Neonatal Anthropometric Parameters Research Articles

Child Head Circumference and Placental MFSD2a Expression Are Associated to the Level of MFSD2a in Maternal Blood During Pregnancy.

Gestational diabetes mellitus (GDM) is a world-wide health challenge, which prevalence is expected to increase in parallel to the epidemic of obesity. Children born from GDM mothers have lower levels of docosahexaenoic acid (DHA) in cord blood, which might influence their neurodevelopment. Recently, the membrane transporter Major Family Super Domain 2a (MFSD2a) was associated with the selective transportation of DHA as lysophospholipids. The expression of the DHA membrane transporter MFSD2a is lower in GDM placentas, which could affect materno-fetal DHA transport. Humans with homozygous inactivating mutations in the MFSD2a gene present severe microcephaly and intellectual impairments. Herein, we intended to identify early blood biomarkers that may be of use during pregnancy to monitor the offspring development and the adequate nutritional interventions, such as nutritional supplementation, that may be selected to improve it. We evaluated MFSD2a expression in maternal blood at the third trimester of pregnancy, and its potential relationship with the expression of placental MFSD2a at delivery and child outcomes. Three groups of pregnant women were recruited: 25 controls, 23 GDM with dietary treatment, and 20 GDM with insulin treatment. Maternal and neonatal anthropometric and biochemical parameters were evaluated. MFSD2a was analyzed in placenta, blood and serum. MFSD2a protein expression in maternal blood was significantly lower in GDM groups and correlated with placental MFSD2a and Z-score neonatal head circumference during the first 6 months of life. The cord/maternal serum ratio of DHA, a solid indicator of materno-fetal DHA transport, was reduced in GDM groups and correlated with MFSD2a in maternal blood at the third trimester and in placenta at delivery. This indicates that altered MFSD2a levels in maternal blood during pregnancy might influence placental nutrient transport and fetal neurodevelopment. Furthermore, MFSD2a levels in maternal blood on the third trimester were inversely correlated to DHA in maternal serum lyso-PL. Thus, the level of MFSD2a in maternal blood could be used as a potential biomarker for the early detection of disturbances of MFSD2a expression during pregnancy and the subsequent consequences for the neurodevelopment of the child, as well as it may help to choose the optimal treatment approach for the affected subjects.

Correlation between Capillary Blood-spotted Filter Paper Thyrotropin Results and Serum Thyroid Function Tests in Premature Neonates

Objective: The interpretation of thyroid function test results in preterm infants is affected by various conditions. Neither a definite thyrotropin cut-off nor intercurrent conditions have been clearly determined for premature neonates. This study aimed to determine the specific considerations required in the interpretation of capillary blood thyrotropin concentration by comparing it to serum thyrotropin when screening for congenital hypothyroidism in preterm neonates. Methods: A retrospective review was performed on 57 premature newborns who were screened for thyroid function test. The comparison of thyrotropin measured by two different methods, dried capillary blood-spotted filter paper using an immunofluorometric assay and serum radioimmunoassay, was performed. Clinical and biochemical factors affecting the difference between the two methods were investigated. Results: Filter paper thyrotropin concentration showed a positive correlation with the serum thyrotropin concentration. In total, 50.9% of premature neonates had a difference in the concentration ≥3.0 mIU/L between the methods. In these subjects, the serum thyrotropin concentration was higher, whereas other factors, such as maternal factors, neonatal anthropometric parameters, Apgar score, and corrected age, were not different when compared to that in subjects with a difference of <3.0 mIU/L. Conclusion: The filter paper thyrotropin concentration differed from the serum level in a substantial portion of premature neonates, and the degree of deviation may be affected by the serum thyrotropin concentration and gestational age at birth. Further investigations and longitudinal studies are warranted to establish clinical consensus guidelines for hypothyroidism screening in preterm neonates.

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.

Caffeine Intake During Pregnancy and Neonatal Anthropometric Parameters.

