Intrauterine Growth Pattern Research Articles

O-191 Delayed fetal growth in pregnant women with polycystic ovary syndrome using serial ultrasonographic biometry

Abstract Study question To investigate the effect of maternal polycystic ovary syndrome (PCOS) on intrauterine growth and perinatal outcome of offspring. Summary answer Maternal PCOS might have an adverse impact on fetal growth, represented by serial biometric measurements, and consequently lower the birth weight. What is known already Women with PCOS often have low fertility and high risk of certain pregnancy complications, including miscarriage, gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP) and preterm birth (PTB). In addition, the offspring of PCOS mothers are susceptible to short- and long-term health consequences, such as metabolic diseases and neuropsychiatric disorders. And the suboptimal intrauterine environment caused by maternal PCOS condition might be the origin of impaired long-term health of the offspring. Study design, size, duration A total of 1153 pregnant women with pregestational diagnosis of PCOS and 1383 non-PCOS controls were included in the retrospective case-control study for clinical record and ultrasonographic database at women’s hospital, school of medicine, Zhejiang university over a 6-year period. Participants/materials, setting, methods Maternal demographic data, fetal biometric measurements with ultrasound, obstetrical and neonatal outcomes were analyzed. A meta-analysis of birth weight in PCOS offspring in the literature was performed to assess the relationship between the maternal PCOS and neonatal growth. Main results and the role of chance After adjustment for potential confounding variables, we found that biparietal diameter (BPD) and femur length (FL) were notably smaller in fetuses of women with PCOS than controls across the entire gestation. This effect still existed after excluding three major pregnancy complications of PCOS, including GDM, HDP and PTB. Although other fetal biometry including estimated fetal weight and birth weight in PCOS offspring were comparable with controls in our study, the meta-analysis of 22 studies showed that the birth weight in offspring of women with PCOS was lower than controls (WMD -37.813, 95%CL [-69.713, -5.913]), especially for offspring in South America (WMD -84.69, 95%CL [-166.69, -2.68]). Limitations, reasons for caution First, data of other fetal parameters like abdominal and head circumference was scanty. Second, neonatal anthropometric parameters apart from the birth weight were not included. Lastly, we did not have the long-term follow-up results of the offspring to explore the potential effect of delayed fetal biometry in their later life. Wider implications of the findings More attention needs to be paid to the smaller-than-average fetuses in PCOS mothers, and proper management may be needed during and after pregnancy. Further studies are needed to confirm the intrauterine growth pattern of the PCOS offspring and its clinical significance in the neonatal period and beyond. Trial registration number N/A

Correlation of Zinc and Copper Levels In Mothers and Cord Blood of Neonates With Prematurity and Intrauterine Growth Pattern.

Background Trace elements like zinc and copper are indispensable for human growth and development, exerting significant influence on a multitude of physiological processes. Acting as pivotal components for transcription factors and catalytic cofactors for enzymes, these elements play essential roles in cellular differentiation and maturation Objective The objective of this study was to study serum zinc and copper levels in mothers and neonates in relation to prematurity and intrauterine growth retardation (IUGR). Methods This was a cross-sectional study that included 100 mothers who met the inclusion criteria. Maternal history was recorded, and gestational age was estimated using the New Ballard scoring system. Maternal and cord blood samples were taken for zinc and copper analysis. Results The comparison of maternal copper and zinc levels between term and preterm neonates revealed a statistically significant difference with both trace elements found in less concentration in preterm when compared to the term patients (p= 0.03 for Zinc; 0.0001 for copper). We also report a statistically significant difference in maternal and cord blood copper and zinc levels in cases with IUGR compared to normal neonates. Conclusion The findings show that maternal zinc and copper levels are critical for the intrauterine growth of the fetus and for appropriate gestational age.

Fetal Growth Velocity-A Breakthrough in Intrauterine Growth Assessment?

