Low Gestational Birth Weight Research Articles

Global, regional, and national burden of upper respiratory infections, 1990–2021: findings from the global burden of disease study 2021

BackgroundUpper respiratory infections (URIs) are common infectious diseases worldwide. Accurate and timely assessment of the disease burden of URIs is crucial for governments to develop comprehensive prevention and control strategies, and to allocate and utilize healthcare resources more efficiently. MethodsFor URIs in Global Burden of Disease (GBD) 2021 database, age-standardized incidence rates (ASIR), age-standardized prevalence rates (ASPR), age-standardized mortality rates (ASMR), disability-adjusted life-years (DALYs), and case numbers for incidence, prevalence, deaths, and DALYs across the globe, five socio-demographic Index (SDI) regions, 21 geographical regions, and 204 countries and territories were provided and analyzed. Trends from 1990 to 2021 were described using the average annual percentage change (AAPC), and future URIs burden was projected with a Bayesian age-period-cohort (BAPC) model. ResultsFrom 1990 to 2021, there was a significant decline in global ASIR (APCC = −289.86, 95% confidence interval [CI]: −298.59 – −281.12), ASPR (AAPC = −4.04, 95% CI: −4.16 – −3.92), ASMR (AAPC = −0.02, 95% CI: −0.02 – −0.03) and age-standardized DALY rate (AAPC = −0.75, 95% CI: −0.76 – −0.74). The ASIR, ASPR, ASMR, and age-standardized DALY rate were high in elderly for both males and females, and both genders. Similarly, the number of incident cases, prevalence cases, deaths, and DALY cases for URIs was highest in children under five years. The ASMR and age-standardized DALY rate exhibited a negative correlation with SDI across 204 countries and territories in 2021. The ASIR and ASPR for URIs will show an upward trend from 2022 to 2050, while ASMR and age-standardized DALY rate are expected to decline. Low birth weight for gestation remains the leading contributor to deaths related to URIs. ConclusionDespite the global decline in URIs burden, significant challenges remain among the elderly population. These findings support the optimization and implementation of public health policies, including targeted vaccination and integrated One Health approaches to reduce the burden in high-risk populations.

The impact of low birthweight in infant patterns of regulatory behavior, mother-infant quality of interaction, and attachment

It remains unclear whether infants born preterm are more likely to develop an insecure attachment with their mothers. In this study, instead of using gestational age criteria, we observe attachment in infants born with very low birthweight. Although the collinearity between gestational age and birthweight is high, infants born with very low birthweight for their gestational age tend to stay more days in NICU and to have more comorbidities than other infants with the same gestational age. Thus, we wonder about the impact of low gestational birth (per se) in infants' regulatory behavior, the quality of mother-infant interactions, and attachment security. The participants are 71 infants' weight lower than 1599 g of gestational weight (varying between 23 and 34 weeks of gestational) and their mothers. Dyads were observed in free play and during Face to Face Still-Face paradigm with infants at 3 months of corrected age. At 12 months of corrected age, mother-infant attachment was observed during Strange Situation. Results indicate that infants with low/very low gestational birthweight have high levels of insecure attachment (70 %) and non-positive patterns of regulatory behavior (64 %). Maternal and infant interactive behavior is highly associated with infant attachment. In turn, maternal interactive behavior is associated with gestational age, birthweight, and number of days in NICU.

Analysis of influencing factors of extra uterine growth retardation in premature very low birth weight infants

