Similar Birth Weight Research Articles

Does the timing of postprandial glucose monitoring affect the obstetric and neonatal outcomes in patients with gestational diabetes? A prospective study comparing 1 and 2-h postprandial monitoring.

The aim of this study was to examine the obstetrical and neonatal outcomes in patients with gestational diabetes mellitus (GDM) who had postprandial glucose monitoring 1 vs. 2 h following meals. In this prospective cohort study, we included patients with GDM who were referred to our medical center between July 2019 and June 2021. Patients chose the timing of postprandial glucose monitoring based on their own preferences. Obstetrical and neonatal outcomes, as well as patient satisfaction, were compared between patients who performed postprandial glucose monitoring 1 and 2 h after meals (PPG1 vs. PPG2). The primary outcome was birth weight. The study was powered to detect a 250 g increase in birth weight. Overall, 99 patients were included: 50 in the PPG1 group and 49 in the PPG2 group. Baseline characteristics were comparable between the groups. Neonates in the PPG1 and PPG2 groups had similar birth weights (3319 ± 355 vs. 3319 ± 520 g, respectively, p = 0.99). Glycemic control, mode of delivery, gestational age at delivery, and satisfaction rates were also similar between the study groups. In patients with GDM, performing1 vs. 2 h following meals resulted in similar obstetrical and neonatal outcomes and similar satisfaction rates. We therefore recommend counseling patients to choose either strategy based on their personal preference.

Metagenomics-Metabolomics Exploration of Three-Way-Crossbreeding Effects on Rumen to Provide Basis for Crossbreeding Improvement of Sheep Microbiome and Metabolome of Sheep.

The objective of this experiment was to explore the effects of three-way hybridization on rumen microbes and metabolites in sheep using rumen metagenomics and metabolomics. Healthy Hu and CAH (Charolais × Australian White × Hu) male lambs of similar birth weight and age were selected for short-term fattening after intensive weaning to collect rumen fluid for sequencing. Rumen metagenomics diversity showed that Hu and CAH sheep were significantly segregated at the species, KEGG-enzyme, and CAZy-family levels. Moreover, the CAH significantly increased the ACE and Chao1 indices. Further, correlation analysis of the abundance of the top 80 revealed that the microorganisms were interrelated at the species, KEGG-enzyme, and CAZy-family levels. Overall, the microbiome significantly affected metabolites of the top five pathways, with the strongest correlation found with succinic acid. Meanwhile, species-level microbial markers significantly affected rumen differential metabolites. In addition, rumen microbial markers in Hu sheep were overall positively correlated with down-regulated metabolites and negatively correlated with up-regulated metabolites. In contrast, rumen microbial markers in CAH lambs were overall negatively correlated with down-regulated metabolites and positively correlated with up-regulated metabolites. These results suggest that three-way crossbreeding significantly affects rumen microbial community and metabolite composition, and that significant interactions exist between rumen microbes and metabolites.

Relationship between Rumen Microbial Differences and Phenotype Traits among Hu Sheep and Crossbred Offspring Sheep.

This experiment was conducted to investigate the effect of three-way hybrid sheep and Hu sheep on serum indicators, rumen fermentation, rumen enzyme activity, and microorganisms in sheep. Healthy and similar birth weights from three groups (Hu, n = 11; Charolais × Australian White × Hu, CAH, n = 11; Charolais × Dorper × Hu, CDH, n = 11) were selected to be fed by the ewes until 45 days of age. Subsequently, they were weaned intensively and underwent short-term fattening for 3 months along with selected male lambs fed intensively. During this period, they were fed and watered ad libitum. Blood and rumen fluid were collected and analyzed for serum indicators and rumen fluid microorganisms, enzyme activity, and VFA, respectively, at the end of the fattening period. Compared with Hu lamb, the offspring of the three-way hybrid lamb showed significant improvements in body weight, serum lactate dehydrogenase, and creatinine content. However, there was no significant effect on serum immunity and antioxidant indices. In addition, the rumen fluid volatile fatty acid (VFA) molar concentration and microcrystalline cellulose and lipase content were significantly lower in the three-way hybrid lamb compared to Hu lamb, but β-glucosidase, amylase, pepsin, and VFA molar ratio were not significantly affected. Subsequently, 16S rRNA sequencing diversity analysis revealed that three-way hybrid lamb significantly increased rumen microbial ACE and Chao1 indices compared to Hu lamb. Meanwhile, the abundance of Verrucomicrobiota and Synergistota significantly increased at the phylum level. Correlation analysis showed that Prevotella had the highest proportion, while Rikenellaceae_RC9_gut_group correlated most closely with others genus. The microbial communities isovaleric acid molar concentration and proportion were strongly correlated. In addition, there were significant differences in correlations between microbial communities and isobutyric acid, butyric acid and valeric acid content, and their molar proportion, but they were not significantly correlated with digestive enzymes. From the functional enrichment analysis, it was found that hybrid progeny were mainly enriched in the pyruvate metabolism, microbial metabolism in diverse environments, carbon metabolism, and quorum sensing pathways. In contrast, the Hu sheep were primarily enriched in the cysteine and methionine, amino sugar and nucleotide sugar, and biosynthesis of secondary metabolite pathways. These results suggest that hybridization can play a role in regulating organismal metabolism and improve animal production performance by influencing the structure and characteristics of microbial communities.