The pursuit of assessing fetal well-being in obstetrical practice remains a central tenet, propelling ongoing endeavors to explore innovative markers and diagnostic methodologies aimed at prognosing potential perinatal adversities. Deviations from standard patterns of intrauterine growth, whether exhibiting excessive or insufficient trajectories, stand as pivotal indices hinting at underlying pathophysiological processes or heightened concurrent medical conditions. Initiatives like the Delphi consensus and the INTERGROWTH-21st project strive to refine diagnostic criteria and establish international standards for fetal growth assessment. This article aims to present the current knowledge regarding the assessment of abnormal growth, including novel methods such as growth velocity. Integrating fetal growth velocity assessment into perinatal care protocols holds promise in enhancing diagnostic precision. Growth velocity, involving changes in fetal size over a given period, offers insights into distinguishing between constitutional and pathological growth abnormalities. Various methodologies and models have been proposed to evaluate growth velocity, with notable advancements in understanding fetal growth patterns across different trimesters. It is believed that accelerated and reduced growth velocity may be a sensible parameter in the detection of fetal growth restriction (FGR), small-for-gestational-age (SGA) fetuses, large-for-gestational-age (LGA) fetuses and macrosomic fetuses as well as appropriate-for-gestational age (AGA) fetuses that encounter problems with growth continuation. Recent studies found that changes in growth velocity reflect the risk of adverse perinatal outcomes (APOs). Future directions in fetal health research aim to elucidate the long-term consequences of abnormal fetal growth velocity on neurodevelopmental outcomes, highlighting the critical role of early assessment and intervention.

Twins and Their Risks of Cancer as Children, Teenagers or Young Adults: Updated Meta-Analysis and Retrospective Swedish Cohort Study

AbstractWe investigated whether an observed reduction in overall childhood cancer risk (<15 years of age) in twins has been sustained, and how this extends into young adulthood. We searched for English language publications reporting childhood cancer risk in twins, obtained unpublished data directly from some authors, and updated a meta-analysis. We used the Swedish Multigeneration Register to investigate the age to which the reduced overall risk of childhood cancer (observed previously using that Swedish dataset and in this and earlier meta-analyses) persisted into the teenage/young adult years, and which specific tumors accounted for the overall risk reduction beyond childhood. Our meta-analysis of studies of aggregate childhood cancer risk in twins confirmed their approximate 15% reduction in cancer mortality and incidence. Further analysis of Swedish Multigeneration Register data for 1958 to 2002 suggested these reduced risks of cancer (particularly leukaemias and renal tumors) extended from childhood to young adult ages. Reduced risks of these and some other specific tumor types occurring across childhood/teenage/young adult years appeared to account for most of the overall risk reduction. Our results suggest a persistent reduction of overall childhood cancer risk in twins and that this extends into young adulthood. Risk reductions for several specific tumors might account for this and, although there are several potential explanations, intrauterine growth patterns of twins might be a major contributor.

Postnatal foot length in the estimation of gestational age in relation to intrauterine growth pattern among Nigerian neonates.

To determine the relationship between postnatal foot lengths and estimated gestational age (EGA) in relation to intrauterine growth patterns determined at birth among Nigerian neonates. Hospital-based, cross-sectional. Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. 260 neonates with EGA 30- 42 weeks within 48 hours of life. Postnatal foot lengths (FL) were measured with Vernier digital calliper in millimetres. The intra-uterine growth pattern was determined using the Lubchenco chart. Pearson correlation and regression analysis tests were performed. Postnatal foot length in relation to Intra-Uterine Growth Pattern. The mean postnatal FL had a strong positive correlation with the EGA from 30 through 42 weeks (r = 0.855, p < 0.001). The overall mean foot length for preterm neonates was 65.44 (6.92) mm, while that of term neonates was 77.92 (4.24) mm. The linear regression equation was generated as: EGA = 9.43 + (0.37 × FL), p < 0.001. The EGA as measured by FL had the highest positive correlation with Small for Gestational Age (SGA) intra-uterine-growth pattern, followed by Appropriate for Gestational Age (AGA) and least by Large for Gestational Age (LGA) respectively (r = 0.936> 0.861 > 0.666). The postnatal foot length correlated well with estimated gestational age, and the correlation was best among SGA infants. None declared.

