Normal Weight Infants Research Articles

Correlations of Birth Defects With Birth Weight and Gestational Age

Objective To analyze the incidence rate of birth defects in infants born at different gestational ages and birth weights,so as to provide a basis for improving the surveillance system and reducing the incidence of birth defects. Methods Data of all perinatal infants born at and after 28 weeks of gestation and within 7 days after delivery in all the hospitals with the obstetrical department from October 1,2003 to September 30,2015 were collected. Results From 2003 to 2015,1 236 937 perinatal infants were monitored,including 10 619 with birth defects (incidence rate of 8.59‰).Among the infants with birth defects identified by the hospital surveillance system of birth defects in Xi'an during the study period,3 306,3 473,and 224 infants showed the birth weights less than 2 500 g,the gestational age within the range of [28,37] weeks,and the gestation age≥42 weeks,respectively.The low birth weight infants showed higher incidence rate of birth defects than the normal birth weight infants (χ2=37 097.79,P<0.001).The premature infants (gestational age<37 weeks) and postterm infants (gestational age≥42 weeks) showed higher incidence rates of birth defects than infants born at normal gestational age (χ2=24 998.24,P<0.001;χ2=196.40,P<0.001).The top five birth defects of low birth weight infants were congenital hydrocephalus,spina bifida,congenital heart disease,anencephaly,and cleft lip and cleft palate.The outcomes of birth defects in normal weight infants and low weight infants were mainly live births (68.60%) and stillbirths (54.72%),respectively,which showed a significant difference (χ2=647.59,P<0.001).The main outcomes of birth defects in the infants born at normal gestation age,postterm infants,and premature infants were mainly live births (77.38%),live births (83.93%),and stillbirths (57.79%),respectively,which showed significant differences (premature infants vs.infants born at normal gestation age: χ2=2 025.08,P<0.001;premature infants vs. postterm infants:χ2=245.39,P<0.001;infants born at normal gestation age vs.postterm infants:χ2=16.28,P=0.001). Conclusions Premature infants,low birth weight infants,and postterm infants showed significantly higher incidence rate of birth defects than the infants born at normal gestation age.The outcomes of birth defects had significant differences between low birth weight infants and normal birth weight infants,between premature infants and infants born at normal gestation age,between premature infants and postterm infants,and between infants born at normal gestation age and postterm infants.

Infant feeding-a scoping review for Nordic Nutrition Recommendations 2023.

The 2012 edition of the Nordic Nutrition Recommendations (NNR) included recommendations on breastfeeding, based on the most recent guidelines and recommendations from major national food and health authorities and organizations, systematic reviews, and some original research. For NNR 2023, the scope has been expanded and also includes formula feeding and the introduction of solid food. The main focus in this scoping review is on infants aged 0-12 months but also considers parts both before and beyond the first year, as the concept of 'the first 1000 days' emphasizes the importance of factors during pregnancy and the first 2 years of life for immediate and later health: physical as well as emotional and mental health. Breastmilk is the natural and sustainable way to feed an infant during the first months of life. Numerous studies have indicated immediate as well as long-term beneficial effects of breastfeeding on health for both the infant and the breastfeeding mother, and from a public health perspective, it is therefore important to protect, support, and promote breastfeeding. For full-term, normal weight infants, breastmilk is sufficient as the only form of nutrition for the first 6 months, except for vitamin D that needs to be given as supplement. The World Health Organization (WHO) and several other authoritative bodies therefore recommend exclusive breastfeeding during the first 6 months. Starting solids at about 6 months is necessary for both nutritional and developmental reasons. According to the European Food Safety Authority (EFSA) and the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN), solid foods are safe to give from 4 months although exclusive breastfeeding until 6 months is the desirable goal. Breastfeeding can continue together with complementary foods as long as it is mutually desired by the mother and child. If breastfeeding is not enough or for some reason discontinued before the infant is 4 months of age, the infant should be fed infant formula, and, when possible, breastfeeding should be continued alongside the formula feeding. If the infant is 4 months or older, starting with solids together with continued breastfeeding and/or formula feeding is an option. Infant formulas have been developed for infants who are not breastfed or do not get enough breastmilk. Home-made formula should not be given.

