Normal Birth Weight Research Articles

Analysis of retinopathy of prematurity screening outcomes in a neonatal intensive care unit of Lhasa

Objective: To investigate the incidence and clinical features of retinopathy of prematurity (ROP) among preterm infants in a neonatal intensive care unit (NICU) of Lhasa, and to explore the screening criteria for ROP in high-altitude areas. Methods: It was a single-center retrospective case study. A total of 166 preterm infants of Tibetan ethnicity admitted to the NICU of Lhasa People's Hospital from May 1, 2020 to June 1, 2022 with a gestational age<36 weeks were enrolled. ROP was screened using the third-generation wide-angle digital pediatric retinal imaging system (RetCam Ⅲ). The ROP detection rate, staging, and zonal distribution were analyzed. Multivariate logistic regression was performed and risk factors for ROP in preterm infants were identified by calculating the odds ratio (OR) and its 95% confidence interval (95%CI). Results: There were 88 males and 78 females, among whom 33 patients (66 eyes) were diagnosed with ROP. The birth gestational age of ROP patients was 30 (29, 31) weeks, and the average birth weight was 1 188.5±219.2 g. The disease was at stage 1 in 48 eyes (72.7%), stage 2 in 16 eyes (24.2%), and stage 3 in 2 eyes (3.0%). Two eyes (3.0%) had zone Ⅰ disease, 26 eyes (39.4%) had zone Ⅱ disease, and 38 eyes (57.6%) had zone Ⅲ disease. Thirty ROP patients (90.9%) had spontaneous regression and vascularization. Three patients (9.1%) developed type Ⅰ ROP, which was treated by anti-VEGF therapy (1 patient) or spontaneously resolved during the follow-up (2 patients). Multiple logistic regression analysis showed that gestational age (OR=0.53, 95%CI: 0.33-0.84, P=0.007), birth weight (OR=0.95, 95%CI: 0.92-0.98, P<0.001), and duration of invasive mechanical ventilation (OR=1.42, 95%CI: 1.06-1.90, P=0.018) were influencing factors of ROP. Conclusions: The detection rate of ROP among Tibetan preterm infants in the single-center neonatal intensive care unit in Lhasa was 19.9%, while the detection rate of type Ⅰ ROP was 1.8%. Preterm infants with shorter gestational age, lower birth weight, and prolonged invasive mechanical ventilation were liable to develop ROP.

Abnormal alterations in neurodevelopment in preterm children with very low birth weight during the adolescence.

Preterm infants with very low birth weight are at high risk for long-term neurocognitive deficits. However, whether these neurocognitive deficits are improved or worsened in adolescence remains unclear. We took advantage of the large sample from the Adolescent Brain Cognitive Development dataset to investigate alterations in brain structure, behavior, including cognitive function and mental health symptoms, and in puberty among preterm children with very low/normal birth weight (Pre_VLBW/Pre_NBW) and full-term children with normal birth weight (Con_NBW) from baseline to 2-year follow-up. Pre_VLBW children relative to the other two groups had higher cortical thickness, lower cortical area and cortical/subcortical volumes in large portions of frontal cortex, temporal and occipital gyrus, insula, thalamus, and cerebellum; and attenuated fiber tract volumes in the fornix and foreceps major at baseline. Pre_VLBW children for their baseline measures also had lower cognitive function, higher pubertal levels and psychopathological risk. Furthermore, there were significant interaction effects on increased adrenarche score and cortical and subcortical volumes in medial orbitofrontal cortex (mOFC) and thalamus from baseline to 2-year follow-up. Pre_VLBW individuals showed higher adrenarche scores and lower volumes in the mOFC and thalamus than the other two groups at 2-year follow-up, but not at baseline. These brain structural changes showed associations with pubertal development levels, psychopathological risk and cognitive deficits. These findings support a view that preterm children with VLBW showed distinctive developmental alterations during adolescence, which potentially lead to long-lasting deviations in various brain regions and might be associated with behavioral problems and neurocognitive deficits.

The pattern of visual impairment in the spectrum of hypoxic ischemic encephalopathy.

