Weight Percentile Research Articles

Elevated blood pressure among children born to women with obstructed labour in Eastern Uganda: a cohort study

BackgroundGlobally, high systolic blood pressure accounts for 10.8 million deaths annually. The deaths are disproportionately higher among black people. The reasons for this disparity are poorly understood, but could include a high burden of perinatal insults such as birth asphyxia. Therefore, we aimed to assess the incidence of elevated blood pressure and to explore associated factors among children born to women with obstructed labour.MethodsWe followed up children born to women with obstructed labour aged 25 to 44 months at Mbale regional referral hospital that had participated in the sodium bicarbonate trial ( Trial registration number PACTR201805003364421) between October 2021 and April 2022. Our primary outcome was elevated blood pressure defined as blood pressure (either systolic or diastolic or both) ≥ the 90th percentile for age, height, and sex in the reference population based on the clinical practice guideline for screening and management of high blood pressure in children and adolescents. We used logistic regression to estimate odds ratios between selected exposures and elevated blood pressure.ResultsThe incidence of elevated blood pressure was (39/140, 27.9%: 95% (CI: 20.6–36.1)). Participants aged three years and above had twice the odds of elevated blood pressure as those aged less than three years (Adjusted odds ratio (AOR) 2.46: 95% CI (1.01–5.97). Female participants had 2.81 times the odds of elevated blood pressure as their male counterparts (AOR 2.81 95% CI (1.16–6.82). Participants with reduced estimated glomerular filtration rate had 2.85 times the odds of having elevated blood pressure as those with normal estimated glomerular filtration rate (AOR 2.85 95% CI (1.00–8.13). We found no association between arterial cord lactate, stunting, wealth index, exclusive breastfeeding, food diversity and elevated blood pressure.ConclusionOur findings show a high incidence of elevated blood pressure among children. We encourage routine checking for elevated blood pressure in the pediatric population particularly those with known risk factors.

Interpregnancy interval and adverse birth outcomes: a population-based cohort study of twins

BackgroundTo investigate associations between interpregnancy intervals (IPIs) and adverse birth outcomes in twin pregnancies.MethodsThis retrospective cohort study of 9,867 twin pregnancies in Western Australia from 1980–2015. Relative Risks (RRs) were estimated for the interval prior to the pregnancy (IPI) as the exposure and after the pregnancy as a negative control exposure for preterm birth (< 37 weeks), early preterm birth (< 34 weeks), small for gestational age (SGA: < 10th percentile of birth weight by sex and gestational age) and low birth weight (LBW: birthweight < 2,500 g).ResultsRelative to IPIs of 18–23 months, IPIs of < 6 months were associated with a higher risk of early preterm birth (aRR 1.41, 95% CI 1.08–1.83) and LBW for at least one twin (aRR 1.16, 95% CI 1.06–1.28). IPIs of 6–11 months were associated with a higher risk of SGA (aRR 1.24, 95% CI 1.01–1.54) and LBW for at least one twin (aRR 1.09, 95% CI 1.01–1.19). IPIs of 60–119 months and ≥ 120 months were associated with an increased risk of preterm birth (RR 1.12, 95% CI 1.03–1.22; and (aRR 1.25, 95% CI 1.10–1.41, respectively), and LBW for at least one twin (aRR 1.17, 95% CI 1.08–1.28; and aRR 1.20, 95% CI 1.05–1.36, respectively). IPIs of ≥ 120 months were also associated with an increased risk of early preterm birth (aRR 1.42, 95% CI 1.01–2.00). After negative control analysis, IPIs ≥ 120 months remained associated with early preterm birth and LBW.ConclusionEvidence for adverse associations with twin birth outcomes was strongest for long IPIs.

