Newborn Head Circumference Research Articles

Evaluation of Head Circumference Index in Children under 18 Months and its Associated Factors in Zanjan City: A Retrospective Cohort

Background The growth and development of infancy are vital to health and the quality of life throughout a person's life. We aimed to investigate the factors affecting the growth of head circumference in a sample of Iranian children under 18 months. Materials and Methods: This is a retrospective cohort study conducted among 274 children aged under 18 months in Zanjan, Iran. Multi-stage cluster sampling was applied to obtain a representative sample of residents. About eight representative healthcare centers, including four urban health centers and four rural health centers, as clusters, were randomly selected. We used multiple linear regression and marginal models of Generalized Equation Estimators to examine the predictors of head circumference cross-sectionally and longitudinaly, respectively. Results: Of the subjects, 49.5% (n=136) were females. The mean head circumference of newborns was 34.5±1.57. The marginal model showed that there is a significant association between sex of newborns, gestational age, high risk pregnancy, height and weight of newborns with head circumference over time (p <0.005). In multiple regression models, mothers' job and educational level also showed a significant association with head circumference in addition to sex of newborns (B=0.33, 95% CI:[0.31, 0.53]), gestational age (B=1.47, 95% CI:[0.99, 1.94]), high risk pregnancy (B=0.37; 95% CI:[0.15, 0.57]), height and weight of newborns (p <0.005). Conclusion In our study the mean of head circumference was similar to standard value of 34.9 cm. The sex, gestational age, high risk pregnancy, height and weight of newborns showed a significant association with head circumference, both in cross-sectional (at birth), and longitudinal models (at birth to 18 months); mothers job and educational level showed a significant association with head circumference only at birth.

HUBUNGAN LINGKAR LENGAN ATAS IBU HAMIL TERHADAP ANTROPOMETRI BAYI BARU LAHIR DI RUMAH SAKIT IBU DAN ANAK ANANDA KOTA MAKASSAR

The newborn’s body dimensions are influenced by maternal nutritional status that can be determined by measuring mid upper arm circumference (MUAC). The aim of this study was to determine relationship between maternal MUAC and anthropometry of newborn at Ananda Women and Children Hospital Makassar. The method used in this study was analytic with cross sectional design. A total of 200 pregnant women underwent delivery at Ananda Women and Children Hospital Makassar were taken by purposive sampling method. The study data were sourced from primary data i.e. demographic data, maternal MUAC and newborn anthropometry which included weight, length, head circumference, and chest circumference that were measured immediately after birth. Data were analyzed using the Chi-Square test on the IBM SPSS 23. The results of this study showed a significant relationship between maternal MUAC with body length (p = 0,000), head circumference (p = 0,000), and chest circumference (p = 0,013) of newborns, but no significant relationship was found between maternal MUAC with body weight of newborns (p = 0.127). This study conclude that maternal MUAC influence the anthropometry of newborns on the parameters of body length, head circumference, and chest circumference.

Maternal Vitamin D in the Late First and Second Trimester is Beneficial for Healthy Development of Fetal Head Circumference

Background: We previously showed that vitamin D supplementation might ameliorate typical clinical symptoms in children with autism spectrum disorder. In this study we examined the effects of maternal vitamin D status during pregnancy on the development of the fetus. Methods: Seventy-eight healthy Japanese women with uncomplicated pregnancies were enrolled in the study. Urine 25-hydroxy vitamin D (25OHD) and creatinine were measured. 25OHD concentrations were normalized for creatinine (ng/mg creatinine). Newborn anthropometry (height (cm), head circumference (cm), chest circumference (cm) and birth weight (kg)) of babies delivered naturally were measured and the relationship with the urinary vitamin D concentration of the mother at less than 90 days (third trimester) to delivery and more than 90 days to delivery (late first to second trimester) was examined. PC12 cells with various neurobiological processes were cultured and differentiation induced by 25OHD enhanced nerve growth factor was assessed. Results: Maternal and newborn characteristics were not significantly different between the late first and third trimesters. The associations between newborn length, chest circumference, birth weight and the urinary 25OHD concentration of mother in the late first and second trimester and the third trimester were not significant. As lightly positive association between urinary 25OHD and head circumference was observed in the late first and second trimester (r= 0.309), but not in the third trimester. Six nmol/L of 25OHD (=1/5 of serum level) enhanced nerve growth factor induced differentiation in PC12 cells. Conclusion: These findings show that vitamin D supplementation in the late first and second trimester beneficial for the healthy development of the fetal head circumference and neural system.

