Infant Growth Rates Research Articles

Adjusted versus Targeted Fortification in Extremely Low Birth Weight Preterm Infants: Fortin Study-A Randomized Clinical Trial.

Fortified human milk is the first choice for preterm infants. Although individualized fortification is recommended, the optimal method for this population remains uncertain. We conducted a comparative study assessing the growth effects of adjusted (AF) and targeted fortification (TF) in extremely low birth weight (ELBW) infants. This single-center, randomized, controlled clinical trial was conducted at a tertiary neonatal unit in Spain. Eligible participants were premature infants with a birthweight of <1000 g exclusively fed with human milk. A total of 38 patients were enrolled, 15 of them randomized to AF group and 23 to TF group. AF was based on blood urea nitrogen (BUN) concentration and TF on human milk analysis. The primary outcome was weight gain velocity (g/kg/day). No significant differences were found in weight gain velocity at 28 days, at 36 weeks of postmenstrual age, at discharge, nor during the intervention. Protein intake was significantly higher in the AF group (5.02 g/kg/day vs. 4.48 g/kg/day, p = 0.001). No differences were found in the lipid, carbohydrate, and energy intake; in the weight z score change between the different time points; nor in the length and head circumference growth. Both AF and TF are comparable methods of fortification and provide the appropriate growth rate in ELBW infants.

An investigation of association between human milk mineral patterns and infant growth.

Human milk is widely acknowledged as the optimal food for infant aged 0 ~ 6 months. While there has been extensive documentation on the mineral and trace element composition of human milk, results on the relationship between mineral content and infant growth remain mixed. This cross-sectional study aims to explore human milk mineral patterns and to investigate associations between human milk mineral patterns, human milk metabolomic profile and infant growth. A total of 200 breast milk samples from seven cities in China was included. Human milk mineral and trace elements was detected by inductively coupled plasma mass spectrometer (ICP-MS). K-means cluster analysis was utilized to derived human milk mineral patterns. Untargeted human milk metabolomic profiles was determined using high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Differences of infant growth rate and metabolomic profiles were then compared across patterns identified. Three human milk mineral patterns were identified. Cluster I was characterized as the highest levels of potassium, magnesium and calcium, while the lowest levels of copper, zinc, manganese and selenium. Cluster II showed the most abundant sodium, iron, zinc, manganese and selenium. Cluster III had the lowest levels of sodium, potassium, magnesium, iron and calcium. Infants of cluster I showed significantly higher length-for-age z score (0.60 ± 2.03, p = 0.03). Compared with other clusters, samples of cluster I showed lower expression of metabolites of arachidonic acid (ARA) and nicotinate and nicotinamide metabolism pathway. A human milk mineral pattern was identified which is related to increased infant growth rate and altered metabolic signature. Future work is needed to understand these human milk patterns in terms of biologic mechanisms and generalization to other populations.

Amniotic fluid cortisol predicts neonatal and infant development in non-stressed rhesus monkeys: Implications for prenatal stress

Prenatal stress adversely affects offspring development, with fetal cortisol (CORT) exposure being a primary hypothesized mechanism for stress-induced developmental deficits. Fetal CORT exposure can be assessed via measurements in amniotic fluid. However, in humans, amniocentesis is typically only performed for clinical reasons such as karyotyping; thus, amniotic fluid CORT cannot be obtained from a random sample. To test the hypothesis that fetal CORT exposure predicts neonatal and infant development in healthy primates, we measured amniotic fluid CORT in N = 18 healthy rhesus macaque (Macaca mulatta) dams (50:50 female:male infants) between 80 and 124 days gestation (mean ± SEM = 98.3 ± 2.9 days out of 165 days gestational length; i.e., second trimester). Maternal hair cortisol concentrations (HCCs) were assessed throughout pregnancy and lactation. Offspring were assessed for physical growth, neurological development, cognitive development, and HCCs across postnatal days 30–180. Controlling for gestational age at amniocentesis, higher amniotic fluid CORT significantly predicted slower infant growth rate (g/day) in the first 30 days (β = −0.19; R2 = 0.71, p = .008), poorer sensorimotor scores on the day 30 neonatal assessment (β = −0.28; R2 = 0.76, p = .015), and longer time to complete training (β = 0.48; R2 = 0.54, p = .026), but better performance (β = 0.91; R2 = 0.60, p = .011) on a discrimination cognitive task at 120–180 days. Amniotic fluid CORT was not associated with maternal or infant HCCs. Although these results are correlative, they raise the intriguing possibility that fetal CORT exposure in non-stress-exposed primates, as measured by amniotic fluid CORT, programs multiple aspects of neonatal and infant development. On the other hand, amniotic fluid CORT may not relate to chronic CORT levels in either mothers or infants when assessed by hair sampling.