Caffeine is a psychoactive substance that may affect the normal course of pregnancy, therefore its intake during that time should not exceed 200 mg/day. The aim of this study was to evaluate caffeine intake among pregnant women from the Warsaw region. The study was conducted among 100 pregnant women who delivered at the Department of Obstetrics, Gynecology and Oncology, Medical University of Warsaw. Caffeine intake from coffee, tea, and energy drinks was measured using a questionnaire. Direct interviewing was used, with all interviews conducted by the same dietitian. Multiple regression analysis was used to investigate the relationship between caffeine intake and anthropometric measurements of the newborns. Mean caffeine intake among pregnant women was 68 ± 51 mg/day. Only 2% of the respondents exceeded the safe dose of 200 mg. Tea (mostly black) was the source of 63% of all caffeine. No relationships were found between caffeine intake and neonatal weight, length, or head and chest circumference (p > 0.05). Caffeine intake in our study population was relatively low and did not negatively affect fetal growth.

Correlation of Foot Length and Gestational Maturity in Neonates-A Study from Coastal Karnataka

Introduction: The degree of maturity is a major contributor to neonatal mortality and morbidity. Early identification of preterm babies can prevent life-threatening complications. This study was carried out to determine whether postnatal foot length could accurately identify the gestational age in a specified South Indian neonatal population. Material and Method: This hospital-based cross-sectional study included 320 neonates within 72hours of life. The study was approved by the Institutional ethics committee. After obtaining the informed consent, neonatal foot length was measured using a sliding plastic Vernier caliper. Neonatal anthropometric parameters like weight, crown-heel length, head circumference were also recorded. The data were analysed using SPSS version 11.5. Results: In preterm neonates correlation of foot length with weight, head circumference, crown-heel length and gestational age by Ballard’s score were statistically significant. From receiver operating characteristic curve, cut off value obtained for prediction of prematurity was 7.35cm which had sensitivity and specificity of 80% and 78 % respectively. Conclusion: Neonatal foot length can be a good surrogate measure in predicting prematurity

Reduced Insulin Receptor Expression and Altered DNA Methylation in Fat Tissues and Blood of Women With GDM and Offspring.

Altered expression of the insulin receptor (IR) in adipose tissue (AT) could contribute to gestational diabetes mellitus (GDM) etiopathogenesis. Transcriptional regulation via epigenetic mechanisms (e.g., DNA methylation) may play a critical role. However, the human IR promoter DNA methylation patterns and involvement in gene expression are unknown. We evaluated IR mRNA and protein expression accompanied by targeted DNA methylation analyses in AT and blood cells of women with GDM and their offspring. Prospective observational study. Academic clinic and research unit. GDM-affected (n = 25) and matched control (n = 30) mother-child dyads. Maternal IR gene and protein expression in paired subcutaneous (SAT) and visceral adipose tissue samples (VAT). DNA methylation levels in IR promoter and intronic regions in maternal AT and blood cells of mother-offspring pairs. In SAT and VAT, IR mRNA/protein expressions were significantly reduced in women with GDMs (P < 0.05). The decrease in VAT was more pronounced and independent of maternal body mass index. VAT IR protein levels were inversely associated with key maternal and neonatal anthropometric and metabolic parameters (P < 0.05). DNA methylation patterns were similar across tissues, with significant yet small size alterations between groups in mothers and offspring (P < 0.05). Decreased IR levels in AT may be a relevant pathogenic factor in GDM, affecting materno-fetal metabolism. Further investigation of causal factors for IR dysregulation is necessary, especially in VAT. Potential functional and/or clinical roles of altered DNA methylation also should be evaluated.

Gestational Age Assessment with Anthropometric Parameters in Newborns.

We sought to evaluate the relationship between gestational age (GA) and neonatal anthropometric parameters, namely head circumference (HC) and crown-heel length (CHL). We conducted a cross-sectional study in a tertiary care hospital with 530 consecutively live-born newborns of 28-41 weeks gestation. Anthropometric parameters were measured after three days of life. We summarized the variables using descriptive statistics, including percentile values, and the strength of association was determined through correlation analysis. The correlation was strong for HC and CHL, and linear regression analysis was done to develop predictive equations. HC and CHL correlated well with GA with r-values of 0.863 and 0.859, respectively. The regression equations derived were GA (week) = 9.2671 + [0.8616 × HC (cm)] and GA (weeks) = 7.2489 + [0.621 × CHL (cm)]. Multiple regression gave the relationship as GA (weeks) = 4.0244 + [0.4058 × HC (cm)] + [0.4249 × CHL (cm)]. Application of this multiple regression equation to a test cohort of 30 babies for prediction of GA gave a mean margin of error of 2.9%, indicating that it is a satisfactory tool for prediction. HC and CHL can be used as simple tools for predicting GA in babies when this is in doubt. This can help in identification of high-risk newborns at primary care level without recourse to imaging modalities.

