and length of infants and analyzed the association between metal concentration in human milk and birth outcomes using multivariable linear regression. We observed a significant negative association between the Cd concentration in maternal milk and BW in female infants (β=-162.72, 95% CI=-303.16, -22.25). In contrast, heavy metals did not associate with birth outcomes in male infants. In this study, we found that 34.3% of participants in an e-waste recycling area had a Cr concentration that exceeded WHO guidelines, and there was a significant negative association between prenatal exposure to the Cd and infant BW in females. These results suggest that prenatal exposure to heavy metals in e-waste recycling areas may lead to adverse birth outcomes, especially for female infants.

Assisted Reproductive Technology and Breech Delivery: A Nationwide Cohort Study in Singleton Pregnancies.

Since essential factors have changed in recent years in assisted reproduction technologies (ARTs), this study reassessed the association between ART and breech presentation. We primarily aimed to estimate the correlation between ART and breech at delivery. Secondary purposes were to evaluate the correlation between other subfertility treatments (OSTs) and breech and to assess possible confounding factors and temporal trends. This study investigated the 31,692,729 live birth certificates from US states and territories in the 2009-2020 period. The inclusion criteria were singleton births reporting the method of conception and the presentation at delivery. The outcome was the breech presentation at delivery, while the primary exposure was ART, the secondary exposure was OST, and the potential confounding factors from the literature were considered. ART (OR 2.32 CI.95 2.23-2.41) and OST (OR 1.79 CI.95 1.71-1.87) were independent and significant risk factors for breech at delivery (p < 0.001). This study confirmed breech presentation risk factors maternal age, nulliparity, tobacco smoke, a previous cesarean delivery (CD), neonatal female sex, gestational age, and birth weight. Black race and Hispanic origin were verified to be protective factors. We found breech prevalence among ART and OST to be stable during the study period. Meanwhile, newborn birth weight was increased, and the gap between breech and other presentations in ART was reduced. Our results indicate that singleton pregnancies conceived by ART or OST were associated with a higher risk of breech at delivery. Well-known risk factors for the breech presentation were also confirmed. Some of these factors can be modified by implementing interventions to reduce their prevalence (e.g., tobacco smoke and previous CD).

Correlation Between Ultrasonographically Estimated Fetal Weight and Actual Birth Weight in Females Presenting in a Tertiary Care Hospital

Objective: To determine the correlation between ultrasono-graphically estimated fetal weight and actual birth weight in females presenting in a tertiary care hospital.&#x0D; Study Design: Comparative cross-sectional study.&#x0D; Place and Duration of Study: Department of Radiology Peripheral Nervous System, PNS Shifa Hospital Karachi Pakistan, from Sep 2018 to Jan 2019.&#x0D; Methodology: Fifty pregnant females were enrolled after meeting the inclusion criteria. A consultant radiologist calculated fetal weight by measuring biparietal diameter (BPD), head circumference (HC), femur length (FL) and abdominal circumference (AC) with the help of an ultrasound (USG) machine having a Hadlock 3 weight estimation algorithm. A paediatrician noted actual birth weight with a weighing scale after delivery.&#x0D; Results: The mean fetal weight on ultrasound was 2.52±0.34kg. The mean actual birth weight of the babies was 2.66±0.42 kg. A strong positive correlation (r=0.575, p&lt;0.05) was found between ultrasonographic fetal weight estimation and actual birth weight.&#x0D; Conclusion: Ultrasonography is an accurate, safe, cost-effective and easy available imaging modality for fetal weight estimation.

Critical windows of susceptibility for the effects of prenatal exposure to heat and heat variability on gestational growth