Likelihood of obesity in early and late childhood based on growth trajectory during infancy

BackgroundChildhood obesity rates have reached epidemic levels with Mediterranean countries reporting among the highest numbers globally. Evidence suggests early life factors, including infant growth rate, increase the likelihood of obesity later in childhood. However, optimal rates of infant growth associated with lower odds of future obesity still remain undetermined. The study aim was to determine the optimal infant growth rate associated with a lower likelihood of childhood overweight and obesity.MethodsPerinatal and anthropometric data collected from 1778 Greek preschool (2–5 years old) and 2294 Greek preadolescent (10–12 years old) children participating in the ToyBox and the Healthy Growth Study (HGS) respectively, was combined for examination. Logistic regression models and receiver operating curves were used to determine the association between infant growth rate and development of childhood overweight and obesity, as well as optimal infant growth rate, respectively.ResultsRapid weight gain during the first 6 months of life was positively associated with overweight and obesity in preadolescent children (OR:1.36, 95% CI: 1.13–1.63). Optimal cut-off points for several infancy growth rate indices (i.e., WAZ, WLZ, HAZ, BAZ) associated with a lower likelihood of overweight and obesity in preschool years and preadolescence were also identified.ConclusionsThe current findings could possibly set the basis for healthcare professionals and families to better monitor, assess, and control infant growth rates, thus providing another obesity prevention strategy from early life. These findings, however, and the recommended optimal cut-offs need to be confirmed through further prospective research.

Epilepsy Severity Is Associated With Head Circumference and Growth Rate in Infants With Tuberous Sclerosis Complex

BackgroundAbnormal brain growth in tuberous sclerosis complex (TSC) reflects abnormalities in cellular proliferation and differentiation and results in epilepsy and other neurological manifestations. Head circumference (HC) as a proxy for brain volume may provide an easily tracked clinical measure of brain overgrowth and neurological disease burden. This study investigated the relationship between HC and epilepsy severity in infants with TSC. MethodsProspective multicenter observational study of children from birth to three years with TSC. Epilepsy data were collected from clinical history, and HC was collected at study visits at age three, six, nine, 12, 18, 24, and 36 months. Epilepsy severity was classified as no epilepsy, low epilepsy severity (one seizure type and one or two antiepileptic drugs [AEDs]), moderate epilepsy severity (either two to three seizure types and one to two AEDs or one seizure type and more than three AEDs), or high epilepsy severity (two to three seizure types and more than three AEDs). ResultsAs a group, children with TSC had HCs approximately 1 S.D. above the mean World Health Organization (WHO) reference by age one year and demonstrated more rapid growth than the normal population reference. Males with epilepsy had larger HCs than those without. Compared with the WHO reference population, infants with TSC and no epilepsy or low or moderate epilepsy had an increased early HC growth rate, whereas those with severe epilepsy had an early larger HC but did not have a faster growth rate. ConclusionsInfants and young children with TSC have larger HCs than typical growth norms and have differing rates of head growth depending on the severity of epilepsy.

