Newborn Length Research Articles

Influence of Psychiatric Medications on Neonatal Abstinence Syndrome in Women Treated for Opioid Use Disorder [17E

INTRODUCTION: This study sought to evaluate the impact of prescribed psychiatric medications on newborn hospital stay in women undergoing treatment for opioid use disorder (OUD). METHODS: A cohort of women receiving either methadone or buprenorphine in management of OUD in pregnancy were identified from delivery and newborn records over a 10-year period. Women were excluded with delivery <24 weeks, multiple gestation or known anomalous fetus. Maternal demographics, medications, GA, mode of delivery, BW, NICU admission, newborn length of stay, NAS and treatment requirements for NAS were obtained. The study was IRB approved and standard statistics were used with a P-value of <0.05 considered significant. RESULTS: There were 180 women were identified with 101 (56%) receiving methadone and 79 (44%) receiving buprenorphine therapy. The groups were similar for age, parity, race, BMI, marital status, tobacco use, prenatal care, incidence of preterm birth, mode of delivery, and also had similar incidence of NAS (meth 91% vs bup 90%; P=.47). Buprenorphine users had a greater number of women prescribed psychiatric medications (meth 13% vs bup 35%; P<.001), higher GA at delivery (meth 37+2.8 wk vs bup 39+1.8 wk; P<.001), shorter newborn hospital stay (meth 14+10 d vs bup 9+8 d; P<.001) and fewer newborns with NAS requiring treatment (meth 56% vs bup 24%; P<.001). Psychiatric medication usage demonstrated a 4-fold likelihood of a longer newborn hospital stay (>10 d) and buprenorphine a shorter newborn stay. CONCLUSION: Psychiatric medication usage is an independent predictor of a longer newborn hospital stay in women undergoing treatment for opioid use disorder.

RELATIONSHIP BETWEEN BODY WEIGHT AND LENGTH IN NEWBORNS AND INDICATORS OF AUTHONOMIC NERVOUS SYSTEM IN CHILDREN

The purpose of this work is to study the relationship between body weight and length in newborns and indicators of autonomic nervous system in children. To study the features of the autonomic regulation of heart rhythm, we studied children aged from four to seven years (125 boys and 114 girls). Five‐minute ECG were recorded during rest period. In four‐year‐old boys, we have found positive correlation between body weight at birth and SI («stress index») (r = −0.257, p <0.05), AMo (r = −0.169, p <0.05), heart rate (r = −0.002, p <0.05). In girls of the same age, multiple regression analysis showed a pronounced effect of body weight at birth on SI (r = 0.506, p <0.016) and AMo (r = 0.525, p <0.01). In boys of five years old, a significant correlation was found between body weight at birth and the average value of RR intervals (r = 0.647, p <0.001), Mo (r = 0.598, p <0.001), AMo (r = −0.442, p <0.01), SI (r = −0.465, p <0,05), heart rate (r = −0.666, p <0.001). For boys of five years old, significant correlation was observed between the length of the body of newborns and the average value of RR‐intervals (r = 0.583, p <0.001), Mo (r = 0.518, p <0.002), MxDMn (r = 0.441, p <0.01), AMo (r = −0.539, p <0.001), SI (r = −0.606, p <0.001), heart rate (r = −0.600, p <0.001). In girls of five years of age, a significant positive relationship was found between body weight at birth and SI (r = −0.173, p <0.05), between the length of the body at birth and SI (r = −0.166, p <0.05). The results of multiple regression analysis allow us to come to the conclusion about a more pronounced effect of body length at birth on indicators of autonomic nervous system in children. Body weight and body length of newborns may be use as cofactors when analyzing the influence of environmental factors on the functional state of the cardiovascular system.