The Impact of Demographic and Delivery Factors on Low- and Normal-Weight Infants

The Impact of Demographic and Delivery Factors on Low- and Normal-Weight Infants

Maternal exposure to metal components of PM2.5 and low birth weight in New Mexico, USA.

Infants with low birth weight (LBW) are more likely to have health problems than normal weight infants. In studies examining the associations between particulate matter (PM) exposures and LBW, there is a tendency to focus on PM2.5 as a whole. However, insufficient information is available regarding the effects of different components of PM2.5 on birth weight. This study identified the associations between maternal exposure to 10 metal components of PM2.5 and LBW in offspring based on small area (divided by population size) level data in New Mexico, USA, from 2012 to 2016. This study used a pruned feed-forward neural network (pruned-FNN) approach to estimate the annual average exposure index to each metal component in each small area. The linear regression model was employed to examine the association between maternal PM2.5 metal exposures and LBW rate in small areas, adjusting for the female percentage and race/ethnicity compositions, marriage status, and educational level in the population. An interquartile range increase in maternal exposure to mercury and chromium of PM2.5 increased LBW rate by 0.43% (95% confidence interval (CI): 0.18-0.68%) and 0.63% (95% CI: 0.15-1.12%), respectively. These findings suggest that maternal exposure to metal components of air pollutants may increase the risk of LBW in offspring. With no similar studies in New Mexico, this study also posed great importance because of a higher LBW rate in New Mexico than the national average. These findings provide critical information to inform further epidemiological, biological, and toxicological studies.

Integrative multiomics analysis of infant gut microbiome and serum metabolome reveals key molecular biomarkers of early onset childhood obesity

Evidence supports a complex interplay of gut microbiome and host metabolism as regulators of obesity. The metabolic phenotype and microbial metabolism of host diet may also contribute to greater obesity risk in children early in life. This study aimed to identify features that discriminated overweight/obese from normal weight infants by integrating gut microbiome and serum metabolome profiles. This prospective analysis included 50 South Asian children living in Canada, selected from the SouTh Asian biRth cohorT (START). Serum metabolites were measured by multisegment injection-capillary electrophoresis-mass spectrometry and the relative abundance of bacterial 16S rRNA gene amplicon sequence variant was evaluated at 1 year. Cumulative body mass index (BMIAUC) and skinfold thickness (SSFAUC) scores were calculated from birth to 3 years as the total area under the growth curve (AUC). BMIAUC and/or SSFAUC >85th percentile was used to define overweight/obesity. Data Integration Analysis for Biomarker discovery using Latent cOmponent (DIABLO) was used to identify discriminant features associated with childhood overweight/obesity. The associations between identified features and anthropometric measures were examined using logistic regression. Circulating metabolites including glutamic acid, acetylcarnitine, carnitine, and threonine were positively, whereas γ-aminobutyric acid (GABA), symmetric dimethylarginine (SDMA), and asymmetric dimethylarginine (ADMA) were negatively associated with childhood overweight/obesity. The abundance of the Pseudobutyrivibrio and Lactobacillus genera were positively, and Clostridium sensu stricto 1 and Akkermansia were negatively associated with childhood overweight/obesity. Integrative analysis revealed that Akkermansia was positively whereas Lactobacillus was inversely correlated with GABA and SDMA, and Pseudobutyrivibrio was inversely correlated with GABA. This study provides insights into metabolic and microbial signatures which may regulate satiety, energy metabolism, inflammatory processes, and/or gut barrier function, and therefore, obesity trajectories in childhood. Understanding the functional capacity of these molecular features and potentially modifiable risk factors such as dietary exposures early in life may offer a novel approach for preventing childhood obesity.

