Poor Growth Research Articles

Does atenolol use during pregnancy cause small for gestational age neonates? A meta-analysis.

Atenolol is a commonly used beta bloscker in non-pregnant women. Many providers are hesitant in prescribing atenolol in pregnancy because of a possible association with poor fetal growth. We aimed to assess the association between atenolol and the occurrence of small for gestational age neonates compared to other beta blockers, as described in the existing literature. We used the meta-analytic method to generate a forest plot for risk ratios (RR) of small for gestational age in patients who used atenolol vs. other beta blockers. Statistical heterogeneity was assessed with the I2 statistic. Two studies were included, with a resultant RR of 1.94 [95 % confidence interval (CI) 1.60; 2.35]. A study by Duan etal. in 2018 noted the following rate of small for gestational age for each beta blocker use: 112/638 atenolol, 590/3,357 labetalol, 35/324 metoprolol, and 50/489 propranolol. A study by Tanaka etal. in 2016 noted the following rate of small for gestational age: 8/22 for propranolol, 2/12 for metoprolol, 2/6 for atenolol, 0/5 for bisoprolol. Heterogeneity (I2) was 0 %. Our results suggested an elevated risk of small for gestational age associated with atenolol use in comparison to other beta blockers, specifically labetalol, propranolol, bisoprolol, and metoprolol.

Circumflex left aortic arch: a new vascular ring anomaly in dogs.

To describe the circumflex left aortic arch as a new form of canine congenital vascular ring anomaly leading to esophageal constriction. 3 large-breed dogs of variable age: a 9-month-old entire male German Shepherd Dog-Rottweiler cross, a 17-week-old entire male German Shepherd Dog, and a 9-year-old neutered female Labrador Retriever, seen between April 2022 and May 2023. Dogs presented for chronic postprandial regurgitation and poor growth. One dog presented for a hard mass on the caudal mandibular region. Computed tomography revealed a normal leftward-oriented cranial half and an abnormal caudal half of the aortic arch crossing toward the right dorsal hemithorax leading to esophageal constriction in all dogs. In addition, 1 dog presented with a right patent ductus arteriosus and 1 with an aberrant right subclavian artery. Circumflex left aortic arch is a newly discovered rare type of congenital vascular ring anomaly in dogs, which presents a similar anatomical derangement to the human form. Clinical signs include postprandial regurgitation and poor growth. Circumflex left aortic arch vascular anomaly cannot be surgically corrected via the left thoracotomy that is commonly used for the more common vascular ring anomalies in dogs. Computed tomography is a useful diagnostic modality for the diagnosis of this condition, detection of concomitant congenital vascular malformations, evaluation of associated pathologies, and surgical planning.

Management of Early Childhood Caries under General Anesthesia at a Tertiary Care Service Hospital: A Retrospective Study

Abstract Introduction: Early childhood caries (ECC) affects almost 50% of preschool children and may lead to chronic pain, halitosis, fever, trismus, poor growth and development, and repeated airway and gastrointestinal infections. Managing this is challenging in the face of anxiety, developmental delay, and other comorbidities in children. This necessitates their management under general anesthesia (GA). Methodology: We carried out a retrospective descriptive study to analyze the characteristics of pediatric patients who underwent oral rehabilitation under GA at a tertiary care service hospital. Results: The data of 20 children inflicted with ECC who underwent full-mouth rehabilitation under GA were analyzed. The majority were boys and the mean age was 69.5 months. Five of these children had comorbidities. The most common indication for GA was the uncooperation of the child. Inhalational induction was carried out for most of them, and postoperatively, two children had emergence delirium and one child had nausea and vomiting. Conclusion: We share our experiences toward standardization of safe anesthesia practices.

Characterization of susceptibility patterns and adaptability of the newly emerged Candida auris.

