Newborn Body Composition Research Articles

Newborn regional body composition is influenced by maternal obesity, gestational weight gain and the birthweight standard score.

This study investigated whether newborn body composition is influenced by prepregnancy obesity and gestational weight gain (GWG) and explored any associations between body composition and birthweight standard score (z-score), categorised by size for gestational age. We recruited 231 obese and 80 normal weight mothers and their newborn infants and assessed the babies' body composition using dual-energy X-ray absorptiometry. The total and abdominal fat masses of infants born to mother who were obese before pregnancy were 135g (p<0.001) and 18g (p<0.001) higher than the offspring of normal weight mothers. The infants' fat mass increased by 11g (p<0.001) for every kilogram of GWG. There were no associations between prepregnancy obesity and fat-free mass. The fat percentage was significantly higher in infants who were large for gestational age (15.3%) than small for gestational age (5.2%) and appropriate for gestational age (9.8%) (p<0.001). Lower birthweight z-score was associated with a higher proportion of abdominal fat mass (p=0.009). Infants born to obese mothers had higher fat mass at birth, with abdominal fat accumulation. Low birthweight was associated with a lower crude abdominal fat mass, but a higher proportion of total fat mass placed abdominally.

A case study of the influence of maternal pregnancy body composition changes on newborn outcomes (1031.16)

Studies suggest women are entering pregnancy overweight/obese and gaining excess gestational weight, both negatively associated with pregnancy outcome. This was a case study that examined the impact of gestational body composition changes of 3 pregnant women and their newborns. Maternal body composition was monitored via the BOP POD at 16, 24 and 36 weeks gestation as well as 2 weeks postpartum. Newborn body composition via the PEA POD was measured at 2 weeks after delivery. All 3 mothers were Caucasians, aged 29 yrs, 34 yrs and 37 yrs, pre‐pregnancy BMI of 18.8 kg/m2, 22.1 kg/m2 and 40.5 kg/m2, respectively. All cases have college level or more education. Pregnancy weight gain was within the recommended gestational weight gain for each case. Interestingly, the obese case lost percent body fat but gained fat free mass during gestational weight gain. Although, both the normal weight and lean cases gained percent body fat during pregnancy, the gain was lower in the normal weight case compared to the lean case (4.2% vs. 7.9%). Overall, each case had normal vaginal deliveries of normal birth weight newborns. The infant of the normal weight case weighed the most (3.38 kg) at birth while that of the lean case weighed the least (3.24 kg). Findings from this study suggest that percent body fat gained during pregnancy may be associated with newborn adiposity and not the absolute gestational weight gain.Grant Funding Source: Hatch‐GEO00701

Fetal Programming of Obesity: Maternal Obesity and Excessive Weight Gain

The prevalence of obesity is an increasing health problem throughout the world. Maternal pre-pregnancy weight, maternal nutrition and maternal weight gain are among the factors that can cause childhood obesity. Both maternal obesity and excessive weight gain increase the risks of excessive fetal weight gain and high birth weight. Rapid weight gain during fetal period leads to changes in the newborn body composition. Specifically, the increase in body fat ratio in the early periods is associated with an increased risk of obesity in the later periods. It was reported that over-nutrition during fetal period could cause excessive food intake during postpartum period as a result of metabolic programming. By influencing the fetal metabolism and tissue development, maternal obesity and excessive weight gain change the amounts of nutrients and metabolites that pass to the fetus, thus causing excessive fetal weight gain which in turn increases the risk of obesity. Fetal over-nutrition and excessive weight gain cause permanent metabolic and physiologic changes in developing organs. While mechanisms that affect these organs are not fully understood, it is thought that the changes may occur as a result of the changes in fetal energy metabolism, appetite control, neuroendocrine functions, adipose tissue mass, epigenetic mechanisms and gene expression. In this review article, the effects of maternal body weight and weight gain on fetal development, newborn birth weight and risk of obesity were evaluated, and additionally potential mechanisms that can explain the effects of fetal over-nutrition on the risk of obesity were investigated

Potential influence of total parenteral nutrition on body composition at discharge in preterm infants