0099 Circadian Rest-Activity Rhythm Development is associated with Weight Gain in Early Infancy

Abstract Introduction In early childhood, irregular sleep schedules that may promote circadian rhythm misalignment predict greater weight gain. However, circadian rest-activity (CRA) rhythmicity in infancy in relation to growth is understudied. The aim of the present study was to investigate the association between newborn circadian rest-activity rhythmicity and change in weight-for-age from birth to three months. Methods Data were captured as a secondary data analysis from the Snuggle Bug / Acurrucadito Study (see Support). English or Spanish speaking mothers (n=41, age M±SD=33.1±4.6y, 31.7% Hispanic/Latina) and their full-term (≥37wk) infants of normal weight (2.5-4kg; 58.5% female; 25.6% WIC enrolled) were recruited from Phoenix, Arizona. CRA rhythmicity was measured at eight weeks with ankle-worn Micro Motionloggers (Ambulatory Monitoring Inc.) for five 24hr periods at one-minute epochs. CRA metrics assessed included 24hr autocorrelation, mesor, magnitude, acrophase, goodness-of-fit R2, interdaily stability, intradaily variability, and relative amplitude. Birthweight was mother-reported and 3mon infant weight was measured with a Seca scale. Weight-for-age Z-scores (WAZ) by infant sex were computed based upon World Health Organization growth charts and the change difference between timepoints was the primary outcome. Regression models adjusting for birth WAZ examined the relationships between CRA metrics at eight weeks with change in WAZ from birth to 3mo. Results At eight weeks, mean±SD CRA metrics were as follows: 24hr autocorrelation of 0.25±0.03, mesor of 115.6±14.7, amplitude of 68.1±18.3, goodness-of-fit R2 of 0.42±0.10, acrophase of 14:12±1:42, interdaily stability of 0.57±0.12, intradaily variability of 0.93±0.19, and relative amplitude of 0.61±0.11. Mean birth WAZ and change in WAZ from birth to 3mon were 0.39±0.73 and -0.57±0.77, respectively. After adjusting for birth WAZ, in separate models, greater mesor (R2 Change=0.10, β=-0.32, p=0.03), amplitude (R2 Change=0.11, β=-0.34, p=0.03), and goodness-of-fit R2 (R2 Change=0.10, β=-0.32, p=0.04) were significantly associated with less change in WAZ from birth to 3mon. Conclusion Among relatively healthy, full-term infants born of normal weight, greater 24hr circadian rest-activity rhythmicity achieved by 8 weeks was associated with slower rate of weight gain across the newborn stage. Promoting behaviors and environmental cues from parents that strengthen early circadian rhythmicity in their infants may promote healthy weight trajectories. Support (if any) NIH/NHLBI R01HL147931

Birth weight concerning obesity and diabetes gene expression in healthy infants; a case-control study

BackgroundSince obesity and diabetes are prevalent worldwide, identifying the factors affecting these two conditions can effectively alter them. We decided to investigate the expression of obesity and diabetes genes in infants with birth weights lower than 2500 g in comparison with infants with normal birth weights.Methods215 healthy infants between the ages of 5–6 months were used in the current case-control research, which was conducted at health and treatment facilities in Kermanshah. Infants who were healthy were chosen for the research after their weight and height were measured and compared to the WHO diagram to ensure that they were well-grown and in good health. There were 137 infants in the control group and 78 infants in the case group. All newborns had 5 cc of blood drawn intravenously. To assess the expression of the genes MC4R, MTNR1B, PTEN, ACACB, PPAR-γ, PPAR-α, NRXN3, NTRK2, PCSK1, A2BP1, TMEM18, LXR, BDNF, TCF7L2, FTO and CPT1A, blood samples were gathered in EDTA-coated vials. Chi-square, Mann-Whitney U, and Spearman analyses were used to examine the data.ResultsA significant inverse correlation between birth weight and obesity and diabetes genes, including MTNR1B, NTRK2, PCSK1, and PTEN genes (r= -0.221, -0.235, -0.246, and − 0.418, respectively). In addition, the LBW infant’s expression level was significantly up-regulated than the normal-weight infants (P = 0.001, 0.007, 0.001, and < 0.001, respectively). The expression level of the PPAR-a gene had a significantly positive correlation with birth weight (r = 0.19, P = 0.005). The expression level of the PPAR-a gene in the normal-weight infants was significantly up-regulated than the LBW infants (P = 0.049).ConclusionThe expression levels of MTNR1B, NTRK2, PCSK1, and PTEN genes were up-regulated in the LBW infants; however, the expression level of PPAR-a gene was significantly down-regulated in the LBW infants compared to the infants with normal birth weight.