The emergence of Candida auris has caused a major concern in the public health worldwide. This novel fungus is characterized by its multidrug resistance profile, ability to thrive in harsh and stressful conditions, as well as high temperatures and salt concentrations, persistence on hospital surfaces, causing nosocomial infections and outbreaks, and unique fitness properties. Here, we study the antifungal susceptibility patterns, thermotolerance, and halotolerance of 15 putative C. auris clinical isolates from Inkosi Albert Academic Hospital, Durban, South Africa. Five of the C. auris isolates showed resistance to all three antifungals (fluconazole, amphotericin B, and micafungin) and were selected for characterization of their adaptability mechanisms. Four of the tested multidrug-resistant C. auris isolates (C. auris strain F25, C. auris strain F276, C. auris F283, and C. auris M153) showed good growth when exposed to high temperature (42°C) and salinity (10% NaCl) conditions whereas one isolate (C. auris F65) showed moderate growth under these conditions. Candida parapsilosis showed poor growth whereas C. albicans no growth under these conditions. The five C. auris strains were positive for all the adaptive features.

Improving growth in infants with CF.

Cystic fibrosis (CF) results in chronic pulmonary infections, inflammation, pancreatic insufficiency, and multiple gastrointestinal manifestations. Malnutrition and poor growth are hallmarks of CF, and strongly associated with poor outcomes. Through newborn screening, many infants can be diagnosed within a few days of life, which allows for early initiation of nutritional counseling and close clinical follow-up. Obstacles to growth for infants with CF start in utero, as newborns with CF can have a lower birth weight than the general population. Improving infant growth has been linked to improved clinical outcomes and survival. It remains a top priority and challenge for caregivers and healthcare teams. An interdisciplinary approach, including registered dietitian and social work support, is essential to optimize health for infants with CF. Remaining barriers to normalcy include deficits in linear growth, lack of accurate nutrition biomarkers, persistence of inequities related to social determinant of health, particularly in the global CF community.

An unprecedented fall drought drives Dust Bowl-like losses associated with La Niña events in US wheat production.

Unprecedented precipitation deficits in the 2022-2023 growing season across the primary wheat-producing region in the United States caused delays in winter wheat emergence and poor crop growth. Using an integrated approach, we quantitatively unraveled a 37% reduction in wheat production as being attributable to both per-harvested acre yield loss and severe crop abandonment, reminiscent of the Dust Bowl years in the 1930s. We used random forest machine learning and game theory analytics to show that the main driver of yield loss was spring drought, whereas fall drought dominated abandonment rates. Furthermore, results revealed, across the US winter wheat belt, the La Niña phase of the El Niño Southern Oscillation (ENSO), increased abandonment rates compared to the El Niño phase. These findings underscore the necessity of simultaneously addressing crop abandonment and yield decline to stabilize wheat production amid extreme climatic conditions and provide a holistic understanding of global-scale ENSO dynamics on wheat production.

What would happen in the United States if there were no cow milk-based preterm infant nutritional products: historical perspective and evaluation of nutrient-related challenges

Recent litigation has led to a situation where preterm cow milk-based infant nutritional products (PCMBPs) may soon have limited or no availability in the United States. Given their limited availability, similar products based only on human milk are unlikely to meet the needs of most preterm infants requiring such products, especially those born >1500 g or very preterm infants born at <1500 g after they reach 34–35 wk postmenstrual age. Alternative nutritional strategies, used before the introduction of specialized preterm products, would require modular nutrient additions to a formula designed for full-term infants and donor or maternal milk. The addition of modular products would require careful calibration to provide needed macro and micronutrients which would expose infants to risks of contamination, poor growth, and limited bioavailability of some of these modulars. Substantial risks of metabolic derangements, and ultimately, poor outcomes would occur. In the long-term greater availability and support for the use of human milk-based products is needed. However, policymakers cannot assume that PCMBPs will not be critically needed and should identify strategies for their continued marketplace availability.