Intrauterine growth pattern in Butajira HDSS, Southern Ethiopia: BUNMAP pregnancy cohort

BackgroundAbnormal fetal growth pattern during pregnancy including excessive fetal size and intrauterine growth restrictions are the major determinants for perinatal outcomes and postnatal growth. Ultrasonography is a useful tool in monitoring fetal growth for appropriate care and interventions. However, there are few longitudinal studies using serial ultrasonography in low and middle-income countries. Moreover, the reference charts used for fetal growth monitoring in low-income countries comes from high income countries with distinct population features. Therefore, the purpose of this study was to evaluate the intrauterine growth pattern of the fetus using serial ultrasonography.MethodsWe conducted a prospective community-based cohort study from March 2018 to December 2019. Pregnant women with gestational age of 24 weeks or below living in the Butajira HDSS were enrolled. We followed the pregnant women until delivery. Serial ultrasound measurements were taken, and fetal weight was estimated using the Hadlock algorithm based on biparietal diameter, head circumference, abdominal circumference, and femur length. The z-scores and percentiles of biometric measurements were calculated and compared to the INTERGROWTH-21st International Standards for Fetal Growth.ResultsWe reviewed a total of 2055 ultrasound scans and 746 women who fulfill the inclusion criteria were involved”. We found similar distribution patterns of biometric measurements and estimated fetal weight compared to the previous study done in Ethiopia, the WHO and INTERGROWTH-21st references. In our study, the 5th,50th and 95th percentiles of estimated fetal weight distribution have a similar pattern to the WHO and INTERGROWTH-21st charts. The 50th and 95th percentile had also a similar distribution pattern with the previous study conducted in Ethiopia. We found that 10% of the fetus were small for gestational age (below the 10th percentile) based on the Z-score of estimated fetal weight.ConclusionOur study evaluated the fetal growth patterns in rural community of Ethiopia using serial ultrasound biometric measurements. We found similar IUG patterns to the WHO and INTERGROWTH-21st reference standards as well as the previous study conducted in Ethiopia.

Sexing of Embryos at the Time of Twin Reduction: A Clinical Approach.

This study provides new unique information on bovine twin pairs during the late embryonic period (28-34 days of pregnancy) in relation to (1) a predictive ultrasound measurement that was differential for sexing heterosexual twins; (2) intrauterine embryonic growth patterns in twin pairs; and (3) a higher vulnerability of female embryos compared to males following an induced embryo reduction in heterosexual twins. The study population comprised 92 dairy cows carrying bilateral twins. A length difference between co-twins equal to or greater than 25% in around 50% of pregnancies served to determine the sex of embryos with 100% accuracy in heterosexual twins, which was assessed four weeks later on the remaining fetus after twin reduction. The apparent rates of growth of twin pairs and of individual male and female embryos from day 28 to 34 of gestation were similar to established growth pattern standards for singletons. Mean embryo sizes in relation to gestational age were smaller by some 5 days' growth equivalent in twins compared to singletons. After the reduction in the female embryo in heterosexual twins, the risk of male embryo loss was null. This new information allowed for sex selection at the time of twin reduction.

Analysis of physical growth of preterm infants with different intrauterine growth patterns in Haikou

Objective: To analyze the physical growth of preterm infants with different intrauterine growth patterns. Methods: A total of 10 856 preterm infants who were born in various districts of Haikou City from October 1st, 2015 to June 1st, 2021 and received regular health care and management were retrospectively enrolled. The preterm infants were divided into appropriate for gestational age (AGA), small for gestational age (SGA) and large for gestational age (LGA) groups according to different intrauterine growth patterns. The general characteristics of preterm infants in different groups were compared by H test (Kruskal and Wallis) or Chi-squared test. And the developmental curves were plotted by local regression (LOESS) with their physical growth indexes. Results: Of the 10 856 preterm infants, 6 317 were boys and 4 539 were girls. The gestational age at birth was 35 (34, 36) weeks, and the birth weight was 2.5 (2.1, 2.8) kg. There were 754 (6.9%) SGA, 9 301 (85.7%) AGA, and 801 (7.4%) LGA preterm infants. All preterm infants were followed up until 18 months of corrected age. The birth weight of the SGA group was lower than that of the AGA and LGA groups (Z=2 274.93, P<0.001). The proportion of exclusive breastfeeding at the first health care interview was higher in the AGA group (68.6% (6 378/9 301)) than in the SGA group (62.9% (474/754)) (χ2=13.82, P=0.003). The LOESS curving fitting showed that the weight and height of the preterm infants in all the 3 groups increased rapidly during 0-6 months of corrected age. The regression prediction values of weight for age Z-score (WAZ), height for age Z-score (HAZ) and weight for height Z-score (WHZ) were around 0 s, while the regression prediction values of these three indicators in SGA were all below 0 s but greater than -1 s. The rates of low birth weight, growth retardation and wasting during 0-17 months of corrected age were 0.3% (16/4 838)-1.9% (47/2 506), 0.4% (18/4 838) -2.4% (51/2 124), and 2.1% (88/4 135) -4.4% (214/4 838) in AGA groups, and 0 (0/296) -1.0% (2/199), 0 (0/341) -1.6% (3/186) and 1.0% (2/199) -2.6% (9/341) in LGA group, whereas 7.6% (25/330) -16.8% (28/167), 5.2% (17/330)-10.6%(32/303) and 3.9% (3/77) -12.6% (21/167) in SGA group. In addition, the monthly growth of weight and height of preterm infants in all the 3 groups decreased with the increasing age, and the monthly weight gain. The length increment was 4.0 cm/month during corrected 0-2 month of age and 2.4 cm/month during corrected 2-5 month of age in the SGA preterm infants. Conclusions: Most of the preterm infants could have an appropriate catch-up growth, but the growth and development in the SGA preterm infants lags behind that of their AGA and LGA peers. The physical growth of SGA premature infants should be paid more attention to, to timely correct the growth deviations.