The effect of educational support intervention including peer groups for infant care on the growth rates of infants, breastfeeding self-efficacy and quality of life of their mothers in Iran: study protocol

BackgroundMothers' knowledge about the infant's problems and will provide the necessary care can increase the mother's confidence in providing care for her infant and eliminate misconceptions in primiparous mothers. The present study will be conducted to evaluate the effect of educational support intervention including peer groups for infant care on the growth rates of infants, breastfeeding self-efficacy and quality of life of their mothers in Iran.MethodsThis quasi-experimental study is an educational support intervention protocol for infant care which will be conducted in two phases. The educational support program will be designed in the first phase. The program includes educational sessions on breastfeeding, growth and development of infants and care for children under 1 year of age in a virtual group where a physician, a nurse, a midwife and a healthcare provider are also present. Using the opinions of the experts, the peer group will discuss various points and the research team will finalize the program based on priorities. The second phase of the educational intervention will be conducted experimentally as a pretest–posttest design for the intervention and control groups.DiscussionThe present study will provide useful protocol about the effect of educational support intervention for infant care and the sharing of peer group experiences on infants' growth rates, breastfeeding self-efficacy, and quality of life of their mothers. The current educational package not only combines virtual education and peer experiences in strengthening the education of mothers, but also it can improve mothers' physical and mental health and reduce medical costs by using telephone follow-up in supporting of the mothers of infants.Trial registration: Registration of this randomized control trial has been completed with the Iranian Registry of Clinical Trials, IRCT20210913052457N1, registered 9/10/2021, https://www.irct.ir/trial/59093.

Linear growth of infants aged 0-6 months in breastfeeding mothers who consume Moringa oleifera leaf extract capsules: randomized controlled doubleblind design

The prevalence of stunting in children in Indonesia is still high. However, linear growth and infant growth rates are relatively rarely published. This study aimed to analyse the effect of linear growth and growth rate of infants aged 0-6 months exclusively breastfed on mothers who consumed Moringa leaf extract and Moringa leaf powder supplements. The design of this study was a randomized controlled Double-Blind Design. Subjects were divided into 35 intervention groups and 35 control groups. The intervention group was given Moringa extract capsules (3.2 g/day) and breastfeeding education, while the control group was given Moringa leaf powder capsules (3.2 g/day) and breastfeeding education for about 3 months. Infant growth was followed until the age of 6 months, the variables of infant growth were expressed in weight for age, body length for age and growth based on the nutritional status of the infant expressed in the Z score of weight for age (W/A), Z score of body length for age (BL/A), Z score of body weight for body length (BW/BL) and Z score of body mass index for age (BMI/A). Statistical analysis with paired T-test, Kolmogorov-Smirnov, and Exat Fisher Test. The results showed that the growth of body weight, body length, and BL/A were not different between the intervention group and the control group (p&gt;0.05). Especially for the Z score of BW/A, BW/BL, BMI/A found a difference between the intervention and control groups with a p-value &lt;0.05. The conclusion of the research is the growth rate of weight and length of infants aged 0-6 months were influenced by birth weight, infant morbidity, and exclusive breastfeeding status. The difference in the average deviation of the Z score value from the four anthropometric indices (BW/A, BW/BL, and BMI/A) roled in the administration of Moringa extract.

The growth rates and influencing factors of preterm and full-term infants: A birth cohort study.

This study aimed to explore the growth rates and influencing factors of the length and weight of preterm and full-term infants in the urban areas of Hubei province to provide a reference for child health and related clinical fields. A birth cohort study was used to analyze the growth rates and influencing factors of the length and weight of preterm and full-term infants using a multivariate regression analysis. The growth rates of the length and weight of preterm infants were significantly lower than those of full-term infants from birth to 3 months of age (P < .05), and gradually caught up to the level of full-term infants after 3 months of age (P > .05). Meanwhile, there were some influencing factors that had significant differences by their contribution to the growth rates of the length and weight of preterm and full-term infants. This study proposed that perinatal factors were attached more importance to the growth rates of preterm infants in the urban areas of Hubei province.

Predicting Exposure to Perfluorinated Alkyl Substances (PFAS) among US Infants.