Engineering the TetR-family transcriptional regulator XNR_0706 to enhance heterologous spinosad production in Streptomyces albus B4 chassis

The TetR family of regulators are an important group of transcription regulators that regulate diverse cellular processes in prokaryotes. In this study, we found that XNR_0706, a TetR family regulator, controlled the expression of XNR_0345, XNR_0454, XNR_0513 and XNR_1438 putatively involved in fatty acid β-oxidation by interacting with the promoter regions in Streptomyces albus B4. The transcription level of these four genes was downregulated in XNR_0706 deletion strain (ΔXNR_0706) and restored by XNR_0706 complementation in Δ0706/pIB-0706, demonstrating that XNR_0706 was a positive transcriptional regulator of the genes. With toxic long-chain fatty acids addition in TSB media, deletion of XNR_0706 caused significantly poor growth, whereas XNR_0706 complementation increased the utilization of additional fatty acids, resulting in restored growth. Fatty acid β-oxidation is one source of acetyl- and malonyl-CoA precursors for polyketides biosynthesis in actinobacteria. Overexpression of XNR_0706 in B4/spnNEW, a spinosad heterologous expression strain derived from S. albus B4, increased spinosad yield by 20.6%. Additionally, supplement of 0.3 g/L fatty acids resulted in a further 42.4% increase in spinosad yield. Our study reveals a regulatory mechanism in long-chain fatty acids metabolism in S. albus and these insights into the molecular regulation of β-oxidation by XNR_0706 are instrumental for increasing secondary metabolites in actinobacteria.

HBS1L deficiency causes retinal dystrophy in a child and in a mouse model associated with defective development of photoreceptor cells.

Inherited retinal diseases encompass a genetically diverse group of conditions caused by variants in genes critical to retinal function, including handful of ribosome-associated genes. This study focuses on the HBS1L gene, which encodes for the HBS1-like translational GTPase that is crucial for ribosomal rescue. We have reported a female child carrying biallelic HBS1L variants, manifesting with poor growth and neurodevelopmental delay. Here, we describe the ophthalmologic findings in the patient and in Hbs1ltm1a/tm1a hypomorph mice and describe the associated microscopic and molecular perturbations. The patient has impaired visual function, showing dampened amplitudes of a- and b-waves in both rod- and cone-mediated responses. Hbs1ltm1a/tm1a mice exhibited profound thinning of the entire retina, specifically of the outer photoreceptor layer, due to extensive photoreceptor cell apoptosis. Loss of Hbs1l resulted in comprehensive proteomic alterations by mass spectrometry analysis, with an increase in the levels of 169 proteins and a decrease in the levels of 480 proteins, including rhodopsin (Rho) and peripherin 2 (Prph2). Gene Ontology biological process and gene set enrichment analyses reveal that the downregulated proteins are primarily involved in phototransduction, cilium assembly and photoreceptor cell development. These findings underscore the importance of ribosomal rescue proteins in maintaining retinal health, particularly in photoreceptor cells.

Effects of sanitation on child growth in Serbian Roma communities

Abstract Poor sanitation may be associated with growth faltering, but empirical evidence on the association between household sanitation infrastructure and child nutrition has been mixed. This article assessed whether sanitation infrastructure is associated with growth penalties for Roma children. Design This is a Roma nationally representative population-based study. Proxies of child nutritional outcomes included children’s height-for-age Z scores below two standard deviations from the median of WHO’s reference population. Multiple and logistic regressions estimated the association between the type of toilet usage, outcomes, and sociodemographic determinants. Setting Data were from UNICEF’s fifth and sixth Multiple Indicator Cluster Surveys for Serbian Roma settlements. Subjects Children aged 0–24 (n = 1,150) and 25–59 (n = 2,024) months born to women aged 15–48 years were included in this study. Results About 16% of children resided in households with no toilet service, and 23% of children were stunted. Roma children aged 25–59 months in households with no toilet service and in rural areas were more likely to be stunted and of significantly shorter stature than their counterparts. Children up to 24 months of age were not affected by the type of toilet, likely due to protective effects of breastfeeding. Child’s age, number of siblings, and birth spacing negatively influenced growth outcomes, while maternal age, birthweight above 2.5 kg, and being a female mitigated against poor growth outcomes. Conclusions The relationship between the type of toilet and growth outcomes among Roma children varied with age and area: having no toilet and living in rural areas were associated with compromised child growth for children aged 25–59 months. Maternal and child characteristics additionally accounted for children’s growth.