Severe Maternal Morbidity in Georgia, 2009-2020.

The increasing focus of population surveillance and research on maternal-and not only fetal and infant-health outcomes is long overdue. The United States maternal mortality rate is higher than any other high-income country, and Georgia is among the highest rates in the country. Severe maternal morbidity (SMM) is conceived of as a "near miss" for maternal mortality, is 50 times more common than maternal death, and efforts to systematically monitor SMM rates in populations have increased in recent years. Much of the current population-based research on SMM has occurred in coastal states or large cities, despite substantial geographical variation with higher maternal and infant health burdens in the Southeast and rural regions. This population-based study uses hospital discharge records linked to vital statistics to describe the epidemiology of SMM in Georgia between 2009 and 2020. Georgia had a higher SMM rate than the United States overall (189.2 vs. 144 per 10,000 deliveries in Georgia in 2014, the most recent year with US estimates). SMM was higher among racially minoritized pregnant persons and those at the extremes of age, of lower socioeconomic status, and with comorbid chronic conditions. SMM rates were 5 to 6 times greater for pregnant people delivering infants <1500 grams or <32 weeks' gestation as compared with those delivering normal weight or term infants. Since 2015, SMM has increased in Georgia. SMM represents a collection of life-threatening emergencies that are unevenly distributed in the population and require increased attention. This descriptive analysis provides initial guidance for programmatic interventions intending to reduce the burden of SMM and, subsequently, maternal mortality in the US South.

Blastocyst culture of non-top-quality cleavage embryos may increase the risk of anembryonic pregnancy following in vitro fertilization: a retrospective cohort study.

Anembryonic pregnancy (AP) is the most severe dysmorphogenesis of human embryo development and a frequent presentation of early pregnancy loss (EPL). Studies have analyzed the association between assisted reproductive technologies (ART) and EPL. However, the specific relationship between ART and AP has not been fully elucidated. Several studies suggested that non-genomic anomalies might be related to AP and ART might increase the risk of epigenetic changes, thus possibly detecting some associations between ART and AP. Our study aims to find out any possible risk factors of AP in ART treatments, and translate the results into clinical practice. A retrospective cohort study was conducted in Nanfang Hospital. Data from 1,765 singleton pregnancies following fresh or frozen-thawed embryo transfer from January 2014 to December 2017 were collated with the inclusion of EPLs and normal live births (NLB). Participants were divided into three groups: NLB (full-term birth with normal body weight infants), EPL (spontaneous pregnancy loss prior to 13 weeks gestation) with embryos (EE), and APs (embryonic pole was invisible in two consecutive ultrasound examinations). The basic characteristics of the patients and the association between ART-related variables and AP were analyzed using one-way analysis of variance (ANOVA) and multivariable logistic regression model, respectively. Products of conception (POC) from AP and EE patients received karyotype analysis using multiplex ligation-dependent probe amplification (MLPA). Blastocyst culture of non-top-quality cleavage stage embryos almost doubled the percentage of AP in EPL (45.9% vs. 24.4%, P=0.037), and the normal euploid rate was significantly higher in the AP group (50.5% vs. 32.3%, P=0.003). Using multivariable logistic regression model, we found that blastocyst transfer and advanced maternal age might be risk factors for AP (OR >1, P<0.05). Deceased β-HCG level might indicate its occurrence (OR <1, P<0.001) while CoQ10 supplementation might be a protective factor (OR <1, P<0.001). The occurrence of AP may be due to epigenetic abnormalities associated with advanced maternal age and extended in vitro embryo culture, while CoQ10 supplementation may be a potential method in preventing AP. Future multi-center prospective cohort studies should be conducted to verify these results.