Relationships between intrauterine fetal growth trajectories and markers of adiposity and inflammation in young adults

BackgroundThere is now good evidence that events during gestation significantly influence the developmental well-being of an individual in later life. This study aimed to investigate the relationships between intrauterine growth trajectories determined by serial ultrasound and subsequent markers of adiposity and inflammation in the 27-year-old adult offspring from the Raine Study, an Australian longitudinal pregnancy cohort.MethodsUltrasound fetal biometric measurements including abdominal circumference (AC), femur length (FL), and head circumference (HC) from 1333 mother-fetal pairs (Gen1–Gen2) in the Raine Study were used to develop fetal growth trajectories using group-based trajectory modeling. Linear mixed modeling investigated the relationship between adult body mass index (BMI), waist circumference (WC), and high-sensitivity C-reactive protein (hs-CRP) of Gen2 at 20 (n = 485), 22 (n = 421) and 27 (n = 437) years and the fetal growth trajectory groups, adjusting for age, sex, adult lifestyle factors, and maternal factors during pregnancy.ResultsSeven AC, five FL and five HC growth trajectory groups were identified. Compared to the average-stable (reference) group, a lower adult BMI was observed in two falling AC trajectories: (β = −1.45 kg/m2, 95% CI: −2.43 to −0.46, P = 0.004) and (β = −1.01 kg/m2, 95% CI: −1.96 to −0.05, P = 0.038). Conversely, higher adult BMI (2.58 kg/m2, 95% CI: 0.98 to 4.18, P = 0.002) and hs-CRP (37%, 95% CI: 9–73%, P = 0.008) were observed in a rising FL trajectory compared to the reference group. A high-stable HC trajectory associated with 20% lower adult hs-CRP (95% CI: 5–33%, P = 0.011).ConclusionThis study highlights the importance of understanding causes of the unique patterns of intrauterine growth. Different fetal growth trajectories from early pregnancy associate with subsequent adult adiposity and inflammation, which predispose to the risk of diabetes and cardiometabolic disease.

To study the effect of early zinc supplementation on growth of low birth weight infants- A randomised control trial

The present study was carried out with aim to study the effect of early zinc supplementation on growth of low birth weight infants — A randomised control trial in the Department of Paediatrics at Government Medical College and Hospital, to study effect of zinc supplementation on LBW infants. The registered subjects were then randomized into Intervention (Group I, Case) and Non-Intervention (Group II, control) groups using computer generated random number technique. Cases (Group I) were given zinc supplements Syrup Zinc acetate (Syp. Zinconia 5ml=20mg) 2mg/kg single dose in morning at 8 a.m. daily and multivitamins drops 10 drops per day (Vit.A 375 µg, Vit.B1-B6, Vit.D 5µg) for duration of 6 weeks and Controls (Group II) were given multivitamins drops (Vit.A 375 µg, Vit.B1-B6, Vit.D 5µg) 10 drops per day for duration of 6 weeks.There was no significant difference in cases and controls in respect to males and females. No significant difference (p value &amp;#62;0.05) in pattern of intrauterine growth in cases and controls.Fifty percent of our study subjects in both group were of weight more than 1400 grams.Zinc had significant effect on weight gain of pre-terms (AGA and SGA) and term AGA only at the end of 6 weeks. There was only significant effect on length in mean difference at 6 weeks when compared to at 48 hours. There was highly significant difference in supplement group (cases) in weight/length at 6 weeks with minimal or insignificant effect on chest circumference and head circumference.