Potassium Availability in Tropical Sandy Soils and Cassava Response to Three-Year K Fertilization

ABSTRACT Potassium (K) is the primary limiting nutrient for cassava, being essential to achieve sustainably satisfactory cassava yields in low K reserve sandy soils that require proper K fertilization to avoid depleting the soil K reserve. Soil K dynamics, the growth, and yield responses of cassava were investigated using varying K fertilizer rates (0, 25, 50, 75, 100, and 125 kg K2O/ha). Four on-farm experiments were conducted in major cassava-producing areas, Northeast Thailand during 2019–2021 year. Cassava responded positively to K, producing yield increases up to 132%, with the highest tuber yield obtained being in the range 100–125 kg K2O/ha. Mineral K was the main K source for cassava grown without K fertilization, which resulted in the poorest growth and yield quantities. Potassium fertilization significantly promoted the uptake of K by cassava, especially in the tuber, causing a negative K balance due to the large removal from the soil, even when the K fertilizer compensated to some degree. Potassium use efficiency of cassava was low, particularly with K fertilization at the highest rate, which reflected intense leaching of the soil. The critical level of soil-available K, identified using a linear-plateau model, was 40.55 mg/kg for 90% relative yield, suggesting the potential to increase K use efficiency through better fertilization guidelines. Our findings suggested that K fertilization of cassava annually is advisable for better yields and to avoid progressive depletion of the soil K capital, even though the residual K from K fertilizer contributed to available K in soils.

Cranial and spinal nerve enhancement in SURF1-associated Leigh syndrome

A 23-month-old boy with poor growth, developmental delay, and hypotonia presented with acute onset of ataxia and fatigue. Magnetic resonance imaging (MRI) of the brain and spinal cord was performed as part of diagnostic work-up. MRI showed bilateral symmetrical lesions in basal ganglia, midbrain, and brainstem consistent with Leigh syndrome. Signal abnormalities were also present within the cervical cord, with enhancement of multiple cranial, spinal, and cauda equina nerve roots. Genetic testing confirmed compound heterozygosity for two pathogenic variants in SURF1 implicated in Leigh syndrome. Whilst nerve root enhancement has been described in other mitochondrial disorders, we believe this is the first published case of both cranial and spinal nerve root enhancement in Leigh syndrome.Graphical

Intestinal microbial and metabolite profile in infants with small bowel stomas after bowel resection.

Infants with small bowel stomas (SBstoma) frequently struggle with absorption and rely on parenteral nutrition (PN). Intestinal absorption is difficult to predict based solely on intestinal anatomy. The purpose of this study was to characterize the microbiota and metabolic by-products within stoma effluent and correlate with clinical features and intestinal absorption. Prospective cohort study collecting stoma samples from neonates with SBstoma (N = 23) or colostomy control (N = 6) at initial enteral feed (first sample) and before stoma closure (last sample). Gut bacteriome (16S ribosomal RNA [rRNA] sequencing), short-chain fatty acids (SCFAs) and bile acids (BAs) were characterized along with volume and energy content of a 48 h collection via bomb calorimetry (last sample). Hierarchical clustering and linear regression were used to compare the bacteriome and BAs/SCFAs, to bowel length, PN, and growth. Infants with ≤50% small bowel lost more fluid on average than those with >50% and controls (22, 18, 16 mL/kg/day, p = 0.013), but had similar energy losses (7, 10, 9 kcal/kg/day, p = 0.147). Infants growing poorly had enrichment of Proteobacteria compared to infants growing well (90% vs. 15%, p = 0.004). An increase in the ratio of secondary BAs within the small bowel over time, correlated with poor prognostic factors (≤50% small bowel, >50% of calories from PN, and poor growth). Infants with SBstoma and poor growth have a unique bacteriome community and those with poor enteral tolerance have metabolic differences compared to infants with improved absorption.