Correlation between maternal and neonatal blood Vitamin D level: Study from Pakistan.

In Pakistan, there is limited evidence for the levels and relationship of 25 (OH) Vitamin D (25(OH)D) status in pregnant women and their newborns, while the association between maternal 25(OH)D and newborn anthropometric measurements remains unexplored. Sociodemographic data were collected from 213 pregnant mothers during their visit to a tertiary care hospital at the time of childbirth. Anthropometric measurements were performed on all mothers and their newborns and blood samples collected from both for 25(OH)D levels. Participants were classified into two groups according to their 25(OH)D status: sufficient (25(OH)D ≥50 nmol L−1) and deficient (25(OH)D <50 nmol L−1). Simple and multiple regression models were used for analysis. Among 213 pregnant women, prevalence of 25(OH)D deficiency was 61.5%, and their newborn was 99.5% (mean 25(OH)D levels: 46.3 [11.3] and 24.9 [5.4] nmol L−1, respectively). Maternal sociodemographic characteristics were similar between 25(OH)D deficient and sufficient mothers, whereas newborn 25(OH)D levels were significantly lower in the former (22.60 [4.53] vs. 27.67 [3.82] nmol L−1, respectively, P < 0.001). There was a strong positive association between maternal and newborn 25(OH)D levels (r, 0.66; r 2, 43%, B [SE], 0.3 [0.02]; P < 0.001). Association of maternal 25(OH)D levels with newborn weight, length and head circumference was not significant (all P > 0.05). Our study shows a high prevalence of 25(OH)D deficiency in pregnant women and their newborns and a strong positive association between maternal and newborn 25(OH)D levels. Findings of this study indicate the importance of maintaining sufficient 25(OH)D levels during pregnancy.

Influence of newborn head circumference and birth weight on the delivery mode of primipara: what is more important?

Objectives Aim of the study was to analyze the impact of head circumference (HC) and birth weight (BW) on the delivery mode and delivery outcomes. Methods Study population consisted of pregnancy, delivery and newborn data from 1,762 women, who delivered between 2004 and 2016at University Hospital of Zurich (UHZ). Odds ratio (OR) with 95% confidence intervals (CI) were calculated for mode of delivery. Newborns were sorted into four groups according HC or BW. To evaluate the association between HC and delivery outcome, a descriptive analysis was performed. In addition reference charts of newborn HC at term were constructed. Results OR for instrumental delivery (ID) was 2.37 (CI 95%, 1.63-3.46), for C-Section (CS) 3.74 (CI 95%, 1.49-9.37) when HC>36cm. OR for ID was 1.59 (CI 95%, 1.02-2.50), for CS 3.18 (CI 95% 1.08-9.350) when BW was>4,000g. OR for ID was 2.15 (95% CI, 1.69-2.73), for CS 1.93 (95% CI, 0.89-4.18) when HC≥36cm and BW<4000g. OR for ID was 2.23 (95% CI, 1.35-3.67), for CS 4.39 (95% CI, 1.48-12.99) when HC≥36cm and BW≥4,000g. HC≥36cm was defined as large in our study. Mothers with higher age and body mass index delivered babies with larger HC (p<0.05). Blood loss and duration of expulsion period and BW was associated with larger HC (p<0.05). Conclusions The rate of ID and CS increased in case of a larger HC and greater BW. However, the main prognostic factor for ID was size of HC:≥36cm, but not macrosomia.

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.