Objective: This study was undertaken to assess the potential influence of total parenteral nutrition (TPN) on body composition (BC) in preterm infants.Study design: This prospective, observational study of infants born <35 weeks measured BC at discharge using air displacement plethysmography. The % body fat (BF) at discharge was correlated with variables gestational age (GA), severity of illness, days on oxygen, time to regain birth weight and duration of TPN.Result: The 61 patients enrolled had a %BF at discharge of 13.9%. GA and TPN days correlated with %BF for the entire group. Multiple regression analysis identified that the time to regain birth weight added to the effect of GA, but not TPN. Isolating the influence of TPN in a subgroup of similarly aged infants (30–35 weeks) did not reveal a difference in body composition at the time of discharge between infants who did or did not receive TPN.Conclusion: These findings fail to demonstrate a clear influence of TPN on the increased accrual of BF in premature infants and implicate gestational modification in nutrient/caloric utilization as a principle regulator of body composition in premature newborns.

Newborn body fat: associations with maternal metabolic state and placental size.

BackgroundNeonatal body composition has implications for the health of the newborn both in short and long term perspective. The objective of the current study was first to explore the association between maternal BMI and metabolic parameters associated with BMI and neonatal percentage body fat and to determine to which extent any associations were modified if adjusting for placental weight. Secondly, we examined the relations between maternal metabolic parameters associated with BMI and placental weight.MethodsThe present work was performed in a subcohort (n = 207) of the STORK study, an observational, prospective study on the determinants of fetal growth and birthweight in healthy pregnancies at Oslo University Hospital, Norway. Fasting glucose, insulin, triglycerides, free fatty acids, HDL- and total cholesterol were measured at week 30–32. Newborn body composition was determined by Dual-Energy X-Ray Absorptiometry (DXA). Placenta was weighed at birth. Linear regression models were used with newborn fat percentage and placental weight as main outcomes.ResultsMaternal BMI, fasting glucose and gestational age were independently associated with neonatal fat percentage. However, if placental weight was introduced as a covariate, only placental weight and gestational age remained significant. In the univariate model, the determinants of placenta weight included BMI, insulin, triglycerides, total- and HDL-cholesterol (negatively), gestational weight gain and parity. In the multivariable model, BMI, total cholesterol HDL-cholesterol, gestational weight gain and parity remained independent covariates.ConclusionMaternal BMI and fasting glucose were independently associated with newborn percentage fat. This effect disappeared by introducing placental weight as a covariate. Several metabolic factors associated with maternal BMI were associated with placental weight, but not with neonatal body fat. Our findings are consistent with a concept that the effects of maternal BMI and a number of BMI-related metabolic factors on fetal fat accretion to a significant extent act by modifying placental weight.

Neonatal Body Composition According to the Revised Institute of Medicine Recommendations for Maternal Weight Gain

In 2009, the Institute of Medicine (IOM) released revised pregnancy weight gain guidelines. There are limited data regarding the effect of maternal weight gain on newborn adiposity. The aim of this study was to estimate neonatal fat mass, lean body mass, and percentage body fat according to current Institute of Medicine (IOM) pregnancy weight gain guidelines. This is a secondary analysis of a prospective observational cohort study of neonates delivered at least 36 wk gestation and evaluated for fat mass, lean body mass, and percentage body fat. Women with abnormal glucose tolerance testing and other known medical disorders or pregnancies with known fetal anomalies were excluded. Pregravid body mass index (BMI) was categorized as normal weight (<25 kg/m2), overweight (25-30 kg/m2), or obese (>30 kg/m2). Maternal weight gain was quantified as less than, equal to, or greater than current IOM guidelines. Newborn body composition measurements were compared according to weight gain and BMI categories. A total of 439 maternal-newborn pairs were evaluated; 19.8% (n=87) of women gained less than IOM guidelines; 31.9% (n=140), equal to IOM guidelines; and 48.3% (n=212), greater than IOM guidelines. Significant differences for each component of body composition were found when evaluated by IOM weight gain categories (all ANOVA, P<0.001). When controlling for pregravid BMI, only weight gain for women who were of normal weight before pregnancy remained significant. Maternal weight gain during pregnancy is a significant contributor to newborn body composition, particularly for women who are of normal weight before pregnancy.

