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Rudar M, Naberhuis JK, Suryawan A, Nguyen HV, Fiorotto ML, Davis TA. Prematurity blunts protein synthesis in skeletal muscle independently of body weight in neonatal pigs. Pediatr Res 2023:10.1038/s41390-022-02456-3. [PMID: 36627358 DOI: 10.1038/s41390-022-02456-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 11/30/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Postnatal growth failure in premature infants is associated with reduced lean mass accretion. Prematurity impairs the feeding-induced stimulation of translation initiation and protein synthesis in the skeletal muscle of neonatal pigs. The objective was to determine whether body weight independently contributes to the blunted postprandial protein synthesis. METHODS Preterm and term pigs that were either fasted or fed were stratified into quartiles according to birth weight to yield preterm and term groups of similar body weight; first and second quartiles of preterm pigs and third and fourth quartiles of term pigs were compared (preterm-fasted, n = 23; preterm-fed, n = 25; term-fasted, n = 21; term-fed, n = 21). Protein synthesis rates and mechanistic target of rapamycin complex 1 (mTORC1) activation in skeletal muscle were determined. RESULTS Relative body weight gain was lower in preterm compared to term pigs. Prematurity attenuated the feeding-induced increase in mTORC1 activation in longissimus dorsi and gastrocnemius muscles (P < 0.05). Protein synthesis in gastrocnemius (P < 0.01), but not in longissimus dorsi muscle, was blunted by preterm birth. CONCLUSION A lower capacity of skeletal muscle to respond adequately to feeding may contribute to reduced body weight gain and lean mass accretion in preterm infants. IMPACT This study has shown that the feeding-induced increase in protein synthesis of skeletal and cardiac muscle is blunted in neonatal pigs born preterm compared to pigs born at term independently of birth weight. These findings support the notion that preterm birth, and not low birth weight, impairs the capacity of skeletal and cardiac muscle to upregulate mechanistic target of rapamycin-dependent anabolic signaling pathways and protein synthesis in response to the postprandial increase in insulin and amino acids. These observations suggest that a blunted anabolic response to feeding contributes to reduced lean mass accretion and altered body composition in preterm infants.
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Affiliation(s)
- Marko Rudar
- Department of Animal Sciences, Auburn University, Auburn, AL, USA
| | - Jane K Naberhuis
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Agus Suryawan
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Hanh V Nguyen
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Marta L Fiorotto
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Teresa A Davis
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
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Wołejszo S, Genowska A, Motkowski R, Strukcinskiene B, Klukowski M, Konstantynowicz J. Insights into Prevention of Health Complications in Small for Gestational Age (SGA) Births in Relation to Maternal Characteristics: A Narrative Review. J Clin Med 2023; 12:jcm12020531. [PMID: 36675464 PMCID: PMC9862121 DOI: 10.3390/jcm12020531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/29/2022] [Accepted: 01/06/2023] [Indexed: 01/11/2023] Open
Abstract
Small for gestational age (SGA) births are a significant clinical and public health issue. The objective of this review was to summarize maternal biological and socio-demographic factors and preventive strategies used to reduce the risk of SGA births. A literature search encompassing data from the last 15 years was conducted using electronic databases MEDLINE/PubMed, Google Scholar and Scopus to review risk factors and preventive strategies for SGA. Current evidence shows that primiparity, previous stillbirths, maternal age ≤24 and ≥35 years, single motherhood, low socio-economic status, smoking and cannabis use during pregnancy confer a significant risk of SGA births. Studies on alcohol consumption during pregnancy and SGA birth weight are inconclusive. Beneficial and preventive factors include the "Mediterranean diet" and dietary intake of vegetables. Periconceptional folic acid supplementation, maternal 25-hydroxyvitamin D, zinc and iron levels are partly associated with birth weight. No significant associations between COVID-19 vaccinations and birthweight are reported. A midwifery-led model based on early and extensive prenatal care reduces the risk of SGA births in women with low socio-economic status. Major preventive measures relate to the awareness of modifiable and non-modifiable risk factors of SGA, leading to changes in parents' lifestyles. These data support that education, monitoring during pregnancy, and implementing preventive strategies are as important as biological determinants in risk reduction of SGA births.
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Affiliation(s)
- Sebastian Wołejszo
- Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, University Children′s Hospital, 15-274 Bialystok, Poland
- Correspondence: (S.W.); (A.G.)
| | - Agnieszka Genowska
- Department of Public Health, Medical University of Bialystok, 15-295 Bialystok, Poland
- Correspondence: (S.W.); (A.G.)
| | - Radosław Motkowski
- Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, University Children′s Hospital, 15-274 Bialystok, Poland
| | | | - Mark Klukowski
- Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, University Children′s Hospital, 15-274 Bialystok, Poland
| | - Jerzy Konstantynowicz
- Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, University Children′s Hospital, 15-274 Bialystok, Poland
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Zhang F, Zhang X, Zhong Y, Zhu S, Zhao G, Zhang X, Li T, Zhang Y, Zhu W. Joint Exposure to Ambient Air Pollutants Might Elevate the Risk of Small for Gestational Age (SGA) Infants in Wuhan: Evidence From a Cross-Sectional Study. Int J Public Health 2023; 67:1605391. [PMID: 36686387 PMCID: PMC9849243 DOI: 10.3389/ijph.2022.1605391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/16/2022] [Indexed: 01/06/2023] Open
Abstract
Objective: To investigate the effect of exposure to multiple ambient air pollutants during pregnancy on the risk of children being born small for gestational age (SGA). Methods: An Air Pollution Score (APS) was constructed to assess the effects of being exposed to six air pollutants simultaneously, PM2.5, PM10, SO2, NO2, CO, and O3 (referred to as joint exposure). A logistic regression model was applied to estimate the associations of APS and SGA. Results: The adjusted odds ratios (ORs) of SGA per 10 ug/m3 increased in APS during the first and second trimesters and the entire pregnancy were 1.003 [95% confidence intervals (CIs): 1.000, 1.007], 1.018 (1.012, 1.025), and 1.020 (1.009, 1.031), respectively. The ORs of SGA for each 10 μg/m3 elevated in APS during the whole pregnancy were 1.025 (1.005, 1.046) for mothers aged over 35 years old vs. 1.018 (1.005, 1.031) for mothers aged under 35 years old. Women who were pregnant for the first time were more vulnerable to joint ambient air pollution. Conclusion: In summary, the results of the present study suggested that joint exposure to ambient air pollutants was associated with the increment in the risks of SGA.
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Affiliation(s)
- Faxue Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
| | - Xupeng Zhang
- Department of Public Health, School of Public Health, Wuhan University, Wuhan, China
| | - Yuanyuan Zhong
- Department of Obstetrics and Gynecology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shijie Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
| | - Gaichan Zhao
- Department of Public Health, School of Public Health, Wuhan University, Wuhan, China
| | - Xiaowei Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
| | - Tianzhou Li
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
| | - Yan Zhang
- Department of Obstetrics and Gynecology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,*Correspondence: Yan Zhang, ; Wei Zhu,
| | - Wei Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China,*Correspondence: Yan Zhang, ; Wei Zhu,
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Jafri L, Khan AH, Ilyas M, Nisar I, Khalid J, Majid H, Hotwani A, Jehan F. Metabolomics of a neonatal cohort from the Alliance for Maternal and Newborn Health Improvement biorepository: Effect of preanalytical variables on reference intervals. PLoS One 2023; 18:e0279931. [PMID: 36607993 PMCID: PMC9821480 DOI: 10.1371/journal.pone.0279931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 12/18/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The study was conducted to determine reference interval (RI) and evaluate the effect of preanalytical variables on Dried blood spot (DBS)-amino acids, acylcarnitines and succinylacetone of neonates. METHODOLOGY DBS samples were collected within 48-72 hours of life. Samples were analyzed for biochemical markers on tandem mass spectrometer at the University of Iowa. Comparison of RI across various categorical variables were performed. RESULTS A total of 610 reference samples were selected based on exclusion criteria; 53.2% being females. Mean gestational age (GA) of mothers at the time of delivery was 38.7±1.6 weeks; 24.5% neonates were of low birth weight and 14.3% were preterm. Out of the total 610 neonates, 23.1% were small for GA. Reference intervals were generated for eleven amino acids, thirty-two acylcarnitines and succinylacetone concentrations. Markers were evaluated with respect to the influence of gender, GA, weight and time of sampling and statistically significant minimal differences were observed for some biomarkers. CONCLUSION RI for amino acids, succinylacetone and acylcarnitine on DBS has been established for healthy neonates, which could be of use in the clinical practice. Clinically significant effect of GA, weight, gender and time of sampling on these markers were not identified.