Objective To analyze the influencing factors of extra uterine growth retardation (EUGR) in premature very low birth weight infants. Methods A total of 61 EUGR premature very low birth weight infants survived in intensive care unit of our hospital were enrolled into EUGR group, and at the same time another 50 non-EUGR premature very low birth weight infants were selected into non-EUGR group.The clinical related medical records in the two groups were compared and analyzed, and the influencing factors of EUGR was analyzed by Logistic regression analysis. Results The birth gestational age of EUGR group was (31.29±1.56)weeks, which was significantly lower than (33.98±1.35)weeks of the non-EUGR group (t=9.60, P<0.05). The birth weight of the EUGR group was (1 206.76±212.14)g, which was significantly lower than (1 341.55±103.26)g of the non-EUGR group (t=4.11, P<0.05). The hospital stay, return to birth weight time, start enteral nutrition time and total parenteral nutrition time in the EUGR group were (27.77±5.00)d, (15.36±5.91)d, (3.36±1.91)d, (16.93±4.02)d respectively, which were significantly longer than those in the non-EUGR group[22.69±3.97)d, (10.61±4.57)d, (2.61±1.37)d, (9.43±3.11)d](t=3.53, 4.65, 2.33, 10.80, all P<0.05). The incidence rates of complications such as respiratory system, digestive system and metabolic disorder in the EUGR group were 26.23%, 19.67% and 67.21%, respectively, which were significantly higher than those of the non-EUGR group(8.00%, 6.00% and 40.00%)(χ2=6.18, 4.39, 8.22, all P<0.05). Logistic regression analysis showed that low birth gestational age and birth weight, long hospital stay, later return to birth weight and total parenteral nutrition time, intrauterine growth retardation, and respiratory system, digestive system and metabolic disorder were independent risk factors for the occurrence of EUGR(all P<0.05). Conclusion The influencing factors of EUGR in very low birth weight infants were mainly low gestational age and birth weight, long hospital stay, later return to birth weight and total parenteral nutrition time, intrauterine growth retardation, and respiratory system, digestive system and metabolic disorder.Therefore, in order to prevent EUGR, active symptomatic measures should be given in clinic. Key words: Infant, premature; Growth and development; Risk factor

Evaluation of hepatitis B virus transmission and antiviral therapy among hepatitis B surface antigen-positive pregnant women.

The aim of the present study was to assess the potential risk of hepatitis B virus (HBV) vertical transmission among Turkish parturient women and to evaluate the efficacy and safety of antiviral agents. Data were collected retrospectively from 114 HBV-infected pregnant women and their infants in eight health institutions in Turkey. The baseline characteristics of the women were: mean age, 28.3 ± 5.2 years; alanine aminotransferase, 57.4 ± 139.0 U/L; aspartate aminotransferase, 56.6 ± 150.0 U/L; and HBV DNA, 8.3 × 10(7) ± 2.6 × 10(8) copies/mL. Family history of HBV infection was detected in 53.5% (n = 61). In total, 60 (52.6%) pregnant women received tenofovir (60.0%), lamivudine (33.3%) or telbivudine (6.7%) therapy at the median gestational age of 22.2 ± 8.5 (1-36) weeks. All infants were vaccinated and hepatitis B immune globulin was administered, with 81 of them (71.1%) available for follow-up. After completion of HBV vaccination course, 71 (87.7%) infants had protective anti-HBs levels, three (3.7%) were hepatitis B surface antigen-positive, and seven (8.6%) were hepatitis B surface antigen-negative with nonprotective anti-HBs levels. Five of the infants had low gestational birthweight but no other birth defects were observed. According to our results, viral load may not be the only effecting factor for transmission of HBV to children of infected mothers. Pregnant women with high viral load should be followed-up closely during pregnancy. They should begin to take tenofovir or telbivudine, which are category B drugs for pregnancy, at the beginning of the third trimester at the latest. We need new treatment strategies; and close follow-up of mothers and children is another important issue.

Response to Birth Factors and Retinal Vascular Caliber in a Twin Study

We thank Cheung1 for his interest in our article and, in particular, for highlighting the issues relating to the use of birth size as a sensitive marker of fetal growth restriction and its relationship with retinal vascular caliber. The prevalence of prematurity is relatively high in twins compared with singletons, and, as such, we used birth weight for gestational score under the 10th percentile as a proxy for fetal growth restriction in our analysis. Although we could not …

Studies of genetic polymorphism in retinopathy of prematurity

Retinopathy of prematurity (ROP) is a vasoproliferative disease that happened in preterm infants with low gestational age and birth weight. Recently, many studies suggested that the incidence of ROP and the results of same clinical intervention vary between different races and countries. It seems that ROP may relate with genetic factors. Several genes are suggested to play a possible role in the occurrence of ROP. This paper reviews these related genes.

An 8 year study of risk factors for SIDS: bed-sharing versus non-bed-sharing

Background: It is unclear if it is safe for babies to bed share with adults. In Ireland 49% of sudden infant death syndrome (SIDS) cases occur when the infant is...

