Thickness In Infants Research Articles

Lens Thickness in Infants and Children with Cataracts

PurposeThe purpose of this study was to determine the association between lens thickness and cataract in subjects aged 0-5 years. DesignThis was a prospective multi-center case-control study. ParticipantsWe enrolled 118 participants (171 eyes) age 0-5 years old, mean age 14.6 ± 17.0 months, range 0 - 60 months. MethodsLens thickness was measured on 342 ultrasound biomicroscopy (UBM) images. Main Outcome MeasuresLens thickness; feasibility of lens thickness measurement from UBM images ResultsMean lens thickness among non-cataracts was 3.60 ± 0.17 mm, compared to 3.16 ± 0.61 mm among cataracts (p<0.0001). Lens thickness less than 3.5 mm was significantly associated with increased odds of cataract, adjusted OR=5.99 [2.41,14.88] (p=0.0003) among subjects age 0-7 months. Lens thickness was significantly associated with cataract laterality among subjects age 0-7 months (p<0.0001). ConclusionsQuantitative UBM can be used to evaluate lens thickness in infants and children with congenital cataracts. The lens in congenital cataract eyes was thinner than that of controls among infants. Abnormal lens thickness was significantly associated with cataract. Future longitudinal studies will examine the association between lens thickness and post-cataract surgery outcomes.

The impact of high-frequency transducers on the sonographic measurements of the pyloric muscle thickness in infants.

Ultrasound is the modality of choice for the diagnosis of hypertrophic pyloric stenosis (HPS). The evolution of high-frequency transducers in ultrasound has led to inconsistent ways of measuring the pylorus. To standardize the measurements and evaluate the appearance of the normal and hypertrophied pylorus with high-frequency transducers. We retrospectively analyzed abdominal ultrasounds of infants with suspected HPS from January 2019-December 2020. We classified the layers of the pylorus while assessing the stratified appearance. Two pediatric radiologists measured the muscle thickness of the pylorus independently by two methods for interrater agreement. Measurement (a) includes the muscularis propria and muscularis mucosa. Measurement (b) includes only the muscularis propria. We also evaluated the echogenicity of the muscularis propria. The interrater agreement, mean, range of the muscle thickness, and the diagnostic accuracy of the two sets of measurements were calculated. We included 300 infants (114F:186M), 59 with HPS and 241 normal cases. There was a strong agreement between the readers assessed in the first 100 cases, and ICC was 0.99 (95% CI, 0.98-0.99). Measurement (a), median thickness is 2.4mm in normal cases and 4.8mm in HPS. Measurement (b), median thickness is 1.4mm in normal cases and 4.0mm in HPS. Measurement (a) has an accuracy of 89.7% (95% CI, 85.7-92.8%) with 98.3% sensitivity and 87.6% specificity. Measurement (b) has an accuracy of 98.0% (95% CI, 95.7-99.3%) with 89.8% sensitivity and 100.0% specificity. The pylorus stratification is preserved in all normal cases and 31/59 (52.5%) cases of HPS. There was complete/partial loss of stratification in 28/59 (47.5%) cases of HPS. In all HPS cases, the muscularis propria was echogenic. Measuring the muscularis propria solely has a better diagnostic accuracy, decreasing the overlap of negative and positive cases. The loss of pyloric wall stratification and echogenic muscularis propria is only seen in HPS.

Sex-Based Differences in the Sonographic Characterization of Diaphragm Thickness in Preterm Infants With Bronchopulmonary Dysplasia at Term Corrected Age: A Secondary Analysis of a Prospective Study.