This study aimed to evaluate the relationship between visual impairment, social maturity, and clinical severity of hypoxic-ischemic encephalopathy (HIE) in the Indian population. An observational study was conducted in children with HIE sequelae aged between 6 months and 5 years. Sixty diagnosed cases of perinatal HIE were recruited, with twenty children in each of clinical grades 1, 2, and 3 according to the Sarnat clinical staging. All children underwent cycloplegic refraction using atropine 1% eye ointment, visual Acuity (VA) testing by teller acuity cards (TAC), anterior and posterior segment examination, FLASH visual evoked response (VER), strabismus workup, and social maturity assessment using the vineland social maturity scale (VSMS). Sixty children, including 14 preterm and 46 term infants, with a mean age of 26.11 ± 16.06 months were studied. Normal birth weight was observed in 54% of the cases, whereas 42% had low birth weight and 4% had very low birth weight. There was no statistically significant difference between birth weight and the clinical severity of HIE (P = 0.970). A significant relationship between VA and clinical severity (TAC- p < 0.0001) and between VA and social maturity was observed. Optic disc pallor was present in 85% of grade 3 HIE cases. Among the 37 children with strabismus, the convergent type was predominant (86.4%). Refractive error was comparable across all grades of HIE. Visual impairment was significantly related to the clinical severity of HIE and had a negative impact on the social maturity of these children.

Compound heterozygous congenital protein C deficiency: a challenging management with recurrent purpura fulminans treated with protein C concentrations.

A female newborn was transferred to the hospital due to progressive necrotic skin lesions. She was born full-term with an average birth weight and no prenatal or perinatal problems. She developed the first purplish skin lesion on her left buttock since postnatal day 1. She was initially treated with antibiotics under the impression of early-onset neonatal sepsis; however, her lesions worsened and rapidly progressed. The protein C chromogenic activity was remarkably decreased at below 10%, similar to a protein C antigen level below 1%, highly suggestive of severe congenital protein C deficiency. Molecular analysis revealed compound heterozygous likely pathogenic variants in the protein C gene. After the diagnosis, fresh frozen plasma (FFP) transfusions every 8 hours until the patient was stabilized and therapeutic low-molecular-weight heparin was started. She developed complications related to FFP administration, such as acute kidney injury, hypertension and proteinuria, during the interim period, awaiting the initiation of protein C concentrate replacement therapy.

Racial Disparities and Comorbidities: Network Analysis of Maternal Outcomes in Alabama.

The study employed a robust network analysis methodology to assess the effects of race and comorbidities on birth outcomes, using a dataset of 443,902 mothers in Alabama from 2014 to 2021. Four multimorbidity networks corresponding to White, Black, Asian, and American Indian and Alaska Native groups were constructed to explore distinct comorbidity patterns. The nodes in these networks represented various diseases, while the edges, quantified by the Salton Cosine Index, depicted the associations between these conditions. Additionally, two separate networks were analyzed for low birth weight (LBW) and normal birth weight (NBW) to identify the differential impacts of specific diseases. Feature selection methods including random forest and logistic regression were applied to pinpoint crucial intersections between the LBW and NBW networks, enhancing the granularity of the analysis. The findings indicated significant racial disparities in the density of comorbidity networks, with more complex disease interactions observed among Black, American Indian and Alaska Native, and Asian groups compared to Whites. Preexisting hypertension and eclampsia emerged as significant risk factors for LBW in White and Black groups, while gestational hypertension was prevalent across multiple racial groups. The LBW network displayed greater density than the NBW network, highlighting the intricate connections between comorbidities leading to adverse birth outcomes. These insights underline the necessity for healthcare interventions tailored to the distinct health profiles of each racial group to effectively address and reduce maternal health disparities.

The performance of sonographic antenatal birth weight assessment assisted with artificial intelligence compared to that of manual examiners at term.