Pregnancy outcomes of women with hypoglycemia in the oral glucose tolerance test

ObjectiveThe aim of this study was to investigate the effects of hypoglycemia measured using 2-h 75-g oral glucose tolerance test (OGTT) on neonatal biometrics (birth weight, head circumference and body length of newborns) and perinatal outcomes. Materials and MethodsAccording to the definition of hypoglycemia by the American Diabetes Association, women with blood glucose levels of ≤70 mg/dL after fasting or at 1 or 2 h after eating measured using on 2-h 75-g OGTT were grouped into a hypoglycemia group. In accordance with the criteria of World Health Organization and the International Association of Diabetes and Pregnancy Study Groups, as per the 2-h 75-g OGTT performed in the second trimester, women with gestational diabetes and were excluded from the study. Also, women meeting the following criteria were excluded from the study: missing records, aged <19 or ≥35 years, multiple pregnancies, delivery before the 24th gestational week, and ≤500-g newborn. Other exclusion criteria included pregnant women with known type 1 and type 2 diabetes mellitus, gestational or essential hypertension, cigarette and/or alcohol abuse, thyroid disease, BMI of <19 and >30, placental abnormalities with variation and/or dysfunction, intrauterine growth restriction, and abnormalities of the umbilical cord. ResultsA total of 625 pregnant women who met the inclusion criteria were included in the study. Hypoglycemia was found in 71 pregnant women according to 2-h 75-g OGTT. The remaining 554 women were grouped into the normoglycemia group. The birth weight, head circumference, and body length of newborns were significantly lower in the hypoglycemia group (p < 0.001, p = 0.004, and p = 0.006, respectively). There was no significant difference between both groups in terms of body mass index, parity, fetal sex, delivery type, and Apgar scores. ConclusionsGlycemia with blood glucose levels of ≤70 mg/dL measured using 75-g OGTT during pregnancy is associated with lower birth weight, small head circumference, and short body length in newborns compared to the normoglycemic group. Hence, pregnant women who are diagnosed with blood glucose levels of ≤70 mg/dL using 2-h 75-g OGTT should be carefully managed.

Protective role of selenium in the shortening of telomere length in newborns induced by in utero heavy metal exposure

The effects of toxic heavy metals, such as arsenic (As), cadmium (Cd), and lead (Pb), on telomere length (TL) have been reported previously. Although selenium (Se) is considered as an anti-oxidant which may detoxify the effects, there are no data on whether Se could protect against the TL-shortening effects of heavy metals. Thus, the aim of this study was to evaluate the protective role of Se against heavy metal-induced TL shortening. A birth cohort study was conducted in Myanmar in 2016, including 408 mother-infant pairs. First, pregnant women in the third trimester were interviewed concerning their socioeconomic, and pregnancy and birth characteristics using a pre-validated questionnaire. Maternal spot urine samples were collected after the interview. During the follow-up period (1–3 months), blood samples were collected from the umbilical cord at birth by local health workers. Metal concentrations were measured using inductively coupled plasma mass spectrometry (ICP-MS). TL was measured by quantitative real-time polymerase chain reaction (PCR). Relative TL was calculated as the ratio of telomere genes to single-copy genes. To evaluate the effect of Se on TL shortening, molar ratios were calculated. Linear regression analyses were performed to examine the associations between heavy metals and TL, individually and after adjustment for Se level. The effects of As, Cd, and Pb exposure on TL were smaller after adjustment for the Se level, especially for Pb (unadjusted β = −0.10; 95% CI: 0.18, −0.01; adjusted β = −0.03; 95% CI: 0.13, 0.05). On stratifying the data by Se concentration, there was no significant association between Cd or Pb exposure and TL in the high-Se group. Our study indicated a protective effect of Se against the TL shortening induced by heavy metal exposure, where the effect sizes were smaller after adjusting for the Se level, compared to individual metal exposure.

Estimating the endotracheal tube insertion length in newborn infants using weight or gestation: A randomized controlled trial

BackgroundThe current recommendation for the estimation of endotracheal tube (ETT) length is based on a weight-based formula to place the tip of the endotracheal tube in the mid-trachea. Among all the methods studied in newborns, none has been found accurate and the ETT tips are often incorrectly positioned. Estimating the insertion length based on gestation may be more accurate. ObjectiveTo determine whether estimating the endotracheal tube insertion length using gestation compared to weight results in more correctly placed ET tube tip. Study designA Randomized controlled trial. Study settingTertiary care level-III neonatal unit. ParticipantsNeonates (corrected gestation between 25 and 43 weeks) without congenital malformations who were intubated orally. Methods103 newborn infants required intubation were randomized to predict their endotracheal tube insertion length using weight [weight (kg) + 6] (n = 53) or gestation [length determined from a table] (n = 50). The primary outcome was the Correct ET tube tip position, defined as the tip located between the upper border of the first thoracic vertebra (T1) and the lower border of the second thoracic vertebra (T2) on a chest Xray.It was determined by a radiologist who was masked to group assignment. Secondary outcomes related to intubation were pulmonary air leaks after intubation, lung collapse on the initial chest x-ray (CXR) following intubation, duration of ventilation, pulmonary hemorrhage, oxygen therapy at 28 days, oxygen therapy at 36 weeks, VAP (ventilator-associated pneumonia) and death before discharge from the hospital. Results103 infants were included and the two groups were well comparable. The proportion of correctly placed ET tube tips was significantly higher in the gestational age-based group [Gestation, 37/50 (74%), versus weight 27/51 (52.9%), p = 0.02]. We found no significant differences in the secondary outcomes. ConclusionEstimating the endotracheal tube insertion length in newborns using gestational age resulted in more correctly placed ET tube tips compared to weight.