To determine the sex-specific diaphragm thickness in infants with bronchopulmonary dysplasia (BPD) as well as in healthy term and near-term infants. We performed a secondary analysis of an observational study to compare the sonographic diaphragm thickness at end expiration (DTexp) in female and male infants. The study included infants with BPD and healthy near-term and term infants. To account for differences in anthropometric measurements, we calculated the DTexp as a ratio of body surface area (BSA). Statistical analysis was performed using R statistical software. Of the 111 infants included, 54 (48.6%) were female. There were no significant differences in mean (SD) birth gestation [26.2 (2.1) vs 26.3 (2.1) weeks] and mean study age [38.0 (2.0) vs 37.4 (1.1) weeks] of male vs female infants with BPD. The mean (SD) DTexp [1.5 (0.4) mm vs 1.2 (0.3) mm, P = .02] and DTexp/BSA [8.3 (2.3) mm/m2 vs 6.7 (1.6) mm/m2, P < .01] were significantly thicker in female than male infants with BPD. In contrast, there were no significant differences in DTexp between sexes [1.5 (0.4) mm vs 1.5 (0.3) mm, P = .89] within the healthy control group. Moreover, there were no differences in inspiratory diaphragm thickness, diaphragm thickness fraction, or excursion between males and females in the BPD or healthy groups. Male infants with BPD exhibit thinner diaphragm thickness compared with female infants. Its implication on higher rates of BPD in preterm males is unclear, but this finding highlights the need for further investigation.

Epicardial fat thickness in infants of diabetic mothers.

Epicardial fat thickness (EFT) in adults and children has been related to the metabolic syndrome and other cardiovascular risk factors; however, scarce studies have evaluated it in infants of diabetic mothers (IDM) in whom, alterations in the thickness of the interventricular septum have been reported. This study compares the EFT in IDM versus infants of non-diabetic mothers (INDM) and its association with others echocardiographic parameters. We performed a cross sectional study in 93 infants (64 IDM and 29 INDM). To evaluate EFT dimensions, an echocardiogram was performed within the first 24h of extrauterine life in both groups. In diabetic mothers, HbA1c was also determined. There was no significant difference in birth weight between the groups although gestational age was lower in IDM. The EFT (3.6 vs. 2.5 mm, p < 0.0001), the interventricular septum thickness (IVST) (6.2 vs. 5.2 mm, p < 0.0001) and the IVST / left ventricle posterior wall (1.3 vs. 1.1, p = 0.001) were higher in the IDM; while the left ventricular expulsion fraction [LVFE] (71.1 vs. 77.8; p < 0.0001) was lower than in the INDM, respectively. We found a positive correlation between EFT with IVST (r = 0.577; p = 0.0001), LVPW (r = 0.262; p = 0.011), IVST/LVPW index (r = 0.353; p = 0.001), and mitral integral early velocity (r = 0.313; p = 0.002), while a negative correlation with LVFE was observed (r = -0.376; p = 0.0001). The EFT is higher in IDM than in INDM. It was positively related with echocardiographic parameters of left ventricular thickness and negatively with left ventricular ejection function.

Vitamin D and its correlation with blood lipids and intima-media thickness in term infants.

Background: an association between low 25(OH)D levels and blood lipids has been identified in children, adolescents, and adults but not in the early stages of life, and a relation to carotid and aortic intima-media thickness has not been well studied and is controversial. Objective: to identify whether 25(OH)D levels are correlated with blood lipids and aortic and carotid intima-media thickness in infants aged 3 to 9 months. Methods: a cross-sectional study was conducted in 109 healthy term infants between the ages of 3 and 9 months. Serum vitamin D [25(OH)D], total cholesterol, HDL-cholesterol, non-HDL-cholesterol, and aortic and carotid intima-media thickness were measured. Feeding method, vitamin D supplementation, and sun exposure habits were recorded. Results: only 2.8 % (n = 3) and 10.1 % (n = 14) had vitamin D deficiency and insufficiency, respectively. Infants with inadequate levels of vitamin D were younger (< 6 months) (p = 0.004), and a lower percentage of their body surface area was exposed to the sun (p = 0.006). A significant positive correlation was found between 25(OH)D levels and non-HDL-cholesterol in the infants that consumed breastmilk substitutes (rho = 0.600, p < 0.001) or were partially breastfed (rho = 0.371, p = 0.026), whereas a positive correlation was found with total cholesterol in the infants receiving breastmilk substitutes (rho = 0.618, p < 0.001). No significant correlation was found between vitamin D and aortic or carotid intima-media thickness. Conclusions: there was a positive correlation between 25(OH)D levels and both total and non-HDL-cholesterol only in infants receiving breastmilk substitutes. The frequency of vitamin D deficiency and insufficiency was low.

Risk factors during first 1,000 days of life for carotid intima-media thickness in infants, children, and adolescents: A systematic review with meta-analyses.