The aim of this study is to investigate the differences in the accuracy of sonographic antenatal fetal weight estimation at term with artificial intelligence (AI) compared to that of clinical sonographers at different levels of experience. This is a prospective cohort study where pregnant women at term scheduled for an imminent elective cesarean section were recruited. Three independent antenatal fetal weight estimations for each fetus were blindly measured by an experienced resident physician with level I qualification from the German Society for Ultrasound in Medicine (group 1), a senior physician with level II qualification (group 2), and an AI-supported algorithm (group 3) using Hadlock formula 3. The differences between the three groups and the actual birth weight were examined with a paired t-test. A variation within 10% of birth weight was deemed accurate, and the diagnostic accuracies of both groups 1 and 3 compared to group 2 were assessed using receiver operating characteristic (ROC) curves. The association between accuracy and potential influencing factors including gestational age, fetal position, maternal age, maternal body mass index (BMI), twins, neonatal gender, placental position, gestational diabetes, and amniotic fluid index was tested with univariate logistic regression. A sensitivity analysis by inflating the estimated weights by daily 25 grams (g) gain for days between examination and birth was conducted. 300 fetuses at a mean gestational week of 38.7±1.1 were included in this study and examined on median 2 (2-4) days prior to delivery. Average birth weight was 3264.6±530.7g and the mean difference of the sonographic estimated fetal weight compared to birthweight was -203.6±325.4g, -132.2±294.1g, and -338.4±606.2g for groups 1, 2, and 3 respectively. The estimated weight was accurate in 62% (56.2%, 67.5%), 70% (64.5%, 75,1%), and 48.3% (42.6%, 54.1%) for groups 1, 2, and 3 respectively. The diagnostic accuracy measures for groups 1 and 3 compared to group 2 resulted in 55.7% (48.7%, 62.5%) and 68.6% (61.8%, 74.8%) sensitivity, 68.9% (58.3%, 78.2%) and 53.3% (42.5%, 63.9%) specificity and 0.62 (0.56, 0.68) and 0.61 (0.55, 0.67) area under the ROC curves respectively. There was no association between accuracy and the investigated variables. Adjusting for sensitivity analysis increased the accuracy to 68% (62.4%, 73.2%), 75% (69.7%, 79.8%), and 51.3% (45.5%, 57.1%), and changed the mean difference compared to birth weight to -136.1±321.8g, -64.7±291.2g, and -270.7±605.2g for groups 1, 2, and 3 respectively. The antenatal weight estimation by experienced specialists with high-level qualifications remains the gold standard and provides the highest precision. Nevertheless, the accuracy of this standard is less than 80% even after adjusting for daily weight gain. The tested AI-supported method exhibits high variability and requires optimization and validation before being reliably used in clinical practice.

Stenting of critical aortic coarctation in newborn: a case series

Introduction: Critical neonatal coarctation of the aorta is one of the most formidable heart defects due to the high risk of ischemic organ injury and the development of multiple organ failure. Such a cohort of patients always requires a search for alternative treatment methods that will reduce the risk of fatal postoperative complications and achieve optimal results of radical correction. Objective: The study aimed to assess the results of staged surgical treatment of critical coarctation of the aorta in newborns in a series of three cases. Methods: The present research is a prospective one. A series of three cases of staged surgical treatment of newborn children with critical coarctation of the aorta was performed at the Research Institute for Complex Problems of Cardiovascular Diseases in 2024. Due to the severity of the conditions caused by multiple organ failure or the infectious process, the first stage in all cases was stenting of the coarctation of the aorta through the access of the common femoral artery on the right, followed by radical correction within one hospitalization. Results: All children were full-term and had normal birth weight, but the severity of the condition did not allow performing the initial radical correction of abnormality. Considering the comorbidity, all children underwent stenting of the aortic coarctation as the first stage of correction. Positive dynamics were observed in all 3 cases and included a decrease in the pressure gradient on the isthmus of the aorta, normalization of clinical and paraclinical indicators that allowed performing radical correction in the shortest time possible. Postoperative complications were not observed in all 3 cases, and all children were discharged home in a satisfactory condition after the rehabilitation stage. Conclusion: The choice of surgical tactics in favor of stenting of critical coarctation of the aorta in newborn children with a severe comorbid background, even with good weight and height indicators, can be the key to salvation, which allows stabilizing the patients and preparing them for subsequent radical correction to achieve the best results. Received 9 December 2024. Revised 23 December 2024. Accepted 25 December 2024. Informed consentThe patients’ legal representatives informed consent to use the records for medical purposes is obtained. FundingThe work was supported by a comprehensive program of basic scientific research of the Russian Academy of Sciences within the framework of the fundamental theme of the Research Institute for Complex Issues of Cardiovascular Diseases No. 0419-2024-0002 “Perioperative neuroprotective strategies in the surgery of congenital heart defects” with financial support from the Ministry of Science and Higher Education of the Russian Federation within the framework of the national project “Science and Universities”. State registration number: 124041800039-2. Conflict of interestThe authors declare no conflict of interest. Contribution of the authorsLiterature review: A.A. Rumyantseva, R.S. Tarasov, E.O. GrishachevaDrafting the article: A.A. RumyantsevaCritical revision of the article: R.S. Tarasov, I.K. Khalivopulo, P.A. ShushpannikovSurgical treatment: R.S. Tarasov, I.K. Khalivopulo, P.A. ShushpannikovFinal approval of the version to be published: A.A. Rumyantseva, R.S. Tarasov, I.K. Khalivopulo, P.A. Shushpannikov, E.O. Grishacheva