Do maternal urinary iodine concentration or thyroid hormones within the normal range during pregnancy affect growth parameters at birth? A systematic review and meta-analysis.

Iodine, an essential constituent of thyroid hormones, is required for proper growth and development. To investigate whether growth parameters at birth are associated with maternal urinary iodine concentration (UIC) or normal ranges of thyroid hormones during pregnancy. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, electronic databases (namely, MEDLINE, Web of Science, the Cochrane Library, Scopus, and Google Scholar) were searched between January 1988 and November 2018 to identify relevant articles. Data from the studies included were independently extracted by 2 investigators using standardized forms developed for this review. The pooled mean birth weight, length, and head circumference values, and 95% confidence intervals were estimated in newborns born to women with UIC < 150 and UIC ≥150 μg/L during pregnancy. Possible linear or nonlinear associations between maternal UIC and the aforementioned anthropometric measures were evaluated. A narrative synthesis of the data was performed for thyroid hormones with levels within the normal range. Of the 123 studies identified, 11 were eligible for inclusion in the meta-analysis. The pooled mean birth weight, length, and head circumference in newborns whose mothers had UIC < 150 μg/L vs UIC ≥150 μg/L were 2898 g vs 2900 g (P = 0.970), 49.6 cm vs 49.4 cm (P = 0.880), and 34.0 cm vs 34.1 cm (P = 0.933), respectively. Dose-response meta-analyses revealed no significant linear or nonlinear associations between maternal UIC during pregnancy and anthropometric measures at birth. Among the different thyroid function parameters evaluated, high-normal values of maternal free thyroxine and thyrotropin during pregnancy were inversely associated with neonatal birth weight. This systematic review showed that birth weight may be affected by even mild variations in the normal concentrations of maternal thyroid hormones. However, in the current meta-analysis, birth anthropometric measures were not associated with maternal UIC during pregnancy.

An investigation into the correlation between pre-pregnancy body mass index and birth outcomes of newborn in Jersey

AbstractThe role of nutritional status of pregnant women and birth outcomes is ambiguous. Recent studies show that pre-pregnancy body weight is equally important as weight gain during pregnancy. Body mass index (BMI) is the most accessible and easy to check a nutritional status index, which may help to control the gestation and predict infant health outcome. This study aimed to examine the associations between pre-pregnancy body mass index and the infant birth parameters. A presented observational study was offered to 200 pregnant women from Antenatal Clinic at Jersey General Hospital in 2017. Total number of 83 women agreed to take part in this project. Diet, lifestyle, socio-economic, and demographic data were obtained from participants. Delivery and birth data were taken from hospital records. Offspring feeding data and selected anthropometric measurements for mothers and their newborns were also collected. Differences between BMI for delivery type and way of feeding were verified with chi-square test. Differences and correlation between maternal BMI and newborn outcomes were verified with Kruskal-Wallis’ test and Spearman's rank test. Mean BMI of mothers included to the study was 22.8 ± 4.4 with mean weight 61.9 ± 11.6. Before pregnancy BMI was normal in 67% women and about 23% was overweight or obese. We do not observed differences between delivery type and way of feeding during first 48 hours, and women in BMI categories. Also no differences and correlation were observed for the Apgar score, gestational age of birth, and newborn's weight and length at birth. However, newborn weight correlated with newborn length (r = 0.433) and gestational age (r = 0.568) at birth. Concluding, the maternal pre-pregnancy BMI was not correlated with type of delivery, way of feeding and newborn outcomes. Previous studies show that high pre-pregnancy maternal BMI may be associated with adverse offspring outcomes at birth and later life. Future extended research is needed to explain these relations, with inclusion of the specific factors as maternal diet, lifestyle and ethnicity.