Retrieval of Tree Height Percentiles over Rugged Mountain Areas via Target Response Waveform of Satellite Lidar

The retrieval of tree height percentiles from satellite lidar waveforms observed over mountainous areas is greatly challenging due to the broadening and overlapping of the ground return and vegetation return. To accurately represent the shape distributions of the vegetation and ground returns, the target response waveform (TRW) is resolved using a Richardson–Lucy deconvolution algorithm with adaptive iteration. Meanwhile, the ground return is identified as the TRW component within a 4.6 m ground signal extent above the end point of the TRW. Based on the cumulative TRW distribution, the height metrics of the energy percentiles of 25%, 50%, 75%, and 95% are determined using their vertical distances relative to the ground elevation in this study. To validate the proposed algorithm, we select the received waveforms of the Global Ecosystem Dynamics Investigation (GEDI) lidar over the Pahvant Mountains of central Utah, USA. The results reveal that the resolved TRWs closely resemble the actual target response waveforms from the coincident airborne lidar data, with the mean values of the coefficient of correlation, total bias, and root-mean-square error (RMSE) taking values of 0.92, 0.0813, and 0.0016, respectively. In addition, the accuracies of the derived height percentiles from the proposed algorithm are greatly improved compared with the conventional Gaussian decomposition method and the slope-adaptive waveform metrics method. The mean bias and RMSE values decrease by the mean values of 1.68 m and 2.32 m and 1.96 m and 2.72 m, respectively. This demonstrates that the proposed algorithm can eliminate the broadening and overlapping of the ground return and vegetation return and presents good potential in the extraction of forest structure parameters over rugged mountainous areas.

Left Ventricular Dysfunction Following Repair of Ventricular Septal Defects in Infants.

Left ventricular systolic dysfunction (LVSD) is frequently observed following repair of ventricular septal defects (VSD), although little is known about its incidence, time course, or risk factors. Among infants undergoing VSD repair, for postoperative LVSD, we sought to determine (1) incidence, (2) predictors, and (3) time to resolution. We queried our institution's surgical database for infants who underwent repair of isolated VSDs from November 2001 through January 2019. The primary outcome was postoperative LVSD, which was defined as a shortening fraction (SF) of <26% by M-mode. Postoperative echocardiograms were reviewed, and measurements were made using standard methods. Receiver operating characteristic analysis was generated to determine the preoperative left ventricular internal dimension (LVIDd) z-score most predictive of LVSD. Multivariable analysis was conducted to determine associations with LVSD; covariates in the model were weight percentile, genetic syndrome, preoperative diuretic, VSD type, and preoperative LVIDd z-score. Of the 164 patients who met inclusion criteria, 62 (38%) had postoperative LVSD. Fifty-eight (94%) of patients had resolution of LVSD within 9months of surgery. Preoperative LVIDd z-score of >3.1 was associated with both an increased incidence of postoperative LVSD and prolonged time to resolution. Multivariable logistic regression analysis showed only preoperative LVIDd z-score was independently associated with postoperative LVSD. LVSD following VSD closure is common, but nearly all cases resolve by 9months postoperatively. Elevated LVIDd prior to surgery is associated with postoperative LVSD. These data suggest VSD closure should be considered prior to the development of significant left ventricular dilation.

Identification of Larch Caterpillar Infestation Severity Based on Unmanned Aerial Vehicle Multispectral and LiDAR Features

Utilizing UAV remote sensing technology to acquire information on forest pests is a crucial technical method for determining the health of forest trees. Achieving efficient and precise pest identification has been a major research focus in this field. In this study, Dendrolimus superans (Butler) was used as the research object to acquire UAV multispectral, LiDAR, and ground-measured data for extracting sensitive features using ANOVA and constructing a severity-recognizing model with the help of random forest (RF) and support vector machine (SVM) models. Sixteen sensitive feature sets (including multispectral vegetation indices and LiDAR features) were selected for training the recognizing model, of which the normalized differential greenness index (NDGI) and 25% height percentile were the most sensitive and could be used as important features for recognizing larch caterpillar infestations. The model results show that the highest accuracy is SVMVI+LIDAR (OA = 95.8%), followed by SVMVI, and the worst accuracy is RFLIDAR. For identifying healthy, mild, and severely infested canopies, the SVMVI+LIDAR model achieved 90%–100% for both PA and UA. The optimal model chosen to map the spatial distribution of severity at the single-plant scale in the experimental area demonstrated that the severity intensified with decreasing elevation, especially from 748–758 m. This study demonstrates a high-precision identification method of larch caterpillar infestation severity and provides an efficient and accurate data reference for intelligent forest management.