Fibrinogen inhibits sonic hedgehog signaling and impairs neonatal cerebellar development after blood–brain barrier disruption

Cerebellar injury in preterm infants with central nervous system (CNS) hemorrhage results in lasting neurological deficits and an increased risk of autism. The impact of blood-induced pathways on cerebellar development remains largely unknown, so no specific treatments have been developed to counteract the harmful effects of blood after neurovascular damage in preterm infants. Here, we show that fibrinogen, a blood-clotting protein, plays a central role in impairing neonatal cerebellar development. Longitudinal MRI of preterm infants revealed that cerebellar bleeds were the most critical factor associated with poor cerebellar growth. Using inflammatory and hemorrhagic mouse models of neonatal cerebellar injury, we found that fibrinogen increased innate immune activation and impeded neurogenesis in the developing cerebellum. Fibrinogen inhibited sonic hedgehog (SHH) signaling, the main mitogenic pathway in cerebellar granule neuron progenitors (CGNPs), and was sufficient to disrupt cerebellar growth. Genetic fibrinogen depletion attenuated neuroinflammation, promoted CGNP proliferation, and preserved normal cerebellar development after neurovascular damage. Our findings suggest that fibrinogen alters the balance of SHH signaling in the neurovascular niche and may serve as a therapeutic target to mitigate developmental brain injury after CNS hemorrhage.

Efficacy of Supplementary Feeding of Bypass Fat and Area Specific Mineral Mixture on the Production and Reproductive Performance in Milch Buffaloes

Background: Bypass fat, also called rumen-protected fat, boosts dairy animals¢energy for better milk production and health. Mineral deficiency is a leading cause of poor growth, weakened immunity, lower milk yield and reproductive issues in dairy animals. Considering the aforementioned details, an on farm trial was undertaken at farmer’s field to assess the effectiveness of bypass fat and mineral mixture on overall performance of milch buffalo. Methods: Twenty lactating Murrah buffaloes reared under farmer's field were selected and distributed equally in two groups of ten buffaloes in each group, i.e. T1 (control) and T2 (supplementation bypass fat @ 100 g and minerals mixture @ 50 g/day/ buffalo beside the farmer practices). Result: The outcome of study revealed that the additional of bypass fat and a mineral mixture had no effect on the weights of the buffaloes undergoing the experiment. Supplementation of bypass fat and mineral mixture did not influence the DM intake (in terms of kg/d and DMI %) in lactating buffalo. The mean milk yield during supplementation period was determined 10.19 ±0.36 and 12.13±0.43 l/day in group T1 and T2, respectively; which was 19.04 per cent higher in group T2 than the control. The average length of the postpartum estrus cycle (62.20±5.86 days) and service period (82.49±7.46 days) was significantly (P less than 0.05) reduced in supplemented group than control (86.40±11.57 days and 131.00±12.33 days, respectively) at farmer¢s field. AI per conception was also observed to be significantly (P less than 0.05) higher in non-supplemented group than the supplemented group. AI per conceptions in supplemented group and control group was recorded 1.39±0.33 and 2.71±0.44, respectively. It could be inferred from the observations that the feeding of bypass fat and area-specific mineral mixture in the diet significantly (P less than 0.05) improved the yield of milk and its composition as well as postpartum reproductive performance in milch buffalo at farmer’s field.

Strategies to build stronger bones in Indian children: Challenges for implementation.