Anthropometric Parameters of HIV-Infected and HIV-Uninfected Mothers and their Premature Infants.

This study aimed to assess the maternal anthropometric parameters of human immunodeficiency virus (HIV)-infected and HIV-uninfected mothers as well as to assess the neonatal anthropometric parameters of premature infants in relation to maternal anthropometric parameters (weight, height and mid-upper-arm circumference), HIV status and anti-retroviral therapy (ART) regimen. Study participants included HIV-infected and HIV-uninfected mothers who gave birth to premature infants. All HIV-infected mothers received ART. The incidence of intra-uterine growth restriction (IUGR) among premature infants was high. Maternal anthropometric parameters, HIV status and ART exposure showed no association with IUGR in this study. Sufficient maternal ART exposure may positively influence head circumference at birth, which might determine the neurodevelopmental outcome of these infants.

Correlation between maternal mid upper arm circumference and neonatal anthropometry

Introduction: An infant’s birth weight has been identified as the best marker of optimal fetal growth and development. Maternal anthropometry (weight, height and Mid-Upper Arm Circumference) have been identified to influence an infant’s birth weight and length. If MUAC can be established as a surrogate marker for neonatal anthropometric parameters it will help to plan the timely intervention for improvement of health of pregnant female. Aim: To study the correlation between maternal mid upper arm circumference and neonatal anthropometry. Material and Methods: A cross sectional study conducted in Dr. B R Ambedkar Memorial Hospital & Pt. JNM Medical college Raipur, Chhattisgarh since January 2015 to September 2016. Sample size was 232. Materials like weighing machine, measuring tape, Infantometer, were used. Data was expressed as percentage and correlation was established using Spearman's chi square test (p<0.05). Data was analyzed using SSPS (version 16.0). Result: Significant correlation exists between maternal MUAC and birth Weight and length of neonates. Low birth weight is higher in female neonates. Birth length is higher in male neonates. MUAC of mother is a good predictor of risk of low birth weight as compared with other classic anthropometric measurements. Conclusion: Maternal MUAC is a significant predictor of neonatal anthropometry and can be used instead of pre- pregnancy weight to assess maternal nutritional status especially in resource poor setting.

Evaluation of the influence of maternal parity on neonatal anthropometric parameters among Hausas in Kano state

Maternal Parity has been shown to increase the risk of adverse neonatal outcomes, such as intrauterine growth restriction (IUGR), prematurity, and mortality. The study was designed to evaluate the influence of maternal parity on neonatal anthropometric parameters among Hausas in Kano. Five hundred and twenty one subjects (mothers and babies) participated in the study. Questionnaire was used to collect the biodata, parity and other anthropometric variables (birth weight, birth length, head circumference, chest circumference, thigh circumference, mid upper arm circumference, hand length, hand breadth, foot length, foot breadth).The anthropometric variables were measured using standard procedures.One way ANOVA was used to determine the differences in neonatal variables across different categories of parity. SPSS (Statistical Package for Social Science) version 20 statistical software was used for data analyses. The result shows that the mothers within the 1st category of parity give birth to babies with lower birth weight and smaller thigh circumference when compared with 2nd, 3rd and 4th. However, in birth length, head circumference and chest circumference of the neonate the differences (p < 0.001) were observed only between 1st and 2nd category of parity. Moreover, the mid upper arm circumference has similar pattern with addition to 3rd categories. In conclusion, the parity of the mother was found to influence the neonatal anthropometric variables. Keywords : Maternal Parity, Neonatal Anthropometry, Hausas

The FTO rs9939609 and LEPR rs1137101 mothers-newborns gene polymorphisms and maternal fat mass index effects on anthropometric characteristics in newborns: A cross-sectional study on mothers-newborns gene polymorphisms-The FTO-LEPR Study (STROBE-compliant article).