The utility of Foot Length as a Non-Invasive Anthropometric Measurement in Neonates Admitted in NICU in A Tertiary Care Centre in North Karnataka, India

Background: Most newborns in NICU would be on respiratory support either on invasive or non-invasive ventilation and it is difficult to measure anthropometries like weight, length and head circumference in these sick newborns. This study was aimed to determine the correlation of foot length of a newborn with occipitofrontal head circumference (OFC), crown-heel length (CHL) and weight of the newborn. Methods: A cross-sectional study was conducted in the NICU of Shri B M Patil Medical College Hospital and Research center, Vijayapura. The foot length, occipitofrontal head circumference (OFC) and crown-heel length (CHL) of neonates of gestational ages 28-42 weeks were measured between 12 hours and 7 days of life. Results: Among 350 neonates enrolled, 61% of babies were preterm and 39% were term babies. In premature babies, the correlation between foot length and birth weight (r=0.90) and foot length and length (r=0.89) was pronounced. A positive linear correlation was observed between foot length and weight in babies of all gestational ages. For the identification of LBW babies (<2500 gm), a foot length of less than 7.41cm had 94% sensitivity and 50% specificity. Foot length less than 6.62 cm had 100% sensitivity and 67% specificity for the identification of VLBW babies (<1500 gm). Conclusion: Birth weight and CHL of premature babies can be estimated from the measurement of foot length that was performed easily and rapidly. Measurement of foot length is valuable in premature babies on a ventilator. Foot length may be used in the identification of LBW and VLBW babies who are admitted to the NICU.

Особенности размножения живородящей ящерицы Zootoca vivipara (Lichtenstein, 1823) (Sauria, Lacertidae) различных высотных поясов Кузнецкого Алатау

In order to identify the specific features of mountain populations of the wide-range species of reptiles Zootoca vivipara, we analyzed various aspects of reproduction. This is the key process that ensures the existence of the species in extreme mountain conditions. From spring to autumn 2012-2016, we studied of Z. vivipara populations in the subalpine and mountain forest belts on the western slope in the central part of the Kuznetsk Alatau ridge (54-55° N, 87-88° E, southeast of Western Siberia). We studied the phenology of the active period of Z. vivipara (dates of the first and last encounters, copulation, birth of yearlings and duration of the active period). The age of animals was determined by the method of skeletochronology. As a result, life expectancy, growth rates of different sexes, gender and age structure during the activity season were estimated. The state of the reproductive system of males (n=61) and females (n=114) during the activity season was studied (See Table 1). The scientific and technical council of the Nature Reserve “Kuznetsk Alatau” approved the research program (Protocol No. 2 as of April 6, 2012). The procedures for trapping and collecting animals comply with international and national requirements for the humane treatment of animals. We detected that the duration of the active period in the studied populations varied from 85 to 152 days. It depended on the height of the territory above sea level and weather conditions in the observed year. The phenological phases of the reproductive period and the sexual cycles of males and females differed depending on the environmental conditions of a particular altitudinal zone: in the mountains, the season of Z. vivipara activity was reduced, which led to a decrease in the growth rate and an increase in the age of puberty of males (2-3 years) and females (3-4 years). As a result, the linear sizes and life expectancy of Z. vivipara individuals were greater in mountain populations than in plain populations. We found that the reproductive core of the low and mid-mountain populations were three-year-old females, and the high-mountain populations were four to five-year-old females. The reproductive core of the high-mountain and mid-mountain populations were two-year-old males, and the low-mountain ones were two- or three-year-old males. The maximum age of breeding males and females in the highlands reaches 8 years (See Fig. 1). The reproductive cycles of males and females of the populations of Z. vivipara of the Kuznetsk Alatau and other populations of the species are similar, but slightly differ in temporal characteristics. It depends on environmental conditions. The cold mountain climate of the Kuznetsk Alatau leads to the fact that spring spermiogenesis, spermation, and mating in the reproductive cycle of males occur a short time before the onset of the warmest period. It is necessary so that the gestation of the offspring by females occurs in optimal thermal conditions. There were no differences in the seasonal dynamics of the relative volume of the testes: the highest values of this parameter were in the beginning and at the end of the active period, as well as during reproduction (See Fig. 2). The sizes of the testes correlated with the length of the males’ body (p<0.01). The relationship of the females’ length and weight with the brood size was revealed (n=80; p<0.01) (See Fig. 3). In the reproductive cycle of females, vitellogenesis occurs in a short time, and the period of embryonic development can be different in time as it largely depends on the temperature conditions of the environment. In some years, the embryo development may be delayed until wintering begins. In the females, vitellogenesis took place after wintering; ovulation and fertilization were in May – early June, and pregnancy and childbirth took place in the third decade of July-August (See Fig. 4). In the midmountain population of Z. vivipara, the body length of newborns is longer compared to the high-mountain population (U=235; Z=4.6; p<0.001) (See Table 3). For mountain populations, a wider range of values was shown; a higher fecundity of females was in low and middle mountains, then in high mountains. In all altitudinal zones, the average long-term population fecundity of females, equal to 7.3 (from 7.1 to 7.6; p<0.001), was 1.2 times higher than in the plain populations in the southeast of Western Siberia and throughout the range (See Table 4). The range of intra-population variability of fertility in the mountains (3-11) was lower than on the plain (2-12). The relationship of the length and weight of females with the brood size was revealed (n = 80; p<0.01). The paper contains 4 Figures, 4 Tables and 30 References.