Timing of cesarean delivery for fetal heart rate abnormalities in hypertensive pregnancies induced with oral misoprostol or Foley catheter: Secondary analysis of a randomized clinical trial.

The study aims to assess how oral misoprostol for cervical ripening affects the time of cesarean delivery (CD) for fetal heart rate (FHR) abnormalities in pre-eclampsia patients. Secondary goals include determining the role of uterine hyperstimulation, comparing misoprostol with Foley catheter, and identifying risk factors for FHR abnormalities associated with CD. A previously published randomized clinical trial was subjected to a secondary analysis (NCT01801410). We conducted a time-dependent analysis, stratifying the population based on the final mode of induction used (low-dose oral misoprostol vs Foley catheter). There was no CD for FHR abnormalities within 2 h of starting misoprostol. At 5 h, the cumulative incidence of CD for FHR abnormalities in the misoprostol group was 2.10%, while it was 1.00% in the Foley group (P = 0.565). After 25 h, the CD risk for FHR abnormalities remained constant in both groups at 21.00% (95% confidence interval [CI] 15.00%-28.00%). Within 5 h of misoprostol induction, the risk of uterine hyperstimulation was similar in both groups (0.33% in misoprostol vs 0.34% in Foley group, P = 0.161). The risk of CD for FHR abnormalities was unaffected by newborn weight centiles. There was no significant difference in CD risk for FHR abnormalities between misoprostol and Foley catheter induction. Nonetheless, the cumulative incidence of CD for FHR abnormalities increased faster in the misoprostol group, indicating that FHR monitoring timing should be tailored to the induction method.

The association between antenatal corticosteroids exposure and postnatal growth in infants born between 23 and 29 weeks of gestation.

To assess the association between antenatal corticosteroids exposure and postnatal growth in infants born at 23-29 weeks' gestation. This retrospective study used data from the Pediatrix Clinical Data Warehouse. Maternal-infant dyads from 2018 to 2020 were included. Inverse propensity weighting (IPW) was applied to balance pre-treatment confounders. Primary outcomes included postnatal weight, length, and head circumference growth trajectory percentiles. The unadjusted cohort consisted of 11,912 dyads. After IPW adjustment, there were 23,231 dyads. Exposed infants showed higher postnatal trajectory percentiles for weight (by 3.4%), length (by 1.8%), and head circumference (by 2.5%) when compared to non-exposed infants. The positive association between antenatal corticosteroids and postnatal growth was only observed in infants not exposed to preeclampsia/eclampsia/HELLP syndrome or without fetal growth restriction. Antenatal corticosteroids exposure is associated with better postnatal growth. The study is limited by its retrospective nature.

Association between anxiety and elevated blood pressure in adolescent patients: a single-center cross-sectional study.