The aim of this study was to assess the impact of mothers’ and newborns’ fat mass and obesity-associated gene (FTO) rs9939609 and leptin receptor (LEPR) rs1137101 gene polymorphisms on neonatal anthropometric parameters in order to identify a potential risk for developing obesity.We performed a cross-sectional study on 355 mother–newborn couples in an Obstetrics Gynecology Tertiary Hospital from Romania, evaluated with regard to anthropometric parameters, clinical and laboratory parameters besides 2 genetic polymorphisms (FTO rs9939609 and LEPR rs1137101).Newborns with mothers carrying variant AT or AA genotype for FTO rs9939609 presented lower BMI (P = 0.012) and lower MUAC (P = 0.029). There was a significant interaction effect between newborn and mother LEPR rs1137101 polymorphism on birth weight (P = 0.009) and BMI (P = 0.007). We noticed significantly increased birth weight and BMI in newborns carriers of AG + GG genotype, coming from mothers with AA genotype (P = 0.006). There was no evidence of significant interaction effect between newborn and mother FTO rs9939609 polymorphism on the studied anthropometrical data (P > 0.05). In addition, lower BMI scores (P = 0.042) were observed in newborns carriers of TT genotype whose mothers had AA + AT genotype. Lower MUAC scores (P = 0.041) were noticed in newborns carriers of AA + AT genotype whose mothers had AA + AT genotype for FTO rs9939609 gene polymorphism. Newborns carriers of the AG + GG genotype (P = 0.003) of LEPR rs1137101 coming from mothers with increased FMI (upper tertile) had significantly increased BMIs.Presence of the variant A allele of FTO rs9939609 polymorphism in mothers decreased BMI and MUAC in newborns. The impact of LEPR rs1137101 polymorphism on BMI and birth weight in newborns differed depending on the presence/absence of the dominant LEPR allele in mothers. In addition, we noticed that maternal FMI presented a significant positive effect on newborns’ BMI by changing the effect of LEPR rs1137101.We can conclude that mothers’ FTO rs9939609 and LEPR rs1137101 gene polymorphisms presented an impact on birth weight and newborns’ BMI, therefore being involved in the newborns’ nutritional status and in the design of a potential protocol.

Placental lactogen, placental growth factor, insulin resistance in early pregnancy and risk for gestational diabetes

Background and aims. Placental hormones and proteins are important regulators of insulin resistance during pregnancy. However, the data concerning the assosiation between placental lactogen (PL) and placental growth factor (PLGF) level in early pregnancy and further development of gestational diabetes mellitus (GDM) are limited and incostintent. The aim of this study was to compare the level of these two placental proteins and homeostasis model assessment of insulin resistance (HOMA-IR) in early pregnancy among women diagnosed with and without GDM months later.Materials and methods. A nested case-control study was conducted in a prospective cohort of pregnant women. Among them, 78 incident GDM cases were identified and 95 women who were not diagnosed with GDM were randomly selected as a control group. Blood was sampled for measurements of PL, PLGF, fasting plasma glucose and insulin at 8-14 weeks of pregnancy. All the women underwent oral glucose tolerance test (OGTT) at 24-32 weeks. GDM was diagnosed according to the International Association of Diabetes In Pregnancy Study Groups (IADPSG) recommendations (fasting glucose ≥5.1 mmol / l and / or 1 hour ≥10.0 mmol / l and / or 2 hours ≥8.5 mmol / L). The maternal and neonatal anthropometric parameters were also measured. Statistical analysis included Student's t-test, logistic regression and Pearson's correlation.Results. There was no difference between GDM and control groups in the mean levels of PL (0,70 +/- 0,53 vs 0,81 +/- 0,58 mg/L, р =0,215 ) and PLGF (60,7 +/- 169.6 vs 46,6+105,6 pg/ml, р=0,503). Women with GDM were older (30.2 +/- 3.9 vs 28.4 +/- 4.7 years, p = 0.008), had higher first trimester body mass index (BMI) (25.2 +/- 5.2 vs 23.1 +/- 4.6 kg/m2, р = 0.006), higher levels of insulin (10.3 +/- 5.5 vs 7.9 +/- 3.9 mU/L, p = 0,007) and HOMA-IR ( 2.17 +/- 1.1 vs 1.7 +/- 0.9, p = 0,007) compared to the control group. Women with GDM also had a higher level of fasting plasma glucose (4.8 + 0.6 and 4.6 + 0,5 mmol/L, p = 0.063), although the difference did not reach statistical significance. HOMA-IR was positively associated with the development of GDM (OR: 1.62, 95% CI: 1.12 - 2.34, P = 0.01) and the association retained under a multivariable analysis controlling for age and BMI (OR: 1.59, 95% CI: 1.04 - 2.45, P = 0.033). Maternal PL and PLGF were not related to the results of OGTT, HOMA-IR or neonatal anthropometry. A positive correlation between PL level and gestational age at the time of blood sampling was observed (r = 0.657, p &lt;0.001).Conclusion. Serum concentrations of PL and PLGF in pregnant women at 8-14 weeks’ gestation were not associated with HOMA-IR and later development of GDM. Higher HOMA-IR score in early pregnancy is significantly associated with an elevated risk for GDM.