Pregnancy and obstetrical outcomes in pseudoxanthoma elasticum

Pseudoxanthoma elasticum (PXE) is a genetic multisystem disorder characterized by calcified dystrophic elastic fibres in skin, retina and arteries. Much of the earlier literature on pregnancy in PXE contained reports of severe complications, leading some healthcare providers to advise women with PXE against becoming pregnant and some women with PXE to avoid pregnancy. To evaluate the obstetrical outcomes and the incidence of pregnancy complications in women with PXE and to determine if pregnancy is associated with an adverse effect on the course of the disease. Women with PXE (n = 407) answered detailed questionnaires regarding reproductive history and pregnancy as well as the course of their disease. The frequency of reported pregnancy outcomes and complications was determined. Severity indices for the major clinical manifestations of PXE were developed and correlated with gravidity of affected women aged 40 years or over. Among the 306 respondents with PXE who had ever been pregnant, there were 795 pregnancies. Of these, 83% ended in live births and 1% in stillbirth. The median birth weight was within the normal range and the incidence of low birth weight for gestation was low. Hypertension occurred in 10% of pregnancies, gastric bleeding and retinal complications in < 1%, and 12% of pregnancies were associated with worsening of skin manifestations. There was no effect of gravidity and clinical severity on cutaneous (P = 0.07), ocular (P = 0.59) or cardiac (P = 0.42) manifestations of PXE in women aged 40+ years, nor did ever having been pregnant adversely affect these clinical severity indices. Of the 101 women who had never been pregnant, 17% made the decision because they were advised against becoming pregnant by a healthcare professional and 11% did not become pregnant because they feared an adverse outcome either in their pregnancy or disease. PXE is not associated with markedly increased fetal loss or adverse reproductive outcomes. The incidence of gastric bleeding, although probably higher than in the unaffected population, is much lower than previously reported, and retinal complications are uncommon. Although a few pregnancies were associated with worsening of skin manifestations, there was no correlation of either gravidity or ever having been pregnant with ultimate severity of skin, ocular or cardiovascular manifestations. There is no basis for advising women with PXE to avoid becoming pregnant, and most pregnancies in PXE are uncomplicated.

Increased adverse pregnancy outcomes with unreliable last menstruation

Objective: To estimate the risk of adverse outcomes in women whose first day of the last menstrual period (LMP) was unreliable. Methods: Among 20,244 singleton pregnancies with measurements of biparietal diameter between 12 and 22 weeks’ gestation, LMP was registered as unreliable in 3775 (18.6%) and reliable in 16,469 (81.4%). Adverse outcomes were defined as spontaneous or missed abortions after 12 weeks’ gestation, stillbirth or postnatal death within 1 year, preterm birth, birth weight less than 2500 g, and low birth weight (LBW) for gestation (lower than 22% below sex-specific expected weight). Logistic regression analysis and Kaplan-Meier survival analysis were used to analyze the risk of adverse outcomes. Results: The risk of death was doubled in pregnant women with unreliable LMPs compared with those with reliable LMPs (odds ratio [OR] 2.0; 95% confidence interval [CI] 1.5, 2.6). This risk was highest with respect to stillbirth (OR 2.7; 95% CI 1.7, 4.3). The risks of preterm birth, LBW, and LBW for gestation were also significantly increased (ORs 1.5, 1.4, and 1.2; 95% CIs 1.3, 1.7; 1.2, 1.6; and 1.0, 1.4, respectively). Conclusion: An unreliable LMP is associated with increased risk of adverse outcomes, especially fetal death.

Prediction of pre-eclampsia, low birthweight for gestation and prematurity by uterine artery blood flow velocity waveforms analysis in low risk nulliparous women.

To assess the performance of four previously reported Doppler abnormalities of uterine artery velocity waveforms (presence of a protodiastolic notch, peak systolic over protodiastolic velocities (A:C ratio) > 2.5, peak systolic over end diastolic velocities (A:B ratio) > 90th centile, resistance index (RI) ([A-B]/A) > or = 0.58) in predicting pre-eclampsia, low birthweight and prematurity. Prospective cohort study. Tertiary care university hospital in Quebec City. 1311 nulliparous women. Evaluation of pulsed Doppler abnormalities of uterine artery velocity waveforms was carried out in 1000 and 1194 of women at 18.3 (SD 0.9) or 26.7 (SD 0.9) weeks of pregnancy. Pre-eclampsia, birthweight below the 10th centile for gestational age and spontaneous preterm birth (< 37 completed gestation weeks). Pre-eclampsia, low birthweight for gestation and prematurity occurred in 4%, 11% and 7% of the pregnancies, respectively. At 26 weeks all the abnormalities of the studied Doppler indices were significantly associated with pre-eclampsia and low birthweight for gestation as reflected by the 95% confidence intervals of the positive likelihood ratios which did not include the value 1. However, sensitivities (26% to 34%) and positive predictive values (7% to 28%) were low. No Doppler indices performed significantly better than the others. The abnormalities of the Doppler indices were not associated with spontaneous prematurity. The performance of the Doppler measurements performed at 18 weeks was poor. Uterine artery Doppler velocimetry waveform analysis does not qualify as a reliable screening test for pre-eclampsia or low birthweight for gestation in low risk pregnancies but may be useful in selected high risk populations.