Monthly buprenorphine depot injection (SUBLOCADE®) for opioid use disorder during pregnancy.

Untreated opioid use disorder (OUD) in pregnancy is associated with adverse obstetrical outcomes, maternal morbidity, and maternal mortality. This article will inform clinicians about the use of monthly extended-release buprenorphine (BUP-XR, SUBLOCADE®) to treat OUD during pregnancy and postpartum. We examined the use of monthly BUP-XR during pregnancy in patients with OUD, summarizing case studies (N = 4) from clinical practice, reviewing >5 years of pregnancy and postpartum surveillance data (quantitative [N = 322] and qualitative) and relevant literature in PubMed (N = 4). The clinical practice case studies highlight the experience from four pregnant patients with OUD who received monthly BUP-XR. All four neonates were delivered full-term with normal birthweight, no fetal anomalies, and no medication required for neonatal opioid withdrawal syndrome. Additionally, over 300 pregnancies have been reported through postmarketing surveillance, of which 68 have known outcomes consistent with information described in the product label. Findings from literature, postmarketing surveillance, and clinical practice case studies were consistent with the established safety profile of buprenorphine. This study addresses a lack of knowledge of treatment of pregnant individuals with OUD and draws on relevant experience from prescribers treating patients with monthly BUP-XR during pregnancy and postpartum. These data support consideration of implementing BUP-XR as part of evidence-based practice that prioritizes OUD treatment access, patient stability, and patient choice during the perinatal period. Three sources of data illustrate that the use of monthly BUP-XR during pregnancy has demonstrated no increased risk and is consistent with the established buprenorphine safety profile.

Impact of maternal anemia during pregnancy on neonatal metabolic profiles: evidence from the Beijing Birth Cohort Study

BackgroundAnemia during pregnancy is associated with various adverse neonatal outcomes. However, the association between maternal anemia during pregnancy and newborn metabolic profiles remains unclear. This study aimed to investigate whether anemia during pregnancy is associated with alterations in neonatal metabolic profiles.MethodsThis prospective observational cohort study included 12,116 pregnant women, with or without gestational anemia, recruited through the Beijing Birth Cohort Study (ChiCTR2200058395), along with their neonates born between July 2021 and October 2022 in Beijing, China.ResultsAmong the 12,116 participants, 576 pregnant women were diagnosed with anemia (Anemia group), while 11,540 did not have anemia (Control group). The rates of metabolic profile abnormalities were significantly higher in the Anemia group compared to the Control group (P < 0.05): 20.83% vs. 16.1% for the overall metabolic profile, 11.9% vs. 9.25% for amino acid profiles, and 11.11% vs. 8.04% for acylcarnitine profiles. Individual metabolic indicators showed significant differences: alanine and arginine levels significantly decreased, while tyrosine levels significantly increased in the Anemia group. Notably, most acylcarnitines indicators (C0, C2, C4DC + C5-OH, C5DC + C6-OH, C6, C6DC, C10, C10:1, C12, C12:1, C14, C14:1, C14:2, C16, C16:1, C16:1-OH, C18, and C18:1) were significantly reduced in the Anemia group, except for C5, which was elevated. Pathway analysis revealed that these alterations were associated with beta-oxidation of very long-chain fatty acids, oxidation of branched-chain fatty acids, mitochondrial beta-oxidation of long-chain saturated fatty acids, and fatty acid metabolism. All of these pathways were related to fatty acid oxidation. Sensitive analyses in normal birth weight (NBW) and term infants (TI) confirmed these findings and demonstrated their robustness. In addition, in NBW infants and TIs, citrulline and arginine were significantly decreased, which were associated with aspartate metabolism and the urea cycle.ConclusionsMaternal anemia during pregnancy is significantly associated with alterations in neonatal metabolic profiles, particularly in fatty acid beta-oxidation and related pathways. These findings highlight the potential metabolic consequences of gestational anemia and provide insights into its role in adverse neonatal outcomes and abnormal newborn screening results.