Comparing Neonatal Outcome Following the Use of Ondansetron versus Vitamin B6 in Pregnant Females with Morning Sickness: A Randomized Clinical Trial

Background: Pregnancy-related nausea and vomiting or morning sickness with an overall prevalence rate of 80% is commonly appeared at the eighth week and frequently disappeared in most pregnant females at the 16th week of gestation. The severe form of the condition named hyperemesis occurs in one per 200 to 300 pregnancies; it is accompanied by dehydration, electrolyte instability and nutritional deficits and needs medical interventions. Limited data are available on harmful effects of common antiemetic medications used within pregnancy on human neonates. Objectives: The current study aimed to compare the effects of ondansetron and vitamin B6 on neonatal outcome in pregnant females with pregnancy-related nausea and vomiting. Neonatal outcome included the probable difference in neonates’ gestational age, weight, height, head circumference and frequency of apparent congenital anomalies. Methods: This randomized double-blinded clinical trial was conducted on 188 primipara singleton pregnant females with pregnancy-related nausea and vomiting who referred to state healthcare centers of Zabol, Iran, in 2014. The pregnant females were randomly assigned to receive drug packages including ondansetron tablets (4 mg) or vitamin B6 tablets (40 mg) and patients were instructed to take one tablet twice daily. Females were followed up until delivery and neonatal outcomes including any congenital anomaly, weight, height and head circumference at birth were assessed. Results: There was no difference between the groups in the mean age of mother and the mean age of gestation. No differences were found between the groups regarding birth weight (3006.93 ± 441.86 versus 2949.65 ± 457.36 g, P= 0.67), height at birth (49.50 ± 1.45 versus 48.97 ± 1.47 cm, P= 0.75) and head circumference at birth (34.23 ± 1.22 versus 33.88 ± 1.26 cm, P = 0.56). No neonatal anomaly was observed in the two groups. Conclusions: No significant differences were observed between the groups based on the neonatal outcome including neonatal anthropometric parameters and lack of congenital anomaly.

Pleuritic chest pain due to migratory bullet

There has been a continuous effort to develop standard growth charts for neonates. Reference growth charts based on cross-sectional intrauterine data were developed from measurement of anthropometric parameters of neonates of different gestations at birth. Similarly postnatal charts for preterm neonates were developed based on longitudinal measurements of infant's parameters over intervals. Fetal–infant growth charts were devised by combining cross-sectional intrauterine data and postnatal infant's longitudinal parameters. Revised Fenton 2013 charts incorporating neonatal anthropometric data look to be most adequate for preterm infants of 22 weeks gestation till 50 weeks post-menstrual age. These growth references describe how infants grew in certain time in a defined population. There was a need of developing growth standard defining growth of healthy population in optimal conditions. WHO Multicentre Growth Reference Study charts were developed as growth standards describing the growth of healthy children from term gestation till 5 years of age. Intergrowth 21st growth chart is the new growth standards for preterm infants and looks promising in infants of gestation 33 weeks or more.