The first 1,000 days of life, i.e., from conception to age 2 years, could be a critical period for cardiovascular health. Increased carotid intima-media thickness (CIMT) is a surrogate marker of atherosclerosis. We performed a systematic review with meta-analyses to assess (1) the relationship between exposures or interventions in the first 1,000 days of life and CIMT in infants, children, and adolescents; and (2) the CIMT measurement methods. Systematic searches of Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), and Cochrane Central Register of Controlled Trials (CENTRAL) were performed from inception to March 2019. Observational and interventional studies evaluating factors at the individual, familial, or environmental levels, for instance, size at birth, gestational age, breastfeeding, mode of conception, gestational diabetes, or smoking, were included. Quality was evaluated based on study methodological validity (adjusted Newcastle-Ottawa Scale if observational; Cochrane collaboration risk of bias tool if interventional) and CIMT measurement reliability. Estimates from bivariate or partial associations that were least adjusted for sex were used for pooling data across studies, when appropriate, using random-effects meta-analyses. The research protocol was published and registered on the International Prospective Register of Systematic Reviews (PROSPERO; CRD42017075169). Of 6,221 reports screened, 50 full-text articles from 36 studies (34 observational, 2 interventional) totaling 7,977 participants (0 to 18 years at CIMT assessment) were retained. Children born small for gestational age had increased CIMT (16 studies, 2,570 participants, pooled standardized mean difference (SMD): 0.40 (95% confidence interval (CI): 0.15 to 0.64, p: 0.001), I2: 83%). When restricted to studies of higher quality of CIMT measurement, this relationship was stronger (3 studies, 461 participants, pooled SMD: 0.64 (95% CI: 0.09 to 1.19, p: 0.024), I2: 86%). Only 1 study evaluating small size for gestational age was rated as high quality for all methodological domains. Children conceived through assisted reproductive technologies (ART) (3 studies, 323 participants, pooled SMD: 0.78 (95% CI: -0.20 to 1.75, p: 0.120), I2: 94%) or exposed to maternal smoking during pregnancy (3 studies, 909 participants, pooled SMD: 0.12 (95% CI: -0.06 to 0.30, p: 0.205), I2: 0%) had increased CIMT, but the imprecision around the estimates was high. None of the studies evaluating these 2 factors was rated as high quality for all methodological domains. Two studies evaluating the effect of nutritional interventions starting at birth did not show an effect on CIMT. Only 12 (33%) studies were at higher quality across all domains of CIMT reliability. The degree of confidence in results is limited by the low number of high-quality studies, the relatively small sample sizes, and the high between-study heterogeneity. In our meta-analyses, we found several risk factors in the first 1,000 days of life that may be associated with increased CIMT during childhood. Small size for gestational age had the most consistent relationship with increased CIMT. The associations with conception through ART or with smoking during pregnancy were not statistically significant, with a high imprecision around the estimates. Due to the large uncertainty in effect sizes and the limited quality of CIMT measurements, further high-quality studies are needed to justify intervention for primordial prevention of cardiovascular disease (CVD).

Prospective Longitudinal Evaluation of the Peripheral Choroidal Thickness in High-Risk Infants with Retinopathy of Prematurity: A Pilot Study.

Objective The purpose of this study was to prospectively follow up the peripheral choroidal development and thickness for retinopathy of prematurity (ROP) in high-risk premature infants using optic coherence tomography. Materials and Methods All infants included in the analysis had an optical coherence tomography (OCT) evaluation, serially over 6 weeks, starting at the first ROP screening exam and at each follow-up screening exam. We included infants born at or earlier than 25 weeks of gestation, weighing less than 700 grams, and those who developed interventricular hemorrhage. We evaluated the choroidal thickness and development, centrally and at the extreme nasal and temporal periphery, for each eye with each ROP screening exam. Changes in the choroidal thickness and the choroidal thickness to retinal thickness ratio (C/R ratio) were evaluated over time not only for each individual infant, but between the infants as well. Results Six infants met our inclusion criteria. Infants with severe ROP had a mean choroidal thickness that was significantly thinner in the extreme temporal periphery than infants that did not develop significant ROP (P=0.02). The mean value of the C/R ratio was smaller in infants with severe ROP compared to those that did not develop any significant ROP at any of the evaluated locations (P < 0.001). Conclusion The peripheral choroid appears to be significantly thinner relative to the retinal thickness in infants with severe ROP.