Relationship Between Maternal Nutritional Status and Birth Outcome Among Pregnant Women Attending Antenatal Clinic at Yusuf Dantsoho Memorial Hospital Kaduna

This study was undertaken to find out the relationship between maternal dietary pattern, anthropometric indices with birth outcome among pregnant women in their 3^rd trimester attending antenatal clinic at Yusuf Dantsoho Memorial Hospital, Tudun Wada, Kaduna. Sixty-seven mothers – baby pair participated in the study. Weight, height, and Mid Upper Arm Circumference (MUAC) of mothers were measured with unclothed newborn length, weight, head and chest circumference also taken. Results obtained shows mean maternal age, weight, height, and MUAC of 31.20±8.40 years, 70.37±12.73 kg, 1.620±0.07 m, 26.65±4.08 cm, and 26.63±3.80 kg/m² respectively. Majority of the pregnant women (77.60%) had good nutritional status while 16.40%, 6.00% are moderately and severely malnourished respectively. Maternal dietary pattern showed daily to weekly intake of all the food groups with less than 50% except for bread and cereals which is more than 50%. Maternal mean intake of total protein and total calories was close to the recommended daily intake of 60- 75 kg/day, and 2500 – 3000 kcal respectively. Newborn anthropometric measurements indicated that 61.20% were mildly stunted, 70.10% mildly underweight, and 62.70% moderately wasted neonates. Head and chest circumference are within the normal range. Maternal anthropometry and dietary pattern showed a positive correlation with birth outcome.

MORPHOLOGY OF BRACHIAL PROFUNDA ARTERY OF THE DOMESTIC REINDEER’S THORACIC LIMB IN ONTOGENESIS

The authors argue the reindeer’s vascular morphology is not sufficiently investigated. They focus on the distal part of the thoracic and pelvic limbs, which the reindeer steps on the ground and hurts it often, as it leads to necrobacterial lesions in summer. In the postnatal period of the reindeer growth, the most intensive one in the length and diameter of the main arteries is observed in the first year, especially in the first month. During this period, the newborn deer gets into the new conditions of existence and the organs of movement become more and more functional. By the age of 3 - 3.5 years, the growth of the main arteries in length is almost over. The paper explores the features of blood supply of the thoracic limbs of a domestic reindeer, caused by the prominent growth of the second and fifth fingers. The absolute growth of arterial length in newborns and deers aged 0.5 months is 0.6 cm per day. In the following years of life, the length is reduced to 0.03 cm in the reindeers aged 3 y.o. The relative diameter of the arteries to the limb length in the postnatal period decreases from 4.4% in newborns to 3.3% in old deer. The irregularity of changes in the absolute and relative development of the thoracic limb arteries can be explained by different growth of blood vessels, bones, joints and limb muscles.

Cortisol, leptin and free leptin index (FLI) in newborns in the first days of life and their importance for body weight programming

BackgroundBirth weight and leptin seem to be the factors responsible for early programming of body weight in later life. A marker for leptin action is free leptin index (FLI), which depends on soluble leptin receptor (Ob-Re) (FLI = leptin/Ob-Re). In the present article, we suggest that FLI is modulated partly by cortisol variations observed in newborns in the first days of life and is connected with their postnatal weight loss.MethodsThe study group consisted of 44 full-term newborns. Leptin, cortisol and Ob-Re concentrations were determined in the umbilical cord blood (UCB) and in the newborns’ blood (NB) on the fourth day of life, free leptin index (FLI = leptin/Ob-Re) was calculated. Correlations between the assessed parameters and the somatic features of the newborns were examined.ResultsBirth weight, length and chest circumference of newborns were positively correlated with leptin concentration in the UCB but not with FLI in the UCB. Cortisol and leptin concentrations, as well as FLI values declined concomitantly with body weight, and were lower on the fourth day of life than on the first one; however, Ob-Re concentration increased (p < 0.0001). There was a positive correlation between the newborns’ birth weight loss percentage evaluated on the fourth day of life and FLI in newborns (R = 0.39; p < 0.01). Positive correlations between cortisol and Ob-Re in UCB (R = 0.35; p < 0.02) and in NB (R = 0.36; p < 0.01), as well as a negative correlation between cortisol and FLI (R = -0.32; p < 0.03) in NB were noted.ConclusionsOur data suggest a possible relationship between cortisol and a soluble leptin receptor (Ob-Re), which changes free leptin index (FLI) and is connected with birth weight loss in newborns. Whether these observations are important for programming of future body weight of children requires further research.