BackgroundStudies have shown that prenatal heat exposure may impact fetal growth, but few studies have examined the critical windows of susceptibility. As extreme heat events and within season temperature variability is expected to increase in frequency, it is important to understand how this may impact gestational growth. ObjectivesWe investigated associations between various measures of weekly prenatal heat exposure (mean and standard deviation (SD) of temperature and heat index (HI), derived using temperature in °C and dew point) and term birthweight or odds of being born small for gestational age (SGA) to identify critical windows of susceptibility. MethodsWe analyzed data from mother-child dyads (n = 4442) in the Boston-based Children's HealthWatch cohort. Birthweights were collected from survey data and electronic health records. Daily temperature and HI values were obtained from 800 m gridded spatial climate datasets aggregated by the PRISM Climate Group. Distributed lag-nonlinear models were used to assess the effect of the four weekly heat metrics on measures of gestational growth (birthweight, SGA, and birthweight z-scores). Analyses were stratified by child sex and maternal homelessness status during pregnancy. ResultsHI variability was significantly associated with decreased term birthweight during gestational weeks 10–29 and with SGA for weeks 9–26. Cumulative effects for these time periods were −287.4 g (95% CI: −474.1 g, −100.8 g for birthweight and 4.7 (95% CI: 1.6, 14.1) for SGA. Temperature variability was also significantly associated with decreased birthweight between weeks 15 and 26. The effects for mean heat measures on term birthweight and SGA were not significant for any gestational week. Stratification by sex revealed a significant effect on term birthweight in females between weeks 23–28 and in males between weeks 9–26. Strongest effects of HI variability on term birthweight were found in children of mothers who experienced homelessness during pregnancy. Weekly HI variability was the heat metric most strongly associated with measures of gestational growth. The effects observed were largest in males and those who experienced homelessness during pregnancy. DiscussionGiven the impact of heat variability on birthweight and risk of SGA, it is important for future heat warnings to incorporate measure of heat index and temperature variability.

Association of paternal cadmium and other heavy metal exposure to birth outcomes using propensity score matching.

BackgroundHuman exposure to cadmium has various effects on health, especially on male reproductive organs. Although it is widely known that prenatal maternal cadmium exposure can affect birth outcomes, the effect of paternal exposure to cadmium remains unclear. ObjectivesThis study aimed to evaluate the effect of paternal cadmium exposure on fetal growth by considering maternal cadmium exposure and exposure to other heavy metals, namely mercury and lead. MethodsThe Mothers and Children's Environmental Health (MOCEH) study is a prospective birth cohort study in Korea. Overall, 1313 families (father-mother-child triple) without child abnormalities and who completed paternal whole blood cadmium assessments were included in this study. Families were divided into two subgroups based on the blood sampling periods, namely early and late pregnancy. Subjects were selected as follows: one family triple with a high level of paternal cadmium and two triples with low levels of paternal cadmium, using the method of propensity score matching. And linear regression analyses were performed. ResultsThe group with high paternal cadmium exposure (80% or more; 1.93 μg/L) had lower birth weight infants compared to the group with low cadmium concentrations (β(se) = −0.21(0.10); p-value = 0.0283). After stratification by infant sex, prenatal paternal cadmium exposure significantly reduced the birth weight of females in subgroups of different sampling times, namely early pregnancy (β(se) = −0.52 (0.22); p-value = 0.0170) and late pregnancy (β(se) = −0.43 (0.18); p-value = 0.0160). Finally, after performing propensity score matching in the early pregnancy measurement group, it was found that the prenatal exposure of father to cadmium significantly reduced birth weight in females (β(se) = −0.72(0.25); p-value = 0.0047). ConclusionThis study assessed the effect of paternal cadmium exposure on birth outcomes in family units consisting of a father, mother, and child. Prenatal paternal cadmium exposure negatively affected birth weight, especially that of female, considering covariates and other heavy metals exposure, namely mercury and lead.

Educational attainment and offspring birth weight: A bidirectional Mendelian randomization study.

Background: The association between educational attainment (EA) and offspring birth weight (BW) has been reported by several traditional epidemiological studies. However, evidence for this association tends to be mixed and confounded. This study aimed to investigate the causal association between EA of parents and offspring BW. Methods: Here, we carried out a two-sample bidirectional Mendelian randomization (MR) analysis to examine the causal association between EA of males (n = 131,695) and females (n = 162,028) and offspring BW using genetic instruments. Summary statistics of EA associated single nucleotide polymorphisms (SNPs) were extracted from a GWAS incorporating 293,723 individuals of European descent performed by the Social Science Genetic Association Consortium (SSGAC), and the effects of these SNPs on offspring BW were estimated using a GWAS meta-analysis of 86,577 participants of European descent from 25 studies. Univariable MR analyses were conducted using the inverse-variance weighted (IVW) method and four other methods. Further sensitivity analyses were carried out to test the viability of the results. Multivariable MR was used to examine the confounders between the exposure and outcome. Results: The result shows evidence that the offspring BW is positively causally affected by female EA. Each one standard deviation (SD) increase in female EA was associated with 0.24 SD higher of offspring BW (95% confidence interval [CI], 0.10 to 0.37, p < 0.001 for the IVW method). Similarly, change in offspring BW was 0.21 SD (95% CI: 0.07 to 0.34, p = 2.82 × 10-3) per one SD higher in male EA. No causal effect of BW on EA was found by any of the five methods. The causal association between female EA and offspring BW maintained after adjusting for alcoholic drinks per week and BMI. The effect of male EA on offspring BW was attenuated when we adjusted for BMI and alcoholic drinks per week using multivariable MR analysis. Conclusion: Our study indicated that female EA is positively causally associated with offspring BW. The association between male EA and offspring BW may be confounded by alcoholic drinks per week and BMI.