Factors associated with increased atrial septum thickness in infants with Hypoplastic Left Heart Syndrome (HLHS)

Introduction: In the usual procedures performed on newborns affect by Hypoplastic Left Heart Syndrome (HLHS), phenotypic variations influence the success of the treatment, especially the characteristics related to the atrial septum and foramen ovale (FO) in case of catheter septostomy. Objectives: To analyze macroscopics features of the atrial septum of hearts with HLHS in order to define and guide therapeutic procedures on this structure. Methods: 18 hearts of deceased patients diagnosed with HLHS were evaluated for FO patency and size, bulging of its blade, atresia or patency of the mitral valve and caliber of the ascending aorta and pulmonary trunk. Histological sections of the atrial septum were made for measurements of maximum and minimum thickness of the lamina. Results: The mean age of the patients was 34.5 days (57% male), with a mean atrial septal thickness of 1.90 mm (0.63 - 4.09 mm). The mean diameter of the pulmonary trunk and aorta were 1.16 cm and 0.22 cm, respectively. FO was patent in 39% of cases. The mitral valve was atresic in 21% of the specimens. There was a significant difference in the thickness of the atrial septum in cases with patent or closed FO, being greater in cases where the FO was closed (p = 0.047). The ratio FO/age presented a statistically significant negative correlation with atrial septum thickness (r = -0.76 and p &lt;0.05). Conclusions: The results indicate that the patency and size of the oval foramen have repercussions on the thickness of the atrial septum, suggesting that this factor may limit the success of therapeutic interventions, especially catheter septostomy.

Factors associated with increased atrial septum thickness in infants with left heart hypoplasia syndrome

Introduction: Hypoplastic Left Heart Syndrome (HLHS) encompasses a spectrum of cardiac malformations characterized by underdevelopment of the left heart structures and aorta that, despite the low incidence among cases of congenital heart disease have high mortality rates. Phenotypic variations of the anomaly may influence the success of the interventional and surgical procedures, especially the characteristics related to the atrial septum and foramen ovale (FO), in cases where balloon catheter septostomy is necessary to maintain the interatrial shunt.Objectives: To analyze the gross features of the atrial septum of hearts with HLHS in order to define and guide therapeutic procedures on this structure, correlating them with other morphological alterations of the syndrome, such as the anatomy of the heart valves. Methods: We studied 18 hearts of patients diagnosed and deceased with HLHS, all belonging to the anatomic collection of the Laboratory of Pathology of the Heart Institute (InCor) HCFMUSP. The atrial septum was evaluated for FO patency and size, as well as for the presence of bulging of its lamina to one or the other atrial cavity. Other morphological features of the anatomical specimen such as atresia or patency of the mitral valve and caliber of the ascending aorta and pulmonary trunk were annotated. After resection of the atrial septum, histological sections were made for microscopic measurements of the maximum and minimum thickness of the lamina (atrial septum).Results: The mean age of the patients was 34.5 days (57% male), with a mean atrial septal thickness of 1.90 mm (0.63-4.09 mm). The mean diameter of the pulmonary trunk and aorta were 1.16 cm and 0.22 cm, respectively. FO was patent in 39% of cases (mean diameter 4,4 mm, range 4 to 8 mm), with bulging of the lamina to one of the atrial cavities in half of the cases. The mitral valve was atretic in 21% of the specimens. There was a significant difference in the mean thickness of the atrial septum in cases with patent versus closed FO, being thicker in cases where the FO was closed (p = 0.047). The ratio FO/age presented a statistically significant negative correlation with the atrial septum thickness (r = -0.76 and p &lt;0.05).Discussion and Conclusions: The results indicate that the patency and size of the oval foramen may influence the thickness of the atrial septum, suggesting that this factor may limit the success of therapeutic interventions, especially balloon catheter septostomy.