Sympathetic nervous system in chronic joint pain.

<h3>Introduction</h3> This study explored the pregnancy outcomes of Inflammatory Bowel Disease (IBD) patients in Bradford against the standards of the British Society of Gastroenterology (BSG) and European Crohn’s and Colitis Organisation (ECCO) Reproduction and Pregnancy Consensus and includes a patient evaluation on the quality of care they received. It is well documented that pregnant women with IBD are at risk of poor outcomes from pregnancy, but less clear if there is a need for a dedicated pregnancy service for IBD patients. <h3>Methods</h3> A qualitative retrospective analysis of the pregnancy outcomes of IBD patients in Bradford Royal Infirmary (BRI) and patient perspective on care was conducted. Data search was performed using the ‘IBD database’, ‘Evolve’ and electronic patient clinical notes. 4112 females patients were identified. Questionnaires were sent to 89 of these patients who fulfilled the inclusion criteria for the project. An initial response of 12 questionnaires were received and telephone interviews were then conducted to generate a further 11 sets of data. The final study sample was 25. Data was analysed using descriptive statistical analysis in Microsoft Excel. No ethical approval was required for this project. <h3>Results</h3> 47% of patients in our study flared during pregnancy compared to an expected rate of 30%. 4 out of 9 complications during pregnancy could be attributable to IBD. The rates of prematurity, low gestational birth weight and emergency caesarean sections were 17% in each case in our study, as opposed to 45%, 32% and 29.5% respectively in the general IBD population. 13 out of 25 participants rated the IBD helpline a 10 out of 10, and 18 out of 25 participants rated the level of support a 5 out of 5. Overall, 60% of participants were in favour of a dedicated IBD pregnancy service in Bradford. <h3>Conclusion</h3> Pregnancy outcomes in the IBD population in BRI were favourable compared to national statistics, although the sample size was small. The Bradford IBD service provision and outcomes for pregnant patients are in line with the BSG national standards and ECCO guidelines. The majority of patients wanted to discuss their pregnancy and pre-pregnancy planning in an IBD clinic. Patient information posters and leaflets will be made available in out-patient clinics to enhance patient knowledge about IBD before and during pregnancy and to actively encourage patients to discuss concerns. A large proportion of participants were content with the care they received and felt supported with improvements to the helpline accessibility being a key area for improvement. The IBD Nurse Helpline remains a vital and valued part of the service, to ensure timely management and telephone advice.

Mid‐trimester levels of alphafetoprotein in the screening of low birthweight

Elevated maternal levels of alphafetoprotein (AFP) in midtrimester are believed by some to be a useful screening test for premature labour, low birthweight and low birthweight for gestation. In a prospective study on 887 randomly selected pregnant women we found that although there was an association between low birthweight and elevated AFP, the test would miss five out of every six cases of low birthweight and there would be nine false-positives for every case correctly identified. The test is not therefore sufficiently predictive of low birthweight to be of value as a screening test for this condition.

Prediction of Small-for-Dates Infants by Measurement of Symphysial-Fundal-Height

A standard chart of symphysial-fundal height from 20 to 40 weeks of pregnancy was derived from measurements in 103 women who were delivered of infants weighing between the 25th and 90th centile for gestation. The chart was used to predict birth weight in a group of 138 high-risk patients. Thirty (73.1 per cent) of 41 infants with birth weight for gestation less than 10th centile could be detected by this one clinical measurement. A single measurement was most accurate for detecting low birth weight for gestation at 32 to 33 weeks. It is suggested that symphysial-fundal height measurements should be made routinely on all antenatal patients and that each obstetric unit should derive its own standard curves.