Association of CRP Levels in 3rd Trimester with Fetal Birth Weight in Normotensive and Preeclamptic Pregnant Females

Aim: To assess the level of C-reactive protein, which is an inflammatory marker, in pregnant women with pre-eclampsia and with normal blood pressure, and to assess its relationship with fetal weight at birth. Study design: An analytical and Cross-sectional study. Place and duration of study: In the Obstetrics and Gynecology department of Chandka Medical Hospital, Larkana and Murshid Hospital, Karachi for nine months duration from January to September 2021. Methodology: A total 70 cases of pre-eclampsia and 70 pregnant women with normal blood pressure participated, all in the 3rd trimester of gestation. All females were in the 20-40 years of age group and had a BMI ranging from 18 to 25. Highly sensitive levels of C-reactive protein (hsCRP) were evaluated using the Enzyme Link immunosorbent assay. Statistical analysis was performed with SPSS program 20.0. The values were taken as significant at the significance level of 0.05. Results: C-reactive protein levels were significantly advanced in the pre-eclampsia group with a mean value of 8.4 (0.4 to 24.2) compared to 5.1 (0.21 to 10.1) mg / L in women with normal blood pressure (p-value &lt;0.001). Spearman's correlation coefficient between birth weight and CRP was -0.405 in the pre-eclampsia group (p = 0.001) and 0.118 in the normal blood pressure group. In the group with pre-eclampsia, the birth weights of children were also significantly lower. High CRP levels in the preeclampsia group were negatively correlated with fetal birth weight. Conclusions: High levels of C-reactive protein in pregnant women with pre-eclampsia are part of the excessive systemic maternal inflammatory response and are associated with low fetal weight. Keywords: Pre-eclampsia. C-reactive protein. Pregnancy. Third trimester

Impact of Gonadectomy on Sex‐Selective Dysregulation of Cardiovascular Function Resulting From In UteroExposure to Dexamethasone

Prenatal insults leading to increased fetal glucocorticoid exposure can sex‐selectively impact cardiovascular function in adulthood. In support of this, we have shown that when pregnant rat dams are treated with the glucocorticoid, dexamethasone (DEX), for the last 4 days of gestation, female‐specific changes resulting in enhanced pressor and heart rate (HR) responses to stress occur in adult offspring. Moreover, we demonstrated that females exposed to DEX in uteroshow altered autonomic function compared to vehicle‐exposed females. This is characterized by a reduced high frequency (HF) power component of heart rate variability (HRV) in DEX‐exposed rats, suggesting a lower reliance on parasympathetic drive. The present study evaluated the degree to which the sex‐specific changes in autonomically‐driven cardiovascular responses are due to activational effects of gonadal steroid hormones. Pregnant dams were administered DEX (0.4mg/kg per day, s.c.) or vehicle on gestation days 18‐21. This resulted in a significant reduction in birthweight in DEX‐exposed males and females. At 8 weeks, rats underwent a gonadectomy (GDX) or sham surgery, or remained intact, and at 10 weeks rats were instrumented with radiotelemetric transmitters for direct recording of arterial pressure, HR, and HRV in conscious, freely moving male and female rats. At 11‐12 weeks rats were placed in a restraint tube for 20 minutes, followed by a 3‐hour recovery period, to assess whether GDX alters the sex‐specific stress responses in DEX‐exposed offspring. Restraint‐stress testing was performed on diestrus in intact and sham females, and absence of cycling in GDX females was confirmed via cytological analysis. We demonstrate that intact females, but not males, that were exposed to DEX in utero exhibit an exaggerated pressor response to restraint, as compared to vehicle‐exposed females. We found that GDX did not alter stress‐responsive MAP in males regardless of prenatal treatment, suggesting testosterone does not play a role in acute cardiovascular stress responses in adult rats. In vehicle‐exposed females, when compared to intact, both sham and GDX surgery resulted in an exaggerated pressor response to restraint. However, in females that were prenatally exposed to DEX, there was no difference in the pressor response to restraint between intact, sham, and GDX rats. This suggests that the exaggerated pressor response observed in DEX females compared to males is not due to activational effects of estradiol. GDX was shown to have opposing effects on HRV in males and females, with no influence of prior DEX. In females, GDX resulted in a tendency toward reduced HF (p=0.065) and low frequency (LF, p=0.074) power component of HRV, whereas males showed a significant increase in HF (p=0.044) and a tendency toward increased LF (0.051). Taken together, activational effects of gonadal steroids appear to impact HRV, but not acute cardiovascular responses to stress. It may be that gonadal steroids act at an organizational level to mediate the sex difference observed in rats exposed to DEX in utero. Future studies to identify the mechanisms by which prenatal dexamethasone produce long‐term changes in cardiovascular function will be important for better understanding the sex‐specific consequences of prenatal programming over the lifespan.