Analysis of gluteal subcutaneous and muscle thickness in infants and children for application to intramuscular injection, autologous fat grafting, and gluteal artery perforator flaps

BackgroundTo achieve improvements in intramuscular injection, autologous fat grafting, and gluteal artery perforator flaps in infants and children, the relationships of computed tomography (CT)-determined gluteal muscle thickness (MT) and subcutaneous tissue thickness (SCT) with age and body mass index (BMI) were analyzed.MethodsGluteal SCT and MT at ventrogluteal (VG) and dorsogluteal (DG) sites were measured in a standardized manner in 350 patients aged 0 to 6 years who had visited a tertiary hospital and had undergone abdominopelvic CT between January 2005 and December 2016. Recorded measurements were analyzed using one-way analysis of variance and stepwise multiple regression to identify the factors that were most closely related to MT and SCT.ResultsSubcutaneous tissue at VG sites was thinner than at DG sites, but not significantly so in any age group. Muscles tended to be thinner at VG sites in 4 to 7-year-old, but thicker at VG sites in 1 to 3-year-old, though the differences were not significant. MT in the VG and DG regions was found to be related to age, and SCT in these regions to be related to age and BMI.ConclusionsThe VG and DG sites should be considered as alternatives for intramuscular injection in infants and children when the anterolateral site is problematic. In addition, considering the gluteal MT and SCT of infants and children should help produce good results in autologous fat grafting and gluteal artery perforator flap harvesting.

Spatial Patterns, Longitudinal Development, and Hemispheric Asymmetries of Cortical Thickness in Infants from Birth to 2 Years of Age.

Cortical thickness (CT) is related to normal development and neurodevelopmental disorders. It remains largely unclear how the characteristic patterns of CT evolve in the first 2 years. In this paper, we systematically characterized for the first time the detailed vertex-wise patterns of spatial distribution, longitudinal development, and hemispheric asymmetries of CT at 0, 1, and 2 years of age, via surface-based analysis of 219 longitudinal magnetic resonance images from 73 infants. Despite the dynamic increase of CT in the first year and the little change of CT in the second year, we found that the overall spatial distribution of thin and thick cortices was largely present at birth, and evolved only modestly during the first 2 years. Specifically, the precentral gyrus, postcentral gyrus, occipital cortex, and superior parietal region had thin cortices, whereas the prefrontal, lateral temporal, insula, and inferior parietal regions had thick cortices. We revealed that in the first year thin cortices exhibited low growth rates of CT, whereas thick cortices exhibited high growth rates. We also found that gyri were thicker than sulci, and that the anterior bank of the central sulcus was thicker than the posterior bank. Moreover, we showed rightward hemispheric asymmetries of CT in the lateral temporal and posterior insula regions at birth, which shrank gradually in the first 2 years, and also leftward asymmetries in the medial prefrontal, paracentral, and anterior cingulate cortices, which expanded substantially during this period. This study provides the first comprehensive picture of early patterns and evolution of CT during infancy.

Skin thickness in young infants and adolescents: Applications for intradermal vaccination

As compared with standard intramuscular and subcutaneous vaccines, intradermal (ID) vaccines elicit a more potent immune response in both adults and children, with equivalent dosage or antigen dose sparing.Recently, various devices for ID injection have been developed; the length of needles ranges in 0.6–1.5mm. However, skin thickness must be measured to determine optimal needle length for ID vaccines. Use of ID vaccines in infants and children is appealing because children require more vaccines than do adults; however, information on skin thickness in infants and children is limited. We used ultrasound echography to measure skin thickness in Japanese infants aged 2 months (n=78) and adolescents aged 13–15 years (n=82). Mean (range) deltoid and suprascapular skin thickness was 1.67mm (1.16–2.39mm) and 1.83mm (1.24–2.60mm), respectively, in infants and 1.81mm (1.25–3.00mm) and 2.43mm (1.51–3.95mm), respectively, in adolescents. Among infants who underwent re-measurement of skin thickness at age 6 months (n=11), mean deltoid skin thickness (1.84mm) was significantly greater than at age 2 months (1.60mm) (P<0.001). In contrast, no significant difference was observed in suprascapular skin thickness (1.79mm vs. 1.67mm, respectively; P=0.17). Gender was not associated with skin thickness in either age group. Skin thickness was positively correlated with body weight in adolescents (r=0.43, P<0.001 in deltoid region; r=0.30, P=0.01 in suprascapular region). In conclusion, this is the first study to evaluate skin thickness in different age groups of children, including at age 2 months. Skin thickness gradually increased from age 2 months to age 13–15 years, but no consistent trend was noted in analysis stratified by measurement site, gender, or age. These findings suggest that an appropriate length of ID device needle for infants and children is likely to be less than 1.2mm and a special device with shorter length of needle is warranted for infants and children.