Neonatal Birth Weight With Daily Compared With Every-Other-Day Glucose Monitoring in Gestational Diabetes Mellitus: A Randomized Controlled Trial.

To assess whether universal use of every-other-day glucose monitoring in patients with gestational diabetes mellitus (GDM) resulted in similar birth weights and medication use and was preferred by the patient compared with traditional daily glucose monitoring. This was a noninferiority randomized controlled trial conducted at a single New York City hospital between April 2021 and May 2022. Patients with singleton pregnancies who were diagnosed with GDM after 20 weeks of gestation and had a minimum of 7 days of previous daily blood glucose testing were randomly assigned to test blood glucose values daily or every other day. The primary outcome was neonatal birth weight. We calculated a total sample size of 196 participants needed for noninferiority to be tested, assuming the mean birth weight in the every-other-day group, compared with the daily group, was no higher than the predefined noninferiority margin of 200 g (80% power and one-sided alpha of 0.05). Postrandomization characteristics, including blood glucose values and medication initiation and timing, were recorded. Satisfaction with treatment group was assessed using the validated Oxford Maternity Diabetes Treatment Satisfaction Questionnaire. A total of 197 patients were randomized: 98 in the daily group and 99 in the every-other-day group. Baseline characteristics were similar between groups. The mean neonatal birth weight was similar between groups (mean±SD 3,090±418 g among newborns in the daily group compared with 3,181±482 g among newborns in the every-other-day group). For the primary outcome, the every-other-day group was found to be noninferior to the daily group with an upper confidence limit for the mean difference in mean birth weight of 197 g, which was below the noninferiority margin of 200 g ( P =.046). Postrandomization, there were no significant differences in the number of patients who required medication, the gestational age at which medication was started, or the type of medication used. Average fasting and postprandial glucose values were similar between groups. There was an increase in adherence to treatment group in those randomized to every-other-day blood sugars, but no difference in patient satisfaction. In patients with GDM, testing blood glucose values every other day was as effective as testing daily, without apparent effects on birth weight, medication initiation, or glucose control. Reduced frequency of blood glucose monitoring might help decrease the emotional, physical, and financial burden experienced by patients with GDM. ClinicalTrials.gov , NCT04857073.

Effects of Lactobacillus rhamnosus Supplementation on Growth Performance, Immune Function, and Antioxidant Capacity of Newborn Foals.

This study aimed to explore the effects of Lactobacillus rhamnosus GG (LGG) supplementation on the growth performance, immune function, and antioxidant capacity of foals. Fifteen newborn foals with similar birth weight (51.67 ± 6.07 kg) and good health were randomly assigned to three groups: control group and test groups I and II, which were supplemented with 5.0 × 109 CFU/day and 1.0 × 1010 CFU/day LGG, respectively, for 150 days. LGG intake increased the daily body height (P < .01) and weight (P < .01) gain of foals aged 120 to 150 days. The foals' IgA (P < .05) and IgG (P < .01) plasma levels increased at 30 and 150 days, respectively, and IL-6 plasma level increased at 90 days (P < .01). Plasma total antioxidant capacity level was significantly higher in test group I than in the control and test group II at 30 days (P < .01), whereas glutathione peroxidase level was significantly higher in test group II than in the control and test group I at 30 days (P < .01). Both test groups had significantly higher superoxide dismutase level than the control group (P < .01) and significantly decreased malondialdehyde plasma level at 90 and 150 days (P < .05). Overall, our findings indicate that dietary supplementation of LGG can improve the growth performance, immune function, and antioxidant capacity of newborn foals.

Do neonatal birth weight thresholds for labor dystocia outcomes differ between short and normal stature women?