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Affiliation(s)
- Lena Jafri
- Department of Pathology and Laboratory Medicine, Chemical Pathology, Aga Khan University, Karachi, Pakistan
- * E-mail: (LJ); (FJ)
| | - Aysha Habib Khan
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Muhammad Ilyas
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Imran Nisar
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Javairia Khalid
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Hafsa Majid
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Aneeta Hotwani
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Fyezah Jehan
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
- * E-mail: (LJ); (FJ)
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Groten T, Lehmann T, Städtler M, Komar M, Winkler JL, Condic M, Strizek B, Seeger S, Jäger Y, Pecks U, Eckmann-Scholz C, Kagan KO, Hoopmann M, von Kaisenberg CS, Brodowski L, Tauscher A, Schrey-Petersen S, Friebe-Hoffmann U, Lato K, Hübener C, Delius M, Verlohren S, Sroka D, Schlembach D, de Vries L, Kraft K, Seliger G, Schleußner E. Effect of pentaerythritol tetranitrate (PETN) on the development of fetal growth restriction in pregnancies with impaired uteroplacental perfusion at midgestation-a randomized trial. Am J Obstet Gynecol 2023; 228:84.e1-84.e12. [PMID: 35931132 DOI: 10.1016/j.ajog.2022.07.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 07/12/2022] [Accepted: 07/16/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Fetal growth restriction is strongly associated with impaired placentation and abnormal uteroplacental blood flow. Nitric oxide donors such as pentaerythritol tetranitrate are strong vasodilators and protect the endothelium. Recently, we demonstrated in a randomized controlled pilot study a 38% relative risk reduction for the development of fetal growth restriction or perinatal death following administration of pentaerythritol tetranitrate to pregnant women at risk, identified by impaired uterine perfusion at midgestation. Results of this monocenter study prompted the hypothesis that pentaerythritol tetranitrate might have an effect in pregnancies with compromised placental function as a secondary prophylaxis. OBJECTIVE This study aimed to test the hypothesis that the nitric oxide donor pentaerythritol tetranitrate reduces fetal growth restriction and perinatal death in pregnant women with impaired placental perfusion at midgestation in a multicenter trial. STUDY DESIGN In this multicenter, randomized, double-blind, placebo-controlled trial, 2 parallel groups of pregnant women presenting with a mean uterine artery pulsatility index >95th percentile at 19+0 to 22+6 weeks of gestation were randomized to 50-mg Pentalong or placebo twice daily. Participants were assigned to high- or low-risk groups according to their medical history before randomization was performed block-wise with a fixed block length stratified by center and risk group. The primary efficacy endpoint was the composite outcome of perinatal death or development of fetal growth restriction. Secondary endpoints were neonatal and maternal outcome parameters. RESULTS Between August 2017 and March 2020, 317 participants were included in the study and 307 were analyzed. The cumulative incidence of the primary outcome was 41.1% in the pentaerythritol tetranitrate group and 45.5% in the placebo group (unadjusted relative risk, 0.90; 95% confidence interval, 0.69-1.17; adjusted relative risk, 0.90; 95% confidence interval, 0.69-1.17; P=.43). Secondary outcomes such as preterm birth (unadjusted relative risk, 0.73; 95% confidence interval, 0.56-0.94; adjusted relative risk, 0.73; 95% confidence interval, 0.56-0.94; P=.01) and pregnancy-induced hypertension (unadjusted relative risk, 0.65; 95% confidence interval, 0.46-0.93; adjusted relative risk, 0.65; 95% confidence interval, 0.46-0.92; P=0.01) were reduced. CONCLUSION Our study failed to show an impact of pentaerythritol tetranitrate on the development of fetal growth restriction and perinatal death in pregnant women with impaired uterine perfusion at midgestation. Pentaerythritol tetranitrate significantly reduced secondary outcome parameters such as the incidence of preterm birth and pregnancy-induced hypertension in these pregnancies.
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Affiliation(s)
- Tanja Groten
- Department of Obstetrics, Jena University Hospital, Jena, Germany.
| | - Thomas Lehmann
- Institute of Medical Statistics and Computer Science, Jena University Hospital, Jena, Germany; Center for Clinical Studies, Jena University Hospital, Jena, Germany
| | - Mariann Städtler
- Center for Clinical Studies, Jena University Hospital, Jena, Germany
| | - Matej Komar
- Department of Gynecology and Obstetrics, Technische Universität Dresden, Dresden, Germany
| | - Jennifer Lucia Winkler
- Department of Gynecology and Obstetrics, Technische Universität Dresden, Dresden, Germany
| | - Mateja Condic
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | - Brigitte Strizek
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | - Sven Seeger
- Department of Gynaecology and Obstetrics, Perinatal Centre, Hospital St. Elisabeth and St. Barbara, Halle (Saale), Germany
| | - Yvonne Jäger
- Department of Gynaecology and Obstetrics, Perinatal Centre, Hospital St. Elisabeth and St. Barbara, Halle (Saale), Germany
| | - Ulrich Pecks
- Department of Obstetrics, Christian-Albrecht University of Kiel, Kiel, Germany
| | | | - Karl Oliver Kagan
- Department of Feto-Maternal Medicine, Women's University Hospital Tübingen, Tübingen, Germany
| | - Markus Hoopmann
- Department of Feto-Maternal Medicine, Women's University Hospital Tübingen, Tübingen, Germany
| | | | - Lars Brodowski
- Department of Obstetrics, Gynecology and Reproductive Medicine, Hannover Medical School, Hannover, Germany
| | - Anne Tauscher
- Department of Obstetrics and Gynecology, University of Leipzig, Leipzig, Germany
| | | | | | - Krisztian Lato
- Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany
| | - Christoph Hübener
- Department of Obstetrics and Gynecology, Perinatal Center, University Hospital, Campus Grosshadern, Ludwig Maximilian University of Munich, Munich, Germany
| | - Maria Delius
- Department of Obstetrics and Gynecology, Perinatal Center, University Hospital, Campus Grosshadern, Ludwig Maximilian University of Munich, Munich, Germany
| | - Stefan Verlohren
- Department of Obstetrics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Dorota Sroka
- Department of Obstetrics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Dietmar Schlembach
- Vivantes Network for Health GmbH, Klinikum Neukölln, Clinic for Obstetric Medicine, Berlin, Germany
| | - Laura de Vries
- Department of Obstetrics and Gynecology, München Klinik Harlaching, Munich, Germany
| | - Katrina Kraft
- Department of Obstetrics and Gynecology, München Klinik Harlaching, Munich, Germany
| | - Gregor Seliger
- Center for Reproductive Medicine and Andrology, University Medical Center Halle (Saale), Halle (Saale), Germany
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Salvatore T, Galiero R, Caturano A, Rinaldi L, Criscuolo L, Di Martino A, Albanese G, Vetrano E, Catalini C, Sardu C, Docimo G, Marfella R, Sasso FC. Current Knowledge on the Pathophysiology of Lean/Normal-Weight Type 2 Diabetes. Int J Mol Sci 2022; 24:ijms24010658. [PMID: 36614099 PMCID: PMC9820420 DOI: 10.3390/ijms24010658] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
Since early times, being overweight and obesity have been associated with impaired glucose metabolism and type 2 diabetes (T2D). Similarly, a less frequent adult-onset diabetes in low body mass index (BMI) people has been known for many decades. This form is mainly found in developing countries, whereby the largest increase in diabetes incidence is expected in coming years. The number of non-obese patients with T2D is also on the rise among non-white ethnic minorities living in high-income Western countries due to growing migratory flows. A great deal of energy has been spent on understanding the mechanisms that bind obesity to T2D. Conversely, the pathophysiologic features and factors driving the risk of T2D development in non-obese people are still much debated. To reduce the global burden of diabetes, we need to understand why not all obese people develop T2D and not all those with T2D are obese. Moreover, through both an effective prevention and the implementation of an individualized clinical management in all people with diabetes, it is hoped that this will help to reduce this global burden. The purpose of this review is to take stock of current knowledge about the pathophysiology of diabetes not associated to obesity and to highlight which aspects are worthy of future studies.
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Affiliation(s)
- Teresa Salvatore
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Raffaele Galiero
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Alfredo Caturano
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Luca Rinaldi
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Livio Criscuolo
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Anna Di Martino
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Gaetana Albanese
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Erica Vetrano
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Christian Catalini
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Celestino Sardu
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Giovanni Docimo
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
- Mediterrannea Cardiocentro, I–80122 Napoli, Italy
| | - Ferdinando Carlo Sasso
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
- Correspondence:
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Gailey S, Mortensen LH, Bruckner TA. Job loss and fetal growth restriction: identification of critical trimesters of exposure. Ann Epidemiol 2022; 76:174-180. [PMID: 35605768 PMCID: PMC10194830 DOI: 10.1016/j.annepidem.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/29/2022] [Accepted: 05/12/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE Previous research suggests that job loss in a household during pregnancy may perturb fetal growth. However, this work often cannot rule out unmeasured confounding due to selection into job loss. Recent work using data on exogenous job loss (due to a plant closure) finds that a father's unexpected job loss during his spouse's pregnancy increases the risk of a low weight birth. Using a unique set of linked registries in Denmark, we build on this work and examine whether associations between a father's unexpected job loss and low birthweight differ by trimester of in utero exposure. We additionally examine trimester-specific associations of job loss with small-for-gestational-age, a proxy for restricted fetal growth, which may cause low birthweight. METHODS We apply a sibling control design to over 1.4 million live births in Denmark, 1980 to 2017, to examine whether this plausibly exogenous form of job loss corresponds with increased risk of low weight or small-for-gestational-age births, depending on the timing of displacement in the first, second, or third trimester. RESULTS Results indicate an elevated risk of low birthweight (OR = 1.80, 95% CI: 1.24, 2.62) and small-for-gestational-age (OR = 1.40, 95% CI: 1.02, 1.93) among gestations exposed to job loss in the second trimester of pregnancy. Sensitivity analyses using continuous outcome measures (e.g., birthweight in grams, birthweight for gestational age percentile) and maternal fixed effects analyses produce substantively similar inference. CONCLUSIONS Findings support the notion that unexpected job loss may affect fetal growth and that the second trimester in particular appears sensitive to this external stressor.
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Affiliation(s)
- Samantha Gailey
- Minnesota Population Center, University of Minnesota, Twin Cities, Minnesota, USA.
| | - Laust H Mortensen
- Statistics Denmark, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tim A Bruckner
- University of California Irvine, Center for Population, Inequality and Policy and Program in Public Health, Irvine, California, USA
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Debere MK, Haile Mariam D, Ali A, Mekasha A, Chan GJ. Factors associated with small-for-gestational-age births among preterm babies born <2000 g: a multifacility cross-sectional study in Ethiopia. BMJ Open 2022; 12:e064936. [PMID: 36414292 PMCID: PMC9685265 DOI: 10.1136/bmjopen-2022-064936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES This study aimed to determine the prevalence of small-for-gestational-age (SGA) and appropriate-for-gestational-age (AGA); compare variations in multiple risk factors, and identify factors associated with SGA births among preterm babies born <2000 g. DESIGN Cross-sectional study. SETTING The study was conducted at five public hospitals in Oromia Regional State and Addis Ababa City Administration, Ethiopia. PARTICIPANTS 531 singleton preterm babies born <2000 g from March 2017 to February 2019. OUTCOME MEASURES Birth size-for-gestational-age was an outcome variable. Birth size-for-gestational-age centiles were produced using Intergrowth-21st data. Newborn birth size-for-gestational-age below the 10th percentile were classified as SGA; those>10th to 90th percentiles were classified as AGA; those >90th percentiles, as large-for-gestational-age, according to sex. SGA and AGA prevalence were determined. Babies were compared for variations in multiple risk factors. RESULTS Among 531 babies included, the sex distribution was: 55.44% males and 44.56% females. The prevalences of SGA and AGA were 46.14% and 53.86%, respectively. The percentage of SGA was slightly greater among males (47.62%) than females (44.30%), but not statistically significant The prevalence of SGA was significantly varied between pre-eclamptic mothers (32.42%, 95% CI 22.36% to 43.22%) and non-pre-eclamptic mothers (57.94%, 95% CI 53.21% to 62.54%). Mothers who had a history of stillbirth (adjusted OR (AOR) 2.96 95% CI 1.04 to 8.54), pre-eclamptic mothers (AOR 3.36, 95% CI 1.95 to 5.79) and being born extremely low birth weight (AOR 10.48, 95% CI 2.24 to 49.02) were risk factors significantly associated with SGA in this population. CONCLUSION Prevalence of SGA was very high in these population in the study area. Maternal pre-eclampsia substantially increases the risk of SGA. Hence, given the negative consequences of SGA, maternal and newborn health frameworks must look for and use evidence on gestational age and birth weight to assess the newborn's risks and direct care.