Zależność pomiędzy matczynym wskaźnikiem masy ciała a parametrami antropometrycznymi noworodka

Introduction. Excessive or inefficient body weight in pregnant women is a serious obstetric problem, associated with an increased risk of complications for the mother and child. Excessive birth weight of an infant carries the risk of emergency obstetric conditions, in turn, low birth weight of an infant may pose a risk of developmental disorders. Objectives. To evaluate the impact of nutritional condition of mothers on anthropometric parameters value of newborns. Material and methods. The study included 247 women and their newborns. The diagnostic survey method was applied. An original questionnaire was used and anthropometric measurements of women and newborns were taken. Results and Conclusions. Statistically significant differences were found in birth weight of newborns depending on the nutritional condition of women prior to pregnancy. The children of mothers with insufficient bodyweight had a significantly lower birth weight (p = 0.0079) than the children of mothers with normal weight, excessive weight and obesity. It was also demonstrated that the children of mothers with insufficient body weight had significantly lower (p < 0.0001) head circumference than the children of mothers with normal weight, excessive weight and obesity. The research revealed a correlation between maternal body mass index and neonatal anthropometric parameters. Mothers with insufficient weight gave birth to children with a significantly lower birth weight than the children of mothers with normal weight, excessive weight and obesity. Mothers with excessive weight and obesity gave birth to infants with significantly higher birth weight than mothers with normal or insufficient weight before pregnancy. Nursing Topics 2015; 23 (4): 490–495

Associations between maternal phenolic exposure and cord sex hormones in male newborns.

Are maternal urinary phenol concentrations associated with cord steroid hormone levels and anogenital distance (AGD) in male newborns? High maternal urinary Bisphenol A (BPA) levels are associated with decreases in cord testosterone levels and the ratio of testosterone to estradiol in male newborns, but there was no significant association with AGD. Early life exposure to phenolic endocrine disrupting compounds (EDCs) is known to disrupt hormonal activities and affect reproductive development in males. However, studies on the health effects of prenatal human exposure are scarce. This was a cross-sectional study to investigate the association between maternal phenolic exposure and cord sex steroid hormones and AGD in male newborns. We recruited 100 mother-infant pairs from each of two hospitals, one in a polluted town (Guiyu) and the other in a cleaner town (Haojiang), from September 2010 to September 2011. One hundred and seventy eight maternal urine samples and 137 cord blood samples were available for quantification, thus 137 complete records entered into the final analysis. Of them, 77 pairs were from Guiyu, and 60 were from Haojiang. The chemical concentrations were determined by solid phase extraction and gas chromatography-mass spectrometry (SPE-GC-MS), and cord sex hormones were detected by radioimmunoassay (RIA). Neonatal anthropometric parameters including AGD were measured. Log2-transformed maternal urinary BPA concentration was negatively correlated with testosterone level and the ratio of testosterone to estradiol (T/E2) in male fetal cord blood after adjustment for potential confounders in linear regression models (βadjusted = -31.09 (95% CI, -53.07 to -9.11) and βadjusted = -0.08 (95% CI, -0.13 to -0.01), respectively). Moreover, compared with the lowest quartile group of BPA level, the highest group showed a significant decrease in testosterone level and T/E2 (βadjusted = -179.84 (95% CI, -333.45 to -26.24) and βadjusted = -0.37 (95% CI, -0.81 to 0.07), respectively). No significant associations between AGD or anogenital index (AGI, [AGI = AGD/birthweight (mm/kg)]) and phenolic EDCs or cord hormone levels were found. Results in the present study should be interpreted with caution because of its cross-sectional nature, small sample size and sampling time. Testosterone plays an important role in sex differentiation and normal development of the fetus and newborn, and the balance between testosterone and estradiol is thought an important mediator of prostate disease. Therefore, our findings may have important implications for human reproductive health. This work was supported by the National Natural Science Foundation of China (21377077) and Guangdong University Project for International Cooperation and Innovation Platform (2013gjhz0007). The authors declare they have no actual or potential competing financial interests.

Serum pregnancy-associated plasma protein A levels in the first, second and third trimester of pregnancy: relation to newborn anthropometric parameters and maternal tobacco smoking.