Although anxiety is known to be associated with elevated blood pressure and hypertension in adults, this has not been studied in children. The aim of this study was to determine the association between anxiety and elevated blood pressures in adolescents. Adolescents, aged 12-18 years old, referred to the nephrology clinic were eligible to participate. Elevated blood pressure was defined as either SBP or DBP measurement above the 95th percentile for age, height, and sex. Participants were evaluated for anxiety using the validated Screen for Child Anxiety Related Disorders questionnaire filled independently by the child (SCARED-C) and parent (SCARED-P) evaluating the child. Two hundred adolescents participated in this study. Thirty-one (53%) of SCARED-P-positive participants were found to have elevated blood pressure compared with 27 (19%) of SCARED-P negative, P 0.03. Twenty-five (43%) of SCARED-P positive had elevated DBP compared with 31 (28%) of SCARED-P negative ( P 0.003). In SCARED-P positive, mean DBP (78.4 ± 9.9) was higher compared with SCARED-P negative (74.9 ± 9.2) ( P 0.03). In a subgroup of adolescents (№ 130) not treated with blood pressure medications mean DBP was higher in both SCARED-P (79.0 ± 10.1) and SCARED-C (77.1 ± 10.4) positive groups compared with SCARED-P (73.6 ± 9.3) and SCARED-C (73 ± 8.9) negative, respectively. Our study demonstrates an association between anxiety and elevated DBP in adolescent children. Screening adolescents for anxiety should be a part of the routine evaluation of adolescent children.

Pancreas agenesis and fetal growth: a semi-quantitative analysis.

Pancreas agenesis is a rare condition underlying a variant of permanent neonatal diabetes mellitus. Neonates with this condition are born small for gestational age, but less is known about which components of growth are impacted, the timing of the growth restriction and potential sex differences. Our objective was to assess in which periods in gestation complete pancreas agenesis restricts fetal growth and possible sex differences in susceptibility. Published cases (n=49) with pancreas agenesis providing relevant data (gestational age, fetal sex, birth weight, birth length, head circumference, placental weight) were identified by MEDLINE and secondary literature search covering the years 1950-January 2023. Semi-quantitative analysis of these case reports used centiles based on Intergrowth-21 reference charts. Neonates with pancreas agenesis were severely growth restricted, however, median centiles for birth weight, length and head circumference of those born before week 36 were significantly higher compared to those born from 36 weeks. Similar results were found when data were separated by before and from 38 weeks. Head circumference was less affected than birth weight or length. No sex differences were found. In conclusion, pancreas agenesis severely restricts fetal length and head circumference in addition to weight growth, with stronger effects evident from 36 weeks of gestation. In addition to the well-known effects of insulin on growth of fetal fat mass, the pronounced effect on birth length and head circumference indicates effects of insulin on fetal lean body growth as well. Lack of power may account for failure to find sex differences.

Impact of lockdown on the growth of children in China aged 3-6 years during the COVID-19 pandemic.

Lockdowns in COVID-19 pandemic led to less physical activity and more intake of unhealthy food in children. The aim of this study was to investigate the negative impact of major lockdowns on the growth of children aged 3-6 years during COVID-19 pandemic period. Physical examination results in 2019 to 2022 from 5834 eligible children (2972 males and 2862 females) from Southwestern China who were 3 years old in 2019 were retrospectively collected. Height and weight data points were extracted from the results, and percentiles of height (height%), weight (weight%), and BMI (BMI%), and rates of overweight and obesity were calculated and compared between different years during the pandemic. After analyzing the 15404 growth data points from 5834 children, a slowly increasing trend of height% from 2019 to 2022 was observed. Weight%, BMI%, overweight rate, obesity rate, and combined overweight and obesity rate had two peaks in 2020 and 2022 when major lockdowns were adopted and a drop in between (year 2021), except for obesity rate which did not drop in 2021. Similar results were shown after stratification by gender. The lockdowns in COVID-19 pandemic promoted obesity of kindergarten children, but did not show any negative impact on their height growth possibly due to over-nutrition of children during lockdowns. More efforts need to be made to limit the increase of obesity rate in kindergarten children during possible future lockdowns.