Maternal active smoking and newborn body composition

ObjectiveMaternal smoking during pregnancy is associated with a reduction in birth size but very few studies have collated changes in neonatal anthropometry. Our aims were both to assess body composition differences by anthropometry between new-borns from smoking mothers and those from non-smoking mothers, and to show whether these differences affect proportional body mass distribution. MethodsCaucasian mothers and their full term singleton new-borns (N=1216) were selected during 2009. A structured questionnaire was completed regarding obstetric and demographic data, as well as tobacco consumption. Women were categorized, according to their smoking habits, into a non-smoking group (never smoked or stopped smoking prior to pregnancy) and a smoking group (smoked throughout pregnancy). Results22.1% of mothers smoked during pregnancy (median: 6 cigarettes/day, range: l–40). Smoking mothers were significantly younger than non-smoking mothers but there were no differences regarding other aspects which could affect infant weight. Infants from non-smoking mothers were heavier, longer, and body circumferences were all larger than those from smoking mothers (p<0.001), but the Ponderal Index showed no statistical differences. Skinfold thicknesses were significantly lower in new-borns from smoking mothers but these differences were less evident than those from body size. Subcutaneous fat distribution did not show statistical differences between the two groups. After gestational age, to smoke during gestation is the second main determinant of birth weight. ConclusionsSmoking during pregnancy involves a generalized reduction of most axiological parameters as a result of proportionate fetal growth impairment. In those infants born from mothers who smoked during gestation, neonatal lean body mass appears to be more affected than body fat, and distribution of subcutaneous fat is not different.

Assessing Body Composition in Healthy Newborn Infants: Reliability of Dual-Energy X-Ray Absorptiometry

Dual-energy X-ray absorptiometry (DXA) is used to measure body composition in newborns; however, data on DXA accuracy are limited. We investigated the reliability of body composition measurements by DXA. The present study included 207 normal-term newborn babies, recruited from a larger study on the determinants of birth weight in healthy pregnancies (STORK) between 2005 and 2008. Reliability analysis of total fat mass (FM DxA), fat-free mass, lean mass (LM DxA), bone mineral content (BMC), and bone mineral density (BMD) were based on 2 DXA scans of 50 neonates. We also performed a comparison analysis for DXA (FM DxA) measurements and caliper (CLP) or circumference (CF) measurements of trunk and extremities (performed on all neonates, n = 207). Reliability: All intraclass correlation coefficients (ICC) were satisfactory to excellent for total body and the extremity-compartment FM DxA, LM DxA, BMD, and BMC; ICC ranged from 0.86 to 0.96 but with a lower ICC for trunk FM DxA. For comparison analysis, the Pearson correlation coefficients for CLP vs DXA and CF vs DXA ranged from 0.48 to 0.79 and 0.41 to 0.77, respectively. Quadriceps CLP and CF measurements correlated best with the most reliable DXA results, whereas more modest correlations were found for the trunk region. DXA measurements of body composition demonstrated good reliability and can be used as a reference method in neonates. CLP and CF measurements are appropriate for larger cohorts or when DXA is unavailable, and they provide fair rough estimations of fat mass.

Neonatal Period: Body Composition Changes in Breast-Fed Full-Term Newborns

Background: Weight loss during initial days of life in healthy infants is known to consist of loss of both body solids and total body water. However, the nature of these body composition changes needs further investigation. Objective: To investigate the nature of changes in body composition that accompany weight loss during the first days of life in healthy term newborns. Methods: Body composition of healthy full-term newborns was assessed using air-displacement plethysmography. Cross-sectional (n = 262) and longitudinal samples (n = 28) were assessed during the first 4 and 5 days after delivery, respectively. Results: In the cross-sectional sample, mean body weight decreased significantly through day 4 (p < 0.001), mean fat mass (FM) and %FM decreased significantly (p = 0.005 and p = 0.031, respectively) by day 3. There was a significant decrease in mean fat-free mass on days 3 and 4 (p = 0.01 and p < 0.001, respectively). In the longitudinal sample, there was a significant decrease in mean body weight, FM and %FM (p < 0.001, p = 0.001, p = 0.013, respectively) by day 4. On day 5 there was a significant increase in mean body weight, FM and %FM (p < 0.001, p = 0.024, p = 0.036, respectively) when compared to day 4. There was no significant difference in mean FM and %FM values between day 1 and day 5. Conclusions: These results indicate that body composition changes are constituted by a reduction in both fat and fat free mass. However, a greater %FM is lost and consequently regained by day 5 when compared to fat-free mass.

A principal components approach to parent-to-newborn body composition associations in South India.