A Narrative Review of Kangaroo Mother Care (KMC) and Its Effects on and Benefits for Low Birth Weight (LBW) Babies.

Kangaroo mother care (KMC) is a preventative, economical method for infants with low birth weight (LBW). KMC benefits LBW infants in a number of ways. This review standpoints the effect of KMC on the weight gain of LBW neonates. KMC also improves breastfeeding rates during the hospital stay as well as at home. KMC can be provided not only by mothers but also by fathers and other adults in the family. However, it is not routinely practiced in hospitals.Short-term and long-term KMC is beneficial for survival, neurodevelopment, breastfeeding, and mother-infant bonding. Preterm infants are more likely to experience neonatal mortality and morbidity due to acute breathing problems, gastrointestinal problems, autoimmune disorders, and neurologicaldefects as compared to full-term and normal-weight infants. A thorough literature search was conducted using key databases like PubMed and Google Scholar, as well as Medical Subject Heading (MeSH) terms and related keywords. Clinical health experts also believed that implementing KMC would assist mothers in developing more solid emotional bonds with their newborns. As a result, both mothers and their newborns felt more secure, and the babies were more relaxed.KMC was also seen to support the infants' growth and development, which improved the mothers' sense of connection. It is crucial to remember that KMC works better for babies with very low birth weight (VLBW). The mother-child relationship enhances sucking-feeding, and KMC infants have higher means of growth parameters.

Effects of Different Nutritional Factors on Neonates Birth Weight

Under nutrition in mothers is a major factor which results in abnormal or reduced growth of fetus, low birth weight (LBW), neonatal illness and infant death Objective: To determine the association of dietary factors with birth weight of neonates Methods: This cross-sectional study was conducted on 100 mothers, divided into 2 groups, one having normal weight (NW) infants and other having LBW infants. Data regarding their dietary habits and anthropometric measurements were taken Results: The results showed that 29 mothers of NW babies were older child born with NW, 21 mothers of NW babies were not older child born with NW, whereas 29 mothers of LBW babies were older child born with NW, 21 mothers of LBW babies were not older child born with NW. There was an insignificant association (p=1.000) between education and neonate’s birth weight as p-value is greater than 0.05. Conclusions: The rate of LBW were more affected by their food choices (lack of knowledge, improper antenatal care, less consumption of milk and protein and also fruits and vegetable) as compared to mothers with NW babies, other confounding determinants such as illiteracy rate, poor maternal nutrition and lifestyle factors, no knowledge regarding balanced diet and supplementation among pregnant females leads to prevalence of LBW infants.

Postnatal exposure to PM2.5 and weight trajectories in early childhood.

Background:Inconsistent evidence has assessed the impact of air pollution exposure on children’s growth trajectories. We investigated the role of 90-day average postnatal fine particulate matter (PM2.5) exposures by estimating the magnitude of effects at different ages, and the change in child weight trajectory by categories of exposure.Methods:We obtained weight values from electronic health records at each hospital visit (males = 1859, females = 1601) from birth to 6 years old children recruited into the Boston-based Children’s HealthWatch cohort (2009–2014). We applied mixed models, adjusting for individual and maternal confounders using (1) varying-coefficient models allowing for smooth non-linear interaction between age and PM2.5, (2) factor-smooth interaction between age and PM2.5 quartiles. Additionally, we stratified by sex and low birthweight (LBW) status (≤2500 g).Results:Using varying-coefficient models, we found that PM2.5 significantly modified the association between age and weight in males, with a positive association in children younger than 3 years and a negative association afterwards. In boys, for each 10 µg/m3 increase in PM2.5 we found a 2.6% increase (95% confidence interval = 0.8, 4.6) in weight at 1 year of age and a −0.6% (95% confidence interval = −3.9, 2.9) at 5 years. We found similar but smaller changes in females, and no differences comparing growth trajectories across quartiles of PM2.5. Most of the effects were in LBW children and null for normal birthweight children.Conclusions:This study suggests that medium-term postnatal PM2.5 may modify weight trajectories nonlinearly in young children, and that LBW babies are more susceptible than normal-weight infants.