Rapid assessment of dose for large-scale individual: a feasibility study

In certain situations, it is crucial to quickly estimate the dose for radiation workers across different weight percentiles. This study sets out to create weight percentiles above 50 by adding proper adipose and muscle layers around the revised ORNL hermaphrodite phantom torso. Neutron fluence-to-organ absorbed and effective dose conversion coefficients were calculated to different weight percentiles. Simulations were performed in the energy range 10−9 to 20 MeV, under Six different source irradiation geometries: anterior–posterior (AP), posterior–anterior (PA), right-lateral (RLAT), left-lateral (LLAT), Rotation (ROT), and Isotropic (ISO) by MCNPX code. The maximum relative differences observed between the 50th and other percentiles ranged from 11% to 28%. Comparative analysis of the fluence-to-absorbed and effective dose conversion coefficients between the 95th percentile and VIPMAN indicated that approximately 58% and 57% of the data had a relative difference below 15%, respectively overall neutron energies and irradiation geometries. Our finding demonstrate that this straightforward method is reliable, especially when the whole body is irradiated in the energies above 1 MeV.

Estimation of Above Ground Carbon Stock Using Airborne Lidar in Yellapur Forest Division of Uttara Kannada District, Karnataka, India

The study was carried out at Yellapur Forest Division, Karnataka, with 86.97% forest area, exploring aboveground carbon (AGC) variations across different forest types and their correlation with LiDAR metrics. Ten one-hectare permanent plots were established, with 3 in dry and moist deciduous each, and 4 in semievergreen forests. All trees with &gt;30 cm girth at breast height were inventoried. AGC estimates were 308.28 mg ha–1 in semi-evergreen, 207.77 mg ha–1 in moist deciduous, and 117.88 mg ha–1 in dry deciduous forests. LiDAR data were acquired using a Nextcore Lumos XM120 UAV LiDAR system. In dry deciduous and moist deciduous forests, the 95th height percentile correlated strongly with observed AGC, yielding predicted AGC values of 118.56 mg ha–1 and 208.86 mg ha–1, with R2 values of 0.91 and 0.83, respectively. Conversely, in semi-evergreen forests, the 50th height percentile outperformed other metrics, resulting in a predicted AGC of 310.90 mg ha–1 (R2 =0.57).

The Relationship between Nutritional and Biochemical Markers with Growth Parameters in Adolescents with Chronic Kidney Disease on Maintenance Dialysis

Background: Adolescents with chronic kidney disease (CKD) undergoing maintenance dialysis often experience challenges related to nutritional and biochemical markers, which can impact their growth parameters. Understanding the association between these markers and growth outcomes is crucial for optimizing the management of CKD in this population. Objectives of the study: The objective of this study is to investigate the relationship between nutritional and biochemical markers and growth parameters in adolescents with CKD undergoing maintenance dialysis in a cross-sectional single-center setting. Methodology: Participants recruited for this study were children aged 12–18 years diagnosed with CKD 5 undergoing maintenance dialysis. The assessed nutritional and biochemical markers included dry weight, body mass index (BMI), caloric and protein intake, normalized protein catabolic rate (nPCR), total body fat percentage, muscle mass, serum albumin, blood urea nitrogen, serum creatinine, and C-reactive protein. Results: Twenty-six children were enrolled in the study (male: female – 1:1.6). Thirteen participants were from each treatment group (peritoneal dialysis and hemodialysis). Among them, twenty (76.9%) exhibited stunting, defined as a height percentile below the third percentile for the group’s population. Notably, patients with stunting showed a significant decrease in dry weight (37.4 kg vs. 54.7 kg, P &lt; 0.01) and BMI (17.3 kg/m2 vs. 22.3 kg/m2, P = 0.03). Serum creatinine levels were notably lower among patients with stunting compared to those with normal height percentiles (728 μmol/L vs. 969 μmol/L, P &lt; 0.01). Using bioelectrical impedance, muscle mass was noted to be significantly reduced in those with stunting compared to children with normal growth. Furthermore, a significant association was observed between nPCR and protein intake (P = 0.010). Conclusion and Recommendation: This study reveals a high prevalence of stunting in pediatric CKD patients on maintenance dialysis, suggesting compromised nutritional status. CKD patients with stunting exhibit reduced muscle mass and lower serum creatinine levels. Additionally, nPCR appears to be a useful marker for assessing protein adequacy. These findings highlight the need for early and regular monitoring of growth parameters, comprehensive biochemical assessments, and further research to enhance outcomes in pediatric CKD patients.