Biomarkers of placental redox imbalance in pregnancies with preeclampsia and consequent perinatal outcomes

ObjectiveTo compare redox and inflammatory markers between normal and PE-derived placentas and to evaluate the relationship between placental redox imbalance markers and perinatal outcomes in pregnancies with PE. MethodsThis was a cross-sectional study conducted at the maternity hospital of a university hospital in Maceio-Alagoas, Brazil, in 2017, including women diagnosed with PE and healthy pregnant women and their conceptuses. After screening, standardized questionnaires containing socioeconomic, clinical, obstetric and anthropometric data were applied. After delivery, placental samples were collected for quantification of biomarkers of redox imbalance (catalase – CAT; malondialdehyde – MDA; hydrogen peroxide – H2O2; superoxide dismutase – SOD; reduced glutathione – GSH; oxidized glutathione – GSSG; and their ratio – GSH/GSSG) and inflammation (myeloperoxidase – MPO; interleukin (IL)-6; IL-8; IL-10; and tumor necrosis factor-alpha – TNF-α). All biomarkers were evaluated via linear regression with adjustments of variables with measures of weight, length, head circumference (HC), chest circumference (CC) and gestational age of newborns at birth, considering p < 0.05 as significant. ResultsA total of 100 pregnant women with PE and 50 healthy pregnant women were studied. Higher placental levels of catalase (p = 0.018), SOD (p = 0.031), the GSH/GSSG ratio (p = 0.019) and IL-6 (p = 0.010) and lower GSSG (p = 0.001) were observed in pregnant women with PE than in the control group. Positive associations between placental GSH levels and body weight, HC, CC and gestational age at birth (p < 0.05) were identified. ConclusionPE-derived placentas had high concentrations of some antioxidants (enzymes and thiols), which might be a compensation mechanism against oxidative stress. Placental GSH levels were the only biomarker, among the studied ones, related positively with beneficial perinatal outcomes, suggesting that this endogenous antioxidant plays an important role in maintaining the health of the conceptus and women with PE.

The Nomogram of Clitoral Length and Width in Iranian Term and Preterm Neonates.

Background and Objectives: Clitoromegaly is an important parameter in the evaluation of ambiguous genitalia in neonates, but the normative data for clitoral size in newborns have racial/ethnic differences. The present study aimed to determine clitoral length (CL) and clitoral width (CW) values and establish cutoff measurement to define clitoromegaly in both term and preterm Iranian neonates for the first time.Methods: A total number of 580 female newborn infants delivered at 28–42 weeks of gestation were enrolled in the study, and their CL and CW were measured on the first 72 h of birth. Data about birth weight (BW), body length (BL), and head circumference (HC) of newborns; mothers' age; and gestational age (GA) were recorded, too. Results were presented as mean ± standard deviation (SD) for quantitative variables and were summarized by frequency (percentage) for categorical variables. Backward stepwise regression analysis was used for prediction of CL and CW.Results: Among 580 Iranian female newborns studied, 187 were term neonates and the other 393 newborns were preterm. Mean ± SD values of CL were 6.11 ± 0.39 mm in term infants and 5.45 ± 0.64 mm in preterm infants (P < 0.001). Mean ± SD values of CW were 4.22 ± 0.43 in term infants and 3.68 ± 0.53 in preterm infants (P < 0.001). Regression analysis showed that CL was correlated with GA considered by last menstrual period, BL, BW, and HC; and CW was associated with GA, BL, and BW.Conclusion: This study suggests normative values (mean + 1, 2, and 3 SD) of CL and CW according to GA, which can be used as a reference for Middle East's newborns, especially Iranian newborn babies.

Cognitive function in metformin exposed children, born to mothers with PCOS \u2013 follow-up of an RCT

BackgroundMetformin is widely used in pregnancy to treat gestational diabetes mellitus and polycystic ovary syndrome (PCOS). Association between PCOS and developmental delay in offspring, and larger head circumference of metformin-exposed newborns has been reported. The objective of this study was to explore whether metformin exposure in utero had any effect on offspring cognitive function.MethodThe current study is a follow-up of two randomized, placebo-controlled studies which were conducted at 11 public hospitals in Norway In the baseline studies (conducted in 2000–2003, and 2005–2009), participants were randomized to metformin 1700 and 2000 mg/d or placebo from first trimester to delivery. There was no intervention in the current study. We invited parents of 292 children to give permission for their children to participate; 93 children were included (mean age 7.7 years). The follow-up study was conducted in 2014–2016. The Wechsler Preschool and Primary Scale of Intelligence version III and the Wechsler Intelligence Scale for Children version IV were applied for cognitive assessment. Androstenedione and testosterone were measured in maternal blood samples at four time-points in pregnancy.ResultsWe found no difference in mean, full scale IQ in metformin (100.0 (SD 13.2)) vs. placebo-exposed (100.9 (SD 10.1)) children. There was an association between metformin exposure in utero and borderline intellectual function of children (full scale IQ between 70 and 85). Free testosterone index in gestational week 19, and androstenedione in gestational week 36 correlated positively to full scale IQ.ConclusionsWe found no evidence of long-term effect of metformin on average child cognitive function. The increase of borderline intellectual functioning in metformin-exposed children must be interpreted with caution due to small sample size.Trial registrationThe baseline study was registered on 12 September 2005 at the US National Institute of Health (ClinicalTrials.gov) # NCT00159536.