Spatial Patterns, Longitudinal Development, and Hemispheric Asymmetries of Cortical Thickness in Infants from Birth to 2 Years of Age

Spatial Patterns, Longitudinal Development, and Hemispheric Asymmetries of Cortical Thickness in Infants from Birth to 2 Years of Age

Parcellation of Infant Surface Atlas Using Developmental Trajectories of Multidimensional Cortical Attributes.

Cortical surface atlases, equipped with anatomically and functionally defined parcellations, are of fundamental importance in neuroimaging studies. Typically, parcellations of surface atlases are derived based on the sulcal-gyral landmarks, which are extremely variable across individuals and poorly matched with microstructural and functional boundaries. Cortical developmental trajectories in infants reflect underlying changes of microstructures, which essentially determines the molecular organization and functional principles of the cortex, thus allowing better definition of developmentally, microstructurally, and functionally distinct regions, compared to conventional sulcal-gyral landmarks. Accordingly, a parcellation of infant cortical surface atlas was proposed, based on the developmental trajectories of cortical thickness in infants, revealing regional patterning of cortical growth. However, cortical anatomy is jointly characterized by biologically-distinct, multidimensional cortical attributes, i.e., cortical thickness, surface area, and local gyrification, each with its distinct genetic underpinning, cellular mechanism, and developmental trajectories. To date, the parcellations based on the development of surface area and local gyrification is still missing. To bridge this critical gap, for the first time, we parcellate an infant cortical surface atlas into distinct regions based solely on developmental trajectories of surface area and local gyrification, respectively. For each cortical attribute, we first nonlinearly fuse the subject-specific similarity matrices of vertices' developmental trajectories of all subjects into a single matrix, which helps better capture common and complementary information of the population than the conventional method of simple averaging of all subjects' matrices. Then, we perform spectral clustering based on this fused matrix. We have applied our method to parcellate an infant surface atlas using the developmental trajectories of surface area and local gyrification from 35 healthy infants, each with up to 7 time points in the first two postnatal years, revealing biologically more meaningful growth patterning than the conventional method.

Effect of hyperglycaemia in pregnancy on adiposity in their infants in India: a protocol of a multicentre cohort study

IntroductionThe carbohydrate ‘fuel’ metabolism in a pregnant woman may have a long-term impact on the development of her offspring (‘fuel-mediated teratogenesis’ hypothesis) including in utero exposure to maternal hyperglycaemia leading...

ABSTRACT 410

Background and aims: M-mode sonography is a non-invasive method for detection of diaphragmatic movements. Few studies assessed diaphragmatic kinetics in children with diaphragmatic paralysis but no data about normal values in pediatrics are available. Aims: Determine reference values for diaphragmatic excursion and thickness, evaluated by ultrasonography in healthy infants and children and identify correlation between them and anthropometric measurements, age and sex. Methods: 400 healthy subjects aged between 1 month and 16 years, divided into 4 equal groups. Group 1 (1 month - 2 years), group 2 (2 - 6 years), group 3 (6 - 12 years) and group 4 (12 - 16 years) were studied. M-mode sonography was used to measure the excursion and thickness of right and left hemidiaphragm in supine position during quiet breathing. The study was approved by our institutional IRB. Results: Reference values for diaphragmatic excursion and thickness were determined in different age groups. There were no significant differences with respect to sex. Significant positive correlations were found between excursion of right and left hemidiaphragm in all age groups (r = 0.67; 0.50; 0.61; 0.37) for group 1; 2; 3; 4 respectively. Significant correlations were found between excursion and thickness of both hemidiaphragm and anthropometric measurements and age in group 1 only. Conclusions: This study provided normal reference values for diaphragmatic excursions and thickness in infants and children. Significant correlations were found between excursion and thickness of both hemidiaphragm and anthropometric measurements in infants but not in older children.

Is There a Relation Between Pyloric Muscle Thickness and Clinical and Laboratory Data in Infants with Hypertrophic Pyloric Stenosis?