The concentration of selected elements in the placenta according to selected sociodemographic factors and their effect on birth mass and birth length of newborns

Background and aimsThe placenta is a remarkable organ which provides critical transport functions between the maternal and fetal circulations during pregnancy. The demand for mineral components increases during the gestational period, therefore, an appropriate intake of minerals, such as calcium, phosphorus, potassium, magnesium, iron, zinc, copper, and manganese, determines the correct growth and development of a fetus. The aim of the study was to assess the concentration of selected elements in the placenta, and to assess the impact of their concentrations on the birth weight and birth length of newborns. The second aim of the study was to assess the influence of selected sociodemographic factors on the concentration of elements in the placenta. ResultsThe study demonstrated that the age of mothers affected the concentration of Ca and Mn in the placenta, and their habit of tobacco smoking during the gestational period was associated with higher concentrations of Ca, P, K, Mg, Fe, Cu, and Cd in the placental tissue. The results also showed that concentrations of K, Fe, Zn, and Mn in the placental tissue affected birth length. Furthermore, the association was demonstrated between a higher Cd concentration in the placenta (≥ 0.0503 μg/g) and the birth anthropometric parameters of neonates. ConclusionsSmoking during pregnancy and environment pollution are the factors that affects the concentration of elements in the placenta and contributes to their high accumulation in the placenta. Smoking during pregnancy causes an increased concentration of cadmium in the placenta which has negative health effects for the newborn. Women living in a big city or village had a higher concentration of cadmium in their placentas compared to women living in smaller cities. The significant influence of some elements (K, Fe, Zn, Cu and Cd) on the newborn’s birth parameters was also demonstrated. The results of our research indicate the importance of the mother’s lifestyle in providing the placenta with elements, which affects the growth of the fetus.•The placenta is an organ that is responsible for the proper course of pregnancy and fetal development.•The demand for mineral components increases during the gestational period, therefore, an appropriate intake of minerals determines the correct growth and development of a fetus•Increased exposure to arsenic, cadmium and lead during the gestational period can induce miscarriage, premature delivery, risk of fetal death, inhibition of intrauterine growth and development of the fetus, and low birth parameters.

Differences in Birth Size Associated with Preconception Maternal Nutrition Intervention Persist in Postnatal Growth Through 6 Months (OR10-05-19)

ObjectivesNewborn size, including length, has been associated with later growth. Preconception nutrition supplementation in Women First (WF) trial (clinicaltrials.gov NCT01883193) was associated with higher newborn length and lower rates of stunting. The objective was to examine postnatal growth outcomes through 6 mo in the WF offspring. MethodsSubjects were 2450 infants from the WF sites in Democratic Republic of Congo (DRC), Guatemala, India, and Pakistan with the 3 WF arms maintained: Arm 1 started a lipid-based nutrition supplement ≥ 3 mo prior to conception; Arm 2 started same supplement at ∼11 wk gestation; and Arm 3 received no trial supplements. Maternal supplementation was discontinued at delivery. Anthropometric measurements were obtained at birth, 0.5, 1, 3, and 6 mo; Z-scores were calculated from WHO Child Growth Standards. Primary and secondary outcomes were analyzed using longitudinal generalized estimating equations accounting for the correlation of repeated measures over time and study cluster. Intervention effects were evaluated within each site as well as overall, adjusting for site and baseline maternal covariates that differed by arm. Statistical interaction between arm and infant sex was evaluated and included if significant. ResultsLongitudinal growth (length and weight) curves from 0–6 mo demonstrated differences by intervention arm, with Arms 1 and 2 more favorable compared to Arm 3 (Table + LAZ in Figure). Relative risks (RR) for stunting were significantly lower for Arms 1 and 2 (vs. Arm 3) (Table). Site-specific analyses revealed some site differences warranting further exploration. ConclusionsWithout any postnatal intervention, differences in fetal growth evident at birth persisted at 6 months. Funding SourcesBill & Melinda Gates Foundation; NIH, NICHD & ODS. Supporting Tables, Images and/or Graphs▪▪

Comparison of birth weight, length, and head circumference between the BRISA-RP and Intergrowth-21st cohorts