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Affiliation(s)
- Mesfin K Debere
- School of Public Health, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
- Epidemiology and Biostatistics, Arba Minch University, Arba Minch, SNNPR, Ethiopia
| | - Damen Haile Mariam
- School of Public Health, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
| | - Ahmed Ali
- School of Public Health, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
| | - Amha Mekasha
- Pediatrics and Child Health, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
| | - Grace J Chan
- Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
- Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
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Wathes DC. Developmental Programming of Fertility in Cattle-Is It a Cause for Concern? Animals (Basel) 2022; 12:2654. [PMID: 36230395 PMCID: PMC9558991 DOI: 10.3390/ani12192654] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/26/2022] [Accepted: 09/30/2022] [Indexed: 11/16/2022] Open
Abstract
Cattle fertility remains sub-optimal despite recent improvements in genetic selection. The extent to which an individual heifer fulfils her genetic potential can be influenced by fetal programming during pregnancy. This paper reviews the evidence that a dam's age, milk yield, health, nutrition and environment during pregnancy may programme permanent structural and physiological modifications in the fetus. These can alter the morphology and body composition of the calf, postnatal growth rates, organ structure, metabolic function, endocrine function and immunity. Potentially important organs which can be affected include the ovaries, liver, pancreas, lungs, spleen and thymus. Insulin/glucose homeostasis, the somatotropic axis and the hypothalamo-pituitary-adrenal axis can all be permanently reprogrammed by the pre-natal environment. These changes may act directly at the level of the ovary to influence fertility, but most actions are indirect. For example, calf health, the timing of puberty, the age and body structure at first calving, and the ability to balance milk production with metabolic health and fertility after calving can all have an impact on reproductive potential. Definitive experiments to quantify the extent to which any of these effects do alter fertility are particularly challenging in cattle, as individual animals and their management are both very variable and lifetime fertility takes many years to assess. Nevertheless, the evidence is compelling that the fertility of some animals is compromised by events happening before they are born. Calf phenotype at birth and their conception data as a nulliparous heifer should therefore both be assessed to avoid such animals being used as herd replacements.
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Affiliation(s)
- D Claire Wathes
- Department for Pathobiology and Population Sciences, Royal Veterinary College, Hatfield AL9 7TA, UK
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Yuan X, Han X, Zhou W, Long W, Wang H, Yu B, Zhang B. Association of folate and vitamin B12 imbalance with adverse pregnancy outcomes among 11,549 pregnant women: An observational cohort study. Front Nutr 2022; 9:947118. [PMID: 35958250 PMCID: PMC9358651 DOI: 10.3389/fnut.2022.947118] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/29/2022] [Indexed: 01/05/2023] Open
Abstract
Objective This study aimed to evaluate maternal serum levels of folate, vitamin B12, and their ratio on admission for labor and determine whether an imbalance between folate and vitamin B12, represented by a higher or lower serum folate to vitamin B12 ratio (SFVB12R), was associated with adverse pregnancy outcomes. Methods A retrospective cohort study of 11,549 pregnant women attending a district specialized hospital and who had serum folate (SF) and serum vitamin B12 (SVB12) levels measured at delivery was performed. The levels of SF, SVB12, and SFVB12R were defined as high (>95th percentile), normal (5–95th percentile), and low (<5th percentile). Information on pregnancy outcomes was retrieved from medical records. Linear regression was performed to examine the association of abnormal SF, SVB12, and SFVB12R levels with fetal growth indicators. Logistic regression was applied to estimate the association between abnormal SF, SVB12, and SFVB12R levels and pregnancy outcomes. Results Lower SF levels were associated with higher risks of intrahepatic cholestasis of pregnancy (ICP, OR 1.58; 95% CI 1.15–2.17), pre-eclampsia (PE, OR 1.89; 95% CI 1.28–2.81), and a lower risk of gestational diabetes mellitus (GDM, OR 0.40; 95% CI 0.23–0.70), whereas higher SVB12 levels were associated with a higher risk of ICP (OR 2.22; 95% CI 1.67–2.96), PE (OR 1.69; 95% CI 1.04-2.74), and GDM (OR 1.62; 95% CI 1.24–2.11). A higher SFVB12R increased birthweight (β 60.99; 95% CI 29.52–92.45) and was associated with a higher risk of large-for-gestational-age (LGA) newborns (OR 3.08; 95% CI 1.63–5.83); a lower SFVB12R decreased birthweight (β −43.81; 95% CI −75.62, −12.00) and was associated with a lower risk of LGA newborns (OR 0.75; 95% CI 0.56–1.00), and with higher risks of ICP (OR 2.03; 95% CI 1.54–2.67) and pregnancy-induced hypertension (PIH, OR 1.81; 95% CI 1.09–3.00). Conclusion An imbalance between folate and vitamin B12, represented by a higher or lower SFVB12R before delivery, was significantly associated with adverse pregnancy outcomes (ICP/PIH/LGA).
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Affiliation(s)
- Xiaosong Yuan
- Department of Medical Genetics, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China
| | - Xiaoya Han
- Department of Medical Genetics, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China
| | - Wenbo Zhou
- Department of Medical Genetics, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China
| | - Wei Long
- Department of Medical Genetics, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China
| | - Huiyan Wang
- Department of Obstetrics and Gynecology, Changzhou Medical Center, Changzhou Maternal and Child Health Care Hospital, Nanjing Medical University, Changzhou, China
| | - Bin Yu
- Department of Medical Genetics, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China
| | - Bin Zhang
- Department of Medical Genetics, Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China
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Wang J, Zhou M, Chen D. Relationship between changes of high-density lipoprotein cholesterol levels in advanced pregnancy and the risk of neonatal small for gestational age in healthy full-term puerpera. Zhejiang Da Xue Xue Bao Yi Xue Ban 2022; 51:462-469. [PMID: 37202097 PMCID: PMC10264996 DOI: 10.3724/zdxbyxb-2022-0144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/29/2022] [Indexed: 05/20/2023]
Abstract
OBJECTIVE To explore the relationship between changes in blood high-density lipoprotein cholesterol (HDL-C) levels in advanced pregnancy and the risk of small for gestational age (SGA) in healthy full-term pregnant women. METHODS In this retrospective nested case-control study, pregnant women who got antenatal visits and experienced a healthy full-term delivery in Affiliated Women's Hospital, Zhejiang University School of Medicine in 2017 were enrolled. From the cohort, 249 women delivered SGA infants with completed clinical data were set as SGA group, 996 women who delivered normal neonates were randomly selected as matched controls (1∶4). The data of baseline characteristics, the HDL-C levels in 24 th-27 th week and after 37 th week were collected, the average HDL-C changes every four weeks in the third trimester (ΔHDL-C) were calculated. Paired t test was used to compare the differences of HDL-C and ΔHDL-C between cases and controls, and a conditional logistic regression model was applied to analyze the association between ΔHDL-C and the risk of SGA. RESULTS HDL-C levels after the 37 th week in both groups were lower than those in mid-pregnancy (ΔHDL-C<0 and P<0.05 for both groups), while the ΔHDL-C levels in SGA group were significantly higher ( P<0.05). Compared with women with low ΔHDL-C, the risk of SGA was higher for women with middle and high ΔHDL-C ( OR=1.74, 95% CI:1.22-2.50; OR=2.48, 95% CI:1.65-3.70, both P<0.05). CONCLUSION In healthy full-term pregnant women, the risk of SGA is associated with the HDL-C changing trend, HDL-C level decreasing slowly or even raising in the third trimester indicate that SGA may be likely to occur.
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Silva-Jose C, Sánchez-Polán M, Barakat R, Díaz-Blanco Á, Mottola MF, Refoyo I. A Virtual Exercise Program throughout Pregnancy during the COVID-19 Pandemic Modifies Maternal Weight Gain, Smoking Habits and Birth Weight—Randomized Clinical Trial. J Clin Med 2022; 11:jcm11144045. [PMID: 35887809 PMCID: PMC9321470 DOI: 10.3390/jcm11144045] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/29/2022] [Accepted: 07/11/2022] [Indexed: 02/01/2023] Open
Abstract
The intrauterine environment is key to health from a short- and long-term perspective. Birth weight is an important indicator that may influence the fetal environment due to epigenetics. Considering physical inactivity, in parallel with higher levels of stress, affecting smoking patterns and the physical and emotional health of the pregnant population, maintaining the health of future generations is crucial. A randomized clinical trial (NCT04563065) was conducted. One-hundred and ninety-two healthy pregnant individuals were assigned to the intervention (IG) or control (CG) group. Overall, significant differences were found between groups when stratified by birth weight (χ2 (1) = 6.610; p = 0.037) with low birth weight and macrosomia found more often in the CG (4% vs. 14% and 3% vs. 9%, respectively) and higher admissions to the neonatal intensive care unit (χ2 (1) = 5.075; p = 0.024) in the CG (20/28.6%) compared to the IG (9/13.0). Smoking during pregnancy was also found more often in the CG (12/17.1%) compared to the IG (3/4.4%) (p = 0.016). A virtual program of supervised exercise throughout pregnancy during the ongoing pandemic could help to maintain adequate birth weights, modify maternal smoking habits, and lower admissions to the neonatal intensive care unit.
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Affiliation(s)
- Cristina Silva-Jose
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.S.-J.); (R.B.)
| | - Miguel Sánchez-Polán
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.S.-J.); (R.B.)