PREDICTION OF SMALL‐FOR‐DATES INFANTS BY MEASUREMENT OF SYMPHYSIAL‐FUNDAL‐HEIGHT

A standard chart of symphysial-fundal height from 20 to 40 weeks of pregnancy was derived from measurements in 103 women who were delivered of infants weighing between the 25th and 90th centile for gestation. The chart was used to predict birth weight in a group of 138 high-risk patients. Thirty (73.1 per cent) of 41 infants with birth weight for gestation less than 10th centile could be detected by this one clinical measurement. A single measurement was most accurate for detecting low birth weight for gestation at 32 to 33 weeks. It is suggested that symphysial-fundal height measurements should be made routinely on all antenatal patients and that each obstetric unit should derive its own standard curves.

ENDOCRINE ASPECTS OF THE ROTHMUND-THOMSON SYNDROME

Three siblings (15 6/12 to 17 6/12 yrs.) with the Rothmund-Thomson Syndrome showed the following characteristic features: low birth weight for gestation, severe growth failure (present height: 110–113 cm), mental retardation, alopecia, hypoplastic nails, absent sexual development with cryptorchidism in the males, microdontia and anodontia, aphakia, decreased sweating, and congential poikiloderma, Routine studies were normal. Radiographs revealed delayed bone age in the males, complete epiphyseal fusion in the female, and generalized skeletal abnormalities. Endocrine studies revealed normal glucose responses with hyperinsulinemia to oral glucose, I.V, tolbutamide, and arginine. All had normal serum TSH, thyroxine and serum cortisol levels. Serum growth hormone (hGH) responses were variable but each subject showed at least one value over 10 ng/ml to argine (0.5 gm/kg) or insulin (0.10 u/kg) with insulin insensitivity, Serum hGH response to L-DOPA (0.5 gm p.o.) were all less than 6 ng/ml. Basal serum LH, FSH and testosterone were decreased and LH-RH (100 ug S.C.) did not produce a significant rise in serum LH or FSH in any of the subjects. The patients were treated with testosterone 10 mg/day, hGH 15 units/week or estradiol 50 μg/day respectively, for 6 months, with no clinical benefit. These studies suggest normal pituitary function for TSH, ACTH, and hGH, but the absent LH/FSH response to LH-RH with low basal levels suggest diminished pituitary gonadotropin reserve.

The pre-term baby.

Babies who weigh 2,500 g (5 lb 8 oz) or less at birth present special problems in the newborn period, and though (in the United Kingdom) these babies constitute only 7% of all new borns, about half the total neonatal deaths occur in this group. It used to be an internationally agreed convention to classify all babies weighing 2,500 g or less at birth as premature. Nevertheless, it has been increasingly recognized in the past 10 years that not all of them are born prematurely?that is, after an abnormally short gestation. There are, in fact, two major categories of low-birth weight baby?the pre-term baby and the smali-for-dates baby?and they differ not only in the cause of their low birth weight but also in the clinical problems they encounter in the perinatal period. Pre-term babies are those born before 37 completed weeks from the first day of the mother's last menstrual period. In the United Kingdom they comprise about two-thirds of low birth weight babies and their clinical problems may largely be accounted for by immaturity and unreadiness to adapt to life outside the uterus. Small-for-dates babies are those whose birth weight is abnormally low for the gestational age at which they are born. The definition of low birth weight for gestation is necessarily an arbitrary one, but there is now a fair measure of agreement for describing babies whose birth

Neonatal hypoglycemia. II. A clinical study of 44 idiopathic cases with special reference to corticosteroid treatment.

SummaryForty‐four newborn infants with significant hypoglycemia, i. e. with two or more true blood glucose values of 20 mg/100 ml or less, have been studied. Two thirds of the patients were males, and a similar proportion had low birth weight for gestation, mostly associated with maternal toxemia.Hypoglycemia was diagnosed during the first day of life in 34 cases. Only three infants were asymptomatic, whereas the others exhibited various nonspecific symptoms, which generally were more severe in patients aged two or three days. A therapeutic test with glucose was positive in only 20 infants, and mostly negative before 24 hours of age. The hypoglycemia was transient in all cases.Mental retardation with spasticity and infantile spasms has developed in four infants by the age of six months, and one of them died at the age of eight months. The others appear normal after 4–26 months of observation.A significant effect of hydrocortisone in shortening the duration of hypoglycemia was demonstrated.On the basis of experience with the patients reported, it is suggested that all infants with significant hypoglycemia should be efficiently treated, regardless of symptomatology.