To determine if there is a correlation between maternal short stature and neonatal birth weight among women with adverse outcomes related to labor dystocia. The medical records of singleton deliveries with adverse obstetric outcomes related to labor dystocia during 2014-2020, in a single tertiary center, were reviewed. Outcomes included at least one of the following: cesarean delivery (CD) due to cephalopelvic disproportion (CPD), prolonged second stage, shoulder dystocia, third- or fourth-degree perineal tear. Maternal short stature was defined as height below the 10th centile (short stature group) and normal stature was defined as maternal height between the 10th and 90th centiles (normal stature group). Maternal and neonatal characteristics were compared between the groups. A total of 3295 women were included, among them, 307 in the short stature group (9.3%, height 1.52 ± 0.02 m) and 2988 in the normal stature group (90.7%, height 1.63 ± 0.04 m). Evaluating the entire cohort revealed similar neonatal birth weights comparing the short and normal stature groups. A subgroup analysis of women after CD due to CPD (n = 296) revealed lower neonatal birth weights in the short stature group (n = 31) compared with the normal stature group (n = 265) (3215 ± 411 vs 3484 ± 427 g, P = 0.001, respectively). Multivariable linear regression was performed for women who underwent CD due to CPD. After adjusting for obesity and diabetes mellitus, short stature and nulliparity were found to be independently associated with decreased neonatal birth weight (266 g less for short stature, P = 0.001, and 294 g less for nulliparity, P = 0.001). Among women with short stature, CD due to CPD occurs at lower neonatal birth weights.

Association of Age at Duodenal Atresia Repair With Outcomes: A Pediatric NSQIP Analysis

PurposeNeonates with duodenal atresia (DA) are often born prematurely and undergo repair soon after birth, while others are delayed to allow for growth until closer to term corrected gestational age (cGA). Premature infants have been demonstrated to experience worse outcomes, but it is unclear whether delaying surgery mitigates the increased morbidity. This study evaluates the association of timing of DA repair with postoperative morbidity. MethodsWe retrospectively evaluated neonates undergoing DA repair from the National Surgical Quality Improvement Program-Pediatric database (2015–2020). A multivariable regression analyzed factors associated with composite morbidity, including cGA and age in days of life (DOL) at surgery. A propensity score matched analysis was completed in premature neonates born at ≤35 weeks gestation to compare outcomes at similar birth gestational ages (bGA) and birth weight who underwent early (<7 DOL) versus delayed (≥7 DOL) repair. Results809 neonates were included with a median bGA of 36 weeks (IQR 34–38), birth weight of 2.46 kg (IQR 1.96–2.95), and DOL at surgery of 2 (IQR 1–5). Infants born ≤35 weeks represented 35.23% of the cohort. On multivariable analysis, increasing cGA at surgery was associated with decreased morbidity (OR: 0.91, CI [0.84, 0.99]), and increasing DOL at surgery was associated with increased morbidity (OR: 1.02, CI [1.00, 1.04]). On propensity score matched analysis, delayed repairs were associated with increased postoperative ventilation (6 days vs. 2 days, p < 0.05); however, there were no differences in composite or surgical morbidity between early and delayed repairs. ConclusionsMorbidity after DA repair in neonates ≤35 weeks cGA is primarily driven by non-surgical causes, but delaying surgery does not appear to mitigate the risks associated with prematurity. It seems reasonable to consider repair in neonates around 33–34 weeks gestation without prohibitive risk factors. Optimal timing of DA repair requires a delicate balance between these factors. Level of EvidenceLevel III. Type of StudyRetrospective Cohort Study.

Comparison of Outcomes of Less Invasive Surfactant Administration in Prematurely Born Infants in the Delivery Suite and the Neonatal Unit.

This study aimed to compare outcomes of infants who received less invasive surfactant administration (LISA) in the delivery suite (LISA-DS) with those who received LISA on the neonatal unit (LISA-NNU). A prospective cohort study was undertaken of all infants who received LISA in a single center. Clinical outcomes included admission temperature, the need for intubation, durations of invasive and noninvasive ventilation, length of hospital stay and the incidences of bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), retinopathy of prematurity (ROP), and requirement for home oxygen were compared between the two groups as were complications of the procedure. The 54 LISA-DS infants had similar gestational ages and birth weights to the 26 LISA-NNU infants (p = 0.732, 0.928, respectively). There were no significant differences between the admission temperatures (median [range]: 36.8 [36-38.7] vs. 36.8°C [36.4-37.7]; p = 0.451) or need for intubation in less than 72 hours of birth (28 vs. 23%, p = 0.656). The durations of invasive ventilation (median: 2 [0-65] vs. 1 [0-35] days; p = 0.188) and noninvasive ventilation (median: 37 [24-81] vs. 37 [3-225] days; p = 0.188) and the incidences of BPD (p = 0.818), IVH (p = 0.106), ROP (p = 0.526), and home oxygen requirement (p = 0.764) were similar. The percentage of successful first attempts with LISA (63 vs. 70%, p = 0.816) or associated with hypoxia episodes (32 vs. 42%, p = 0.194) did not differ significantly by site of administration. The outcomes of LISA performed on the DS were similar to those of LISA performed on the NNU. · Prematurely born infants who received LISA in the DS had comparable clinical outcomes to infants who received LISA on NNU.. · No significant differences in admission temperature was noticed in infants who received LISA, in DS versus NNU..