Moringa oleifera Seed at the Interface of Food and Medicine: Effect of Extracts on Some Reproductive Parameters, Hepatic and Renal Histology.

The lipid-rich Seed of Moringa oleifera has been promoted as an effective water clarifier. Aside its vital nutritional application as an emerging food additive, the seed has continued to gain a wider acceptance in various global ethnomedicines for managing several communicable and lifestyle diseases, howbeit, its potential toxic effect, particularly on fertility and pregnancy outcomes has remained uninvestigated; the effect of Moringa oleifera seed (MOSE) aqueous-methanol extracts on fertility and pregnancy outcome, was investigated in vivo using female Wistar rats that were divided into 50, 100, 300 and 500 mg per kilogram body weight. Group six was given Moringa oleifera seed treated water ad-libitum (ad-libitum group). Organs harvested for histological assessment included ovary, uterus, liver and kidney. In addition to HPLC fingerprint and a preliminary peptide detection, we determined the physico-chemical characteristics and mineral content of MOSE using standard methods. Data were analyzed with significance at p ≤ 0.05. There was no significant difference in the estrus cycle, mating index, gestation survival index, gestation index, fertility index and sex ratio among all groups. Gestation length was reduced in some groups. While the male pup birth weight was comparable among the different groups, female pups birth weights were significantly reduced in 50 and 100 mg groups. Anogenital distance indices of female pups in ad libitum group were significantly increased. Pathologies were observed in liver and kidneys of dams while kidneys of pups presented a dose dependent reduction in the number of glomeruli. There were no observed pathological changes in the ovary and uterus. This study showed for the first time in rodents, that the lipid-rich MOSE is unsafe to the kidney of rodents while the lipid-free MOSE appears to be safe at doses up to 300 mg/kg body weight. Findings from this study suggested that the female pups were masculinized. In conclusion, the lipid-rich seed extracts of MOSE appear to be unsafe during pregnancy, induce hepatic and renal toxicity while the lipid-free MOSE excludes inherent toxicity as the hydrophobic part has been linked to toxicity as observed in this study due to the developmental programming effect on female offspring in rodents.

A rare case of persistent fetal intestinal hyperechogenicity – Question

A 24-year-old pregnant woman with an in vitro fertilization (IVF)-assisted pregnancy was examined at 12 weeks of gestation with a fetal ultrasound showing intestinal hyperechogenicity. The maternal anamnesis revealed 3 previous miscarriages, 2 due to ectopic pregnancies. Fetal karyotype and screening for cystic fibrosis performed on both parents were normal. Another ultrasound examination at 27 weeks showed fetal intestinal and gastric dilation and moderate polyhydramnios. The day before delivery, an ascitic effusion was found, not associated with pleural or pericardial effusion. At 29 weeks and 6 days of gestation, an emergency cesarean section was performed for absent variability of the cardiotocographic tracing. The female newborn birth weight was 1,390 g. Apgar scores were 5 at 1 minute and 7 at 5 minutes. The patient was intubated in the Delivery Room and remained on mechanical ventilation until she was transferred to the Neonatal Intensive Care Unit (NICU), then she was ventilated in high-frequency oscillatory ventilation (HFOV). At the time of admission to the NICU, in addition to severe respiratory insufficiency (the saturation was at the lower limits, with FiO2 = 1), at the clinical examination she had moderate pale skin and globose abdomen with generalized tenderness. The nasogastric tube was positioned correctly, and 6 ml of gastric fluid mixed with blood were aspirated. It was possible to insert the rectal tube only for 1.5 cm. To better understand the case, anteroposterior (AP) and translateral chest-abdomen X-rays were performed. 1. What do you see in these X-rays? 2. Which further investigations would you suggest? 3. What is your diagnosis?