PFASs have been detected in nearly every serum sample collected over the last two decades from US adults as part of the National Health and Nutrition Examination Survey (NHANES) and are commonly found in other data sets from around the world. However, less is known about infant PFAS exposures, primarily because the collection of infant serum samples is less common and frequently avoided. Cord blood samples are often preferred for chemical exposure assessments because this is thought to provide a good representation of infant serum concentrations, at least at the time of birth. In this paper, we will provide a statistical and probabilistic analysis of what can be expected for infants living in the US using NHANES from 2007 to 2008, which contains a rare subset of infant data. Regulatory efforts that require estimation of exposures among the very youth can be challenging, both because of a lack of data in general and because variability among this most vulnerable population can be uncertain. We report that US infant exposures are extremely common and that serum concentrations remain fairly constant, despite infant growth rates and relatively high caloric and fluid intake, with the possible exception of PFOS. Infant serum PFOS concentrations between months 1 and 3 are consistently higher than at less than one month, even though healthy infants at 1 and 2 months weigh more than they did at birth. This suggests that the babies are exposed to greater concentrations of PFOS after birth or that excretion kinetics differ for this PFAS.

Human Milk Metabolomics Are Related to Maternal Adiposity, Infant Growth Rate and Allergies: The Chinese Human Milk Project.

The metabolomic profiles of Chinese human milk have been poorly documented. The objective of the study was to explore associations between human milk metabotypes, maternal adiposity, infant growth patterns, and risk of allergies. Two hundred mother–infant dyads from seven cities were randomly selected from the Chinese Human Milk Project (CHMP). Untargeted human milk metabolomic profiles were determined using HPLC-MS/MS. Two human milk metabotypes were identified using principal component analysis. Principal component (PC) 1 was characterized by high linoleic acid metabolites with low purine nucleosides and metabolites of glutamate and glutathione metabolism. PC 2 was characterized by high glycerophospholipids and sphingomyelins content. Higher PC1 scores were associated with slower infant growth rate and higher ambient temperature (p < 0.05). Higher PC 2 scores were related to higher maternal BMI and increased risk of infant allergies (p < 0.05). Future work is needed to understand the biologic mechanisms of these human milk metabotypes.

Convex and Concave Model 3D Printing for Designing Right-side Bronchial Blocker for Infants.

It is technically challenging for pediatric anesthesiologists to use bronchial blocker (BB) to isolate the lungs of infants during thoracoscopic surgery. Further, BB currently sold in the market cannot match the anatomical characteristics of the infants, especially on the right main bronchus. It may easily cause poor exhaustion of the right upper lobe, which leads to interference with the thoracoscopic surgical field. The two dimensional reconstruction data of 124 normal infants’ airways were extracted from the medical image database of Beijing Children’s Hospital for statistical analysis. After using linear fitting and goodness-of-fit test, a good linear relationship was detected between infant age and various parameters related to aid in designing a new BB for infants (R2=0.502). According to the growth and development rate of infants, the DICOM files of airway CT scan of 7 infants aged 30, 60, 90, 120, 180, 270, and 360 days were selected to print non-transparent convex and transparent concave 3D models. The non-transparent convex model was precisely measured to obtain the important parameters for BB design infants only, to complete the design of BB, to generate the sample, and to verify the blocking effect of produced sample in transparent concave three-dimensional (3D) model.

Современные принципы организации питания недоношенных новорожденных с очень низкой и экстремально низкой массой тела

The growth rate of infants born preterm should match the growth rate of healthy fetuses of the same gestational age. However, despite many existing clinical guidelines and dietary protocols, preterm infants almost invariably experience postnatal growth restriction. To ensure optimal growth and development of preterm infants, it has become essential to revise nutritional strategies. For preterm infants with extremely low and very low birth weight, it is recommended to initiate parenteral nutrition within the first hours of life, as well as to initiate early enteral nutrition directly in the delivery room with mother’s colostrum using buccal and cotton swabs. If possible, to increase the volume of enteral nutrition, to enrich breast milk, preferably with liquid fortifiers and/or human milk-based fortifiers, and to optimize supplementation with additional minerals. This review presents the scientific rationale for nutrient requirements, practical recommendations and strategies for parenteral and enteral nutrition in preterm infants, current recommendations for initial and maximum macro- and micronutrient gestational requirements. Key words: parenteral nutrition, enteral nutrition, preterm infant, nutrients, micronutrients, breast milk fortifiers

Assessment of growth pattern of preterm infants up to a corrected age of 24 months.