1057 Redefining birth weight centiles: Parity is more significant than gender

1057 Redefining birth weight centiles: Parity is more significant than gender

Evaluation of maternal serum fibroblast growth factor-23 levels in fetal growth restriction and gestational hypertensive disease.

The objective of this study was to determine serum fibroblast growth factor-23 levels in preeclampsia, eclampsia, gestational hypertension, and the presence of fetal growth restriction subgroups. A total of 55 pregnant women with planned cesarean section were included in this cross-sectional study. They were divided into two groups, namely, control (25) and gestational hypertensive disease (30). The gestational hypertensive disease group was evaluated by dividing it into three subgroups (preeclampsia, eclampsia, and gestational hypertension) according to the clinical and laboratory findings of the disease and two subgroups (presence of fetal growth restriction and absence of fetal growth restriction) according to the birth weight percentile. Demographic parameters, obstetric history, physical examination findings, and laboratory values were evaluated. Demographic parameters and obstetric history were similar between the two groups, while gestational week of delivery was lower in the gestational hypertensive disease group (p=0.002). Laboratory parameters and serum fibroblast growth factor-23 (pg/mL) values were similar between the two groups. In the subgroup analysis for gestational hypertension, preeclampsia, and eclampsia, there was no statistically significant difference in serum fibroblast growth factor-23 levels between gestational hypertension, preeclampsia, eclampsia, and control groups. In the subgroup analysis based on the presence of fetal growth restriction, serum fibroblast growth factor-23 levels were similar to the control group in the gestational hypertensive disease absence of fetal growth restriction, while serum fibroblast growth factor-23 levels and serum calcium levels were statistically significantly lower in the gestational hypertensive disease with the presence of fetal growth restriction (p=0.044 and p<0.001, respectively). Serum fibroblast growth factor-23 levels are similar between pregnancies complicated with gestational hypertensive disease and normotensive pregnancies. However, serum fibroblast growth factor-23 levels were found to be lower in pregnancies complicated with gestational hypertensive disease with the presence of fetal growth restriction.

تأثير خصائص التعبئة والتغليف على تقييم المستهلك للمنتجات الغذائية

The purpose of this study is to demonstrate the effect of packaging characteristics on consumer evaluation of food products. The questionnaire form prepared for this purpose included 20 questions for 149 consumers in Baghdad, regarding consumer awareness of the importance of packaging design, the impact of packaging materials from which the packaging is made, product characteristics, the influence of the brand and the country of origin on the consumer's purchasing decision, the results of questionnaire analyzed using percentages, weighted arithmetic mean and percentile weight, the results showed that the packaging characteristics of food products was effect on the purchasing decision for Iraqi consumer.

Growth and development impact of sustainable nutrition education: An experimental study.

Healthy societies are formed by learning and maintaining sustainable healthy eating behaviors from childhood. The aim of this study was to determine the effect of short-term sustainable nutrition education on growth and development parameters of preschool children. This study is an experimental design with pretest-posttest control group. This study was carried out in two kindergartens between February 2022 and June 2023 in Turkey. The education group received 4 months of dietary behavior training. The dietary scale and anthropometric measurements were administered at the first and last meetings. Data were analyzed with 95% confidence interval. The study was completed with 174 children. A statistically significant difference was found, especially in body weight (p<0.05) and body weight percentile values (p<0.05) in the posttest of the education group. A statistically significant difference (p<0.05) was found between the groups in the eating behavior scale posttest score. Nutrition education in schools is important in promoting healthy eating habits. Nutrition education improves eating behavior positively. To maintain healthy eating behaviors, however, the continuity of education is necessary. In addition, as growth and development are physical processes, it is recognized that growth and development cannot be assessed by nutrition alone.