Insemination methods for embryos transferred in frozen-thawed embryo transfer cycles do not impact reproductive outcomes in couples with non-male factor infertility

In couples with of non-male factor infertility, prevailing discussions have focused primarily on patients undergoing fresh embryo transfer. However, whether intracytoplasmic sperm injection (ICSI) improves reproductive outcomes in patients with non-male factor infertility undergoing frozen-thawed embryo transfer (FET) treatment remains unclear. This retrospective study analyzed 57,907 cycles from the Human Fertilisation and Embryology Authority. All FET cycles with non-male factor infertility were initially included. The final included cycles were divided into the ICSI and in vitro fertilization (IVF) groups. Primary outcomes include clinical pregnancy rate, live birth rate, and miscarriage rate; secondary outcomes comprised neonatal outcomes such as birthweight, gestational week, and sex. Binary logistic regression analysis was used to investigate the impact of ICSI on the studied population. The overall clinical pregnancy rate and live birth rate were significantly higher in the ICSI group than in the IVF group (29.6% vs. 26.0%, P < 0.001; 21.5% vs. 19.1%, P < 0.001). However, ICSI showed no significant association with clinical pregnancy or live birth [adjusted OR: 1.01 (0.95, 1.05), P = 0.969; 1.05 (0.86, 1.28), P = 0.611] after adjustment for confounders. Furthermore, while ICSI was associated with increased rates of full-term births and normal birthweight in singletons, these associations were attenuated after adjustment. Finally, ICSI exhibited no significant effect on neonatal sex ratio [adjusted OR: 0.91(0.93, 1.01), P = 0.052]. In conclusion, ICSI was not associated with improved clinical or neonatal outcomes in FET cycles with non-male factor infertility.

A Bayesian quantile regression approach for determining risk factors of low birth weight of under five children in Cambodia

Birth weight (BW) is a key indicator of a newborn’s health, survival, and development. It is associated with the risk of childhood mortality and is also related to health, physical growth, emotional well-being, and academic success throughout both childhood and adulthood. Therefore, it is crucial to pinpoint the sociodemographic characteristics that have an impact on BW. This study aimed to explore the risk factors associated with children’s low birth weight using the latest nationwide secondary data extracted from the Cambodia Demographic and Health Survey (CDHS) 2021/22. The study included a weighted sample of 4701 children from the CDHS 2021–22 data. Multivariable simultaneous quantile regression models in a Bayesian setting were used to determine the factors associated with Cambodian children’s low birth weight. The average BW is 3.064 (SD 0.483 kg) kg. It is observed that there are some outliers in the target variable and the birth weight of the child is deviated from normal distribution. Women who are young (15–17 years) for their first baby have more low BW infants overall than women who have their first babies later. For mothers aged 18–24 years, children’s birth weight increases by 0.068 to 0.149 points when moving from the 10th to the 50th quantile. For overweight mothers, children’s birth weight increases by 0.123 to 0.348 points when moving from the 10th to the 90th quantile. It is observed that the prevalence of smaller size of children comes from illiterate mothers and the prevalence decreases as the mother’s education increases. More small children are born in rural areas than in urban areas in Cambodia. Our study findings show that the mother’s poor economic status is one of the major risk factors for LBW. Moreover, the birth weights of children from the richest families in the 10th, 20th, 50th, 75th, and 90th quantiles are increased by 0.075, 0.058, 0.111, 0.114, and 0.053 points respectively. The child’s sex and birth order, the mother’s age at first birth, her education level and BMI, the number of ANC visits during pregnancy, drinking water sources, types of bathroom facilities, place of residence, and wealth index are all related to the child’s size. Furthermore, mothers who have low education levels and grew up in low-income households require special consideration. To lessen the number of low birth weight babies, the authors suggest that the Cambodian government may prioritize food and health education in its school system. Additionally, the authors think that the policymakers will benefit from these findings in order to achieve SDG-3.