Comparison of Infants with Low Birth Weight and Normal Weight Regarding Anemia at the Age of 12 Months in Yazd

Introduction: Anemia is common in both age groups of 9-24 months and adolescence. Considering the fact that anemia in children is associated with various complications such as stunted growth, activity intolerance, behavioral changes, inattention, irritability and changes in the immune response, the aim of this study was to compare the frequency of anemia in infants with normal birth weight and LBW at 12 months of age. Methods: This was an analytical study using the historical cohort method with a parallel design from February 2017 to July 2016. The study population was all the infants referred to health centers of Yazd at the age of 12 months for vaccination, who were monitored. 100 infants were selected and divided into two groups of 50 with normal birth weight (more than 2500 g) and the birth weight less than 2500 g by simple random sampling, and CBC and ferritin tests were run for them. In this study, the hemoglobin less than 11 was considered anemia, and finally, the data were analyzed by SPSS software. Results: The results showed that the two groups of the LBW and the normal weight were not different in terms of sex, but the type of feeding was different, and infants of LBW group used more powdered milk. 22% of LBW infants and 38% of normal weight infants were anemic. Conclusion: According to the results of the study, it seems that the rate of anemia is due to the use of powdered milk, iron supplements with higher doses for LBW infants early on, and better and constant care compared to infants with normal weight. However, more comprehensive studies with larger sample sizes can be effective in explaining these anemia-related factors in LBW infants.

Dioxin-like Activity in Pregnant Women and Indices of Fetal Growth: The ACCEPT Birth Cohort.

Exposure to lipophilic persistent organic pollutants (lipPOPs) elicits a number of species- and tissue-specific toxic responses, many of which involve the aryl hydrocarbon receptor (AhR). This study aims to measure the combined serum dioxin-like activity of lipPOPs in Greenlandic Inuit pregnant women and the associations with fetal growth indices. The combined dioxin-like activity of serum lipPOPs extracts was determined using the AhR reporter gene bioassay and expressed as pico-gram (pg) TCDD equivalent (TEQ) per gram serum lipid [AhR-TEQ (pg/g lipid)]. Significant AhR-TEQ was found in >87% of serum samples with the median level of 86.2 pg TEQ/g lipid. The AhR-TEQ level positively correlated with the marine food intake biomarker n-3/n-6 polyunsaturated fatty acids ratio, while negatively correlated with body mass index and parity. Women giving birth to infants with low birth weight (<2500 g) and length (<50 cm) had higher AhR-TEQ level compared to those with normal weight and length infants. For previous smokers, we found significant inverse associations between maternal AhR-TEQ level and fetal growth indices. In conclusion, exposure of Greenlandic Inuit pregnant women to dioxin-like compounds through traditional marine food can adversely influence the fetal growth via induced AhR activity. Smoking might have modifying effects.

The levels of pro- and anti-inflammatory cytokines in premature infants with perinatal infections.

Intrauterine infections are an urgent problem of modern neonatology. One of the causes of intrauterine infective foetal lesions is physiological immunosuppression. The purpose of this study is to investigate the cytokine status in newborns infected with perinatal infections, depending on their body weight. The study examined 145 newborns. Taking into account their body weight, they were divided into 2groups: main and secondary. The study was conducted in the immunological laboratory of the Medical Centre of Marat Ospanov West Kazakhstan Medical University in the city of Aktobe, with the determination of the level of IgM and IgG to the herpes simplex virus (HSV) types 1, 2, cytomegalovirus (CMV), and chlamydia using the MULTISKANASCENT analyser with the "Chemo" T system. The main results of this study are the predominance of the anti-inflammatory component in both normal weight and underweight infants, which is evidence of the Th-cell-mediated immune response prevalence. The applied value of this study lies in the possibility of applying its results in practice to obtain effective methods to counteract the occurrence and development of intrauterine infections.