FC 059EARLY LIFE FACTORS AND ADULT KIDNEY FUNCTION ESTIMATED BY CYSTATIN C AND CREATININE GLOMERULAR FILTRATION RATE EQUATIONS AND ALBUMINURIA: A SWEDISH COHORT STUDY

Abstract Background and Aims Renal functional capacity is influenced by factors acting early in life, such as intrauterine environment, maturity, birth weight, length at birth, placental weight etc. Early life factors are responsible for the number of nephrons a person starts life with, and the consequence of a low nephron number is earlier kidney ageing and chronic kidney disease (CKD). Notably, most reports addressing early life factors in the context of adult kidney function use creatinine-based eGFR equations and/or albuminuria and lack longer follow-up (&amp;lt;30 years). Therefore, we aimed to identify early life factors associated with kidney function, determined by different creatinine and cystatin C equations and urinary albumin-to-creatinine ratio (UACR), more than 40 years later. Method 94 women and 494 men, born 1923-50, who participated in The Malmo Diet and Cancer (MDC) study were analyzed. Perinatal data records including birth weight (BW), birth length, head circumference, gestational age, placenta weight (PW) and mother related risk factors were collected from hospital and regional state archives. After a follow-up of 46 to 67 years study subjects underwent physical examination, blood pressure measurements and estimation of glomerular filtration rate (eGFR) using 4 different equations: Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) 2012 creatinine and cystatin C formula (CKD-EPI_creatinine, CKD-EPI_cystatin C), cystatin C eGFR equation based on Caucasian, Asian, pediatric, and adult cohorts (CAPA), the Lund-Malmö revised creatinine based eGFR equation (LM_rev). Urinary albumin-to-creatinine ratio (UACR) was measured in morning urine samples, albuminuria was defined as UACR ⩾3 mg/mmol. Birth weight z-scores (gender specific BWz and combined BWz) acquired by using the equation as reported by Marsal et al.(1996). Four growth mismatch phenotypes defined by combining low or high BW z-score (lowBWz or hiBWz respectively) with lower or higher body mass index at 20 years of age (lowBMI20 ir hiBMI20 respectively). Results Linear regression analysis of early life factors indicated that in females birth weight was positively associated with kidney function measured by both CAPA and CKD-EPI_cystatin C. In the whole population, birth weight adjusted for gestational age and sex, together with prematurity were independently associated to CKD-EPI_cystatin C, while BW/PW ratio was related to LM_rev. Logistic regression analysis showed that only gender specific BWz and combined BWz shared the same odds ratios for age and pulse pressure adjusted albuminuria in males (OR 0,75 (95%CI [0,58; 0,96]). While analyzing postnatal growth mismatch we found that females with hiBWz/lowBMI20 phenotype had significantly worse kidney function acquired by both cystatin C equations compared to those with lowBWz/lowBMI20 phenotype (p=0.044 for CAPA, p=0.040 for CKD-EPI_cystatin C). The logistic regression analysis revealed that hiBWz/hiBMI20 phenotype was related to lower risk of age and pulse pressure adjusted albuminuria (OR 0,35 (95%CI[0,12;0,93]) Conclusion Here we report that lower birth weight in females is associated with worse kidney function determined by cystatin C eGFR equations, while in males lower birth weight z-score is a risk factor for albuminuria in adulthood. Postnatal growth catch-up is not related to worse kidney function. We identified the protective phenotype (hiBWz/hiBMI20) for albuminuria in males and the unfavorable phenotype (hiBWz/lowBMI20) for kidney function in females. This suggests that lower birth weight and postnatal growth curve have a potential sex specific effect to kidney function and development of CKD in middle-aged Swedish subjects. Further studies are warranted to address early life factor prognostic accuracy in kidney function and outcomes prediction later in the lifetime.