IntroductionThe purpose of this study was to evaluate the associations of the first, second and third trimester serum pregnancy-associated plasma protein A (PAPP-A) concentrations with neonatal anthropometric parameters. The effect of tobacco smoking during pregnancy on PAPP-A level was also studied.Material and methodsOne hundred and fifty healthy pregnant women were divided into smoking and tobacco-abstinent groups. Serum PAPP-A level was measured with the KRYPTOR rapid random-access immunoassay analyzer. The relationship between PAPP-A and newborn related outcome as well as markers of estimated intensity of cigarette smoking was evaluated by univariate and multivariate linear regression.ResultsPregnancy-associated plasma protein A concentration was positively correlated with birth weight in the first (β = 31.6; p < 0.001), second (β = 10.6; p < 0.05), and third (β = 4.6; p < 0.001) trimester of gestation. A significant association between PAPP-A and birth body length and head circumference in the second (β = 0.02; p < 0.05) and third trimester (β = 0.01; p < 0.01) was also found. The serum PAPP-A levels were significantly lower in the smoking than in the tobacco-abstinent group in each trimester of pregnancy (p < 0.001). The largest impact of the number of cigarettes smoked per day on PAPP-A level was found in the second (β = –1.2; p = 0.004) and third trimester (β = –2.6; p = 0.001).ConclusionsMaternal serum PAPP-A levels during gestation might be significant predictors for birth weight. Increased PAPP-A concentrations in the second and third trimester appeared to also be predictive for newborn body length and head circumference. Smoking alters maternal PAPP-A levels in all trimesters, with the greatest impact related to the number of cigarettes smoked per day.

The effect of Ramadan fasting and maternal hypoalbuminaemia on neonatal anthropometric parameters and placental weight

In Islamic religion, daytime fasting during the month called Ramadan is an annual practice. In this study, we aimed to investigate the effect of Ramadan fasting and maternal hypoalbuminaemia on neonatal growth parameters. A prospective case–control study was conducted in Diyarbakir and Istanbul, Turkey. The sample size of fasting group was 168 and that of non-fasting group was 170. Demographic characteristics, obstetrics ultrasonographic findings and laboratory parameters of the participants were recorded. Neonatal anthropometric parameters and placental weight were noted. The mean placental weight was significantly higher in the fasting group (p = 0.037). Also, in the fasting group, pregnant women with hypoalbuminaemia had significantly higher placental weight (p = 0.009). In conclusion, the mean placental weight in the fasting group was significantly higher. Also a significant correlation between placental weight and maternal serum albumin level was observed in the fasting group.

Estimation of Gestational Age, Using Neonatal Anthropometry: A Cross-sectional Study in India

Prematurity is a significant contributor to neonatal mortality in India. Conventionally, assessment of gestational age of newborns is based on New Ballard Technique, for which a paediatric specialist is needed. Anthropometry of the newborn, especially birthweight, has been used in the past to predict the gestational age of the neonate in peripheral health facilities where a trained paediatrician is often not available. We aimed to determine if neonatal anthropometric parameters, viz. birthweight, crown heel-length, head-circumference, mid-upper arm-circumference, lower segment-length, foot-length, umbilical nipple distance, calf-circumference, intermammary distance, and hand-length, can reliably predict the gestational age. The study also aimed to derive an equation for the same. We also assessed if these neonatal anthropometric parameters had a better prediction of gestational age when used in combination compared to individual parameters. We evaluated 1,000 newborns in a cross-sectional study conducted in Guru Teg Bahadur Hospital in Delhi. Detailed anthropometric estimation of the neonates was done within 48 hours after birth, using standard techniques. Gestational age was estimated using New Ballard Scoring. Out of 1,250 consecutive neonates, 1,000 were included in the study. Of them, 800 randomly-selected newborns were used in devising the model, and the remaining 200 newborns were used in validating the final model. Quadratic regression analysis using stepwise selection was used in building the predictive model. Birthweight (R=0.72), head-circumference (R = 0.60), and mid-upper arm-circumference (R = 0.67) were found highly correlated with gestation. The final equation to assess gestational age was as follows: Gestational age (weeks) = 5.437 x W-0.781 x W(2) + 2.815 x HC-0.041 x HC(2) + 0.285 x MUAC-22.745 where W=Weight, HC=Head-circumference and MUAC=Mid-upper arm-circumference; Adjusted R = 0.76. On validation, the predictability of this equation is 46% (+/-1 week), 75.5% (+/- 2 weeks), and 91.5% (+/- 3 weeks). This mathematical model may be used in identifying preterm neonates.