The effects of different parity and delivery mode on wheezing disorders in the children—a retrospective cohort study in Fujian, China

Background The relationship between childbirth delivery methods and the risk of wheezing in children remains controversial. Few studies have explored it under different maternal conditions. Objective To explore the influence of childbirth delivery method on the onset of wheezing in children of different parity. Methods A total of 21716 patients were included in this retrospective observational study. Multivariable logistic regression was used to analyze the relationship between childbirth delivery method and wheezing in children under 18 years of age in Fujian Province. Results Wheezing differed statistically based on the child’s sex, age, season of onset, parity, jaundice history, and feeding patterns (P < 0.05). After adjusting for confounding factors, in cases of parity greater than two, the risk of wheezing in cesarean section deliveries was higher than that in vaginal deliveries (OR: 1.107; 95% CI 1.010–1.214). In girls with parity greater than two (OR: 1.179; 95% CI 1.003–1.387) and normal-weight infants with parity greater than two (OR: 1.106; 95% CI 1.003–1.220), the risk of wheezing in cesarean section deliveries was higher. The interaction term between the mode of childbirth and parity was significant in girls (P = 0.014). Conclusion The method of childbirth delivery and parity are related to the risk of wheezing and may be relevant to gender and birth weight. Parity and gender have synergistic effects on wheezing.

Does kangaroo mother care have an impact on morbidity, mortality and duration of hospital stay of newly born low birth weight babies?

Background: Preterm and low birth weight infants are more likely to experience neonatal morbidity including acute respiratory, gastrointestinal, central nervous system, immunologic, hearing and vision problems than both term and normal weight infants who survive the neonatal period. The present study was aimed to evaluate the impact of Kangaroo Mother Care (KMC) on morbidity and mortality of new-borns and duration of hospital stay.Methods: A prospective case control study over a 12 month period was conducted from August 2013 to August 2014 on 50 new-borns weighing less than 1.8 kg. The primary outcome variable was “weight gain”. Secondary measures included morbidity, mortality and duration of hospitalization. Observations were recorded in a proforma specially designed for the study. The results were subjected to statistical analysis.Results: The hospital stay was less amongst neonates who received KMC. Twenty four (48%) out of 50 were discharged within 10 days, another 24 within 11 to 20 days. Neonates who did not received KMC, majority i.e. 27 of the neonates were in the ICU for 11-20 days. There were 3 neonates who stayed beyond 1 month.Conclusions: The study showed that KMC is useful method of caring VLBW baby in respect of early weight gain and decrease morbidity, mortality and hospital stay in our set up. However, there are still insufficient evidences to recommend its routine use in VLBW babies in our country. Well-designed large randomized controlled trail of this intervention are needed.

The relationship between maternal vitamin D level with infants’ birth-weight, height and head circumference at birth