Association of birth weight with blood pressure and renal function variables in children aged 3 to 6 years

INTRODUCTION:Intrauterine growth retardation (IUGR) has recently been related to an increase in blood pressure figures in different countries.OBJECTIVEThe objective of this research was to evaluate the relationship between blood pressure and kidney function with birth weight in children aged 3 to 6 years.MATERIAL AND METHODSThirty-two healthy, normotensive children with a history of low birth weight due to IUGR or normal birth weight, aged between 3 and 6 years, were studied in the Marianao municipality of Havana. Their nutritional status was determined based on their body surface area, using the Haycock formula expressed in square meters. Arterial, systolic and diastolic pressures were measured using the Riva Rocci-Korotkoff method, calculating the average. Glomerular filtration rate (GFR) was determined using the Schwartz 2 formula (GFR WS) and Pottel for serum creatinine and for serum Cystatin C using Pottel. The renal and blood pressure variables were adjusted to body surface area and analyzed using Pearson's correlation. Ethical standards for research on humans were respected.RESULTSSystolic, diastolic and mean arterial pressures, as well as GFR, were inversely correlated with birth weight. Children with a history of low birth weight due to IUGR presented higher blood pressure values, although not pathological with respect to their peers; the IFG values in this group of children were higher with respect to their peers, calculated both by creatinine through the Pottel method and serum Cystatin C.CONCLUSIONThere is a tendency for higher blood pressure values in children with low birth weight due to IUGR. The correlation between IFG and birth weight supports theories about the influence of hyperfiltration on high blood pressure, so we suggest more extensive studies of the variables studied, as well as the use of the Pottel formula for its study.

Gender, Birth Length and Low Birth Weight as Determinants of Stunting: A Study in Kebon Kalapa Village, Indonesia

Aims: to reveal the relationship between Gender, Birth Length and Low Birth Weight with Stunting in Kebon Kalapa Village Sumedang in 2021. Methods: using simple cross sectional approach, all primary data obtained from children age between 2-5 years old in Kebon Kalapa Village, Sumedang west Java which eligible for the inclusion criteria. Results: Simple analysis conducted on 130 respondents obtained using the total sampling technique revealed that the incidence of stunting in children aged 2-5 years in Kebon Kelapa Mekarsari Village, Sumedang was found to be 24.6% (n=32) and non-stunting was 75.4% (n=98). The gender distribution of respondents with female compared to male was 51.5% (n=67) vs 48.5%,(n=63) respectively. Respondent with history of short birth length (length of birth less than 48 cm) was found to be 19.2% and normal (≥48 cm) was 80.2%, while low birth weight was found to be 4.6% and normal birth weight was 95.4%. Conclusion: stunting formation in children associated with their gender, short birth length and low birth weight. The birth condition of the baby solely depend on the mother’s nutritional status and anemia condition. This implies that it is crucial to prevent anemia since very early, e.g., in adolescent girls and in women before and during pregnancy, with the regular monitoring of nutritional status of pregnant women, as a part of programs to eliminate stunting in children.

A narrative review of metformin in pregnancy: Navigating benefit and uncertainty.