Anthropometrics of neonates born to mothers with PCOS with metformin or placebo exposure in utero.

Fetal growth may be affected by both maternal polycystic ovary syndrome (PCOS) and metformin therapy. Here, we explore the effect of intrauterine metformin exposure on birth anthropometrics of infants born to women with PCOS. We also investigated whether the effect of metformin on birth anthropometrics is modified by maternal pre-pregnancy body mass index, PCOS hyperandrogenic phenotype, serum androgen levels, preconception use of metformin and offspring sex. Additionally, we assessed newborn anthropometrics in relation to a national reference population. Individual data from three randomized controlled triasl were pooled. The randomized controlled trials investigated the effects of metformin in pregnant women with PCOS. In all, 397 and 403 were randomized to the metformin and placebo groups, respectively. A Scandinavian growth reference was used to calculate sex and gestational age adjusted z-scores. Linear regression models were used to estimate the effect of metformin on offspring z-scores of head circumference, birth length, birthweight, placental weight, body mass index, ponderal index and birthweight:placental weight ratio. S-testosterone, s-androstenedione, and s-sex-hormone binding globulin from four timepoints in pregnancy were analyzed. Compared with the PCOS-placebo group, newborns in the PCOS-metformin group had larger head circumference (head circumference z-score: mean difference = 0.25, 95% CI = 0.11- 0.40). This effect of metformin on head circumference z-score was particularly observed among offspring of overweight/obese mothers and mothers with hyperandrogenic PCOS-phenotype. We observed no difference in other anthropometric measures between the metformin and placebo groups or any clear interaction between maternal androgen levels and metformin. Newborns in the PCOS-placebo group were shorter than in the reference population (birth length z-score: mean = -0.04, 95% CI = -0.05 to -0.03), but head circumference and birthweight were similar. Larger head circumference was observed at birth in metformin-exposed offspring of mothers with PCOS. PCOS-offspring were also shorter, with a similar birthweight to the reference population, indirectly indicating higher weight-to-height ratio at birth.

1205-P: Abnormal Fetal Growth and Adverse Neonatal Outcomes in Pregnancies Affected by Both Gestational Diabetes and Hypertensive Disorders of Pregnancy

Objective: We evaluated how the co-occurrence of gestational diabetes (GDM) and hypertensive disorders of pregnancy (HDP) influence fetal growth and neonatal outcomes. Methods: In a retrospective study of 47720 singleton deliveries from a US medical center, we compared the incidence of appropriate for gestational age birthweight (AGA) in pregnancies affected by GDM alone, HDP alone, or both GDM and HDP (GDM/HDP) to that in pregnancies affected by neither disorder (Control) using generalized estimating equations (covariates: maternal age, parity, BMI, insurance type, race, marital status, and prenatal care site). Secondary outcomes were small for gestational age birthweight (SGA), large for gestational age birthweight (LGA), and a neonatal composite outcome (stillbirth, hypoglycemia, hyperbilirubinemia, respiratory distress, encephalopathy, preterm delivery, neonatal death, NICU admission). Results: Median [IQR] birthweight (BW) percentile in GDM/HDP (50 [24, 78], N=179) was similar to Control (50 [27, 73], N=35885), while GDM had increased (60 [35, 83], N=1322) and HDP had decreased (43 [18, 71], N=2749) BW percentiles. GDM (OR 0.8, P&amp;lt;0.001), HDP (OR 0.7, P&amp;lt;0.001), and GDM/HDP (OR 0.7, P=0.04) each had decreased odds of AGA. GDM had decreased SGA odds (OR 0.7, P=0.02) and increased LGA odds (OR 1.7, P&amp;lt;0.001). HDP had increased SGA odds (OR 2.0, P&amp;lt;0.001) and no difference in LGA odds (OR 0.99, P=0.914). While unadjusted rates of abnormal growth in GDM/HDP suggested that reduced AGA was due to excess LGA (14.5%) without excess SGA (7.3%), adjusted models suggested that both SGA (OR 1.3, P=0.33) and LGA (OR 1.4, P=0.12) contributed. GDM/HDP conferred the highest risk of neonatal morbidity (OR 3.4, P&amp;lt;0.001 compared to Control). Conclusion: Although pregnancies with GDM/HDP co-occurrence have a similar median birth weight to unaffected pregnancies, they carry an increased risk of abnormal fetal growth and neonatal morbidity. Disclosure C.A.Onuoha: None. T.Thaweethai: None. S.Hsu: None. C.C.M.Schulte: None. K.James: None. A.Kaimal: None. C.E.Powe: Consultant; Mediflix, Inc., Other Relationship; Wolters Kluwer Health.

