Neonatal Skinfold Research Articles

Relationship between paternal excessive weight and neonatal anthropometry in a clinical trial of nutritional counseling for pregnant women with overweight.

Human studies suggest that fathers with obesity influence infant growth and development. This study aimed to evaluate the relationship between paternal body mass index (BMI) and waist circumference (WC) with neonatal anthropometry and adiposity. This study is a cohort nested in a randomized controlled clinical trial of nutritional counseling for pregnant women with overweight. In total, 89 partner-pregnant woman-neonate triads were included. Paternal anthropometric measurements were taken at the time of the interview. Secondary data related to birth were obtained through access to the health information systems. Neonatal skinfold thickness was assessed and the adiposity was estimated using a predictive anthropometric model. Pearson's correlation and adjusted multivariate linear regression models were employed to evaluate the relationship between paternal BMI and WC with neonatal anthropometric measurements and adiposity. In total, 57.0% of the fathers presented a BMI ≥ 25 kg/m² and 14.6% a waist circumference ≥102 cm. The mean ± SD birth weight of the newborns (g) was 3357 ± 538. Paternal BMI and WC were inversely correlated with head circumference at birth [r = -0.31 (p = 0.004), r = -0.23 (p = 0.03), respectively]. Paternal BMI was also inversely correlated with the birth weight standardized by gestational age (z-score) [r = -0.23 (p = 0.03)]. In adjusted multivariate linear regression models, the paternal BMI (kg/m²) was inversely associated with the head circumference at birth (cm) [β = -0.07 (95% CI -0.15; -0.001) p = 0.04]. The data suggest that paternal excessive weight have a negative effect on fetal development, as assessed by anthropometric measurements. The inverse association between paternal BMI and the head circumference at birth was independent of confounders. Future studies with larger sample sizes are necessary to confirm or refute such hypotheses.

406: The association between one abnormal value on oral glucose tolerance test and neonatal diabetic markers

Infants who are large for gestational age (LGA) are more likely than other infants to be obese in childhood, adolescence and early adulthood, and are inherently at a higher risk of cardiovascular and metabolic complications in adulthood. We aimed to investigate the association between pregnancies with one abnormal value (OAV) in the oral glucose tolerance test (OGTT) to neonatal skinfold thickness and umbilical cord C-peptide. This was a prospective controlled trial performed from January 2016 - May 2018. Included were women with OAV in the OGTT performed between 24-28 weeks of gestation, who delivered at the Edith Wolfson Medical Center. The control group included normoglycemic women, who delivered during the same time period. The following 'diabetic' variables were measured: maternal HbA1C and blood glucose level (on admission), umbilical cord (UC) C-peptide concentration, and neonatal skinfold thickness at 3 sites. Maternal and obstetric characteristics, and the 'diabetic variables, were compared between the OAV group and the control group. LGA was defined as birthweight (BW) >90th % and macrosomia was defined as BW>4000 gram. As compared to the control group (n=56), the OAV group (n=84) was older, 33.4±5 years vs. 32.5±7 years p=0.002, had lower GA at delivery (p=0.01), increased rate of macrosomia (<0.001) and LGA (p=0.003). Regarding the diabetic variables, as compared to the controls, the OAV group had increased concentration of UC C-peptide (1.7±1.6 vs. 1.3±1.1 units, p=0.007) and increased maternal HbA1C (5.3±0.4 vs. 5.1±0.3 units, p=0.01). Neonatal skinfold thickness measurements did not differ between the groups. By logistic regression analysis after controlling for confounders (birthweight, GA at delivery, and maternal body mass index), LGA was independently associated with the presence of OAV group: aOR 4.7, 95%CI 1.48-14.8, p=0.008. One pathological value on OGTT is associated with increased level of UC C-peptide and increased maternal HbA1C. LGA is independently associated with OAV. These findings indicate the continuum of risk for fetal adiposity that is associated with increasing maternal glucose intolerance in pregnancy.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Genetic determinants of adiponectin regulation revealed by pregnancy.

ObjectiveWe investigated genetic determinants of adiponectin during pregnancy to reveal novel biology of adipocyte regulation.MethodsWe conducted a genome-wide association study in 1,322 pregnant women from the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study with adiponectin measured at ~28 weeks of gestation. We selected variants reaching P<5x10−5 for de novo genotyping in two replication cohorts (Genetics of Glycemic regulation in Gestation and Growth (Gen3G) N=522; ECOGENE-21 N=174).ResultsIn the combined meta-analysis, the maternal T allele of rs900400 located on chr3q25 (near LEKR1/CCNL1) was associated with lower maternal adiponectin (β±SE= −0.18±0.03 SD of adiponectin per risk allele; P=1.5x10−8; N=2004; multivariable adjusted models). In contrast, rs900400 showed only nominal association with adiponectin in a large sample of non-pregnant women (β±SE= −0.012±0.006; P=0.05; N=16,678 women from the ADIPOgen consortium). Offspring rs900400 T risk allele was associated with greater neonatal skin fold thickness (β±SE=0.19±0.04 SD per risk allele; P=4.1x10−8; N=1489) and higher cord blood leptin (β±SE=0.28±0.05 log-leptin per risk allele; P=8.2x10−9; N=502), but not with cord blood adiponectin (P=0.23; N=495). T allele of rs900400 was associated with higher expression of TIPARP in adipocytes.ConclusionOur investigations of adipokines during pregnancy and early life suggest that rs900400 has a role in adipocyte function.