BackgroundSize at birth is influenced by environmental factors, like maternal nutrition and parity, and by genes. Birth weight is a composite measure, encompassing bone, fat and lean mass. These may have different determinants. The main purpose of this paper was to use anthropometry and principal components analysis (PCA) to describe maternal and newborn body composition, and associations between them, in an Indian population. We also compared maternal and paternal measurements (body mass index (BMI) and height) as predictors of newborn body composition.MethodsWeight, height, head and mid-arm circumferences, skinfold thicknesses and external pelvic diameters were measured at 30 ± 2 weeks gestation in 571 pregnant women attending the antenatal clinic of the Holdsworth Memorial Hospital, Mysore, India. Paternal height and weight were also measured. At birth, detailed neonatal anthropometry was performed. Unrotated and varimax rotated PCA was applied to the maternal and neonatal measurements.ResultsRotated PCA reduced maternal measurements to 4 independent components (fat, pelvis, height and muscle) and neonatal measurements to 3 components (trunk+head, fat, and leg length). An SD increase in maternal fat was associated with a 0.16 SD increase (β) in neonatal fat (p < 0.001, adjusted for gestation, maternal parity, newborn sex and socio-economic status). Maternal pelvis, height and (for male babies) muscle predicted neonatal trunk+head (β = 0. 09 SD; p = 0.017, β = 0.12 SD; p = 0.006 and β = 0.27 SD; p < 0.001). In the mother-baby and father-baby comparison, maternal BMI predicted neonatal fat (β = 0.20 SD; p < 0.001) and neonatal trunk+head (β = 0.15 SD; p = 0.001). Both maternal (β = 0.12 SD; p = 0.002) and paternal height (β = 0.09 SD; p = 0.030) predicted neonatal trunk+head but the associations became weak and statistically non-significant in multivariate analysis. Only paternal height predicted neonatal leg length (β = 0.15 SD; p = 0.003).ConclusionPrincipal components analysis is a useful method to describe neonatal body composition and its determinants. Newborn adiposity is related to maternal nutritional status and parity, while newborn length is genetically determined. Further research is needed to understand mechanisms linking maternal pelvic size to fetal growth and the determinants and implications of the components (trunk v leg length) of fetal skeletal growth.

Is term newborn body composition being achieved postnatally in preterm infants?

Background The American Academy of Pediatrics (AAP) recommends that preterm infants' growth duplicates fetal growth rates and that body composition replicates in utero body composition. Aims To compare the total body fat mass between preterm infants assessed at term corrected age and full-term newborns, and to investigate the effects of gestational age, gender, weight increase, being breast fed on total adiposity. Study design Prospective observational study. Subjects One hundred and ten preterm infants [mean (SD) gestational age: 29.9 (2.3) weeks; birth weight: 1118 (274) g], and 87 full term [mean (SD) 38.6 (1.21) weeks, 3203 (385) g], breastfed infants. Outcome measures Growth and body composition by means of a pediatric air displacement system were assessed at term corrected age in preterm infants and on day 3 of life in full term infants. Results Weight, length and head circumference were smaller in the preterm group as compared to the term group. Mean (SD) percentage of fat mass in preterm infants was significantly higher as compared to term infants [14.8 (4.4) vs 8.59 (3.71), P < 0.0001]. Fat mass was negatively correlated with gestational age ( P < 0.001), and positively associated with weight increase ( P < 0.05). Conclusions Our data suggest that body composition, in terms of fat mass, in preterm infants at term corrected age is different from that of full term newborns.

Effects of maternal tobacco-smoke exposure on fetal growth and neonatal size

Exposure to tobacco smoke, through both active and passive measures, has a significant impact on women's health, including effects on the cardiovascular, pulmonary and reproductive systems. Of particular interest is the effect of smoking on pregnancy outcomes. One crucial outcome that has been linked to the subsequent development of both neonatal and adult disease is intrauterine or fetal growth restriction. In this article, we will summarize the effects of smoking on newborn size and fetal growth. We will review evidence showing that tobacco consumption during pregnancy leads to a reduction in birthweight, largely through affecting specific anthropometric measures and newborn body composition. We will highlight the role of genetic susceptibility to these effects and discuss how smoking cessation prior to the third trimester results in a reduction in the risk of fetal growth restriction.