Association between Birth Weight and Mortality over the Two First Months after Birth in Feline Species: Definition of Breed-Specific Thresholds.

In many species, low birth weight is identified as a major determinant for neonatal survival. The objectives of the present study were (i) to assess, in a large feline purebred population, the impact of birth weight on 0-2 months mortality in kittens, and (ii) if such mortality occurs, to define cut-off values for birth weight to identify at-risk kittens. Data from 5596 kittens from 15 breeds and provided by 194 French breeders were analysed. A logistic mixed model was used to identify low birth weight, being a male, and being born in a large litter as significant risk factors for kitten mortality during the first two months after birth. Classification and regression tree analysis was used to define the thresholds, first at the species level and, when possible, at the breed level. Two thresholds were defined to group kittens into three categories: low, moderate, or high risk of 0-2 months mortality (normal, low, and very low birth weight, respectively). In our population, 19.7% of the kittens were classified as low birth weight and 1.9% as very low birth weight. Critical thresholds may differ between breeds with similar birth weight distributions and equivalent mortality rates (e.g., Russian Blue/Nebelung vs. Egyptian Mau). These critical birth weight thresholds, established in 15 breeds, could be used to identify kittens requiring more intensive nursing to improve survival.

Role of Environmental Discrimination on Birth Weight: A Systematic Examination in a Sample of Black, Latina, and White Women in the Phoenix Metropolitan Area [ID: 1341491

INTRODUCTION: Health inequities begin before birth, with Black women being more likely to have low-birth-weight babies than White and Latina women. The purpose of this study is to examine the relationship of discrimination (environmental, vicarious, and daily) on birth weight in Black, Latina, and White women. METHODS: This study utilized medical records and face-to-face interviews to examine the role of discrimination on birth weight (controlling for gestational age and assigned sex). Data analysis involved multiple linear regression. The spatial relationship between environmental discrimination and mean birth weights from neighborhoods in Phoenix was examined using heat maps that layer environmental discrimination onto geographic locations. Institutional review board approval was obtained from St. Joseph Medical Center. RESULTS: In this sample of 329 patients, Black women reported the lowest birth weight (M 3,268.25, SE 65.61), with Latina (M 3,313.99, SE 33.91) and White (M 3,327.98, SE 39.23) women reporting similar birth weights. Only environmental discrimination emerged as a significant predictor of baby’s birth weight (b=−67.57, SE 25.99, P=.01), such that greater perceived environmental discrimination was related to lower birth weight. Environmental discrimination was compared to geographic areas in the Phoenix metropolitan area using zip code data and a comparison of these regions showed statistically significant differences in experiences of environmental discrimination based on geographic location (P=.010). CONCLUSION: Women experiencing high rates of environmental discrimination had lower birth weight babies. These experiences were localized to geographic areas within the Phoenix metropolitan area. These findings may help better target resources to specific centers to overcome the issues that influence how people experience their environment.

Slow Development of a Day 5 Fresh Transferred Embryo Leads to Reduced Live Birth Rate but Not Birthweight: A Multicenter Retrospective Cohort Study