Introduction: Prevalence of vitamin D deficiency has been reported from all over the world since lower levels of vitamin D has been one of word’s problem in the 21st century; especially pregnant women are the most prominent one. Objectives: This study aims to investigate the relationship between mothers’ vitamin D level with infants’ birth-weight and head circumference. Patients and Methods: A cross-sectional study was conducted in the department of obstetrics and gynecology of Akbarabadi hospital during 2017-2018. Regarding two groups, infants’ three main characteristics including their weight, head circumference and height were studied. Results: The mean blood levels of vitamin D in mothers with normal-born neonates were 15.23 ± 7.14 (ng/ mL) and in the mothers who gave birth to low-birth weight were 10.02 ± 8.06 (ng/mL), which was significantly lower than the mothers of normal-weight infants (P=0.018). The mean blood levels of vitamin D in mothers who gave birth to a normal head circumference neonate were 16.07 ± 8.1 (ng/mL) and in mothers with infants’ head circumference of less than 33 cm, was 9.87 ± 7.57 (ng/mL), which was significantly lower from mothers of normal-head circumference infants (P=0.007). The serum levels of vitamin D in mothers with normal-height infants were 14.74 ± 7.52 (ng/mL) and in the mothers with a height of less than 47 cm were 15.17 ± 7.91 (ng/mL), that does not suggest any significant difference (P=0.341). The mean serum vitamin D level in mothers who had normal vaginal delivery was lower than those with cesarean delivery, however there was no significant difference (P=0.174). Conclusion: Nutrition improvement and prescribing vitamin D supplements can positively be effective in the way of curbing low-birth weight infants. Moreover, Exposure to sunlight and letting rays strike skin is essential for maintaining a healthy vitamin D status for girls and women.

Exploring parents' provision of factors related to the establishment of physical activity between normal weight and overweight infants.

Infancy is a critical time for the prevention of obesity and establishment of healthy behaviors such as physical activity that help to control weight. A limited amount of research has examined if factors related to infant physical activity vary by infant weight status. Therefore, the purpose of this mixed methods triangulation study was to examine differences in motor development, the home environment, and infant-parent play behaviors as well as to explore how parents promote active play opportunities with normal weight infants (NWIs) and overweight infants (OWIs). We used a mixed methods triangulated approach to combine quantitative and qualitative data strands to examine variables associated with active play in normal weight (n = 16) and overweight (n = 11) infants. Data were analyzed using a two-tailed Mann-Whitney U nonparametric test and a summative content analysis approach. Although there were no differences in infants' motor development and parent play behaviors based on infant weight, several other differences were found. OWIs had less access to materials that stimulate locomotor movement. Further, parents of OWIs more often reported utilizing cognitive play strategies in comparison to parents of NWIs who more often reported using physical play strategies. Parents felt they were the greatest influence on their child's activity regardless of infant size. Importantly, all parents desired more specific guidelines on how to encourage active play and preferred this information was delivered by their healthcare provider. To meet parents' desires and potentially improve infants' developmental outcomes through the establishment of healthy physical activity behaviors, pediatric nurses could provide more specific guidance on providing active opportunities for infants.

Outcome of Interventional Cardiac Catheterization in Infants Weighing Less Than 2500 Grams: A Comparative Study

ABSTRACT Objectives: A retrospective study to evaluate the outcome of interventional cardiac catheterization in infants weighing &lt;2500 grams. Background: The mortality of small weight infants undergoing heart surgery remains high, so cardiac catheterization has been utilized to improve the outcome. Methods: The study included infants who underwent interventional cardiac catheterization within the first 60 days of life in New Children Cairo University Hospital, Cairo, Egypt from January 2015 to January 2018. The study group included infants &lt; 2500 grams while the comparative group included infants ≥ 2500 grams. Adverse events were classified according to the mechanism and seriousness. Results: The study group (37 patients) had a mean weight of 2.35 ±0.13 Kg, while the comparative group (164 patients) had a mean weight of 3.54 ±0.71 Kg. The procedures included balloon atrial septostomy, pulmonary balloon valvuloplasty, ductus arteriosus stenting and radiofrequency perforation of pulmonary atresia. The study group showed less success rates as compared with the comparative group (83.8% versus 93.9%, p = 0.04), and higher incidence of overall adverse events (48.6% versus 20.1 %, p&lt;0.001) as well as catheterization-related mortality (29.7% versus 4.9%, P&lt;0.001). In the study group, pulmonary balloon valvuloplasty showed the highest incidence of major adverse events while ductus arteriosus stenting had the highest incidence of mortality. Conclusions: Compared to normal weight infants, interventional cardiac catheterization in small weight infants is associated with lower success and higher morbidity and mortality rates. Pulmonary balloon valvuloplasty and ductus arteriosus stenting have the highest morbidity and mortality, respectively.