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.

Impact of maternal smoking associated lyso-phosphatidylcholine 20:3 on offspring brain development

Maternal smoking during pregnancy affects fetal neurological development. Metabolomic studies in the general population suggest that smoking is associated with characteristic metabolic alterations. We investigated the association between the maternal smoking status, the fetal metabolome and head circumference at birth, as a surrogate parameter of brain development. 320 mother/newborn pairs of the Berlin Birth Cohort were investigated. Anthropometric parameters, including head circumference, of newborns of smoking mothers, former smoking mothers, and never smoking mothers were compared to assess the impact of maternal smoking behavior. Associations between maternal smoking behavior and 163 cord blood metabolites and associations between newborn head circumference and concentrations of smoking behavior related metabolites were analysed. Male newborns of smoking mothers had a reduced head circumference when compared with newborns from former smoking and never smoking mothers (p < 0.05). Using linear regression models corrected for established confounding factors, maternal smoking during pregnancy showed an independent association with head circumference (95% CI: -0.75～-0.41 cm, p = 2.45×10−11). In a stepwise linear regression model corrected for known confounding factors of brain growth lyso-phosphatidylcholine 20:3 (95% CI: 6.68～39.88 cm, p = 4.62×10-4) was associated with head circumference in male offspring only. None of the metabolites were associated with head circumference of female newborns. In conclusion, maternal smoking during pregnancy impacted on male offspring’s development including brain development. The smoking related metabolite lyso-phosphatidylcholine 20:3 was associated with head circumference of male offspring.

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.

Prenatal exposure to metal mixture and sex-specific birth outcomes in the New Hampshire Birth Cohort Study.

In utero exposure to individual metals may impact fetal growth, though little is known about the effects of exposure to metal mixtures. Therefore, we investigated joint effects of in utero exposure to a mixture of As (arsenic), Mn (manganese), and Pb (lead) on newborn outcomes in a United States population. Concentrations of As, Mn, and Pb were determined in maternal postpartum toenail samples, a biomarker of in utero exposure, from 989 maternal-infant pairs (492 females and 497 males). Newborns' anthropometric characteristics, including head circumference, length, and weight, were obtained from medical records. The joint effects of the three metals were modeled using Bayesian kernel machine regression and linear regression. Both sex-combined and sex-stratified statistical analyses were performed. We observed an inverted-U-shape association between maternal toenail Mn concentrations and newborn head circumference, particularly among female infants. Concentrations of Pb were related to reduced head circumference, weight, and length, especially among females at lower concentrations of the other metals. Overall, toenail As concentrations were related to reduced head circumference, especially among males, and an increase in birth length and weight among females. We found little evidence of As interactions with other metals within the mixture. Our findings suggest that in utero metal mixture exposures may influence birth outcomes, and that such relations may differ by infant sex.

Association between Gestational Phthalate Exposure and Newborn Head Circumference; Impacts by Race and Sex

Association between Gestational Phthalate Exposure and Newborn Head Circumference; Impacts by Race and Sex

Misclassification in defining and diagnosing microcephaly.