Background & objectives Globally, vitamin D deficiency has been incriminated in poor bone health and growth retardation in children, impaired adult musculoskeletal health (classically described), increased risk of cardiovascular events, immune dysfunction, neurologic disorders, insulin resistance and its multiple sequelae, polycystic ovary syndrome (PCOS) and certain cancers. This review intends to holistically highlight the burden of vitamin D deficiency among children in India, the public health importance, and potential therapeutic and preventive options, utilizing the concept of implementation research. Methods A systematic search was carried out on PubMed, Embase, China National Knowledge Infrastructure (CNKI) and Cochrane database, clinicaltrials.gov, Google Scholar, and ctri.nic.in with the keywords or MeSH terms namely 'vitamin D', 'cholecalciferol', 'ergocalciferol', 'children', connected with appropriate boolean operators. Results Vitamin D deficiency/insufficiency prevalence varies from 70-90 per cent in Indian children. Rickets, stunting, impaired bone mineral health, and dental health are common problems in these children. Serum 25-hydroxy vitamin D (25(OH)D) should be maintained >20 ng/ml in children. Oral vitamin D supplementation has a high therapeutic window (1200-10,000 IU/d well tolerated). Fortification of grains, cereal, milk, bread, fruit juice, yogurt, and cheese with vitamin D has been tried in different countries across the globe. From Indian perspective, fortification of food items which is virtually used by everyone would be ideal like fortified milk or cooking oil. Fortification of "laddus" made from "Bengal gram" with vitamin D as a part of a mid-day meal programme for children can be an option. Interpretation & conclusions There is enough evidence from India to suggest the importance and utility of food fortification with vitamin D to address the epidemic of vitamin D deficiency/insufficiency in children.

Genome-Wide Identification and Expression Analysis of ADK Gene Family Members in Cotton under Abiotic Stress.

Adenosine kinase (ADK) is a key enzyme widely distributed in plants, playing an important role in maintaining cellular energy homeostasis and regulating plant growth, development, and responses to environmental stresses. However, research on ADK genes in cotton (Gossypium hirsutum), an economically significant crop, has been limited. This study identified 92 ADK genes from four cotton species (G. arboreum, G. raimondii, G. hirsutum, and G. barbadense) using HMMER and Local BLASTP methods and classified them into six groups. Chromosomal localization revealed a random distribution of ADK genes in G. hirsutum, with 13 genes located on the At subgenome and 14 genes on the Dt subgenome. Gene structure analysis showed consistency in exon-intron organization within subgroups, while conserved motif analysis identified subgroup-specific motifs, indicating functional diversity. Synteny and collinearity mapping analysis revealed that the primary expansion mechanisms of the ADK gene family in cotton are polyploidy and segmental duplication. Cis-regulatory elements in GhADK promoters were classified into light response, hormone response, developmental regulation, and stress response. We also analyzed the expression patterns of GhADK genes under a low temperature (4 °C) and drought conditions. Most GhADK genes responded to cold stress with different expression patterns, indicating their roles in rapid response and long-term cold adaptation. Under drought stress, expression patterns varied, with some genes showing sustained high expression levels. The qRT-PCR validation of transcriptomic data confirmed the stress-induced expression patterns of selected GhADK genes. Functional analysis through the VIGS silencing of GhADK25 demonstrated its importance in cold and drought stress responses, with silencing resulting in poor growth under stress, highlighting its significance in stress tolerance. This study provides a basis for further understanding the evolutionary relationships and functions of the cotton ADK gene family.

Iskanje in določanje bakterij, ki so sposobne razgraditi celulozo s pomočjo IAA kot potencialnih pospeševalcev rasti rastlin

Strains with both straw degradation and plant growth promotion ability were selected from the cultivated soil in Bac Kan, Vietnam to solve the problems of poor soil microbial diversity status, weak corrosion promotion effect, and poor crop growth caused by fungal rot diseases. Among seventeen bacteria isolated, strain NR1 presented the highest value for cellulase enzyme activity (Hydrolysis index = 24.8 mm), and IAA production (20.15 mg l-1), and was identified as Bacillus amyloliquefaciens Priest et al., 1987. Inoculation with NR1 significantly increased the rot promotion rate of straw under liquid fermentation by 54.71 % compared with the control and increased the root length and average diameter, and SPAD value of maize under soil culture by 18.3 %, 22.0 %, and 5.24 % respectively (p &lt; 0.05). In addition, fertilizing 8 or 9 tons of NR1-degraded compost fertilizer per hectare had the best effect on the growth, development, and productivity of the L14 peanut variety. These results suggest strain NR1 could be used to produce multi-functional humus, accelerate the decomposition of straw in the cultivated soil, and promote crop growth.