- Correspondence: ; Tel.: +34-913364120
| | - Ruben Barakat
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.S.-J.); (R.B.)
| | - Ángeles Díaz-Blanco
- Gynecology and Obstetrics Department, Hospital Universitario Severo Ochoa de Leganés, 28911 Leganés, Spain;
| | - Michelle F. Mottola
- R. Samuel McLaughlin Foundation-Exercise and Pregnancy Lab, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Children’s Health Research Institute, The University of Western Ontario London, London, ON N6A 3K7, Canada;
| | - Ignacio Refoyo
- Sports Department, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
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Takatani T, Eguchi A, Yamamoto M, Sakurai K, Takatani R, Taniguchi Y, Nakayama SF, Mori C, Kamijima M. Individual and mixed metal maternal blood concentrations in relation to birth size: An analysis of the Japan Environment and Children's Study (JECS). ENVIRONMENT INTERNATIONAL 2022; 165:107318. [PMID: 35679738 DOI: 10.1016/j.envint.2022.107318] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 05/15/2022] [Accepted: 05/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Growth restriction in the prenatal period is a significant public health concern. Metals can negatively affect birth size, and pregnant women may be exposed to metal mixtures. Comprehensive studies analyzing the effects of combined metal exposure with accurate individual blood metal concentrations are limited. The current study investigated the associations between maternal metal exposure and birth size in a large, nationwide Japanese cohort using individual and mixed model approaches. METHODS Lead, cadmium, mercury, selenium, and manganese blood concentrations were measured in pregnant women in the Japan Environment and Children's Study (JECS). Measurements of infant birth size-including body weight, body length, and head and chest circumference-were collected. Linear and logistic regressions were used for birth size measurements and the odds of an infant being small in size for gestational age, respectively. Associations between combined metal mixtures and measurements at birth were evaluated using quantile g-computation and Bayesian kernel machine regression (BKMR). RESULTS Of the 103,060 JECS pregnancies, 93,739 mother-infant pairs were analyzed. The linear regression models showed that lead, selenium, cadmium, and manganese-but not mercury-were associated with body weight. Cadmium was associated with length and chest circumference and mercury was associated with head circumference. Quantile g-computation revealed that manganese increased infant birth weight, length, head circumference, and chest circumference. Lead was the strongest negative factor for infant birth weight, length, head circumference, and chest circumference. The BKMR analysis revealed that the metals had an additive, rather than a synergistic effect. CONCLUSION Metal exposure is associated with infant birth size, with lead and manganese playing a more significant role in Japan. The effects of prenatal combined metal exposure at low levels warrant public health attention.
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Affiliation(s)
- Tomozumi Takatani
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - Akifumi Eguchi
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Midori Yamamoto
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Kenichi Sakurai
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Rieko Takatani
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Yu Taniguchi
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Ibaraki, Japan
| | - Shoji F Nakayama
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Ibaraki, Japan
| | - Chisato Mori
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Michihiro Kamijima
- Department of Occupational and Environmental Health, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan.
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Takatani T, Kunii Y, Satoh M, Eguchi A, Yamamoto M, Sakurai K, Takatani R, Nomura F, Shimojo N, Mori C. Vitamin D Metabolite Ratio in Pregnant Women with Low Blood Vitamin D Concentrations Is Associated with Neonatal Anthropometric Data. Nutrients 2022; 14:2201. [PMID: 35684001 PMCID: PMC9182679 DOI: 10.3390/nu14112201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/20/2022] [Accepted: 05/21/2022] [Indexed: 12/10/2022] Open
Abstract
Existing evidence on the correlation between maternal vitamin D concentrations and birth outcomes is conflicting. Investigation of these associations requires accurate assessment of vitamin D status, especially in individuals with low 25-hydroxyvitamin D (25(OH)D) concentrations. This study examined the correlations between birth outcomes and the maternal vitamin D metabolite ratio (VMR) 1 (defined as the ratio of 24,25(OH)2D3 to 25(OH)D) and VMR2 (defined as the ratio of 3-epi-25(OH)D3 to 25(OH)D) using data from the Japan Environment and Children's Study at Chiba Regional Center. A total of 297 mother-neonate pairs were analyzed. Using liquid chromatography-tandem mass spectrometry, we measured 25(OH)D2, 25(OH)D3, 24,25(OH)2D3, and 3-epi-25(OH)D3 concentrations in maternal serum samples. These data were analyzed in relation to birth anthropometric data using multivariable linear regression. Of the study participants, 85.2% showed insufficient vitamin D concentrations. VMR1 was strongly correlated with 25(OH)D concentrations, whereas VMR2 showed a weak correlation. Only VMR2 was associated with all anthropometric data. VMR2 in pregnant women with low vitamin D blood concentrations is a useful marker for neonatal anthropometric data and is independent of 25(OH)D. Accurate measurement of vitamin D metabolites could help better understand the effects of vitamin D on birth outcomes.
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Affiliation(s)
- Tomozumi Takatani
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan;
| | - Yuzuka Kunii
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan;
| | - Mamoru Satoh
- Division of Clinical Mass Spectrometry, Chiba University Hospital, Chiba 260-8677, Japan; (M.S.); (F.N.)
| | - Akifumi Eguchi
- Center for Preventive Medical Sciences, Chiba University, Chiba 263-8522, Japan; (A.E.); (M.Y.); (K.S.); (R.T.); (N.S.); (C.M.)
| | - Midori Yamamoto
- Center for Preventive Medical Sciences, Chiba University, Chiba 263-8522, Japan; (A.E.); (M.Y.); (K.S.); (R.T.); (N.S.); (C.M.)
| | - Kenichi Sakurai
- Center for Preventive Medical Sciences, Chiba University, Chiba 263-8522, Japan; (A.E.); (M.Y.); (K.S.); (R.T.); (N.S.); (C.M.)
| | - Rieko Takatani
- Center for Preventive Medical Sciences, Chiba University, Chiba 263-8522, Japan; (A.E.); (M.Y.); (K.S.); (R.T.); (N.S.); (C.M.)
| | - Fumio Nomura
- Division of Clinical Mass Spectrometry, Chiba University Hospital, Chiba 260-8677, Japan; (M.S.); (F.N.)
| | - Naoki Shimojo
- Center for Preventive Medical Sciences, Chiba University, Chiba 263-8522, Japan; (A.E.); (M.Y.); (K.S.); (R.T.); (N.S.); (C.M.)
| | - Chisato Mori
- Center for Preventive Medical Sciences, Chiba University, Chiba 263-8522, Japan; (A.E.); (M.Y.); (K.S.); (R.T.); (N.S.); (C.M.)
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
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Öztürk Önsal FD, Elitok GK, Bülbül A, Uçar A. Serum spexin levels are not associated with size at birth but are associated with metabolic syndrome components in prepubertal children born at term. J Pediatr Endocrinol Metab 2022; 35:649-655. [PMID: 35334196 DOI: 10.1515/jpem-2021-0721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 03/08/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Babies born small for gestational age (SGA) are at risk of obesity and metabolic syndrome (MetS). Spexin (SPX) is a novel peptide implicated in food intake and obesity. Spexin levels are lower in obese subjects. This study investigated the potential association of SPX and some obesity related peptides such as leptin and active ghrelin with size at birth and MetS components in prepubertal children born term and either SGA or appropriate for GA (AGA). Secondary aim was to identify whether any of the investigated peptides were associated with MetS components. METHODS We conducted a cross-sectional study of 37 consecutive (median age: 5.6 y) SGA- and 50 (median age: 5.9 y) AGA-born children. Clinical evaluations were performed using standard methods. Several biochemical variables (SPX, total leptin, and active ghrelin levels) were analyzed. Age-dependent cut-off values were used to define MetS components, including excess adiposity, hypertension, insulin resistance, and dyslipidemia. The associations between the assessed clinical and laboratory variables and MetS components were investigated. RESULTS Children born SGA had higher frequencies of MetS components than AGA-born peers (p < 0.01). None of the investigated peptides were different between children born SGA and AGA after correcting for body mass index (p > 0.05 for all). Serum SPX levels were lower in children with at least one metS component than those without MetS components (p = 0.018). CONCLUSIONS Size at birth had no association with serum SPX. Serum SPX levels are decreased in prepubertal children with MetS components.
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Affiliation(s)
- Fatma Duygu Öztürk Önsal
- Department of Pediatrics, Well-Child Care Clinic, University of Health Sciences, Şişli Hamidiye Etfal Education & Research Hospital, Istanbul, Turkey.,Department of Pediatric Endocrinology & Diabetes, University of Health Sciences, Şişli Hamidiye Etfal Education & Research Hospital, Istanbul, Turkey
| | - Gizem Kara Elitok
- Department of Pediatrics, Well-Child Care Clinic, University of Health Sciences, Şişli Hamidiye Etfal Education & Research Hospital, Istanbul, Turkey
| | - Ali Bülbül
- Department of Pediatrics, Well-Child Care Clinic, University of Health Sciences, Şişli Hamidiye Etfal Education & Research Hospital, Istanbul, Turkey.,Department of Neonatology, University of Health Sciences, Şişli Hamidiye Etfal Education & Research Hospital, Istanbul, Turkey
| | - Ahmet Uçar
- Department of Pediatric Endocrinology & Diabetes, University of Health Sciences, Şişli Hamidiye Etfal Education & Research Hospital, Istanbul, Turkey
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Determinants of adolescent sleep: Early family environment, obstetric factors, and emotion regulation. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2022. [DOI: 10.1016/j.appdev.2022.101420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Pregnancy and Kidney Diseases: Multidisciplinary Follow-Up and the Vicious Circles Involving Pregnancy and CKD, Preeclampsia, Preterm Delivery and the Kidneys. J Clin Med 2022; 11:jcm11092535. [PMID: 35566661 PMCID: PMC9105432 DOI: 10.3390/jcm11092535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 04/29/2022] [Indexed: 02/05/2023] Open
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Habte MH, Seid SJ, Alemu A, Hailemariam HA, Wudneh BA, Kasa RN, Bitew ZW. The effect of unemployment and post-natal care on the exclusive breast-feeding practice of women in Ethiopia: a systematic review and meta-analysis. Reprod Health 2022; 19:94. [PMID: 35428313 PMCID: PMC9013047 DOI: 10.1186/s12978-022-01404-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/05/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Promoting exclusive breastfeeding (EBF) is a major child survival strategy in developing countries like Ethiopia. Studies in EBF are found in a fragmented and inconclusive way in Ethiopia. Therefore, the aim of this study was to examine evidences on the effect of post natal care counseling and maternal employment status on exclusive breastfeeding practice of women in Ethiopia. METHODS A systematic literature search was conducted from PubMed (contains MEDLINE), CINAHL (EBSCO), Global Health, Food Science and Technology Abstracts (FSTA) (EBSCO) and Grey literature sources such as Google and Google scholar. All primary studies on the effects of employment status and/or post-natal care utilization on EBF practices of women in Ethiopia were included. Data analyses were performed using STATA software. Forest plot, I2 test and the Cochrane Q statistics were used to detect heterogeneity among studies. Heterogeneity was considered significant when the I2 value was ≥ 50%, with p-value < 0.05. Publication bias was checked by looking the asymmetry of funnel and confirmed by Egger's regression test at a 5% significant level. The pooled odds ratio (POR) with 95% confidence interval (CI) was used to report the measures of associations. RESULT A total of 622 studies were identified in the initial search of which 42 articles were included this systematic review and meta-analysis. A meta-analysis of 24 studies indicated that maternal employment status was significantly associated (POR = 0.51, 95% CI 0.16, 0.86) EBF practice in that employed mother were less likely to practice to practice EBF. Post-natal care service utilization significantly increases (POR = 1.76, 95% CI 1.32, 2.34) the EBF practice in Ethiopia and it was computed using 25 eligible articles. Besides, the pooled estimates of EBF practice was found to be 62.58% (95% CI 56.98, 68.19, I2 = 96.4%, p < 0.001). CONCLUSION This review found that post-natal care service utilization and maternal employment status has a significant effect on EBF practice. The findings from this review may be used to inform for better supportive and promotive strategies for EBF practice in Ethiopia.