To assess the growth of preterm infants up to a corrected age of 24 months, and to understand the growth trend and pattern of preterm infants. A preterm infant follow-up database was established based on the Internet Plus follow-up system. A total of 3 188 preterm infants who were born from April 2018 to April 2021 were enrolled. Their length, weight, and head circumference were recorded at birth and at the corrected ages of 1, 3, 6, 12, 18, and 24 months. The preterm infants were grouped by perinatal factors. The growth curves of these infants were plotted and compared with the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) standard and World Health Organization (WHO) standard. The weight, length, and head circumference curves of each group of preterm infants grouped by various perinatal factors all rose rapidly within the corrected age of 6 months, but the growth rate slowed down after the corrected age of 6 months. Based on the actual age for the groups of preterm infants with different gestational ages (<28 weeks, 28-31+6 weeks, 32-33+6 weeks, and 34-36+6 weeks), the length curve gradually coincided with the WHO curve after the actual age of 9 months (P=0.082), while for the preterm infants with a gestational age of <32 weeks, the weight and head circumference curves were significantly lower than the WHO curves (P<0.001). Based on the corrected age, the physical growth curve of preterm infants with different gestational ages (<28 weeks, 28-31+6 weeks, 32-33+6 weeks, and 34-36+6 weeks) basically coincided with each other (P>0.05). For the infants with extremely low birth weight and the small-for-gestational-age infants, the length, weight, and head circumference curves were significantly lower than those of the INTERGROWTH-21st standard and the WHO standard (P<0.05). The physical growth rate of preterm infants is faster within the corrected age of 6 months, and the growth rate slows down after the corrected age of 6 months. Preterm infants with a smaller gestational age need longer time to catch up in weight and head circumference. More attention should be paid to the physical growth of extremely preterm infants, extremely low birth weight infants, and small-for-gestational-age infants.

The Role of Pediatric Nutrition as a Modifiable Risk Factor for Precocious Puberty.

Puberty is a critical phase of growth and development characterized by a complex process regulated by the neuroendocrine system. Precocious puberty (PP) is defined as the appearance of physical and hormonal signs of pubertal development at an earlier age than is considered normal. The timing of puberty has important public health, clinical, and social implications. In fact, it is crucial in psychological and physical development and can impact future health. Nutritional status is considered as one of the most important factors modulating pubertal development. This narrative review presents an overview on the role of nutritional factors as determinants of the timing of sexual maturation, focusing on early-life and childhood nutrition. As reported, breast milk seems to have an important protective role against early puberty onset, mainly due to its positive influence on infant growth rate and childhood overweight prevention. The energy imbalance, macro/micronutrient food content, and dietary patterns may modulate the premature activation of the hypothalamic–pituitary–gonadal axis, inducing precocious activation of puberty. An increase in knowledge on the mechanism whereby nutrients may influence puberty will be useful in providing adequate nutritional recommendations to prevent PP and related complications.

The Effect of Growth Rate during Infancy on the Risk of Developing Obesity in Childhood: A Systematic Literature Review.

The prevalence of childhood obesity has been trending upwards over the last few decades. Recent evidence suggests that infant growth rate has the potential to increase the risk of obesity development during childhood. This systematic literature review aimed to summarise the existing evidence on the relationship between infant growth rate and subsequent childhood obesity. Studies were sought for that assessed the effect of infant growth rate on outcomes of overweight, obesity, BMI, waist circumference or body composition measures among a population group of children aged 2 to 12 years old. Data sources included PubMed, CINAHL, Web of Science and MedLine. Twenty-four studies were identified as eligible and included in this review, out of 2302 publications. The ADA Quality Checklist was used to assess the quality of individual studies. Ten studies received a positive result and 14 studies a neutral result. A narrative synthesis was completed to present study characteristics and results. Several independent positive associations were determined between rapid growth at different stages during infancy and overweight, obesity, BMI, waist circumference and body composition in childhood. Further investigation is required to determine if a specific period of infancy carries greater associations of risk with childhood outcomes. Determining an ideal rate of infants’ growth as a means to minimise the future risk of childhood obesity should be the focus of future research that will also inform early life obesity prevention strategies. Registration no.: CRD42021244029.