Hypophosphatemic rickets and short stature.

An 18-month-old male presented with gross motor delay and poor growth (weight z-score -2.21, length z-score -4.26). Radiographs showed metaphyseal irregularities suggesting metaphyseal dysplasia and sagittal craniosynostosis. Biochemical evaluation supported hypophosphatemic rickets [serum phosphorus 2.3mg/dL (reference range (RR) 4.3-6.8), alkaline phosphatase 754 unit/L (RR 156-369)] due to renal phosphate wasting (TmP/GFR 4.3mg/dL, normal for age 4.3-6.8), with C-terminal fibroblast growth factor 23 (FGF23) 125 RU/mL (>90 during hypophosphatemia suggests FGF23-mediated hypophosphatemia). Treatment was initiated with calcitriol and phosphate. Genetic analysis showed a pathogenic variant of FGF23: c.527G > A (p.Arg176Gln) indicative of autosomal dominant hypophosphatemic rickets (ADHR). Consistent with reports linking iron deficiency with the ADHR phenotype, low ferritin was detected. Following normalization of ferritin level (41ng/mL) with oral ferrous sulfate replacement, biochemical improvement was demonstrated (FGF23 69 RU/mL, phosphorus 5.0mg/dL and alkaline phosphatase 228 unit/L). Calcitriol and phosphate were discontinued. Three years later, the patient demonstrated improved developmental milestones, linear growth (length Z-score -2.01), radiographic normalization of metaphyses, and stabilization of craniosynostosis. While the most common cause of hypophosphatemic rickets is X-linked hypophosphatemia, other etiologies should be considered as treatment differs. In ADHR, normalization of iron leads to biochemical and clinical improvement.

Impact of Maternal Pre-Pregnancy Underweight on Cord Blood Metabolome: An Analysis of the Population-Based Survey of Neonates in Pomerania (SNiP).

Intrauterine growth restriction leads to an altered lipid and amino acid profile in the cord blood at the end of pregnancy. Pre-pregnancy underweight is an early risk factor for impaired fetal growth. The aim of this study was to investigate whether a pre-pregnancy body mass index (ppBMI) of <18.5 kg/m2, as early as at the beginning of pregnancy, is associated with changes in the umbilical cord metabolome. In a sample of the Survey of Neonates in Pomerania (SNIP) birth cohort, the cord blood metabolome of n = 240 newborns of mothers with a ppBMI of <18.5 kg/m2 with n = 208 controls (ppBMI of 18.5-24.9 kg/m2) was measured by NMR spectrometry. A maternal ppBMI of <18.5 kg/m2 was associated with increased concentrations of HDL4 cholesterol, HDL4 phospholipids, VLDL5 cholesterol, HDL 2, and HDL4 Apo-A1, as well as decreased VLDL triglycerides and HDL2 free cholesterol. A ppBMI of <18.5 kg/m2 combined with poor intrauterine growth (a gestational weight gain (GWG) < 25th percentile) was associated with decreased concentrations of total cholesterol; cholesterol transporting lipoproteins (LDL4, LDL6, LDL free cholesterol, and HDL2 free cholesterol); LDL4 Apo-B; total Apo-A2; and HDL3 Apo-A2. In conclusion, maternal underweight at the beginning of pregnancy already results in metabolic changes in the lipid profile in the cord blood, but the pattern changes when poor GWG is followed by pre-pregnancy underweight.