Objectives(a) To determine the 3rd, 50th, and 97th percentiles of weight, length, and head circumference of newborns from the Ribeirão Preto BRISA cohort, according to gender and gestational age, and compare them with the Intergrowth-21st standard; (b) To estimate the small for gestational age (<3rd percentile), large for gestational age (>97th percentile), stunting (length<3rd percentile), and wasting (body mass index<3rd percentile). MethodsObservational study of a cohort of 7702 newborns between 01/01/2010 and 12/31/2010 in the city of Ribeirão Preto, SP, Brazil. The 3rd, 50th, and 97th percentiles were determined for the anthropometric measurements using fractional polynomial regression. ResultsThe weight difference between Ribeirão Preto and Intergrowth-21st was small, being more pronounced in preterm infants (mean difference between the two populations of +266g); for full-term newborns, there was a mean difference of +66g, and for post-term infants, of −113g. For length, the mean variation was always <1cm; whereas for head circumference, preterm newborns showed a variation >1cm, and full-term and post-term newborns showed a variation of <1cm. The small and large for gestational age detection rates were 2.9% and 4.3%, respectively. Stunting affected 6.5% of all newborns and wasting, 1.5%, with a predominance in girls and in full-term pregnancies; both conditions were present in 0.4% of the sample. ConclusionsNewborns from Ribeirão Preto, when compared to the Intergrowth-21 standard, are heavier, longer, and have a larger head circumference until they reach full-term.

Assessment of the stretched penile length in Sri Lankan newborns

Evaluation of the external genitalia is important in the routine neonatal examination, since abnormalities of the genitalia give clues to underlying endocrine disorders or structural malformations. The objectives of the study were to document the stretched penile length (SPL) of healthy term neonates born following an uncomplicated delivery at a tertiary care hospital in Sri Lanka, and to establish the normative data for the SPL for Sri Lankan neonates. This was a cross sectional observational study, carried out at post natal wards of the Castle Street Hospital for Women, Sri Lanka. The study was done on 369 stable newborns delivered at the gestational age of 37 to 42 weeks. A complete neonatal examination was performed by the principal investigator and the measurements of the weight, length, head circumference and stretched penile length were obtained. Mean penile length and statistically significant difference of penile length (SD) values were calculated. The correlation of mean penile length, period of gestation, birth weight and length were analysed. The SPL positively correlated with the length of the baby. There is no statistically significant correlation of birth weight, head circumference and gestational age with the SPL. The mean SPL for term Sri Lankan new-borns was 3.03cm ± 0.37cm and the -2SD value was 2.29cm. Since the -2SD of SPL was 2.29cm, measurements less than this should be considered as micropenis.

Birth Size in Neonates with Congenital Adrenal Hyperplasia due to 21-hydroxylase Deficiency

Objective:Classic congenital adrenal hyperplasia (CAH) secondary to 21-hydroxylase deficiency is characterized by increased prenatal adrenal androgen secretion. There are a small number of reports in the literature showing higher birth weight and length in CAH newborns.Methods:We analyzed birth weight and length data of 116 German newborns (48 boys, 68 girls) with classic CAH who were born during the period from 1990 to 2017. All children have been followed or are currently treated as outpatients in our clinic. All children were born at term. The mothers were healthy and their pregnancies were uneventful. The diagnosis of CAH was confirmed by molecular analyses of the CYP21A2 gene. Birth data were calculated as standard deviation (SD) scores according to German reference values.Results:Weight and length in male CAH newborns (mean ± SD) (3601±576 g; 52.4±2.85 cm) were significantly higher than in female CAH newborns (3347±442 g; 51.2±2.55 cm), but male-female differences in the CAH cohort were lost when the data were converted into SD scores. The birth sizes of the CAH newborns did not differ from the reference group. The birth sizes also did not differ between the different CAH genotypes. Maternal age, mode of delivery and maternal parity had no influence on birth size.Conclusion:Our data show that prenatal hyperandrogenism does not affect fetal growth.

Prenatal cadmium exposure is associated with shorter leukocyte telomere length in Chinese newborns