Metformin is well-established as a treatment for type 2 diabetes in non-pregnant individuals. The low cost, acceptability and broad tolerability of metformin have also made it an attractive option for research into the treatment of other conditions associated with insulin resistance. Despite almost 50 years of clinical experience with the use of metformin to treat diabetes in pregnancy, many questions remain regarding its precise effectiveness in different maternal subgroups, as well as potential short-term and long-term effects on the offspring. In this narrative review, we present the current evidence for the use of metformin during pregnancy in various maternal subgroups, including women living with overweight and obesity, women at risk of gestational diabetes, women diagnosed with gestational diabetes and women with pregestational diabetes, including type 2 diabetes. Our specific focus is on the impact of metformin on short-term maternal, fetal and neonatal outcomes. We also consider the evidence for other emerging indications for metformin in pregnancy, such as the prevention and management of pre-eclampsia. PLAIN LANGUAGE SUMMARY: This article looks at research on how metformin use in pregnancy affects mothers and newborns in the short term. Doctors have prescribed metformin since the 1970s for the treatment of diabetes in pregnancy. Despite years of use, there are still questions about how safe and effective metformin is for mothers and their children. Metformin taken during pregnancy moves through the placenta into the foetus's bloodstream. The short-term and long-term effects of metformin on offspring need careful attention. The studies that have looked at the link between metformin use and birth defects have not found any strong link between taking metformin in pregnancy and birth defects, however close attention will continue to be paid in this area. Some large studies have examined the use of metformin in pregnant women who do not have diabetes, but who do live with overweight or obesity. The studies are difficult to compare. Some, but not all, of these studies have shown less weight gain for the mother if metformin is taken by these women during pregnancy. Other large studies have looked at whether metformin can prevent gestational diabetes. The results are mostly disappointing. They suggest that metformin does not stop gestational diabetes from developing. However, the participants in these studies were mostly from white backgrounds and metformin may help prevent gestational diabetes in women of different ethnic backgrounds. However, more research is needed. Metformin has been widely studied as an alternative to insulin for the treatment of gestational diabetes. Because different countries diagnose and treat GDM differently, this makes comparing study results difficult. Women with gestational diabetes seem to gain less weight during pregnancy if they use metformin rather than insulin. Using metformin instead of insulin may result in lower average birth weights for babies from these pregnancies. Also, the use of metformin may lead to fewer babies being born abnormally large. Similarly, large trials have examined the use of metformin in pregnant women who are living with type 2 diabetes. These studies show that metformin can lower a mother's insulin needs. It can also help control weight gain and reduce the risk of having a large baby. One study found that metformin use in women living with Type 2 diabetes might increase the risk of having smaller babies. This was especially true if the mother had high blood pressure or kidney disease. This finding requires further investigation. Metformin might help prevent pre-eclampsia, but this is still unclear. Research is ongoing into a potential role for metformin in the treatment of pre-eclampsia. In conclusion, metformin has been studied in many groups of pregnant women. Women with gestational diabetes or type 2 diabetes may see benefits like less weight gain and better blood sugar/glucose control. Current evidence suggests that metformin shouldn't be used if there are foetal growth issues. It is also not recommended for mothers with high blood pressure or kidney disease. Future studies might find specific groups of pregnant women who would benefit the most from metformin.

Association between adverse birth outcomes and long-term risk of premature cardiovascular disease and mortality in a contemporary population-based cohort of 502,383 pregnant women.

Association between adverse birth outcomes and long-term risk of premature cardiovascular disease and mortality in a contemporary population-based cohort of 502,383 pregnant women.

Gender and educational stage-specific association of birth weight with overweight and obesity among children and adolescents aged 7–18 years: a school-based cross-sectional study

ObjectivesTo investigate the associations between birth weight and overweight/obesity in school-aged children and adolescents according to different gender and educational stages, and explore the interactions among the lifestyle factors.DesignCross-sectional study.SettingHenan...

A Retrospective Study of Infant and Maternal Risk Factors in LUMBAR Syndrome.

LUMBAR syndrome is the association of segmental infantile hemangiomas that affect the Lower part of the body with Urogenital anomalies, hemangioma Ulceration, spinal cord Malformations, Bony deformities, Anorectal malformations, Arterial anomalies and/or Renal anomalies. The etiology is not known but is suspected to be multifactorial, involving genetic and environmental factors. We retrospectively reviewed a large database of 109 published reports of LUMBAR syndrome to study potential associated clinical risk factors, the first such effort. LUMBAR is significantly more common in full-term, normal birth weight, singleton girls. We found no statistically significant differences in disease severity between affected girls and boys. There were no reports in twins or other multiple births, no reports of familial recurrence, and no repeated maternal illnesses, exposures, or other prenatal risk factors. Prospective studies in LUMBAR syndrome are needed to further evaluate maternal risk factors for prenatal hypoxia, gene-environment interactions, and genetic susceptibility variants.

The Complex Interplay of Irisin Levels, Low Birth Weight, and Blood Pressure in Prepubescent Children.