Literature about the association between clinical and laboratory presentation and pyloric muscle thickness in infants with pyloric stenosis is lacking. The objective of this study is to examine the effect of pyloric muscle thickness on clinical and laboratory presentation in infants with pyloric stenosis. Thirty infants with hypertrophic pyloric stenosis presented at the Maternity and Children Hospital, Al-Madinah, Saudi Arabia, were included in this study analysis. Clinical and laboratory data of these infants were recorded. Statistical tests and univariate linear regression analyses were used as appropriate. P value was considered significant at a level ≤0.05. The mean age of the studied infant was 5.1 ± 2.6weeks and mean weight was 3.4 ± 0.7kg. Most of these infants were full-term (93.3%), some presented to the hospital dehydrated (80%), and some were lethargic (56.7%). The mean pyloric muscle thickness among these infants showed statistically significant difference with regard to the studied clinical and laboratory data. A linear regression analyses also showed positive association between increasing pyloric muscle thickness and almost all studied clinical and laboratory data, with statistically significant difference observed for hyponatremia, hypochloremia, and high bicarbonates. The findings suggest that pyloric muscle thickness is a significant factor that determines the severity of clinical and laboratory presentation in infants with pyloric stenosis.

1293 Umbilical Artery Intima-Media and Wall Thickness in Infants of Diabetic Mothers and its Relation to Maternal Hyperglycemia

BackgroundChildren who are large for gestational age at birth and exposed to an intrauterine environment of either diabetes or maternal obesity are at increased risk of developing metabolic syndrome. This...

Umbilical Artery Intima-Media and Wall Thickness in Infants of Diabetic Mothers

Background: Large for gestational age (LAG) neonates who had been exposed to an intrauterine environment of either diabetes or maternal obesity are at increased risk of developing the metabolic syndrome. This can be explained by exposure to high glucose and insulin levels in utero which alter fetal adaptation and programming. Objectives: The aim of the study was to evaluate the onset of preclinical atherosclerosis in utero. Methods: We measured umbilical artery wall thickness (ruWT) in the third trimester by obstetric ultrasound and umbilical artery intima-media thickness (uIMT) in pathologic specimens of umbilical cords obtained shortly after delivery and investigated the relation between these measurements and serum insulin level and C-peptide level in cord blood and assessed insulin resistance with the homeostasis model assessment of insulin resistance (HOMA-IR) in infants of diabetic mothers (IDMs), i.e. the study group, which was divided into a large for gestational age group (LGA)-IDM group and an appropriate for gestational age group (AGA)-IDM group and compared with a control group. Results: The LGA-IDM group had significantly higher insulin (p < 0.001), C-peptide (p = 0.018) and HOMA-IR levels (p < 0.001) compared with the AGA-IDM and control groups. The LGA-IDM group had significantly larger ruWT (p = 0.013) and uIMT (p < 0.001) compared with the AGA-IDM and the control groups. The LGA-IDM group had increased uIMT and ruWT that correlated with the severity of maternal hyperglycemia. Conclusions: Measurement of ruWT in the third trimester is feasible, reproducible and strongly correlated with pathological serum insulin, C-peptide in cord blood and HOMA-IR levels.

Absence of Increase in Carotid Artery Intima-Media Thickness in Infants of Diabetic Mothers

Objective: Infants of diabetic mothers (IDM) are considered as a risk group for atherosclerosis. Increased aortic intima-media thickness has been reported in IDM. The purpose of this study was to assess carotid artery intima-media thickness (CA-IMT), left ventricular mass index (LVMI) and atherosclerotic risk factors in IDM. Methods: Thirty IDM and 25 healthy controls were included in the study. Of these infants, 14 were appropriate-for-gestational age (AGA) and 16 were large-for-gestational age (LGA). CA-IMT and LVMI were obtained by M-mode echocardiographic examination. The relationship between parameters of atherosclerosis and echocardiographic measurements was assessed by Pearson’s correlation analysis. Results: LVMI was higher in LGA IDM when compared to AGA IDM and controls. CA-IMT was not significantly different between the groups and was also not related to atherosclerotic risk factors. Serum lipid and insulin levels were higher in LGA IDM when compared with AGA IDM and controls. There were no correlations between CA-IMT, LVMI and atherosclerotic risk factors. Conclusions: In contrast to previous reports indicating an increase in CA-IMT in IDM, no differences were found between IDM and controls in this study. Our results indicate that macrosomic IDM are prone to hypertrophic cardiomyopathy but not to atherosclerotic changes in the blood vessels. Conflict of interest:None declared.