Growth patterns of preterm infants in Korea.

With advancements in neonatal care and nutrition, the postnatal growth of preterm infants has improved; however, it remains an issue. Accurate assessments of growth using a standardized reference are needed to interpret the intrauterine and postnatal growth patterns of preterm infants. Growth in the earlier periods of life can contribute to later outcomes, and the refinement of postnatal growth failure is needed to optimize outcomes. Catchup growth occurs mainly before discharge and until 24 months of age, and very low birth weight infants in Korea achieve retarded growth later in life. Knowing an infant’s perinatal history, reducing morbidity rates during admission, and performing regular monitoring after discharge are required. Preterm infants with a lower birth weight or who were small for gestational age are at increased risk of poor neurodevelopmental outcomes. Furthermore, poor postnatal growth is predictive of adverse neurodevelopmental outcomes. Careful monitoring and early intervention will contribute to better development outcomes and national public health improvements.

Fetal Growth and Fetoplacental Circulation in Pregnancies Following Bariatric Surgery: A Prospective Study

(BJOG. 2020;127:839–846) Nearly one third of the population within the United States and one fourth of the population of the UK can be classified as obese, which includes one quarter of all reproductive-aged women. There are significant short-term and long-term adverse outcomes for both baby and mother associated with pregnancy while obese. Obese mothers exhibit a higher propensity for gestational diabetes mellitus, preeclampsia, cesarean delivery, or postpartum hemorrhage, as well as the development of cardiovascular disease and type 2 diabetes later in life. In addition to macrosomia, children of obese mothers are more likely to develop type 2 diabetes and cardiovascular disease in adulthood. Bariatric surgery, an effective weight-reduction treatment, is becoming more common for women of childbearing age. This study aimed to investigate the intrauterine fetal growth pattern and placental function, in postbariatric pregnancies as compared with patients of no history of maternal weight-loss surgery.

Fetal growth and fetoplacental circulation in pregnancies following bariatric surgery: a prospective study.

To investigate the intrauterine fetal growth pattern and fetoplacental circulation in pregnancies following bariatric surgery. Prospective study. Maternity Unit, UK. One hundred and sixty-two pregnant women; 54 with previous bariatric surgery and 108 with no surgery but similar booking body mass index. Participants were seen at 11-14, 20-24, 30-33 and 35-37weeks of gestation and an oral glucose tolerance test (OGTT) was performed at 27-30weeks. Fetal head and abdominal circumference (AC), femur length (FL), estimated fetal weight (EFW) and fetoplacental Dopplers were measured at three time-points in pregnancy. Birthweight (BW) was recorded. Variables were modelled after adjustment for maternal/pregnancy characteristics. Model estimates are reported as posterior means and quantile-based 90% credible intervals (CrI). Fetal biometry, fetoplacental Doppler, BW. Compared with the no surgery group, the post-bariatric surgery group had lower EFW during gestation (up to -120g; [-189g, -51g] lighter) at 35-37weeks, with smaller AC and FL. Similarly, infants of mothers with previous bariatric surgery had lower average BW [-202g [-330g, -72g] lighter). Overall, there was no difference in the fetoplacental Doppler indices between groups but maternal glucose levels at OGTT were positively correlated with third-trimester EFW and BW. Fetuses of women with previous bariatric surgery are smaller during pregnancy and at birth, compared with those of women without such surgery, and this may be related to the lower maternal glucose levels seen in the former population. The fetoplacental circulation appears not to be altered by maternal weight loss surgery. Offspring of post-bariatric women are smaller during pregnancy and at birth but this is not due to placental insufficiency.

Association between maternal periodontal status and ultrasonographic measurement of fetal growth: A longitudinal study

The aim of this prospective cohort study was to investigate the association between intrauterine fetal growth patterns and periodontal status in pregnant women. Fifty-three pregnant women were recruited. Periodontitis was diagnosed based on probing pocket depth and clinical attachment level. Maternal urinary 8-hydroxy-2’-deoxyguanosine levels and body mass index were recorded. Ultrasonographic measurements of the biparietal diameter (BPD), abdominal circumference (AC), and femur length (FL) were recorded, and estimated fetal weight (EFW) was calculated. In addition, approximation spline curves of BPD, AC, FL, and EFW were obtained throughout the gestation period. Recorded delivery outcomes were gestational age (GA), birth weight and length, sex, placental weight, and umbilical cord length. Forty-four participants (34.1 ± 4.9 years) were analyzed. Mean neonatal birth weight was 2906.0 ± 544.4 g. On multiple regression analysis, birth weight was related with periodontitis (standardized β = −0.21, P = 0.001). For EFW and BPD, the curves of the periodontitis group were located lower than those of the non-periodontitis group, with significant differences after 32 weeks and 20 weeks of GA, respectively. In conclusion, periodontal treatment before conception may be recommended and a good periodontal condition in the early stage of pregnancy at the latest is desirable for infant growth.