990 Ethnic Differences in Neonatal Body Composition and the Impact of Parental Size. a Population-Based Cohort Study

Background and AimNeonatal size, and especially a relative “thinness”, is associated with future risk of obesity and type 2 diabetes. The aim was to explore ethnic differences in neonatal body...

Relationship between sonographically estimated fetal subcutaneous adipose tissue measurements and neonatal skinfold measurements

Increased subcutaneous adipose tissue is a well known characteristic of diabetic fetopathy. Prenatal estimation of adipose tissue can be performed by ultrasound, while postnatally skinfold measurements are performed using a Holtain caliper. The aim of this study was to compare these methods in the same patients. This was a prospective study of 172 pregnant patients (142 controls and 30 with gestational diabetes) at ≥ 37 gestational weeks. In addition to fetal weight estimation, fetal subcutaneous tissue was measured at the anterior abdomen lateral to the umbilicus (SonoSfAbd) and at the middle of the femur (SonoSfFem). Within 72 h after delivery, a Holtain caliper was used to measure neonatal skinfold thickness at the left anterior iliac spine (SfAbd), at the lower angle of the left scapula (SfSca), at the middle of the femur, above the left quadriceps femoris (SfFem) and at the middle of the left triceps (SfHum). Ultrasound and mechanical measurements were correlated. The sonographic and mechanical methods showed good correlation with each other. Linear regression analysis gave the following equations: SfAbd (mm) = SonoSfAbd (mm) × 0.489 + 1.988 (r(2) = 0.34, P < 0.001); SfSca (mm) = SonoSfAbd (mm) 0.457 + 2.043 (r(2) = 0.40, P < 0.001); SfFem (mm) = SonoSfFem (mm) × 0.714 + 1.763 (r(2) = 0.41, P < 0.001); SfHum (mm) = SonoSfFem (mm) 0.564 + 2.09 (r(2) = 0.39, P < 0.001). Ultrasound examination is a reliable method for non-invasive intrauterine measurement of fetal subcutaneous tissue and can be used to predict mechanical neonatal skinfold thickness measurements.

Reliability of routine clinical measurements of neonatal circumferences and research measurements of neonatal skinfold thicknesses: findings from the Born in Bradford study

SummaryWest J, Manchester B, Wright J, Lawlor DA, Waiblinger D. Reliability of routine clinical measurements of neonatal circumferences and research measurements of neonatal skinfold thicknesses: findings from the Born in Bradford study. Paediatric and Perinatal Epidemiology 2011.Assessing neonatal size reliably is important for research and clinical practice. The aim of this study was to examine the reliability of routine clinical measurements of neonatal circumferences and of skinfold thicknesses assessed for research purposes. All measurements were undertaken on the same population of neonates born in a large maternity unit in Bradford, UK. Technical error of measurement (TEM), relative TEM and the coefficient of reliability are reported.Intra-observer TEMs for routine circumference measurements were all below 0.4 cm and were generally within ±2-times the mean. Inter-observer TEM ranged from 0.20 to 0.36 cm for head circumference, 0.19 to 0.39 cm for mid upper arm circumference and from 0.39 to 0.77 cm for abdominal circumference. Intra and inter-observer TEM for triceps skinfold thickness ranged from 0.22 to 0.35 mm and 0.15 to 0.54 mm, respectively. Subscapular skinfold thickness TEM values were 0.14 to 0.25 mm for intra-observer measurements and 0.17 to 0.63 mm for inter-observer measurements. Relative TEM values for routine circumferences were all below 4.00% but varied between 2.88% and 14.23% for research skinfold measurements. Reliability was mostly between 80% and 99% for routine circumference measurements and ≥70% for most research skinfold measurements.Routine clinical measurements of neonatal circumferences are reliably assessed in Bradford. Assessing skinfolds in neonates has variable reliability, but on the whole is good. The greater intra-observer, compared with inter-observer, reliability for both sets of measurements highlights the importance of having a minimal number of assessors whenever possible.