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Affiliation(s)
| | - Seada Jemal Seid
- St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Ayinalem Alemu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | - Rahel Nega Kasa
- St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Research for type 2 diabetes mellitus in endemic arsenism areas in central China: role of low level of arsenic exposure and KEAP1 rs11545829 polymorphism. Arch Toxicol 2022; 96:1673-1683. [PMID: 35420349 DOI: 10.1007/s00204-022-03279-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/14/2022] [Indexed: 11/02/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is one of the major public health problems worldwide; both genetic and environmental factors are its risk factors. Arsenic, an environmental pollutant, might be a risk factor for T2DM, but the association of low-to-moderate level arsenic exposure with the risk of T2DM is still inconsistent. Single nucleotide polymorphisms (SNPs) can affect the development of T2DM, but the study on KEAP1 rs11545829 (G>A) SNP is few. In this paper, we explored the effect of KEAP1 rs11545829 (G>A) SNP and low-to-moderate level arsenic exposure on risk of T2DM in a cross-sectional case-control study conducted in Shanxi, China. Total of 938 participants, including 318 T2DM cases and 618 controls, were enrolled. Blood glycosylated haemoglobin (HbA1c) was detected by Automatic Biochemical Analyzer, and participants with HbA1c≧6.5% were diagnosed as T2DM. Urinary total arsenic (tAs, mg/L), as the indicator of arsenic exposure, was detected by liquid chromatography-atomic fluorescence spectrometry (LC-AFS). Genomic DNA was extracted and the genotypes of KEAP1 rs11545829 SNP were examined by multiplex polymerase chain reaction (PCR). The urinary tAs concentration in recruited participants was 0.075 (0.03-0.15) mg/L, and was associated with an increased risk of T2DM (OR = 8.45, 95% CI 2.63-27.17); rs11545829 mutation homozygote AA genotype had a protective effect on risk of T2DM (OR = 0.42, 95 % CI 0.25-0.73). Although this protective effect of AA genotype was found in participants with higher urinary tAs level (>0.032 mg/L) (OR = 0.48, 95% CI 0.26-0.86), there was no interaction effect for arsenic exposure and rs11545829 SNP on risk of T2DM. In addition, BMI modified the association between rs11545829 SNP and the risk of T2DM (RERI = -1.11, 95% CI -2.18-0.04). The present study suggest that low-to-moderate level arsenic exposure may be a risk factor, while KEAP1 rs11545829 SNP mutation homozygote AA genotype may be a protective factor for risk of T2DM, especially for T2DM patients with urinary tAs level>0.032 mg/L.
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Castro TDF, de Matos NA, de Souza ABF, Costa GDP, Perucci LO, Talvani A, Cangussú SD, Chianca-Jr DA, de Menezes RCA, Bezerra FS. Protein restriction during pregnancy affects lung development and promotes oxidative stress and inflammation in C57BL/6 mice offspring. Nutrition 2022; 101:111682. [DOI: 10.1016/j.nut.2022.111682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 03/22/2022] [Accepted: 04/04/2022] [Indexed: 11/16/2022]
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Moon HS, Kim H, Kim B, Kim MS, Kim JH, Kwon O. Mouse Model of Small for Gestational Age Offspring with Catch-up Growth Failure and Dysregulated Glucose Metabolism in Adulthood. J Obes Metab Syndr 2022; 31:81-85. [PMID: 35301269 PMCID: PMC8987454 DOI: 10.7570/jomes22013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 11/02/2022] Open
Abstract
Background We aimed to build mouse models of small for gestational age (SGA), recapitulating failure of catch-up growth and dysregulated metabolic outcomes in adulthood. Methods Pregnant C57BL/6 mice were given a protein-restricted diet (PRD; 6% kcal from protein) during pregnancy without (model 1) or with cross-fostering (model 2). Model 3 extended the PRD to the end of the lactation period. Model 4 changed to a 9% PRD without cross-fostering. Results Model 1 yielded a reduced size of offspring with a poor survival rate. Model 2 improved survival but offspring showed early catch-up growth. Model 3 maintained a reduced size of offspring after weaning with a higher body mass index and blood glucose levels in adult stages. Model 4 increased the survival of the offspring while maintaining a reduced size and dysregulated glucose metabolism. Conclusion Models 3 and 4 are suitable for studying SGA accompanying adulthood short stature and metabolic disorders.
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Affiliation(s)
- Hyeon Seok Moon
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea.,Department of Biochemistry and Molecular Biology, Seoul National University College of Medicine, Seoul, Korea
| | - Hanbin Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea.,Department of Biochemistry and Molecular Biology, Seoul National University College of Medicine, Seoul, Korea
| | - Bohye Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea.,Department of Biochemistry and Molecular Biology, Seoul National University College of Medicine, Seoul, Korea
| | - Min-Seon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Diabetes Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Hyun Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Obin Kwon
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea.,Department of Biochemistry and Molecular Biology, Seoul National University College of Medicine, Seoul, Korea
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Xu S, Wang W, Li Q, Huang L, Chen X, Zhang X, Wang X, Han W, Hu X, Yang X, Hao L, Xiong G, Yang N. Association of Maternal Longitudinal Hemoglobin with Small for Gestational Age during Pregnancy: A Prospective Cohort Study. Nutrients 2022; 14:nu14071403. [PMID: 35406016 PMCID: PMC9003216 DOI: 10.3390/nu14071403] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 03/26/2022] [Accepted: 03/26/2022] [Indexed: 02/06/2023] Open
Abstract
Background: Few studies have investigated the association of maternal longitudinal hemoglobin (Hb) with small for gestational age during pregnancy. The current study examined the associations of maternal Hb concentrations and Hb changes throughout the middle and late stages of pregnancy with small for gestational age (SGA) in a large prospective cohort study. Methods: This was a prospective cohort study, which enrolled pregnant women at 8−16 weeks of gestation and followed up regularly. Maternal Hb concentrations were measured at the middle (14−27 weeks) and late (28−42 weeks) stages of pregnancy, and the Hb change from the middle to late stage of pregnancy was assessed. The Log-Poisson regression model was used to identify the association of maternal Hb with SGA, including the implications of Hb during specific pregnancy periods and Hb change across the middle to late stages of pregnancy. Of the total 3233 singleton live births, 208 (6.4%) were SGA. After adjusting for potential confounders, compared with Hb 110−119 g/L, Hb ≥ 130 g/L at late pregnancy was significantly associated with a higher risk of SGA (adjusted RR: 2.16; 95% CI: 1.49, 3.13). When Hb changes from the middle to late stages of pregnancy were classified by tertiles, the greatest change in the Hb group (<−6.0 g/L) was significantly associated with a lower risk of SGA (adjusted RR: 0.56; 95% CI: 0.37, 0.85) compared with the intermediate group (−6.0~1.9 g/L). In conclusion, for women at low risk of iron deficiency, both higher Hb concentrations in late pregnancy and less Hb reduction during pregnancy were associated with an increased risk of SGA.
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Affiliation(s)
- Shangzhi Xu
- Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China; (S.X.); (W.W.); (Q.L.); (X.C.); (X.Z.); (X.W.); (X.Y.); (L.H.)
- Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), Department of Public Health, School of Medicine, Shihezi University, Shihezi 832003, China
| | - Weiming Wang
- Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China; (S.X.); (W.W.); (Q.L.); (X.C.); (X.Z.); (X.W.); (X.Y.); (L.H.)
| | - Qian Li
- Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China; (S.X.); (W.W.); (Q.L.); (X.C.); (X.Z.); (X.W.); (X.Y.); (L.H.)
| | - Li Huang
- Shenzhen Baoan Center for Chronic Disease Control, Shenzhen 518101, China;
| | - Xi Chen
- Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China; (S.X.); (W.W.); (Q.L.); (X.C.); (X.Z.); (X.W.); (X.Y.); (L.H.)
| | - Xu Zhang
- Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China; (S.X.); (W.W.); (Q.L.); (X.C.); (X.Z.); (X.W.); (X.Y.); (L.H.)
| | - Xiaoyi Wang
- Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China; (S.X.); (W.W.); (Q.L.); (X.C.); (X.Z.); (X.W.); (X.Y.); (L.H.)
| | - Weizhen Han
- Department of Obstetrics and Gynecology, The Central Hospital of Wuhan, Wuhan 430014, China; (W.H.); (G.X.)
| | - Xingwen Hu
- Clinical Laboratory, Hubei Maternal and Child Health Hospital, Wuhan 430070, China;
| | - Xuefeng Yang
- Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China; (S.X.); (W.W.); (Q.L.); (X.C.); (X.Z.); (X.W.); (X.Y.); (L.H.)
| | - Liping Hao
- Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China; (S.X.); (W.W.); (Q.L.); (X.C.); (X.Z.); (X.W.); (X.Y.); (L.H.)
| | - Guoping Xiong
- Department of Obstetrics and Gynecology, The Central Hospital of Wuhan, Wuhan 430014, China; (W.H.); (G.X.)
| | - Nianhong Yang
- Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China; (S.X.); (W.W.); (Q.L.); (X.C.); (X.Z.); (X.W.); (X.Y.); (L.H.)