Irisin regulates various metabolic, inflammatory, and oxidative stress processes. It has been considered a promising target in the context of the development and maintenance of cardiovascular diseases. We conducted a study to evaluate the levels of plasma irisin in prepubertal children, examining its relationship with birth weight, anthropometric parameters, biochemical profile, and blood pressure levels. A cross-sectional study was conducted involving 136 prepubertal children aged 6 to 11 years, with 27.9% born at a low weight. Anthropometric parameters, blood pressure, and biochemical profiles were assessed. Children with low birth weight had significantly lower irisin levels compared to those with normal birth weight (p < 0.001). Birth weight was negatively correlated with blood pressure levels (systolic: r = -0.213, p = 0.013; diastolic: r = -0.223, p = 0.009) and positively correlated with irisin levels (p < 0.001). Irisin levels were positively associated with systolic blood pressure, even after adjusting for birth weight, BMI, and physical activity (p < 0.001). The linear regression analysis indicated that low birth weight and high plasma levels of irisin were recognized as predictive factors of elevated blood pressure levels. The positive correlation observed between circulating irisin and systolic blood pressure levels in children with low birth weight, despite their lower irisin levels, suggests a complex interplay between birth weight, irisin, cardiovascular regulation, and metabolic function. Understanding this relationship may require considering that irisin may play dual roles in different tissues, compensatory mechanisms, and the broader context of cardiometabolic programming in children with low birth weight.

Effects of Yeast β-Glucan Supplementation on Calf Intestinal and Respiratory Health.

The physiological functions of newborn calves are undeveloped, especially the immune system, making them susceptible to infections. In recent years, the theory of trained immunity has attracted attention and provided new strategies to prevent unknown infections in animals. This study investigated the effects of feeding yeast β-glucan on the intestinal and respiratory health of calves during the suckling period. Newborn Holstein calves (average birth weight: 36.18 ± 0.61 kg, mean ± SE) were randomly assigned to two groups: the PO (Per Os) group (n = 22) and the CON (Control) group (n = 22). Calves in the PO group were fed a yeast β-glucan solution (0.1 g/mL, 65 mg/kg body weight) at 3 and 6 days of age, respectively, while calves in the CON group received equal volumes of sterile saline orally at the same time. Blood and fecal samples were collected at 7 and 30 days of age, respectively. The results showed that (1) Compared to the CON group, being fed yeast β-glucan resulted in an inflammatory response after 24 h of the second administration, including increased gene expression of interleukin-6 (IL-6, p < 0.01), interleukin-1 beta (IL-1β, p < 0.01), and malonaldehyde (MDA, p < 0.001) content. Also, stimulation with β-glucan increased the concentrations of secreted immunoglobulin A (sIgA, p < 0.01) and defensins (p < 0.05) in the rectal feces. (2) Pre-stimulation with yeast β-glucan effectively reduced the incidence of diarrhea (p < 0.05) and bovine respiratory disease (BRD, p < 0.05) from day 31 to day 60. (3) At 30 days of age, the pre-stimulated calves had significantly lower serum DAO (p < 0.001) and MDA levels (p < 0.05), while they had higher levels of serum IL-6 (p < 0.01) and fecal slgA (p < 0.05) than calves in the CON group. (4) Pre-stimulation with yeast β-glucan altered the intestinal bacterial community; the Beta diversity results showed that the CON group and the PO group were clustered separately in the principal coordinate analysis (PCoA) graph. Obviously, the PO group sample points were more clustered. In conclusion, this study highlights the potential of yeast β-glucan-induced trained immunity to improve calf health during the suckling period. The findings offer new insights into the prevention of intestinal and respiratory infections in calves.

Operation allied force: unintended consequences of the North Atlantic Treaty Organization bombing on children’s outcomes

Abstract This paper estimates the causal effect of NATO's Operation Allied Force in Serbia in 1999 on health and educational outcomes of children who were in the womb during the bombing. We use entire birth records of the Serbian Statistical Office and educational outcomes provided by the Ministry of Education. The estimation results of the difference-in-differences models, combined with propensity score matching, suggest that children who were in utero during the bombing were 2 percentage points (pp) more likely to be born with a below average (&amp;lt;3,500 g) birthweight and 1pp less likely to be born with high birthweight (≥4,000 g). We find no effects for low birthweight (&amp;lt;2,500 g) and stillbirth outcomes. In the medium-term, we find a statistically significant negative effect of the bombing on grades in mathematics (around −0.9%) and Serbian language (around −0.6%) at the end of primary school, and a 1pp decrease in the preference for/enrolment in academically oriented secondary school. Our results emphasise that war-related bombing has devastating consequences for pregnant women and affected children, and the necessity of policy intervention to prevent conflicts and mitigate their consequences for the most vulnerable part of the population.