BackgroundNewborn telomere length (TL) is considered a potential marker for future disease and lifelong health, but few epidemiological studies have examined the determinants of TL in early life. The study aim was to investigate whether there is an association between prenatal cadmium exposure and relative cord blood TL in Chinese newborns.MethodsParticipants were 410 mother–newborn pairs drawn from a prospective birth cohort study conducted in Wuhan, China, between November 2013 and March 2015. Urine samples were collected from pregnant women during their period of institutional delivery. Urinary cadmium concentrations were measured by inductively coupled plasma mass spectrometry. The real-time quantitative polymerase chain reaction detection was used to measure relative TL using genomic DNA isolated from umbilical cord blood leukocytes. Multivariate linear regression models were used to estimate the effect of prenatal urinary cadmium concentration on relative cord blood TL.ResultsThe geometric mean of maternal urinary cadmium concentration was 0.68 μg/g creatinine. In the multivariate-adjusted linear regression model, per doubling of maternal urinary cadmium concentration was associated with 6.83% (95% CI − 11.44%, − 1.97%; P = 0.006) shorter relative cord blood TL. Stratified analyses indicated that the inverse association between prenatal urinary cadmium and newborn relative TL was more pronounced among female infants and mothers < 29 years, while there were no significant effect modification according to infant sex (P for interaction = 0.907) and maternal age (P for interaction = 0.797).ConclusionsThe findings indicated that increased maternal urinary cadmium was associated with shortened relative cord blood TL. The results provide more evidence of the negative effects of environmental cadmium exposure and suggest that accelerated aging or cadmium-related diseases may begin in early life.

Relation between pregestational obesity and characteristics of the placenta

Objective: To evaluate the morphology of the placenta in patients with pregestational overweight (OW), pregestational obesity (PGOB), or normal weight.Methods: A cross-sectional study including women (n = 114) ≥20 years of age with a singleton pregnancy was carried out. The groups were integrated according to pregestational body mass index (BMI): 51 patients had a normal BMI (18.5–24.99 kg/m2), 30 were overweight (25–29.99 kg/m2), and 33 women were obese (≥30.0 kg/m2). A morphometric study of the placenta was performed and the placental maturity index (PMI) was calculated according to the formula: PMI = number of vasculo-syncytial membranes (VSM) in 1 mm2/VSM thickness. In the histopathological study, the presence of infarcts, calcifications, hemorrhage, thrombosis, fibrosis, cysts, and edema was determined.Results: The weight and length of newborns at birth were greater in the group with PGOB (p < .01). We observed a lower number of VSM (29 ± 9 versus 39 ± 13 and 34 ± 11) and a greater thickness (1.05 ± 0.24 versus 0.95 ± 0.08 and 0.89 ± 0.09) and, therefore, a lower PMI (29.75 ± 12.63 versus 40.88 ± 15.25 and 39.28 ± 14.4) in the group of women with PGOB compared with the group of women with OW or normal weight (p < .01). The histopathological analyses showed a greater frequency of edema and cysts in the PGOB group.Conclusion: PGOB is associated with a higher placental weight and newborn weight, a lower PMI, and the presence of histopathological alterations. The preceding points highlight the importance of promoting an appropriate pregestational weight in women of reproductive age.

Pre- and postnatal environmental boron exposure and infant growth: Results from a mother-child cohort in northern Argentina

BackgroundExperimental studies show developmental toxicity of boron and we recently found impaired weight and length in newborns of mothers exposed to boron through drinking water during pregnancy. ObjectivesTo evaluate potential impact of pre- and postnatal boron exposure on infant anthropometry. MethodsIn our mother-child cohort (n = 177) in Argentinean Andes, where drinking water concentrations of boron, lithium and arsenic have been found to vary considerably, we collected maternal blood and urine during and after pregnancy, placenta, breast milk, as well as infant urine and blood during the first 6 months of life. In all samples, boron and other potentially toxic elements were measured by ICP-MS. Infant weight (g), length (cm) and head circumference (cm) were measured at birth, 0–3 (n = 120) and/or 3–6 months (n = 120; 79 overlap) of age. ResultsBoron concentrations in breast milk (range: 46–786 µg/L) correlated strongly with those in maternal serum (range: 47–624 µg/L; rs = 0.94) 0–3 months post-partum. In multivariable-adjusted linear regression, urinary boron (log2-transformed; range 60–9200 µg/L) in the youngest infants, but not maternal serum boron during pregnancy, was inversely associated with body weight at both 0–3 months (B: −141, 95% CI: −240; −42, p = 0.006) and 3–6 months (B: −200, 95% CI: −377; −23, p = 0.027). Infant urinary boron was also inversely associated with head circumference at 0–3 months (B: −0.39, 95% CI: −0.74; −0.04, p = 0.028), as well as length (B: −0.57, 95% CI: −1.1; −0.03, p = 0.040) and head circumference (B: −0.30, 95% CI: −0.64; 0.04, p = 0.083) at 3–6 months. ConclusionsThe observed first evidence that elevated environmental boron exposure in early infancy may adversely affect growth supports previous findings of boron-related impaired fetal growth. More research is needed to verify the findings at older age and in other populations.