Objective: This study aims to investigate the impact of slow embryo development on the subsequent live birth rate and birthweight outcomes following a fresh day 5 transfer. Study design: This retrospective multicenter cohort study included 1,213 consecutive patients undergoing autologous oocyte in vitro fertilization (IVF) treatment at four associated private clinics during 2016–2019. Only fresh single day 5 transfers were included for analysis. Results: No implantation was achieved by embryos that failed to reach the early blastocyst stage on day 5 ([Formula: see text]). After adjusting for potential confounding factors, multivariate logistic regression (expressed as adjusted odds ratio or aOR and [Formula: see text] confidence interval) showed a significantly reduced live birth rate in early blastocysts ([Formula: see text]) in reference to those at the expanding (aOR = 0.584, [Formula: see text], [Formula: see text], [Formula: see text]), expanded (aOR = 0.322, [Formula: see text], [Formula: see text], [Formula: see text]), or hatching/hatched stages (aOR = 0.255, [Formula: see text], [Formula: see text], [Formula: see text]). However, early blastocysts led to similar birthweights ([Formula: see text], [Formula: see text]) in comparison to those at the expanding ([Formula: see text], [Formula: see text], [Formula: see text]), expanded ([Formula: see text], [Formula: see text], [Formula: see text]), or hatching/hatched stages ([Formula: see text], [Formula: see text], [Formula: see text]). This was further confirmed by linear regression analysis using either birthweight or [Formula: see text] score (gestation-adjusted birthweight). Conclusion: Slow day 5 development is associated with reduced live birth rate when transferred fresh, however, subsequent birthweight is not impacted once pregnancy is initiated.

Clinical characteristics and risk factors for early-onset necrotizing enterocolitis in preterm infants with very/extremely low birth weight

To investigate the clinical characteristics and risk factors for early-onset necrotizing enterocolitis (NEC) in preterm infants with very/extremely low birth weight (VLBW/ELBW). A retrospective analysis was performed on the medical data of 194 VLBW/ELBW preterm infants with NEC who were admitted to Children's Hospital Affiliated to Zhengzhou University from January 2014 to December 2021. These infants were divided into early-onset group (onset in the first two weeks of life; n=62) and late-onset group (onset two weeks after birth; n=132) based on their onset time. The two groups were compared in terms of perinatal conditions, clinical characteristics, laboratory examination results, and clinical outcomes. Sixty-two non-NEC infants with similar gestational age and birth weight who were hospitalized at the same period as these NEC preterm infants were selected as the control group. The risk factors for the development of early-onset NEC were identified using multivariate logistic regression analysis. Compared with the late-onset group, the early-onset group had significantly higher proportions of infants with 1-minute Apgar score ≤3, stage III NEC, surgical intervention, grade ≥3 intraventricular hemorrhage, apnea, and fever or hypothermia (P<0.05). The multivariate logistic regression analysis showed that feeding intolerance, blood culture-positive early-onset sepsis, severe anemia, and hemodynamically significant patent ductus arteriosus were independent risk factors for the development of early-onset NEC in VLBW/ELBW preterm infants (P<0.05). VLBW/ELBW preterm infants with early-onset NEC have more severe conditions compared with those with late-onset NEC. Neonates with feeding intolerance, blood culture-positive early-onset sepsis, severe anemia, or hemodynamically significant patent ductus arteriosus have a higher risk of early-onset NEC.

Risk factors and clinical outcomes of extubation failure in very early preterm infants: a single-center cohort study

BackgroundEarly extubation success (ES) in preterm infants may reduce various mechanical ventilation-associated complications; however, extubation failure (EF) can cause adverse short- and long-term outcomes. Therefore, the present study aimed to identify differences in risk factors and clinical outcomes between ES and EF in very early preterm infants.MethodsThis retrospective study was conducted between January 2017 and December 2021. Premature infants born at 32 weeks’ gestational age in whom extubation had failed at least once were assigned to the EF group. Successfully extubated patients with a similar gestational age and birth weight as those in the EF group were assigned to the ES group. EF was defined as the need for re-intubation within 120 h of extubation. Various variables were compared between groups.ResultsThe EF rate in this study was 18.6% (24/129), and approximately 80% of patients with EF required re-intubation within 90.17 h. In the ES group, there was less use of inotropes within 7 days of life (12 [63.2%] vs. 22 [91.7%], p = 0.022), a lower respiratory severity score (RSS) at 1 and 4 weeks (1.72 vs. 2.5, p = 0.026; 1.73 vs. 2.92, p = 0.010), and a faster time to reach full feeding (18.7 vs. 29.7, p = 0.020). There was a higher severity of bronchopulmonary dysplasia BPD (3 [15.8%] vs. 14 [58.3%], p = 0.018), longer duration of oxygen supply (66.5 vs. 92.9, p = 0.042), and higher corrected age at discharge (39.6 vs. 42.5, p = 0.043) in the EF group. The cutoff value, sensitivity, and specificity of the respiratory severity score (RSS) at 1 week were 1.98, 0.71, and 0.42, respectively, and the cutoff value, sensitivity, and specificity of RSS at 4 weeks were 2.22, 0.67, and 0.47, respectively.ConclusionsEF caused adverse short-term outcomes such as a higher BPD severity and longer hospital stay. Therefore, extubation in very early preterm infants should be carefully evaluated. Using inotropes, feeding, and RSS at 1 week of age can help predict extubation success.