- Correspondence: ; Tel.: +86-27-83650521
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73
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Gurung S, Tong HH, Bryce E, Katz J, Lee ACC, Black RE, Walker N. A systematic review on estimating population attributable fraction for risk factors for small-for-gestational-age births in 81 low- and middle-income countries. J Glob Health 2022; 12:04024. [PMID: 35356650 PMCID: PMC8942297 DOI: 10.7189/jogh.12.04024] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background Small for gestational age (SGA) is a public health concern since it is associated with mortality in neonatal and post-neonatal period. Despite the large magnitude of the problem, little is known about the population-attributable risk (PAR) of various risk factors for SGA. This study estimated the relative contribution of risk factors for SGA, as a basis for identifying priority areas for developing and/or implementing interventions to reduce the incidence of SGA births and related mortality and morbidity. Methods We conducted a literature review on 63 potential risk factors for SGA to quantify the risk relationship and estimate the prevalence of risk factors (RFs). We calculated the population-attributable fraction for each of the identified RF for 81 Countdown countries and calculated regional estimates. Twenty-five RFs were included in the final model while extended model included all the 25 RFs from the final model and two additional RFs. Results In the final and extended models, the RFs included in each model have a total PAF equal to 63.97% and 69.66%, respectively of SGA across the 81 LMICs. In the extended model, maternal nutritional status has the greatest PAF (28.15%), followed by environmental and other exposures during pregnancy (15.82%), pregnancy history (11.01%), and general health issues or morbidity (10.34%). The RFs included in the final and extended model for Sub-Saharan African (SSA) region have a total PAF of 63.28% and 65.72% of SGA, respectively. In SSA, the top three RF categories in the extended model are nutrition (25.05%), environment and other exposure (13.01%), and general health issues or morbidity (10.72%), while in South-Asia's it was nutrition (30.56%), environment and other exposure (15.27%) and pregnancy history (11.68%). Conclusions The various types of RFs that play a role in SGA births highlight the importance of a multifaceted approach to tackle SGA. Depending on the types of RFs, intervention should be strategically targeted at either individual or household and/or community or policy level. There is also a need to research the mechanisms by which some of the RFs might hinder fetal growth.
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Affiliation(s)
- Sabi Gurung
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Hannah Hanzi Tong
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Emily Bryce
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Joanne Katz
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Anne CC Lee
- Department of Pediatric Newborn Medicine, Global Advancement of Infants and Mothers (AIM), Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Robert E Black
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Neff Walker
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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74
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Zhao R, Zhou L, Wang S, Yin H, Yang X, Hao L. Effect of maternal vitamin D status on risk of adverse birth outcomes: a systematic review and dose-response meta-analysis of observational studies. Eur J Nutr 2022; 61:2881-2907. [PMID: 35316377 DOI: 10.1007/s00394-022-02866-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 03/02/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE Accumulating evidence suggests that vitamin D deficiency increases the risk of adverse perinatal outcomes. However, the dose-response relationship between maternal vitamin D status and adverse birth outcomes remains unclear. Focusing on prospective observational studies, we aimed to explore the dose-response relationship of vitamin D status with the risk of low birth weight (LBW), macrosomia (MA), preterm birth (PTB), small for gestational age (SGA), and intrauterine growth restriction (IUGR). METHODS Databases including PubMed, Embase, Scopus, and Web of Science were used up to 19 January 2021 to search for observational studies that fulfilled criteria as follows: cohort studies, case-cohort studies, or nested case-control studies. Random-effects models were used to pool relative risks (RRs) and 95% confidence intervals (CIs) in the observational studies. RESULTS A total of 72 publications were included in this systematic review and 71 in the meta-analysis. Maternal 25-hydroxyvitamin D (25(OH)D) concentrations were inversely associated with the risk of LBW (RR: 0.65; 95% CI 0.48-0.86), PTB (RR: 0.67; 95% CI 0.57-0.79), and SGA (RR: 0.61; 95% CI 0.49-0.76) in the highest versus lowest meta-analysis, but not associated with MA and IUGR. Linear dose-response analysis showed that each 25 nmol/L increase in 25(OH)D was associated with a 6% and 10% reduction in the risk of PTB (RR: 0.94; 95% CI 0.90-0.98) and SGA (RR: 0.90; 95% CI 0.84-0.97), respectively. CONCLUSION Our study suggests that a sufficient vitamin D status during pregnancy is protective against the risk of LBW, PTB, and SGA.
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Affiliation(s)
- Rui Zhao
- Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Department of Nutrition and Food Hygiene, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, People's Republic of China
| | - Leilei Zhou
- Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Department of Nutrition and Food Hygiene, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, People's Republic of China
| | - Shanshan Wang
- Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Department of Nutrition and Food Hygiene, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, People's Republic of China
| | - Heng Yin
- Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Xuefeng Yang
- Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Department of Nutrition and Food Hygiene, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, People's Republic of China
| | - Liping Hao
- Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Department of Nutrition and Food Hygiene, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, People's Republic of China.
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75
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Vipin VA, Blesson CS, Yallampalli C. Maternal low protein diet and fetal programming of lean type 2 diabetes. World J Diabetes 2022; 13:185-202. [PMID: 35432755 PMCID: PMC8984567 DOI: 10.4239/wjd.v13.i3.185] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/30/2021] [Accepted: 02/10/2022] [Indexed: 02/06/2023] Open
Abstract
Maternal nutrition is found to be the key factor that determines fetal health in utero and metabolic health during adulthood. Metabolic diseases have been primarily attributed to impaired maternal nutrition during pregnancy, and impaired nutrition has been an immense issue across the globe. In recent years, type 2 diabetes (T2D) has reached epidemic proportion and is a severe public health problem in many countries. Although plenty of research has already been conducted to tackle T2D which is associated with obesity, little is known regarding the etiology and pathophysiology of lean T2D, a variant of T2D. Recent studies have focused on the effects of epigenetic variation on the contribution of in utero origins of lean T2D, although other mechanisms might also contribute to the pathology. Observational studies in humans and experiments in animals strongly suggest an association between maternal low protein diet and lean T2D phenotype. In addition, clear sex-specific disease prevalence was observed in different studies. Consequently, more research is essential for the understanding of the etiology and pathophysiology of lean T2D, which might help to develop better disease prevention and treatment strategies. This review examines the role of protein insufficiency in the maternal diet as the central driver of the developmental programming of lean T2D.
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Affiliation(s)
- Vidyadharan Alukkal Vipin
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, United States
| | - Chellakkan Selvanesan Blesson
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, United States
- Family Fertility Center, Texas Children's Hospital, Houston, TX 77030, United States
| | - Chandra Yallampalli
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, United States
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76
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Newman C, Dunne FP. Metformin for pregnancy and beyond: the pros and cons. Diabet Med 2022; 39:e14700. [PMID: 34569082 DOI: 10.1111/dme.14700] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/26/2021] [Accepted: 09/21/2021] [Indexed: 12/16/2022]
Abstract
CONTEXT AND AIM Metformin has been used in pregnancy since the 1970s. It is cheap, widely available and is acceptable to women. Despite its increasing use, controversy remains surrounding its benefits and risks. Metformin effectively reduces hyperglycaemia for the mother during pregnancy and it reduces rates of macrosomia and neonatal hypoglycaemia. However, concern exists surrounding an increase in the rate of SGA births and obesity in childhood. We aim to review the evidence and expert opinion behind metformin in pregnancy through to the post-partum period. METHODS We performed a literature review of relevant studies from online databases using a combination of keywords. We also searched the references of retrieved articles for pertinent studies. RESULTS There is strong evidence that metformin is safe in early pregnancy with no risk of congenital malformations. If used throughout pregnancy, it is likely to lead to reduced maternal weight gain and reduced insulin dose in women with type 2 diabetes. In infants, metformin reduces hypoglycaemia and macrosomia but may increase the rate of infants born SGA. There is some evidence of an increased risk of obesity and altered fat distribution in offspring. Metformin appears well tolerated in pregnancy and is more acceptable to women than insulin therapy. CONCLUSION Due to increasing rates of maternal obesity, GDM and type 2 diabetes, metformin use in pregnancy is increasing. Overall, it appears safe and effective but further research is needed to examine mechanisms linking metformin to obesity reported during childhood in some follow-up studies.
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Affiliation(s)
- Christine Newman
- College of Medicine, Nursing and Health Science, National University of Ireland, Galway, Republic of Ireland
| | - Fidelma P Dunne
- College of Medicine, Nursing and Health Science, National University of Ireland, Galway, Republic of Ireland
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77
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Porschen C, Schmitz R, Schmidt R, Oelmeier K, Hammer K, Falkenberg M, Braun J, Köster HA, Steinhard J, Möllers M. Second trimester fetal thymus size in association to preterm birth. J Perinat Med 2022; 50:144-149. [PMID: 34710316 DOI: 10.1515/jpm-2021-0065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 08/04/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study was to compare the second trimester thymus-thorax-ratio (TTR) between fetuses born preterm (study group) and those born after 37 weeks of gestation were completed (control group). METHODS This study was conducted as a retrospective evaluation of the ultrasound images of 492 fetuses in the three vessel view. The TTR was defined as the quotient of a.p. thymus diameter and a.p. thoracic diameter. RESULTS Fetuses that were preterm showed larger TTR (p<0.001) the second trimester than those born after 37 weeks of gestation were completed. The sensitivity of a binary classifier based on TTR for predicting preterm birth (PTB) was 0.792 and the specificity 0.552. CONCLUSIONS In our study, fetuses affected by PTB showed enlarged thymus size. These findings led us to hypothesize, that inflammation and immunomodulatory processes are altered early in pregnancies affected by PTB. However, TTR alone is not able to predict PTB.