Intrauterine growth patterns in rural Ethiopia compared with WHO and INTERGROWTH-21st growth standards: A community-based longitudinal study.

IntroductionChildren’s well-being is highly influenced by their fetal growth. Adequate intrauterine growth (IUG) is a basic feature of a healthy pregnancy. The aim of our study was to assess IUG patterns in a rural and drought-affected population in the Rift Valley area of the Adami Tullu district in Oromia, Ethiopia.MethodsWe conducted a longitudinal, community-based study of IUG patterns utilizing serial ultrasound measurements. Data were collected for 17 months, from July 2016 to November 2017. We included 675 singleton foetuses ≤ 24 weeks old, based on ultrasound-derived estimates of gestational age, and followed them until delivery. We obtained head circumference, biparietal diameter, abdominal circumference, femur length, and estimated fetal weight at 26, 30, and 36 weeks. Fetal weight was estimated using the Hadlock algorithm, and the 5th, 10th, 25th, 50th, 75th, 90th, and 95th centiles were developed from this model. We compared the biometric measurements and fetal weight data from our study to the World Health Organization (WHO) and INTERGROWTH-21st fetal growth reference standards.ResultsDistribution of the biometric measurements and estimated fetal weights in our study were similar to those for the WHO and INTERGROWTH-21st references. Most measurements were between -2 and +2 of the reference z-scores. Based on the smoothed percentiles, the 5th, 50th, and 95th percentiles of our study had similar distribution patterns to the WHO chart, and the 50th percentile had a similar pattern to the INTERGROWTH-21st chart.ConclusionsOur study determined fetal growth patterns in a drought-affected rural community of Ethiopia using common ultrasound biometric measurements. We found similar IUG patterns to those indicated in the WHO and INTERGROWTH-21st fetal growth reference standards.

Birthweight and gestational age centiles in South Indian newborns

Background: India has recently gone through a vast technological and economic revolution which has influenced all sections of society. The study was undertaken to determine any changes in the pattern of intrauterine growth in South Indian babies over three decades compared with national and international studies. Objectives: To construct new 2015-2017 centile charts for birthweight in babies born from 28 to 42 gestational weeks in the metropolitan city of Bangalore, South India compared with an earlier South Indian centile chart constructed in 1983 at Christian Medical College and Hospital (CMCH), Vellore, India and other national and international studies. Design, setting and method: This is a retrospective study of two cohorts. The first cohort consisted of 4,426 consecutive live births from January to December 1983, at CMCH, a tertiary referral hospital in South India. The second cohort consisted of 2,708 consecutive live births from January 2015 to May 2017 at Shifaa Hospital, a multispecialty centre, in the metropolitan city of Bangalore, South India, about 300 km from CMCH. The chief outcome measure was birthweight centiles according to gestational age. The two cohorts of singleton live births were analysed to determine the mean birth weights, gestation and centile growth patterns. Data were obtained from labour room records. Results: Among a total of 4,426 live births during 1983, the mean birthweight was 2881g and among 2,708 live births during 2015-2017, the mean birth weight was 2873g, a difference of 8g. The mean gestation was 38.8 weeks in the former and 38.2 weeks in the latter study respectively. The centile growth curves among the two cohorts revealed almost similar percentile weight distribution except for preterm 31-36 weeks gestation, where birthweights in the 2015-2017 cohort were 200-300g higher compared to the 1983 cohort. However, the 90thcentile curve, at term 38-40 weeks revealed an increase of 200-300g weight gain in 1983 cohort which thereafter plateaued, with 300g weight gain at 40-41 weeks in the 2015-2017 cohort. Comparison was also made with both national and international centile intrauterine growth curves. Conclusions: The 2015-2017 centile charts for birthweight in babies born from 28 to 42 gestational weeks in the metropolitan city of Bangalore, South India had almost similar growth curves and mean birthweights compared to the 1983 South Indian centile chart indicating an inherent genetic predisposition for the small Indian baby. The updated centiles for births during 2015-2017 provide a more valid tool to assess South Indian fetal growth. Sri Lanka Journal of Child Health, 2019; 48(2): 140-145