Effects of milk replacer feeding level on growth performance, rumen development and the ruminal bacterial community in lambs.

Feeding with a suitable level of milk replacer (MR) can improve the survival rate and stimulate the growth potential of early lambs. However, feeding excessive MR might be detrimental to rumen development and microbial colonization. Herein, we investigated the effects of feeding different levels of MR on rumen digestive function and ruminal microorganisms. Fourteen healthy male Hu lambs with similar birth weights and detailed pedigree records were divided into two groups to receive low (2% of average body weight per day) and high (4% of average body weight per day) levels of MR. We analyzed the effects of the MR feeding level on growth performance, fiber degradation rates, rumen fermentation parameters, enzyme activities and rumen histomorphology. We found that feeding with a high level of MR improved the average daily gain of early lambs, but decreased the starter intake, rumen weight and papillae length. We also analyzed the effects of the MR feeding level on the rumen microbiota using 16S-rRNA amplicon sequencing data. The results showed that high a MR feeding level increased the rumen microbial diversity but decreased the abundance of many carbohydrate degrading bacteria. Several bacterial genera with significant differences correlated positively with rumen cellulase activity and the acid detergent fiber degradation rate. Our results suggested that a high level of MR could improve the growth performance of early lambs in the short term; however, in the long term, it would be detrimental to rumen development and have adverse effects on the adaptation process of the microbiota to solid feed.

Feasibility and Impact of a Pilot Neonatal Cuddler Program on Preterm Infants in the Neonatal Intensive Care Unit.

Preterm infants experience daily stress in the neonatal intensive care unit (NICU). Positive sensory experiences mitigate stress responses, but parental participation can be limited by external pressures. This study aimed to describe the impact of a neonatal cuddler program (NCP) on preterm infants' growth. A multidisciplinary program trained volunteers to interact with NICU infants when family was not at bedside. Infants were followed prospectively throughout admission. Intervention data included frequency, type, and duration of activity throughout the study period. Student t-test and chi-square test were used to analyze the impact of volunteer interaction on anthropometric measures at discharge. Forty-five infants interacted with a volunteer (intervention group, n = 45) compared with the control group (n = 56) following coronavirus disease 2019 restrictions. The median (range) time of interaction with a volunteer in the intervention group was 90.0 (5.0-705.0) minutes per infant. Infants in the two groups had similar gestational ages, birth weights, lengths, and occipitofrontal circumferences (OFC). Infants in the intervention group had higher rates of spontaneous intestinal perforation, bronchopulmonary dysplasia, and reached full enteral feeds later. However, rates of severe intraventricular hemorrhage, retinopathy of prematurity, and duration of mechanical ventilation were similar. Infants in the two groups did not differ in the NICU length of stay. At discharge, infants in the intervention group weighed more (p = 0.04) and had higher OFC's (p = 0.01) and OFC z-scores (p = 0.03). The change in z-scores from birth to discharge was significant for the weight (p = 0.02) but not length or OFC. In regression analyses, only group allocation was identified as a significant factor for OFC z-scores at discharge (β= 0.279, p = 0.011) and for change in weight z-scores from birth to discharge (β = 0.226, p = 0.041). Growth is positively impacted by an NCP despite limited interaction. Additional work is needed to demonstrate the impact on neurobehavioral and developmental outcomes. · Establishing and implementing a neonatal cuddler program in a large, level IV NICU is feasible.. · Neonatal cuddler programs can provide positive sensory experiences when parents are not at bedside.. · Even limited exposure to these positive sensory experiences can positively impact growth parameters for preterm infants..

Supplementation with paraformic acid in the diet improved intestinal development through modulating intestinal inflammation and microbiota in broiler chickens.