Surface-based anthropomorphic bone structures for use in high-resolution simulated medical imaging

Objective. Virtual imaging trials enable efficient assessment and optimization of medical image devices and techniques via simulation rather than physical studies. These studies require realistic, detailed ground-truth models or phantoms of the relevant anatomy or physiology. Anatomical structures within computational phantoms are typically based on medical imaging data; however, for small and intricate structures (e.g. trabecular bone), it is not reasonable to use existing clinical data as the spatial resolution of the scans is insufficient. In this study, we develop a mathematical method to generate arbitrary-resolution bone structures within virtual patient models (XCAT phantoms) to model the appearance of CT-imaged trabecular bone. Approach. Given surface definitions of a bone, an algorithm was implemented to generate stochastic bicontinuous microstructures to form a network to define the trabecular bone structure with geometric and topological properties indicative of the bone. For an example adult male XCAT phantom (50th percentile in height and weight), the method was used to generate the trabecular structure of 46 chest bones. The produced models were validated in comparison with published properties of bones. The utility of the method was demonstrated with pilot CT and photon-counting CT simulations performed using the accurate DukeSim CT simulator on the XCAT phantom containing the detailed bone models. Main results. The method successfully generated the inner trabecular structure for the different bones of the chest, having quantiative measures similar to published values. The pilot simulations showed the ability of photon-counting CT to better resolve the trabecular detail emphasizing the necessity for high-resolution bone models. Significance. As demonstrated, the developed tools have great potential to provide ground truth simulations to access the ability of existing and emerging CT imaging technology to provide quantitative information about bone structures.

Predictors of parenting difficulties at the 18-month health checkups: A retrospective study using administrative data from infant health checkups.

This study aimed to identify predictors of parenting difficulties at 18 months from the results of the 4-, 6-7-, and 9-10-month infant health checkups among caregivers who had not experienced difficulties at 4 months. This retrospective study used data from infant health checkups conducted in a city in Tokyo from November 2019 to October 2021. The participants were caregiver-child dyads of children who had undergone four checkups. Low birthweight, preterm, and multiple birth infants, and caregivers who experienced difficulties at 4 months were excluded. Data included caregiver, child-rearing environment, and child factors at the 4-, 6-7-, and 9-10-month checkups and caregivers' self-reported parenting difficulties at the 18-month checkup. Of the 555 caregivers, 48 (8.6%) experienced parenting difficulties at 18 months. Logistic regression analyses showed that mothers' physical condition (4 months), children being male, abnormal child growth (4 months), less than 10th percentile for children's height (6-7 and 9-10 months), and abnormal examination results (6-7 months) were significantly associated with parenting difficulties at 18 months. To prevent child abuse, public health nurses should consider the identified factors to detect and support caregivers with emerging parenting difficulties.

Autopsy-Based Growth Charts May under-Detect Fetal Growth Restriction at Autopsy

Background: Accurate identification of fetal growth restriction in fetal autopsy is critical for assessing causes of death. We examined the impact of using a chart derived from ultrasound measurements of healthy fetuses (World Health Organization fetal growth chart) versus a chart commonly used by pathologists (Archie et al.) derived from fetal autopsy-based populations in diagnosing small-for-gestational-age (SGA) birth in perinatal deaths. Study Design: We examined perinatal deaths that underwent autopsy at BC Women’s Hospital, 2015-2021. Weight centiles were assigned using the ultrasound-based fetal growth chart for birthweight and autopsy-based growth chart for autopsy weight. Results: Among 352 fetuses, 30% were SGA based on the ultrasound-based fetal growth chart versus 17% using the autopsy-based growth chart (p < 0.001). Weight centiles were lower when using the ultrasound-based versus autopsy-based growth chart (median difference of 9 centiles [IQR 2, 20]). Conclusions: Autopsy-based growth charts may under-classify SGA status compared to ultrasound-based fetal growth charts.