Several health agencies define microcephaly for surveillance purposes using a single criterion, a percentile or Z-score cut-off for newborn head circumference. This definition, however, conflicts with the reported prevalence of microcephaly even in populations with endemic Zika virus. We explored possible reasons for this conflict, hypothesising that the definition of microcephaly used in some studies may be incompletely described, lacking the additional clinical criteria that clinicians use to make a formal diagnosis. We also explored the potential for misclassification that can result from differences in these definitions, especially when applying a percentile cut-off definition in the presence of the much lower observed prevalence estimates that we believe to be valid. We conducted simulations under a theoretical bimodal distribution of head circumference. For different definitions of microcephaly, we calculated the sensitivity and specificity using varying cut-offs of head circumference. We then calculated and plotted the positive predictive value for each of these definitions by prevalence of microcephaly. Simple simulations suggest that if the true prevalence of microcephaly is approximately what is reported in peer-reviewed literature, then relying on cut-off-based definitions may lead to very poor positive predictive value under realistic conditions. While a simple head circumference criterion may be used in practice as a screening or surveillance tool, the definition lacks clarification as to what constitutes true pathological microcephaly and may lead to confusion about the true prevalence of microcephaly in Zika-endemic areas, as well as bias in aetiologic studies.

Maternal Blood Pressure in Relation to Birth Outcomes and Consumption of a Lipid-Based Nutrient Supplement (P11-001-19)

ObjectivesIt is unknown whether prenatal lipid-based nutrient supplements (LNS) affect blood pressure. The cutoffs to define high blood pressure have recently changed and little research has examined the association between the newly proposed blood pressure cutoffs and birth outcomes. Our objectives were to assess 1) the impact of LNS on maternal blood pressure; and 2) the association between blood pressure and birth outcomes. MethodsIn total, 1320 pregnant women ≤ 20 wk gestation in Ghana were randomized to receive daily either: 1) iron and folic acid (IFA), 2) multiple micronutrients (MMN), or 3) LNS. Blood pressure was measured at enrollment and 36 wk gestation. Gestational age was determined by ultrasound and newborn anthropometry included weight, length, and head circumference. The effect of LNS on maternal blood pressure was analyzed using ANOVA and associations between maternal blood pressure and birth outcomes were examined by linear and logistic regressions. ResultsMean (± SD) systolic and diastolic blood pressure (SBP and DBP) at 36 wk gestation were 110 ± 11 and 63 ± 8 mmHg, respectively, and did not differ by supplementation group (P > 0.05). At enrollment, higher DBP was associated with lower birth weight and shorter pregnancy duration; 6.6% of women had high SBP (≥ 130 mmHg) and 3.6% had high DBP (≥ 80 mmHg), and women with high DBP had greater odds of low birth weight (adjusted OR = 2.99 (95% CI = 1.04, 8.62)) and preterm birth (3.99 (1.46, 10.86)) but there were no significant associations with SBP. At 36 wk, higher SBP was associated with a lower birth weight, birth length, newborn head circumference, and a shorter pregnancy duration and higher DBP was associated with a lower birth weight and length; 4.3% of women had high SBP and 2.4% had high DBP and women with high DBP had greater odds of low birth weight (4.14 (1.26, 13.62)) but high SBP (≥ 130 mmHg) was not associated with any birth outcomes. ConclusionsDaily LNS during pregnancy did not have a significant effect on maternal blood pressure compared with IFA or MMN in this setting. Both higher SBP and higher DBP were associated with a shorter pregnancy duration and birth size; however, only high DBP was associated with adverse birth outcomes. It is unclear whether the new cutoff for high SBP is useful for identifying pregnancies at risk for adverse birth outcomes. Funding SourcesFunded through a grant from the Bill & Melinda Gates Foundation to the University of California, Davis.

Maternal gut microbiota is associated with newborn anthropometrics in a sex-specific manner.

Maternal gut microbiota is thought to be one of the important factors in the developmental origins of health and disease (DOHaD) concept, but the effects of maternal gut microbiota on foetal growth are not well known. In this study, the association between maternal gut microbiota and foetal growth was investigated. Maternal and newborn information, as well as stool samples at the third trimester of pregnancy, were obtained from 51 mother-newborn pairs from the Chiba study of Mother and Child Health (C-MACH). Gut microbiota was analysed by 16S rRNA sequencing of stool samples and short-chain fatty acids (SCFAs) in stool were analysed by gas chromatography-tandem mass spectrometry. After adjustment for covariates, it was found that maternal gut microbial diversity had a positive association with head circumference in newborn males (Chao 1: adjusted r = 0.515, p = 0.029). Genus Parabacteroides and genus Eggerthella showed negative associations with newborn head circumference and weight, respectively in males (genus Parabacteroides: adjusted r = -0.598, p = 0.009, genus Eggerthella: adjusted r = -0.481, p = 0.043). On the other hand, genus Streptococcus showed a negative association with newborn height in females (adjusted r = -0.413, p = 0.040). In addition, hexanoate was involved in the association between maternal gut microbiota and newborn anthropometrics in the univariate analysis, but not in the multivariate analysis. These data suggest that maternal gut microbiota has sex-specific effects on foetal growth. Maternal gut microbiota is an important factor for optimal intrauterine growth.