Relationship between in utero sonographic evaluation and subcutaneous plicometry after birth in infants with intrauterine growth restriction: an exploratory study

BackgroundIntrauterine growth restriction (IUGR) is associated with several medical complications before and after delivery. The aim of this study was to evaluate the concordance between the fetal ultrasonographic measurement of subcutaneous tissue thicknesses and the skinfold thicknesses assessment in intrauterine growth restricted newborns.MethodsWe designed an exploratory study. Fetal ultrasonographic measurement of subcutaneous tissue thicknesses, according to Bernstein's and Galan's method, and neonatal skinfold thicknesses were evaluated in 13 intrauterine growth restricted newborns within 4 hours before delivery and on the first day of life, respectively. Concordance between fetal and neonatal measurements was assessed using the Lin's correlation coefficient and the Bland-Altman method.ResultsThe data obtained by the measurements of neonatal skinfold thicknesses was significantly correlated with the prenatal measurements (Lin's coefficients, arm: 0.60; subscapular: 0.72; abdomen: 0.51). Bland-Altman analysis showed moderate agreement between the fetal ultrasonographic measurement of subcutaneous tissue thicknesses and the neonatal skinfold thicknesses assessment.ConclusionsThe present study provides preliminary evidence that fetal sonographic measurements may represent additional indices of intrauterine growth restriction.

Adiposity Gain During Childhood, ACE I/D Polymorphisms and Metabolic Outcomes

We aimed to (i) determine the relative importance of childhood gain in upper body adiposity for insulin resistance (IR) and triglyceridemia (TG); (ii) examine whether the associations between adiposity and metabolic indices were more evident in those with the ACE DD genotype. We examined a birth cohort study of 292 children with measures in the neonatal period (day 4) including subscapular and triceps skinfolds; repeat skinfold measures at age 8, cardiorespiratory (CR) fitness, IR by the homeostasis model assessment (HOMA) equation (HOMA-IR) and serum triglyceride (TG) concentrations and measures of ACE I/D gene variants. A multiple linear regression analysis incorporating a life course approach was undertaken. Childhood gain in upper body adiposity was positively associated with HOMA-IR and TG independently of neonatal skinfolds (P < or = 0.02). The magnitude of these associations was higher among those of the ACE DD genotype. For example, subscapular skinfold gain was not strongly associated with HOMA-IR or TG among those with II or ID genotype (b = 0.03, P = 0.05; b = 0.02, P = 0.18 respectively) but was positively associated among those with the DD genotype (b = 0.11, P = 0.001; b = 0.08, P = 0.003); difference in effect P = 0.05; P = 0.01 respectively. Upper body fat accumulation during childhood was positively associated with HOMA-IR and TG independently of neonatal skinfolds. Further, the stronger associations for those with the ACE DD genotype is consistent with randomised controlled trial findings that ACE inhibition is associated with a reduced risk of developing type 2 diabetes. Further work is required to confirm and extend these findings.

Geographical variation in relationships between parental body size and offspring phenotype at birth

Size and body proportions at birth are partly determined by maternal body composition, but most studies of mother-baby relationships have only considered the effects of maternal height and weight on offspring birth weight, and few have examined the size of effects. Paternal size and body composition also play a role, primarily through the fetal genome, although few studies have investigated relationships with neonatal phenotype. Data from the UK, Finland, India, Sri Lanka, China, DR Congo, Nigeria and Jamaica were used to investigate the effects of maternal measures (derived at 30 weeks' gestation, n=16,418), and also paternal size (n=3,733) on neonatal phenotype, for singleton, live-born, term births. After accounting for variation in maternal size and shape across populations, differences in neonatal phenotype were markedly reduced. Mother-baby relationships were similar across populations, although some were stronger in developing countries. Maternal height was generally the strongest predictor of neonatal length, maternal head circumference of neonatal head and maternal skinfold thickness of neonatal skinfolds. Relationships with maternal arm muscle area were generally weak. Effects of paternal height and body mass index were weaker than the equivalent maternal measurements in most studies. Differences in maternal body composition account for a large part of the geographical variation in neonatal phenotype. The size of the effects of all maternal measures on neonatal phenotype suggests that nutrition at every stage of the mother's life cycle may influence fetal growth. Further research is needed into father-baby relationships and the genetic mechanisms that influence fetal growth.

The relationship between maternal and neonatal anthropometric measurements in term newborns

To determine whether measures of maternal lean mass, fat reserves, or a combination of both best predict the various measures of newborn size at birth. The population consisted of 1205 multiparous, predominantly black women at high risk for fetal growth retardation, who delivered at term at the University of Alabama at Birmingham. Maternal body mass index (BMI) was calculated using the reported pre-pregnancy weight. Maternal anthropometric measurements taken at mid-pregnancy included skinfold thicknesses, lean body mass, and mid-arm, calf, and wrist circumferences. Weight and 11 other neonatal measurements were made within 24 hours of birth and related to various maternal anthropometric measurements. Reported maternal pre-pregnancy weight was the best predictor of all neonatal size measures except for the neonatal skinfold thicknesses, which were better predicted by the pre-pregnancy BMI. For example, the range between the tenth and 90th percentiles of maternal pre-pregnancy weight (46.3-86.4 kg) was associated with 295 g birth weight compared to only 188 g birth weight for a measure of lean body mass. Most maternal anthropometric measurements were significantly associated with most neonatal measurements. However, for nearly every neonatal measurement considered, the maternal pre-pregnancy weight was the best predictor.