Birthweight of female Holstein dairy cows is associated with subsequent lactation performance

Context Birthweight (BW), the weight of an animal taken within 24 h after birth, is the first trait that can be easily measured. Investigating the association between the BW of a calf and her performance later in life is important to realise the optimum weight at birth. Aim The aim was to investigate the association between BW of females and their productive and reproductive performance later in life in Holstein dairy cows. Methods Data used were 214 377 lactation records on 83 440 cows distributed in 134 herds collected from January 2008 to December 2018 by the Animal Breeding Centre of Iran (Karaj, Iran). Based on the BW, animals were classified into six classes: BW of 20.0–37.0 kg, 37.1–39.0 kg, 39.1–41.0 kg, 41.1–43.0 kg, 43.1–45.0 kg and 45.1–70 kg (BW1 to BW6, respectively). Multiple regression mixed models were used to investigate the association between the BW of females and their age at the first calving, lactation performance, 100- and 305-day somatic cell score, the length of the calving interval, calf BW and dystocia later in life. Key results The mean (s.d.) BW across all animals (females) included was 40.9 (4.93) kg. Of the 83 440 animals included, 19.26% weighed ≤37.0 kg and 14.06% weighed ≥45.0 kg, whereas &gt;23% weighed between 39.1 and 41.0 kg at birth. Increased BW of females was associated with a decrease in their age at the first calving; an increase in their 305-day milk, fat and protein yield; longer length of their calving interval; increased BW of their calves; and increased risk for dystocia. However, there was no association between BW of females and their 305-day fat and protein percentages, and 100- and 305-day somatic cell score. Conclusions In any economic evaluation of BW, not only calf perinatal mortality, but also the association between the BW of females and their lactation performance later in life should be taken into account. Implications The BW of a female calf is associated with her production and reproductive performance, and needs to be considered as an important trait in the dairy cattle breeding program.

Reference charts of birth weight and birth length by gestational age in south east Serbian newborns: Preliminary results

Background/Aim. To date, there has been no population-based neonatal anthropometric chart published in Serbia. Charts based on infants born in a single hospital (hospital-based) in the 1 990s are still widely used in our country, as well as the Alexander chart. The aim of this study was to construct population-based centile, gender-specific charts for birth weight and length for singleton infants born in Southeast Serbia from 24 t o 42 weeks of gestation and to compare them with other previously published charts. Methods. Data on 39,842 singleton live infants, delivered from 2006 to 2015 in three maternity wards in Southeast Serbia (Nis, Prokuplje, and Aleksinac), were analyzed. Results. The inclusion criteria met 37,169 newborns. Preterm births were relatively uncommon (5.25%). Estimated centile charts for male and female birth weights and lengths were constructed showing the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th centiles. Conclusion. Our birth weight percentiles provide a population norm for singleton infants adjusted for gender, born in Southeast Serbia. These references are both of epidemiological and clinical use. There is a need for large-scale research that will include a larger number of pre-term newborns which were represented in limited numbers in our study. There is also a need for setting up the gold standard method for the precise determination of the gestational age, i.e. the use of the early fetal ultrasound.

Outcomes of pregnancies in patients with Gaucher Disease: The experience of a center of excellence on rare metabolic Disease-Gaucher Disease, in Greece