Impact of fetal growth restriction on body composition and hormonal status at birth in infants of small and appropriate weight for gestational age

Fetal growth restriction (FGR) has been related to several health risks, which have been generally identified in small-for-gestational age (SGA) individuals. To evaluate the impact of FGR on body composition and hormonal status in infants born either small- or appropriate-for-gestational age (AGA). Fetal growth was assessed by ultrasound every 4 weeks from mid-gestation to birth in 248 high-risk pregnancies for SGA. Fetal growth velocity was calculated as change in the estimated fetal weight percentiles and FGR defined as its reduction by more than 20 percentiles from 22 gestational weeks to birth. Impact of FGR on body composition, cord insulin, IGF-I, IGF binding protein-3 (IGFBP-3), and cortisol concentrations was assessed in SGA and AGA newborns. Growth-retarded AGA infants showed significantly reduced birth weight, ponderal index, percentage of fat mass, and bone mineral density when compared with AGA newborns with stable intrauterine growth. Cord IGF-I and IGFBP-3 concentrations were significantly decreased in growth-retarded infants in both SGA and AGA groups. Cord insulin concentration was significantly lower and cord cortisol significantly higher in AGA infants with FGR versus AGA newborns with stable intrauterine growth. After adjustment for gestational age and gender, birth weight was directly related to fetal growth velocity and cord IGF-I concentration. The variation in infant's adiposity was best explained by fetal growth velocity and cord insulin concentration. FGR affects body composition and hormonal parameters in newborns with birth weight within the normal range, suggesting these individuals could be at similar metabolic risks as SGA. .

OP09.08: Fetal soft tissue and birth weight: their relationship to newborn infant body composition

Results: A total of 602 organ systems in 260 exams out of 193 patients were identified for this study (26 exams in the first trimester, 161 in the second, and 73 in third trimester). Table 1 shows the total number of organs scanned with 3DUS for each impact group. In the D group, the most significant findings were in these organs: face exams 10, brain 5 and uterine shape 4. In the I group, the most significant findings were in these organs: extremities 16 exams, urogenital system 15, placenta 15 and brain 10. In the V group, the most significant findings were in these organs: face 101 exams, spine 75, extremities 74 and skull 68. In the S group, the most significant findings were in these organs: heart 5 exams, and adnexa 3.

Assessing newborn body composition using principal components analysis: differences in the determinants of fat and skeletal size

BackgroundBirth weight is a composite of skeletal size and soft tissue. These components are likely to have different growth patterns. The aim of this paper is to investigate the association between established determinants of birth weight and these separate components.MethodsWeight, length, crown-rump, knee-heel, head circumference, arm circumference, and skinfold thicknesses were measured at birth in 699 healthy, term, UK babies recruited as part of the Exeter Family Study of Childhood Health. Corresponding measurements were taken on both parents. Principal components analysis with varimax rotation was used to reduce these measurements to two independent components each for mother, father and baby: one highly correlated with measures of fat, the other with skeletal size.ResultsGestational age was significantly related to skeletal size, in both boys and girls (r = 0.41 and 0.52), but not fat. Skeletal size at birth was also associated with parental skeletal size (maternal: r = 0.24 (boys), r = 0.39 (girls) ; paternal: r = 0.16 (boys), r = 0.25 (girls)), and maternal smoking (0.4 SD reduction in boys, 0.6 SD reduction in girls). Fat was associated with parity (first borns smaller by 0.45 SD in boys; 0.31 SD in girls), maternal glucose (r = 0.18 (boys); r = 0.27 (girls)) and maternal fat (r = 0.16 (boys); r = 0.36 (girls)).ConclusionPrincipal components analysis with varimax rotation provides a useful method for reducing birth weight to two more meaningful components: skeletal size and fat. These components have different associations with known determinants of birth weight, suggesting fat and skeletal size may have different regulatory mechanisms, which would be important to consider when studying the associations of birth weight with later adult disease.

Body Composition of Newborn Twins: Intrapair Differences

Objective: To measure body composition in newborn twins and to test the hypothesis that differences in body weights between twins are reflected proportionally by their differences in various components of body composition.Methods: 48 pairs of newborn twins delivered at a tertiary teaching hospital had dual energy x-ray absorptiometry (DXA) body composition measurement for bone mineral content (BMC), lean and fat mass (LM, FM). Data analyzed with regression and analysis of variance.Results: Body weight, BMC, LM and FM increased with increased gestational age (p < 0.001). The percent difference in BW between each twin pair was significantly correlated with percent difference in BMC, LM, and FM (p < 0.001). However, mean (± SD) percent difference in body weight (14.3 ± 10.0%) was significantly lower (p < 0.001) than FM (26.0 ± 15.0%) but was not significantly different from LM (13.4 ± 9.0%) or BMC (15.9 ± 11.6%).Conclusion: In newborn twins, body weight and body composition varies with gestational age. For any twin pair, a difference in body weight was correlated with but not proportional to differences in individual components of body composition.