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Affiliation(s)
- Christian Porschen
- Department of Gynecology and Obstetrics, University Hospital Münster, Munster, Germany
| | - Ralf Schmitz
- Department of Gynecology and Obstetrics, University Hospital Münster, Munster, Germany
| | - Rene Schmidt
- Institute of Biostatistics and Clinical Research, University of Münster, Munster, Germany
| | - Kathrin Oelmeier
- Department of Gynecology and Obstetrics, University Hospital Münster, Munster, Germany
| | - Kerstin Hammer
- Department of Gynecology and Obstetrics, University Hospital Münster, Munster, Germany
| | - Maria Falkenberg
- Department of Gynecology and Obstetrics, University Hospital Münster, Munster, Germany
| | - Janina Braun
- Department of Gynecology and Obstetrics, University Hospital Münster, Munster, Germany
| | - Helen Ann Köster
- Department of Gynecology and Obstetrics, University Hospital Münster, Munster, Germany
| | - Johannes Steinhard
- Fetal Cardiology, Heart and Diabetes Center NRW, Ruhr-University Bochum, Bad Oeynhausen, Germany
| | - Mareike Möllers
- Department of Gynecology and Obstetrics, University Hospital Münster, Munster, Germany
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Nobile S, Di Sipio Morgia C, Vento G. Perinatal Origins of Adult Disease and Opportunities for Health Promotion: A Narrative Review. J Pers Med 2022; 12:jpm12020157. [PMID: 35207646 PMCID: PMC8877993 DOI: 10.3390/jpm12020157] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/21/2022] [Accepted: 01/22/2022] [Indexed: 01/27/2023] Open
Abstract
The “developmental origins of health and disease” (DOHaD) hypothesis refers to the influence of early developmental exposures and fetal growth on the risk of chronic diseases in later periods. During fetal and early postnatal life, cell differentiation and tissue formation are influenced by several factors. The interaction between genes and environment in prenatal and early postnatal periods appears to be critical for the onset of multiple diseases in adulthood. Important factors influencing this interaction include genetic predisposition, regulation of gene expression, and changes in microbiota. Premature birth and intrauterine growth restriction (IUGR) are other important factors considered by the DOHaD hypothesis. Preterm birth is associated with impaired or arrested structural or functional development of key organs/systems, making preterm infants vulnerable to cardiovascular, respiratory, and chronic renal diseases during adulthood. Growth restriction, defined as impaired fetal growth compared to expected biological potential in utero, is an additional negative factor increasing the risk of subsequent diseases. Environmental factors implicated in the developmental programming of diseases include exposure to pollution, stress, drugs, toxic agents, nutrition, and exercise. The DOHaD may explain numerous conditions, including cardiovascular, metabolic, respiratory, neuropsychiatric, and renal diseases. Potential antenatal and postnatal preventive measures, interventions, and future directions are discussed.
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79
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Gantenbein KV, Kanaka-Gantenbein C. Highlighting the trajectory from intrauterine growth restriction to future obesity. Front Endocrinol (Lausanne) 2022; 13:1041718. [PMID: 36440208 PMCID: PMC9691665 DOI: 10.3389/fendo.2022.1041718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 10/25/2022] [Indexed: 11/12/2022] Open
Abstract
During the last decades several lines of evidence reported the association of an adverse intrauterine environment, leading to intrauterine restriction, with future disease, such as obesity and metabolic syndrome, both leading to increased cardiovascular and cancer risk. The underlying explanation for this association has firstly been expressed by the Barker's hypothesis, the "thrifty phenotype hypothesis". According to this hypothesis, a fetus facing an adverse intrauterine environment adapts to this environment through a reprogramming of its endocrine-metabolic status, during the crucial window of developmental plasticity to save energy for survival, providing less energy and nutrients to the organs that are not essential for survival. This theory evolved to the concept of the developmental origin of health and disease (DOHaD). Thus, in the setting of an adverse, f. ex. protein restricted intrauterine environment, while the energy is mainly directed to the brain, the peripheral organs, f.ex. the muscles and the liver undergo an adaptation that is expressed through insulin resistance. The adaptation at the hepatic level predisposes to future dyslipidemia, the modifications at the vascular level to endothelial damage and future hypertension and, overall, through the insulin resistance to the development of metabolic syndrome. All these adaptations are suggested to take place through epigenetic modifications of the expression of genes without change of their amino-acid sequence. The epigenetic modifications leading to future obesity and cardiovascular risk are thought to induce appetite dysregulation, promoting food intake and adipogenesis, facilitating obesity development. The epigenetic modifications may even persist into the next generation even though the subsequent generation has not been exposed to an adverse intrauterine environment, a notion defined as the "transgenerational transfer of environmental information". As a consequence, if the increased public health burden and costs of non-communicable chronic diseases such as obesity, hypertension, metabolic syndrome and type 2 diabetes have to be minimized, special attention should be laid to the healthy lifestyle habits of women of reproductive age, including healthy diet and physical activity to be established long before any pregnancy takes place in order to provide the best conditions for both somatic and mental health of future generations.
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Affiliation(s)
| | - Christina Kanaka-Gantenbein
- Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, Athens, Greece
- *Correspondence: Christina Kanaka-Gantenbein, ,
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Lin J, Wang C, Li S, Zhang J, Jin L, Tong M, Meng W, Ren A, Chen L, Jin L. Periconceptional Folic Acid Supplementation and Newborn Birth Weights. Front Pediatr 2022; 10:844404. [PMID: 35573945 PMCID: PMC9096220 DOI: 10.3389/fped.2022.844404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/22/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The relationship between maternal folic acid supplementation and the birth weights of offspring remains inconclusive. AIM To examine the associations between maternal supplementation with folic acid only (FAO) or multiple micronutrients containing folic acid (MMFA) and newborn birth weights, as well as the risk of small for gestational week age (SGA) and large for gestational week age (LGA) newborns. METHODS Data on 31,107 births from 2015 to 2018 were extracted from the population-based prenatal health care system in a district of Beijing. Generalized linear and logistic regression models were used to evaluate the association between maternal periconceptional folic acid supplementation and birth weights or with risk of small for gestational week age (SGA) and large for gestational week age (LGA). RESULTS Compared with newborns whose mothers did not use any folic acid supplements, the newborns with maternal periconceptional folic acid supplementation had similar median birth weight but had a lower risk of SGA [adjusted odds ratio (aOR) = 0.81 (95% CI: 0.68-0.97)], however newborns born to mothers who took multiple micronutrients with folic acid (MMFA) with high compliance had a 25.59 g (95% CI: 6.49-44.69) higher median birth weight. Periconceptional women took folic acid only (FAO) (aOR = 0.83; 95%CI: 0.67-1.01) or MMFA (aOR = 0.74; 95%CI: 0.60-0.91) with high compliance decreased the risk of SGA, but has no impact on the risk of LGA. CONCLUSION Periconceptional FAO supplementation has no impact on the median birth weight of offspring and the risk of LGA. Compared with FAO, MMFA supplementation may increase the average birth weight, and a high compliance of supplementation with FAO or MMFA may reduce the risk of SGA, with MMFA having ad stronger effect than FAO.
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Affiliation(s)
- Jing Lin
- Department of Obstetrics and Gynecology, The Sixth Medical Center of People's Liberation Army (PLA) General Hospital, Beijing, China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Cheng Wang
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, The National Health Commission of the People's Republic of China, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Sisi Li
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, The National Health Commission of the People's Republic of China, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jie Zhang
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, The National Health Commission of the People's Republic of China, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Lei Jin
- Tongzhou Maternal and Child Health Care Hospital of Beijing, Beijing, China
| | - Mingkun Tong
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, The National Health Commission of the People's Republic of China, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Wenying Meng
- Tongzhou Maternal and Child Health Care Hospital of Beijing, Beijing, China
| | - Aiguo Ren
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, The National Health Commission of the People's Republic of China, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Lei Chen
- Department of Obstetrics and Gynecology, The Sixth Medical Center of People's Liberation Army (PLA) General Hospital, Beijing, China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Lei Jin
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, The National Health Commission of the People's Republic of China, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
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81
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ASSIS PPD, MENEZES JSDS, DINIZ ADS, ANTUNES MMDC, CABRAL PC. Growth of infants with gastrointestinal manifestations of cow’s milk protein allergy. REV NUTR 2022. [DOI: 10.1590/1678-9865202235e210075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To assess linear growth and weight gain in infants with suspected cow’s milk protein allergy with gastrointestinal manifestations, seen at a gastropediatrics clinic. Methods A retrospective cohort study conducted with demographic, clinical, anthropometric and dietary information on 84 infants first seen between 2015 and 2018 and followed-up for six months. Stature-for-age, weight-for-age, and body mass index-for-age in z-scores were evaluated according to the cut off points established by the World Health Organization in 2006. Accelerated growth or catch-up was considered a gain ?0.67 in the z-score of the referred indices, evaluated at 3 and 6 months. Results Median age at baseline was 4.0 months and 88.1% of the infants were already in diet exclusion. Regarding the anthropometric evaluation short stature frequency was 15.5% and the underweight frequency was 8.3% and 3.6% respectively based on the weight-for-age and body mass index-for-age indices. High recovery growth was observed during the follow-up period but was not considered catch up. In boys, the gains in weight-for-age and body mass index-for-age were significant (p=0.02 and p=0.01 respectively) and close to the threshold that characterizes the catch up, 0.58 and 0.59, respectively. In girls, significant gains in stature-for-age and weight-for-age (0.38 and 0.37 respectively, p=0.02 for both) were observed. Conclusion Infants with suspected cow’s milk protein allergy with gastrointestinal manifestations should have early access to specialized nutritional counseling to avoid exposure to allergenic food and control allergy symptoms, thereby avoiding malnutrition and ensuring adequate nutritional recovery.