Developmental programming of the ovine placenta

The pattern of intrauterine growth and size at birth, in particular, programmes the structure and function of tissues later in life in many species, which has important implications for the incidence of adult-onset generative diseases in human populations. In mammals, the main determinant of intrauterine growth is the placental supply of nutrients which, in turn, depends on the size, morphology, transport characteristics and endocrine function of the placenta. However, compared to somatic tissues, little is known about the developmental programming of the placenta. This review examines the epigenetic regulation of placental phenotype with particular emphasis on the nutrient transfer capacity of the ovine placenta and environmental factors shown to cause developmental programming of other tissues. Overall, the placenta is responsive to environmental factors and uses a number of different strategies to adapt its phenotype to help support fetal growth during adverse intrauterine conditions. It is, therefore, not just a passive conduit for nutrient transfer to the fetus but alters its nutrient supply capacity dynamically to optimise fetal nutrient acquisition. Thus, the placental epigenome provides both a memory of environmental conditions experienced during development and an index of the future well being of the offspring.

OP13.09: Birthweight and intrauterine growth patterns of fetuses of pregnant women post‐bariatric surgery

OP13.09: Birthweight and intrauterine growth patterns of fetuses of pregnant women post‐bariatric surgery

Morbidities associated with patent ductus arteriosus in preterm infants. Nationwide cohort study

Purpose: To evaluate the predictive factors for the development of haemodynamically significant patent ductus arteriosus (PDA) in preterm infants and to study the morbidities associated with the treatment of PDA during the first hospitalization.Materials and methods: Data were collected from the Finnish national register of preterm infants (<32 gestational weeks) born in 2005–2013. In total, 3668 infants were included. Morbidities during the first hospitalization were analysed and compared between infants who received treatments for the closure of PDA (n = 1132) and infants who received no treatment for PDA (n = 2536). The results were adjusted for the duration of pregnancy, intrauterine growth pattern, antenatal steroids, delivery hospital and respiratory distress syndrome (RDS).Results: RDS and mechanical ventilation were independently associated with an increased risk of PDA requiring treatment. Medical and surgical treatments were associated with the risk of severe bronchopulmonary dysplasia (BPD). Primary surgical ligation was associated with an increased risk of severe intraventricular haemorrhage (IVH) and necrotizing enterocolitis (NEC). Medical treatment itself and also followed by surgical ligation was associated with lower mortality.Conclusion: The severity of lung disease rather than prematurity per se was associated with the development of PDA requiring therapy. Both medical and surgical therapies for PDA were associated with severe BPD, and primary surgical ligation was associated with NEC and severe IVH.

Self-Reported Mental Health Problems Among Adults Born Preterm: A Meta-analysis.

Preterm birth increases the risk for mental disorders in adulthood, yet findings on self-reported or subclinical mental health problems are mixed. To study self-reported mental health problems among adults born preterm at very low birth weight (VLBW; ≤1500 g) compared with term controls in an individual participant data meta-analysis. Adults Born Preterm International Collaboration. Studies that compared self-reported mental health problems using the Achenbach Young Adult Self Report or Adult Self Report between adults born preterm at VLBW (n = 747) and at term (n = 1512). We obtained individual participant data from 6 study cohorts and compared preterm and control groups by mixed random coefficient linear and Tobit regression. Adults born preterm reported more internalizing (pooled β = .06; 95% confidence interval .01 to .11) and avoidant personality problems (.11; .05 to .17), and less externalizing (-.10; -.15 to -.06), rule breaking (-.10; -.15 to -.05), intrusive behavior (-.14; -.19 to -.09), and antisocial personality problems (-.09; -.14 to -.04) than controls. Group differences did not systematically vary by sex, intrauterine growth pattern, neurosensory impairments, or study cohort. Exclusively self-reported data are not confirmed by alternative data sources. Self-reports of adults born preterm at VLBW reveal a heightened risk for internalizing problems and socially avoidant personality traits together with a lowered risk for externalizing problem types. Our findings support the view that preterm birth constitutes an early vulnerability factor with long-term consequences on the individual into adulthood.