ObjectivePregnancy is reported to exacerbate manifestations in women with Gaucher Disease (GD). The objective of our study was to examine the outcome of pregnancies of Caucasian women with GD in a Greek Center of Excellence on GD. Study designFifteen GD women were enrolled. All data were collected by questionnaire: fertility, normal pregnancies, spontaneous-elective-therapeutic abortions, maternal -neonatal status, birth weight and chromosomal abnormalities. ResultsForty-one pregnancies were reported among 15 women: mean conception age (±SD) 27.7 ± 5.8years (range 17–42years). Thirty-seven conceptions were spontaneous, 4 were after in vitro fertilization (IVF).Twenty three out of the 41 (56.1 %) pregnancies were normal. Eleven out of the 41 (26.8 %) pregnancies resulted in spontaneous abortions, 3 out of 41 (7.3 %) in elective and 3 out of 41 (7.3 %) in therapeutic abortions. Therapeutic abortions were due to worsening of GD manifestations, fetal chromosomal abnormalities and GD type 2 embryo.Nine out of 15 women had maternal complications: gestational diabetes, splenomegaly, hepatomegaly, thrombocytopenia, osteoporosis and postpartum hemorrhage.Twenty three out of the 41 pregnancies resulted in live births. Nine out of the 23 (39.1 %) deliveries were caesarian sections and 14 out of 23 (60.9 %) were vaginal.The total number of neonates was 24 (14 females / 10 males). Mean gestational age on delivery (± SD) was 35.9 ± 3.1 weeks (range 26−38 w). Average female birth weight (±SD) was 2671.4 ± 851.6 g (range 900−4100 grams) and male was 3333 ± 996.4 g (range 1930−4700 grams). Nine out of 24 (37.5 %) neonates had low birth weight. Average low birth weight (±SD) was 1931.1 ± 420.52 g (range 900−2300 grams).Twenty out of the 24 (83.3 %) neonates were healthy. Four out of 24 neonates had neonatal complications: two neonates had GD type 1, one had GD type 3 and one neonate died two days after delivery (it was born at 26 weeks). Four neonates were hospitalized in incubators at the intensive neonatal care unit due to low birth weight.Thirty-nine women did not receive enzyme replacement therapy for GD during pregnancy, while, in two pregnancies, treatment was discontinued during the first trimester and re-administered after that.Mean first menarche age (±SD) was 13.6 ± 0.7 years. Thirteen out of 15 women were menopausal, mean menopausal age (± SD) 466 ± 2.6 years. ConclusionMost of GD women experience uncomplicated pregnancies and deliver normal, healthy infants, although the rate of complications and the rate of abortions is high in this population.

Gender Gaps in Birth Weight Across Latin America: Evidence on the Role of Air Pollution

Recent estimates indicate that more than 100 million people in Latin America and the Caribbean are exposed to air pollution levels exceeding World Health Organization guidelines. Air pollution persists because of a development process centered around high rates of urbanization and congestion, geographically concentrated industrialization, and biomass burning. This paper focuses on a relatively understudied consequence of this pollution-intensive development process: its gender impact. The analysis provides systematic evidence across the region on the impact of in utero exposure to air pollution on infant health and well-being, a period when the medical literature suggests male fetuses are more delicate than female fetuses. Health at birth is known to have long-term consequences, so this investigation seems warranted and aids the understanding of future gender gaps in socioeconomic development. The empirical analysis combines satellite and survey data from three countries in the region: Bolivia, Colombia, and Peru. Based on sibling comparisons, the analysis finds that a 10% increase in pollution exposure in utero reduces the male–female birth weight gap by approximately 50 g. This weight reduction is equivalent to the impact of smoking five cigarettes a day (versus none) during pregnancy.

PSII-18 Greater feed amounts during late gestation do not improve piglets birth weight: a dose-response study performed in gilts

Abstract In breeding farms, pork producers commonly use “bump feeding” as a feeding strategy. This technique consists of increasing daily feed amount on late gestation to improve piglets birth weight. A dose-response arrangement with 4 treatments (1.8, 2.3, 2.8, and 3.3 kg/d) was used to evaluate the effects on female reproductive performance and piglet birth weight. A total of 977 gilts were fed based on a corn-soybean meal diet from day 90 of gestation until farrowing. Gilts were weighed on days 90 and 112 of gestation and at weaning. Born alive and stillborn piglets were weighed within 12 h of birth. Colostrum yield and lactation feed intake were measured in a randomly selected sub-sample of 245 gilts. As expected, body weight gains were different at day 112 (P &lt; 0.001) with the highest values observed in 3.3 kg/d treatment. As the feed amount increased during late gestation, greater were the body losses between d 112 and weaning (P &lt; 0.001). Statistical tendencies for a quadratic effect of feeding level were observed for piglets born alive (P = 0.079), average birth weight of piglets (P = 0.083), and litter weight (P = 0.059). However, there were no differences among treatments on total born and mummified fetuses (P &gt; 0.05). Gilts fed with lower feed amounts during late gestation had reduced stillborn percentages compared to those gilts fed with greater amounts. Colostrum yield and voluntary feed intake decreased linearly (P &lt; 0.05) as the feed amount performed during late gestation increased. In conclusion, increasing the feed intake from day 90 of gestation until farrowing increased gilts body weight and stillborn rate, but reduced the colostrum yield and the lactation feed intake. In addition, there were no effects of the feeding level in late gestation on piglets birth weight.