Association of Malaria Infection During Pregnancy With Head Circumference of Newborns in the Brazilian Amazon

Malaria during pregnancy is associated with adverse events for the fetus and newborn, but the association of malaria during pregnancy with the head circumference of the newborn is unclear. To investigate the association of malaria during pregnancy with fetal head growth. Two cohort studies were conducted at the general maternity hospital of Cruzeiro do Sul (Acre, Brazil) in the Amazonian region. One cohort study prospectively enrolled noninfected and malaria-infected pregnant women who were followed up until delivery, between January 2013 and April 2015. The other cohort study was assembled retrospectively using clinical and malaria data from all deliveries that occurred between January 2012 and December 2013. Data analyses were conducted from January to August 2017 and revised in November 2018. Clinical data from pregnant women and anthropometric measures of their newborns were evaluated. A total of 600 pregnant women were enrolled through volunteer sampling (prospective cohort study), and 4697 pregnant women were selected by population-based sampling (retrospective cohort study). After application of exclusion criteria, data from 251 (prospective cohort study) and 232 (retrospective cohort study) malaria-infected and 158 (prospective cohort study) and 3650 (retrospective cohort study) noninfected women were evaluated. Malaria during pregnancy. The primary end point was the incidence of altered head circumference in newborns delivered from malaria-infected mothers compared with that from noninfected mothers. Secondary end points included measures of placental pathology relative to newborn head circumference. In total, 4291 maternal-child pairs were analyzed. Among 409 newborns in the prospective cohort study, the mothers of 251 newborns had malaria during pregnancy, infected with Plasmodium vivax, Plasmodium falciparum, or both. Among 3882 newborns in the retrospective cohort study, 232 were born from mothers that had malaria during pregnancy. The prevalence of newborns with a small head (19 [30.7%] in the prospective cohort study and 30 [36.6%] in the retrospective cohort study) and the prevalence of microcephaly among newborns (5 [8.1%] in the prospective cohort study and 6 [7.3%] in the retrospective cohort study) were higher among newborns from women infected with P falciparum during pregnancy. Multivariate logistic regression analyses revealed that P falciparum infection during pregnancy represented a significant risk factor for the occurrence of small head circumference in newborns (prospective cohort study: odds ratio, 3.15; 95% CI, 1.52-6.53; P = .002; retrospective cohort study: odds ratio, 1.91; 95% CI, 1.21-3.04; P = .006). Placental pathologic findings corroborated this association, with more syncytial nuclear aggregates and inflammatory infiltrates occurring in placentas of newborns born with decreased head circumference. This study indicates that falciparum malaria during pregnancy is associated with decreased head circumference in newborns, which is in turn associated with evidence of placental malaria.

Head Circumference of Babies at Birth in Nigeria.

Measuring head circumference (HC) of newborns is an important tool for evaluating intra-uterine brain development. HC reference charts currently in use in Nigeria are not representative of the local population. We thus present locally derived HC reference data for Nigerian infants at birth. We reviewed birth records of all infants at the Jos University Teaching Hospital (JUTH) over a 10 year period from January 2006. JUTH is a tertiary care center offering obstetric services to a large population of women in Jos and its environs. All births with gestational age between 28 and 42 weeks were included in the study. STATA version 14 was used to calculate gestational age associated HC percentile measurements. We included 18282 babies to generate the reference values. The mean HC value was 34.4 ± 2.1 cm (M = 34.6 ± 2.16 cm, F = 34.1 ± 2.02 cm, p < 0.001). Our HC reference values significantly differ from the USA and INTERGROWTH-21 charts currently in use in our country. Mean HC was higher in male infants compared with female infants. This difference was uniformly so across all gestational age groups. The use of our locally derived HC reference values could be more appropriate in defining normal head growth in Nigerian infant populations thereby improving newborn care.

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.