Growth Rates of Infants Randomized to Continuous Positive Airway Pressure or Intubation After Extremely Preterm Birth

To evaluate the effects of early treatment with continuous positive airway pressure (CPAP) on nutritional intake and in-hospital growth rates of extremely preterm (EPT) infants. EPT infants (240/7-276/7weeks of gestation) enrolled in the Surfactant Positive Airway Pressure and Pulse Oximetry Trial (SUPPORT) were included. EPT infants who died before 36weeks of postmenstrual age (PMA) were excluded. The growth rates from birth to 36weeks of PMA and follow-up outcomes at 18-22months corrected age of EPT infants randomized at birth to either early CPAP (intervention group) or early intubation for surfactant administration (control group) were analyzed. Growth data were analyzed for 810 of 1316 infants enrolled in SUPPORT (414 in the intervention group, 396 in the control group). The median gestational age was 26weeks, and the mean birth weight was 839g. Baseline characteristics, total nutritional intake, and in-hospital comorbidities were not significantly different between the 2 groups. In a regression model, growth rates between birth and 36weeks of PMA, as well as growth rates during multiple intervals from birth to day 7, days 7-14, days 14-21, days 21-28, day 28 to 32weeks PMA, and 32-36weeks PMA did not differ between treatment groups. Independent of treatment group, higher growth rates from day 21 to day 28 were associated with a lower risk of having a Bayley-III cognitive score <85 at 18-22months corrected age (P = .002). EPT infants randomized to early CPAP did not have higher in-hospital growth rates than infants randomized to early intubation.

PHYSICAL AND NEUROPSYCHIC DEVELOPMENT IN INFANTS DEPENDING ON THE VITAMIN D LEVEL IN THE UMBILICAL CORD BLOOD

In order to investigate the role of prenatal sufficiency of 25-hydroxyvitamin D3 (25(OH)D3) in the postnatal development of infants, a dynamic assessment of physical (PD) and neuropsychic development (NPD) was carried out in comparison with the level of 25(OH)D3 in umbilical cord blood in newborns, upon reaching 40 weeks of post-conceptual age (PCA); at 3, 6 and 12 months of corrected age (CA). Materials and Methods: A prospective observational study of 118 children born between 24 and 41 weeks of gestational age was carried out, of which 52 were premature (group 1) and 66 were term infants (group 2). Evaluation of 25(OH)D3 level in cord blood serum was carried out. using an immunochemical analyzer UniCel DxI600 Beckmancoulter, USA. To assess PD indicators (body weight, height, head circumference), the Intergrowth-21st nonparametric method was selected using an online postnatal growth calculator. NPD was assessed according to the CAT/CLAMS and Zhurba -Mastyukova's scales. Comparing the developmental age with the actual age, the developmental coefficient was calculated as a percentage, the value of which &gt;75 % indicated that the NPD corresponded to the actual or corrected age of the child. Research results and discussion: The median of the 25(OH)D3 indicator in the 1st group was 17,63 ng/l, 95 % CI / Q1-Q3: 10,07-21,39; in group 2 - 23,76 ng/l, 95 % CI / Q1-Q3: 17,2-39,34 (p &lt; 0,001). Severe deficiency of 25(OH)D3 (below 10 ng/ml) was observed more often in premature infants (25 %) and only in 9,1% of term infants (p = 0,03). A direct statistical dependence of the growth rates in both full-term and premature infants in compare of 25(OH)D3 in cord blood after they reach 12 months of CA (p = 0,049, p = 0,036, respectively) was proved. In the group of premature infants a statistically significant relationship between speech developmental disorders (coefficient of speech development CAT/CLAMS 75 % in compare of the age norm. The sensitivity and specificity of the method were 75,3 and 55 %, respectively. Conclusions: In order to produce preventive measures it is necessary to continue further study of low vitamin D prenatal supply influence on PD and NPD in the near and long-term prognosis in children.