Asociación entre la composición corporal de la embarazada y la composición corporal del recién nacido

Objective: To study the association between the body composition of women at the end of pregnancy and that of their respective newborn babies. Subjects: 224 pregnant women attending a public hospital in a poor urban area of Santiago, Chile. Methods: Maternal body composition was determined using a deuterium dilution technique to measure total body water as described by Schoeller, fat free mass was calculated using the equations of van Raaji et al. Newborn body composition was estimated using the Dauncey anthropometric method. The association between maternal and newborn body compositions was studied using correlation and multiple regression analyses. Results: The multiple regression models showed that maternal fat free mass, maternal fat mass and gestational age influenced both newborn compartments (p < 0.01), and fat free mass had a greater influence than the other variables. Conclusions: Fat free maternal mass has a greater influence on newborn body composition than the fat mass. This observation is in accordance with other studies revealing an important tole in fetal growth of the maternal total body water and plasma volume expansion.

Changes in Body Composition during the Initial Hours of Life in Breast-Fed Healthy Term Newborns

Newborns usually lose 5–10% of their initial weight during the first 4 days of life. Our aim, using bioelectrical impedance (BI), was to study the body composition of healthy term newborns and the nature of the changes which accompany this physiological weight loss. Forty-three healthy term newborns, all with adequate weight for their gestational age, were studied during the first 3 days of life. Weight and BI were taken on the 1st, 2nd, and 3rd days of life, always at the same time of the day. Total body water (TBW), percentage of total body mass hydration (%TBW), and amount of body solids were calculated. Average weight at birth was 3,297 ± 381 g, length 50.04 ± 1.75 cm, and gestational age 39.9 ± 0.84 weeks. Weight, TBW, and body solids decreased progressively during the first 3 days of life (p < 0.000). By day 3, weight loss represented 5.67 ± 1.98% of birth weight, but %TBW increased slightly (1.72%; p < 0.000). These results suggest that, during physiological weight loss, body composition modifications are produced in the term newborn by a decrease in TBW and loss of body solids. The level of body hydration increases slightly, since the loss of body solids is greater than the loss of TBW. The use of BI can help us in the study of body composition and the short- and/or long-term changes produced therein, in the newborn.

European Regulatory Authorities and Pediatric Labeling

### The Need for Medicinal Product Testing in Children #### Ethical Considerations Children should not be given medicines that have not been evaluated adequately for use in that age group. There is a responsibility, shared by applicants and the appropriate authorities, to ensure that children have timely access to safe and effective medicines that have accurate, scientifically justified prescribing information. Applicants are encouraged to investigate the safety and efficacy of a product in children, if it is likely to be of therapeutic benefit in this age-group, and to develop suitable formulation, even if use is likely to be small. However important a clinical trial may be to prove or disprove the value of a treatment, individual members of one or both of the groups—subject or control—can suffer injury as a result of inclusion in the trial, even if the whole community benefits. As with adults who participate in clinical trials and who understand the issues involved in giving their informed consent, consent should be obtained from the legal guardian of children in accordance with national legislation. Children should be fully informed about the trial in language and terms they understand and, if able, should personally sign and date the written informed consent. The child should be made aware of his/her rights to decline to participate. The child's wish to be withdrawn from a study must be respected. These measures should be applied in conjunction with 1) part 4 of Directive 75/318/EEC, as amended, which requires “… details concerning patients who may be at increased risk”; the CPMP/ICH guideline for good clinical practice; and 3) the CPMP guideline on biostatistical methodology in clinical trials in applications for marketing authorizations for medicinal products. These measures are intended to assist applicants with specific problems presented by medicinal product testing in children. The child should stand to obtain some direct benefit from the clinical trial, except … Address correspondence to Elisabeth Autret, MD, Hopital Bretonneau, Pharmacologie Clinique, Boulevard Tonnele, 37044 Tours, France.

Dual energy X-ray absorptiometry in evaluating body composition and bone minearl content in newborns

Dual energy X-ray absorptiometry in evaluating body composition and bone minearl content in newborns