Relationship between gestational age &amp; anthropometric parameters of neonates - A preliminary study

<p style="margin-bottom: 0in;"><span style="color: #000000;"><span style="font-family: Times New Roman,serif;"><span style="font-size: small;">I</span></span></span><span style="color: #000000;"><span style="font-family: Times New Roman,serif;"><span style="font-size: small;"><strong>ntroduction: </strong></span></span></span><span style="color: #000000;"><span style="font-family: Times New Roman,serif;"><span style="font-size: small;"><span style="font-weight: normal;">In cases of infanticide, surreptitious disposals, still births and spontaneous or induced abortions, the accurate age of the infant needs to be calculated. Furthermore, in cases of sexual abuse, the court may need to know the period of gestation of the infant, to date the crime. However, for assessment of gestational age Sri Lankan anthropometric data is not available. Therefore this study helps to fill this void.</span></span></span></span> <p style="margin-bottom: 0in;"><span style="font-family: Times New Roman,serif;"><span style="font-size: small;"><span style="color: #000000;"><strong>Objective: </strong></span><span style="color: #000000;"><span style="font-weight: normal;">Establish the relationship between the gestational age and Weight, Occipito-Frontal Circumference (OFC), Hand length (HL), and Foot Length (FL) of neonates.</span></span></span></span> <p style="margin-bottom: 0in;"><span style="color: #000000;"><span style="font-family: Times New Roman,serif;"><span style="font-size: small;"><strong>Methodology: </strong></span></span></span><span style="color: #000000;"><span style="font-family: Times New Roman,serif;"><span style="font-size: small;"><span style="font-weight: normal;">Following ethical clearance, data was collected at Teaching Hospital Peradeniya, from neonates of gestational ages ranging from 33 – 40 weeks, within 48 hours of birth by two pre-intern doctors. We excluded those suffering from anomalies which cause distortion of the anthropometric parameters. The weight recorded at birth was taken while a non-stretchable, standard tape was used to measure the OFC. HL and FL were measured with an electronic Vernier caliper. </span></span></span></span> <p style="margin-bottom: 0in;"><span style="font-family: Times New Roman,serif;"><span style="font-size: small;"><span style="color: #000000;"><strong>Results: </strong></span><span style="color: #000000;"><span style="font-weight: normal;">The total sample size of 108 babies consisted of 76 term babies and 32 pre term babies. The values ranged from 1300g to 3850g for weight, 25cm to 36.4cm for OFC, 34.4mm to 72.16mm for HL and 55mm to 87.7mm for FL. The detailed age specific data will be discussed, graphed and compared with available British and USA data. </span></span></span></span> <p style="margin-bottom: 0in;"><span style="font-family: Times New Roman,serif;"><span style="font-size: small;"><span style="color: #000000;"><strong>Conclusion and Suggestions: </strong></span><span style="color: #000000;"><span style="font-weight: normal;">The findings of this preliminary study indicate that the gestational age can be estimated using anthropometric measurements. We suggest the need to expand this study to other areas of Sri Lanka in order to prepare graphs of anthropometric measurements applicable to Sri Lanka. </span></span></span></span> <p style="font-weight: normal;"><span style="font-family: Times New Roman,serif;"><span style="font-size: small;"><span style="color: #0000ff;"><span style="font-family: Times New Roman,serif;"><span style="text-decoration: none;">DOI:</span></span></span><span style="color: #0000ff;"><span style="font-family: Times New Roman,serif;"><span style="text-decoration: underline;"> <a href="http://dx.doi.org/10.4038/mljsl.v1i1.7265">http://dx.doi.org/10.4038/mljsl.v1i1.7265</a></span></span></span></span></span> <p style="margin-bottom: 0in;"><em><span style="color: #000000;"><span style="font-family: Times New Roman,serif;"><span style="font-size: small;"><span style="font-weight: normal;">Medico-Legal Journal of Sri Lanka </span></span></span></span></em><span style="color: #000000;"><span style="font-family: Times New Roman,serif;"><span style="font-size: small;"><span style="font-weight: normal;">2011; 1(1), Jan-April : 14-19</span></span></span></span>