The aim of this study was to explore the effects of supplementing paraformic acid (PFA) to the diet of broiler chickens on intestinal development, inflammation, and microbiota. A total of 378 healthy 1-day-old Arbor Acres broilers with similar birth weight were used in this study, and randomly assigned into two treatment groups. The broiler chickens were received a basal diet or a basal diet supplemented with 1,000 mg/kg PFA. Results showed that PFA supplementation increased (P < 0.05) small intestinal villus height and villus height/crypt depth ratio, elevated intestinal mucosal factors (mucin 2, trefoil factor family, and zonula occludens-1) concentrations, and upregulated mNRA expression of y + L amino acid transporter 1. Moreover, PFA supplementation decreased (P < 0.05) the concentrations of inflammatory cytokines (tumor necrosis factor-alpha, interleukin-1beta, interleukin-6, and interleukin-10), activities of caspase-3 and caspase-8, and mNRA expressions of Toll-like Receptor 4, nuclear factor-kappa B, Bax, and Bax/Bcl-2 ratio in small intestinal mucosa. Dietary PFA supplementation also increased (P < 0.05) alpha diversity of cecal microbiota and relative abundance of Alistipes. The present study demonstrated that supplementation of 1,000 mg/kg PFA showed beneficial effects in improving intestinal development, which might be attributed to the suppression of intestinal inflammation and change of gut microbiota composition in broiler chickens. These findings will aid in our knowledge of the mechanisms through which dietary PFA modulates gut development, as well as support the use of PFA in poultry industry.

Comparison of Vitamin D Levels and Related Factors in Pregnant Women and Neonates Exposed to Second-Hand Smoke.

Introduction: Exposure to second-hand smoke, a significant public health issue today, may lead to various health problems, especially in pregnant women and their infants. Low vitamin D levels during pregnancy may lead to preeclampsia and gestational diabetes in the mother, while it may cause low birth weight and respiratory problems in the infant.Method: The study group consisted of 42 mothers, who smoked regularly, and their infants and 45 mothers (passive smokers), who were regularly exposed to second-hand smoke in their home environment, although they did not smoke, and their infants. Meanwhile, the control group consisted of 46 healthy mothers, who did not smoke and were not exposed to second-hand smoke at home, and their infants with similar gestational age and birth weight. Blood samples were taken as two different samples, from the mother and the baby, and 25-hydroxyvitamin D (25(OH)D) and related blood parameters were studied and compared statistically.Results: 25(OH)D, calcium, and magnesium levels of mothers who smoked were significantly lower than those who were exposed to second-hand smoke and those who did not. Moreover, the vitamin D levels of mothers and babies exposed to second-hand smoke in the non-smoker group were significantly lower than mothers and babies who were not exposed to second-hand smoke. In the babies of these three groups, a significant decrease was observed only in vitamin D levels.Conclusion: The present study shows that pregnant women and their infants exposed to second-hand smoke have lower vitamin D levels. Hence, more emphasis should be put on vitamin D monitoring and supplementation to prevent severe health problems in pregnant women and their infants exposed to tobacco smoke. Further studies are needed to assess the associated risks for maternal and fetal health as well as possible long-term implications for the infant.

Pregnancy-Induced Hypertension: The Potential Role of Cholesterol Crystals in the Maternal Decidua

Lead Author's Financial Disclosures Quest Diagnostics. Study Funding None. Background/Synopsis Pregnancy-induced hypertension/preeclampsia are highly concerning complications of pregnancy, known risk factors for cardiovascular disease including endothelial dysfunction, proteinuria, elevated blood pressure, and presence of atherogenic very small LDL cholesterol particles. Cholesterol crystals (CCs) can form at sites of elevated cholesterol deposition including at the maternal uterine decidua in preparation for embryo implantation. However, CCs can injure the endothelial surfaces of arteries leading to vasospasm - with subsequent placental ischemia - important in the development of hypertension/preeclampsia. Objective/Purpose: Since dyslipidemia is associated with pregnancy complications we sought to determine if CCs are present in the post-delivery decidual tissue attached to the placenta in patients who developed a hypertensive disorder during their pregnancy in the Child Health Advances through Research with Mothers (CHARM) study. Methods Maternal decidua was dissected from placental tissues from both normal (n=5) and late gestational age hypertensive disorder in pregnancy cases (n=5). Cases were of similar gestational age, birth weight, and race. Tissues were prepared by avoiding ethanol to preserve CCs and then examined by scanning electron microscopy (SEM). Two sample runs were performed by SEM and tissues were scored in a blinded manner for presence or absence of CCs. Results Presence of CCs was detected in decidual placental specimens in 4/5 pregnancy- induced hypertensive disorder cases and 2/5 from normal gestational age-matched pregnancies. By SEM both needle and rhomboid forms (representing the anhydrous and monohydrate version of CCs) were found (Figure). Conclusions The presence of CCs in the maternal decidua is a critical finding. CCs are known to trigger an inflammatory response and cause arterial vasospasm. Although preliminary, this is an important finding that could be mechanistically critical in the development of hypertensive disorders of pregnancy. Quest Diagnostics.