Possible Causes Linking Asphyxia, Thick Meconium and Respiratory Distress

The cause of fetal distress and neonatal respiratory distress (RD) in association with meconium-stained liquor is not always clear. To clarify this, a prospective study was undertaken in a tertiary referral maternity hospital for 1 year. In all infants born after meconium-stained liquor who developed RD, evidence was sought for 1) fetal distress (from the cardiotocograph (CTG), the cord blood pH, the Apgar score and the asphyxial complications in the neonate) 2) causes of fetal distress (including maternal risk factors, fetal infection and fetal malnutrition) 3) causes of respiratory distress (including meconium aspiration syndrome (MAS), persistent pulmonary hypertension of the newborn (PPHN) and infection). Of 4,026 livebirths, 717 (17.8%) had meconium-stained liquor and 44 term and 5 preterm infants developed RD. In the 44 term infants, there was frequent evidence of fetal distress possibly caused by previously unrecognized factors such as fetal malnutrition with reduced neonatal skinfold thickness in 35% triceps and 41% subscapular measurements, and histological chorioamnionitis (CA) in 74%. The cause for respiratory distress was identified in only 48% of infants, and included clinical evidence of PPHN (41%), MAS (16%) and infection (2%). However in preterm infants, 80% had definite or suspected infection. The findings indicate that fetal distress is common in infants who develop respiratory distress after meconium-stained liquor. A role for histological CA and reduced nutrition in the fetus, as factors contributing to the vulnerability of the term infant to intrapartum fetal distress, is suggested.

Neonatal skinfold thickness. Measurement and interpretation at or near term.

Skinfold thickness was measured at five sites in 750 infants. The study population was unselected except that twin pregnancies and the infants of diabetic mothers were excluded, and very preterm infants were under represented. A pilot study had indicated that skinfold measurement was most reproducible at the thigh site. Thigh skinfold correlated better with the sum of other skinfolds than did skinfold measurement at any other site and closely resembled the summed skinfold in correlations with a number of maternal and fetal variables. Median skinfold increased with birthweight and was greater in girls than in boys. 'Corrected skinfold', a mathematical approach to comparing skinfolds in infants of differing sex and birthweight, is suggested as an alternative to absolute skinfold measurement.

Evidence for the Possible Relationship of Neonatal Skinfold Thickness to Maternal Glucose Metabolism During the Third Trimester

SummaryForty‐eight infants, including 14 premature infants who were appropriate size for gestational age (AGA), 10 full‐term AGA infants, 18 full‐term infants who were large for gestational age (LGA), and six premature LGA infants of diabetic mothers (IDMs). had measurements of skinfold thickness (SFT) in the first 72 h of life. For the 24 LGA infants, there was a significant positive correlation between maternal glycohemoglobin (Hb AIc.) in the postpartum period and SFT (r = 0.42, p &lt; 0.05). Our observations in this study support those of others, demonstrating that SFT increases with increasing gestational age. In addition, they support the hypothesis that, in diabetic pregnancies, or pregnancies associated with an elevated Hb AIc, a reflection of the time‐integrated blood glucose level over the weeks preceding parturition, fetal hyperglycemia and hyperinsulinemia stimulate increased triglyceride synthesis in adipose cells and lead to an increase in fetal subcutaneous fat.

Evidence for the possible relationship of neonatal skinfold thickness to maternal glucose metabolism during the third trimester.

Forty-eight infants, including 14 premature infants who were appropriate size for gestational age (AGA), 10 full-term AGA infants, 18 full-term infants who were large for gestational age (LGA), and six premature LGA infants of diabetic mothers (IDMs), had measurements of skinfold thickness (SFT) in the first 72 h of life. For the 24 LGA infants, there was a significant positive correlation between maternal glycohemoglobin (Hb AIc) in the post-partum period and SFT (r = 0.42, p less than 0.05). Our observations in this study support those of others, demonstrating that SFT increases with increasing gestational age. In addition, they support the hypothesis that, in diabetic pregnancies, or pregnancies associated with an elevated Hb AIc, a reflection of the time-integrated blood glucose level over the weeks preceding parturition, fetal hyperglycemia and hyperinsulinemia stimulate increased triglyceride synthesis in adipose cells and lead to an increase in fetal subcutaneous fat.