Perinatal determinants of growth trajectories in children born preterm.

BackgroundA growing amount of evidence indicates in utero and early life growth has profound, long-term consequences for an individual’s health throughout the life course; however, there is limited data in preterm infants, a vulnerable population at risk for growth abnormalities.ObjectiveTo address the gap in knowledge concerning early growth and its determinants in preterm infants.MethodsA retrospective cohort study was performed using a population of preterm (< 37 weeks gestation) infants obtained from an electronic medical record database. Weight z-scores were acquired from discharge until roughly two years corrected age. Linear mixed effects modeling, with random slopes and intercepts, was employed to estimate growth trajectories.ResultsThirteen variables, including maternal race, hypertension during pregnancy, preeclampsia, first trimester body mass index, multiple status, gestational age, birth weight, birth length, head circumference, year of birth, length of birth hospitalization stay, total parenteral nutrition, and dextrose treatment, were significantly associated with growth rates of preterm infants in univariate analyses. A small percentage (1.32% - 2.07%) of the variation in the growth of preterm infants can be explained in a joint model of these perinatal factors. In extremely preterm infants, additional variation in growth trajectories can be explained by conditions whose risk differs by degree of prematurity. Specifically, infants with periventricular leukomalacia or retinopathy of prematurity experienced decelerated rates of growth compared to infants without such conditions.ConclusionsFactors found to influence growth over time in children born at term also affect growth of preterm infants. The strength of association and the magnitude of the effect varied by gestational age, revealing that significant heterogeneity in growth and its determinants exists within the preterm population.

Early life of Neanderthals

The early onset of weaning in modern humans has been linked to the high nutritional demand of brain development that is intimately connected with infant physiology and growth rate. In Neanderthals, ontogenetic patterns in early life are still debated, with some studies suggesting an accelerated development and others indicating only subtle differences vs. modern humans. Here we report the onset of weaning and rates of enamel growth using an unprecedented sample set of three late (∼70 to 50 ka) Neanderthals and one Upper Paleolithic modern human from northeastern Italy via spatially resolved chemical/isotopic analyses and histomorphometry of deciduous teeth. Our results reveal that the modern human nursing strategy, with onset of weaning at 5 to 6 mo, was present among these Neanderthals. This evidence, combined with dental development akin to modern humans, highlights their similar metabolic constraints during early life and excludes late weaning as a factor contributing to Neanderthals' demise.

The Effect of a General Healthy Lifestyle Intervention Delivered Around Pregnancy on Gestational Weight Gain and Infant Growth.

A life-course perspective emphasizes healthy behaviors before, during, and after pregnancy to support a multi-generational risk reduction in obesity for mothers and infants. Optimal timing, content, and dose of such interventions is not well defined. We conducted a nested cohort within a randomized trial to evaluate whether a healthy lifestyle intervention around pregnancy led to a "spill-over effect," including a healthier rate (kg/week) of maternal gestational weight gain, and infant growth during the first year. Study enrollment began in 2012, follow-up data collection completed in 2018, and the data were analyzed in 2019. The intervention focused on healthy maternal diet and physical activity but not pregnancy weight or infant feeding. Outcome data were abstracted from electronic medical records. Of the 165 women who became pregnant, 114 enrolled in the nested cohort. The average pre-pregnancy BMI was 29.6 (SD 5.1) kg/m2. Mixed effects models suggested clinically insignificant differences in both the rate of gestational weight gain (-0.02 kg/week; 95% CI -0.09, 0.06) and the rate of infant growth (difference at 1 year: -0.002 kg/cm; 95% CI -0.009, 0.005). A behavioral intervention that focused on overall maternal health delivered in the time around pregnancy did not result in a "spill-over effect" on healthy gestational weight gain or healthy infant growth during the first year of life. This study is registered at www.clinicaltrials.gov NCT01316653.