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82
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Rogers LK, Slaughter JL. Editorial: Developmental origins of health and disease: Impact of preterm birth. Front Pediatr 2022; 10:1120208. [PMID: 36683791 PMCID: PMC9845946 DOI: 10.3389/fped.2022.1120208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 01/05/2023] Open
Affiliation(s)
- Lynette Kay Rogers
- Department of Pediatrics, The Ohio State University, Columbus, OH, United States.,Department of Pediatrics, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Jonathan L Slaughter
- Department of Pediatrics, The Ohio State University, Columbus, OH, United States.,Department of Pediatrics, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
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83
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Patti G, Malerba F, Calevo MG, Schiavone M, Scaglione M, Casalini E, Russo S, Fava D, Bassi M, Napoli F, Allegri AEM, D’Annunzio G, Gastaldi R, Maghnie M, Di Iorgi N. Pubertal timing in children with Silver Russell syndrome compared to those born small for gestational age. Front Endocrinol (Lausanne) 2022; 13:975511. [PMID: 36093089 PMCID: PMC9451521 DOI: 10.3389/fendo.2022.975511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 07/28/2022] [Indexed: 11/13/2022] Open
Abstract
CONTEXT Data on pubertal timing in Silver Russell syndrome (SRS) are limited. DESIGN AND METHODS Retrospective observational study including twenty-three SRS patients [11p15 loss of methylation, (11p15 LOM, n=10) and maternal uniparental disomy of chromosome 7 (mUPD7, n=13)] and 21 small for gestational age (SGA). Clinical (thelarche in females; testis volume ≥ 4 ml in males; pubarche), BMI SD trend from the age of 5 to 9 years to the time of puberty, biochemical parameters of puberty onset [Luteinizing hormone (LH), 17-β-estradiol, testosterone], and bone age progression were evaluated. RESULTS Pubertal onset and pubarche occurred significantly earlier in children with SRS than in SGA (p 0.03 and p 0.001, respectively) and clinical signs of puberty onset occurred earlier in mUPD7 than in 11p15LOM group (p 0.003). Five SRS children experienced central precocious puberty and LH, 17-β-estradiol, testosterone were detected earlier in SRS than in SGA (p 0.01; p 0.0001). Bone age delay in SRS children was followed by rapid advancement; the delta between bone age and chronological age in SRS group became significantly higher than in SGA group at the age of 9-11 years (p 0.007). 11p15LOM patients were underweight at the age of 5 years and showed a progressive normalization of BMI that was significantly higher than in mUPD7 (p 0.04) and SGA groups (p 0.03) at puberty onset. CONCLUSION Timing of puberty is affected in SRS and occurred earlier in mUPD7 compared to 11p15LOM. The impact of early puberty on adult height and metabolic status deserves long-term evaluation.
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Affiliation(s)
- Giuseppa Patti
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health - University of Genova, Genova, Italy
- *Correspondence: Giuseppa Patti, ; Mohamad Maghnie, ;
| | - Federica Malerba
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health - University of Genova, Genova, Italy
| | - Maria Grazia Calevo
- Epidemiology and Biostatistics Unit, Scientific Direction, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | | | - Marco Scaglione
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health - University of Genova, Genova, Italy
| | - Emilio Casalini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health - University of Genova, Genova, Italy
| | - Silvia Russo
- Cytogenetic and Molecular Genetics Laboratory, IRCCS, Istituto Auxologico Italiano, Milano, Italy
| | - Daniela Fava
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health - University of Genova, Genova, Italy
| | - Marta Bassi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health - University of Genova, Genova, Italy
| | - Flavia Napoli
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | | | | | - Roberto Gastaldi
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Mohamad Maghnie
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health - University of Genova, Genova, Italy
- *Correspondence: Giuseppa Patti, ; Mohamad Maghnie, ;
| | - Natascia Di Iorgi
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health - University of Genova, Genova, Italy
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84
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Zhou Y, Liu Y, Zhang Y, Zhang Y, Wu W, Fan J. Identifying Non-Linear Association Between Maternal Free Thyroxine and Risk of Preterm Delivery by a Machine Learning Model. Front Endocrinol (Lausanne) 2022; 13:817595. [PMID: 35282469 PMCID: PMC8907667 DOI: 10.3389/fendo.2022.817595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/17/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Preterm delivery (PTD) is the primary cause of mortality in infants. Mounting evidence indicates that thyroid dysfunction might be associated with an increased risk of PTD, but the dose-dependent association between the continuous spectrum maternal free thyroxine (FT4) and PTD is still not well-defined. This study aimed to further investigate this relationship using a machine learning-based model. METHODS A hospital-based cohort study was conducted from January 2014 to December 2018 in Shanghai, China. Pregnant women who delivered singleton live births and had first-trimester thyroid function data available were included. The generalized additive models with penalized cubic regression spline were applied to explore the non-linear association between maternal FT4 and risk of PTD and also subtypes of PTD. The time-to-event method and multivariable Cox proportional hazard model were further applied to analyze the association of abnormally high and low maternal FT4 concentrations with the timing of PTD. RESULTS A total of 65,565 singleton pregnancies with completed medical records and no known thyroid disease before pregnancy were included for final analyses. There was a U-shaped dose-dependent relationship between maternal FT4 in the first trimester and PTD (p <0.001). Compared with the normal range of maternal FT4, increased risk of PTD was identified in both low maternal FT4 (<11.7 pmol/L; adjusted hazard ratio [HR] 1.34, 95% CI [1.13-1.59]) and high maternal FT4 (>19.7 pmol/L; HR 1.41, 95% CI [1.13-1.76]). The association between isolated hypothyroxinemia and PTD was mainly associated with spontaneous PTD (HR 1.33, 95% CI [1.11-1.59]) while overt hyperthyroidism may be attributable to iatrogenic PTD (HR 1.51, 95% CI [1.18-1.92]) when compared with euthyroid women. Additionally, mediation analysis identified that an estimated 11.80% of the association between overt hyperthyroidism and iatrogenic PTD risk was mediated via the occurrence of hypertensive disorders in pregnancy (p <0.001). CONCLUSIONS We revealed a U-shaped association between maternal FT4 and PTD for the first time, exceeding the clinical definition of maternal thyroid function test abnormalities. Our findings provide insights towards the need to establish optimal range of maternal FT4 concentrations for preventing adverse outcomes in pregnancy.
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Affiliation(s)
- Yulai Zhou
- The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Yindi Liu
- The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Yuan Zhang
- The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Yong Zhang
- The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Weibin Wu
- The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- *Correspondence: Weibin Wu, ; Jianxia Fan,
| | - Jianxia Fan
- The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
- *Correspondence: Weibin Wu, ; Jianxia Fan,
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85
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Association between Paternal age and subtypes of preterm birth: A retrospective study. Reprod Biomed Online 2021; 44:1101-1109. [DOI: 10.1016/j.rbmo.2021.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 12/11/2021] [Accepted: 12/13/2021] [Indexed: 10/19/2022]
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86
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Kodde A, Mischke M, Rakhshandehroo M, Voggel J, Fink G, Nüsken E, Rauh M, van der Beek EM, Dötsch J, Nüsken KD. The effect of dietary lipid quality in early life on serum LysoPC(18:2) levels and their association with adult blood glucose levels in intrauterine growth restricted rats. Nutr Metab (Lond) 2021; 18:101. [PMID: 34838065 PMCID: PMC8627018 DOI: 10.1186/s12986-021-00614-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 08/15/2021] [Indexed: 12/17/2022] Open
Abstract
Being born small-for-gestational-age, especially with subsequent catch-up growth, is associated with impaired metabolic health in later-life. We previously showed that a postnatal diet with an adapted lipid droplet structure can ameliorate some of the adverse metabolic consequences in intrauterine growth-restricted (IUGR) rats. The aim of the present work was to explore possible underlying mechanism(s) and potential biomarkers. To this end, serum metabolomics was performed in postnatal day (PN) 42 and PN96 samples of the above-mentioned rat offspring, born after uterine vasculature ligation. Blood samples were collected at PN42, directly after a postnatal dietary intervention with either complex lipid matrix (CLM) or control (CTRL) diet, and at PN96 after a subsequent western-style diet (WSD). Offspring of Non-operated (NOP) dams fed CTRL in early life were included as control group. In the PN42 metabolomics data, 11 co-abundance modules of metabolites were identified, of which four were significantly correlated to adult blood glucose levels at PN96. Further analyses showed that Lysophosphatidylcholine(18:2) (LysoPC(18:2)) levels were reduced by ligation (p < 0.01) and restored in CLM fed animals (p < 0.05). LysoPC(18:2) levels at PN42 correlated inversely with adult blood glucose levels. These data indicate that early-life LysoPC(18:2) blood levels may predict adult blood glucose levels and are affected by a postnatal diet with an adapted lipid droplet structure in IUGR offspring.
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Affiliation(s)
- Andrea Kodde
- Danone Nutricia Research, Utrecht, The Netherlands.
| | - Mona Mischke
- Danone Nutricia Research, Utrecht, The Netherlands
| | | | - Jenny Voggel
- Department of Pediatrics and Adolescent Medicine, Medical Faculty, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Gregor Fink
- Department of Pediatrics and Adolescent Medicine, Medical Faculty, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Eva Nüsken
- Department of Pediatrics and Adolescent Medicine, Medical Faculty, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Manfred Rauh
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen, Germany
| | - Eline M van der Beek
- Department of Pediatrics, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Jörg Dötsch
- Department of Pediatrics and Adolescent Medicine, Medical Faculty, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Kai-Dietrich Nüsken
- Department of Pediatrics and Adolescent Medicine, Medical Faculty, University Hospital Cologne, University of Cologne, Cologne, Germany
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87
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Chen Y, Xia X, Fang M, Chen G, Cao J, Qu H, Wang H. Maternally derived low glucocorticoid mediates adrenal developmental programming alteration in offspring induced by dexamethasone. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 797:149084. [PMID: 34303245 DOI: 10.1016/j.scitotenv.2021.149084] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/30/2021] [Accepted: 07/13/2021] [Indexed: 06/13/2023]
Abstract
Adverse environments during pregnancy can increase susceptibility to chronic diseases in adult offspring. The occurrence and development of fetal-originated diseases were associated with adrenal developmental programming and homeostasis alteration in offspring. Dexamethasone is widely used for preterm delivery-related pregnancy diseases, but the intrauterine programming alteration and its occurrence mechanism of prenatal dexamethasone exposure (PDE) on adrenal development in offspring have not been clarified. In this study, prenatal dexamethasone therapy could inhibit neonatal development and cause a low exposure of maternally derived glucocorticoid in clinic. Then, we established a rat model of PDE and observed a similar phenomenon. Further, the adrenal steroidogenic function was continuously inhibited in the PDE male offspring rats, accompanied by the decreased H3K27ac level of adrenal insulin-like growth factor 1 (IGF1) and its expression. Moreover, chronic stress in PDE adult offspring rats could reverse the changes of the above indicators through the high level of glucocorticoid. In combination with in vivo, in vitro and a series of interference experiments, we confirmed that the low level of endogenous glucocorticoids inhibited the adrenal IGF1 expression and steroidogenic function through the GRα/miR-370-3p/Sirt3 pathway. In summary, PDE could continuously inhibit the adrenal steroidogenic function in the male offspring, which is associated with the maternally derived low glucocorticoid-mediated the adrenal developmental programming alteration in offspring. This study provides a theoretical and experimental basis for explaining the adrenal development origin of PDE-induced adult chronic diseases.
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Affiliation(s)
- Yawen Chen
- Department of Pharmacology, Wuhan University School of Basic Medical Sciences, Wuhan 430071, China
| | - Xuan Xia
- Department of Pharmacology, Wuhan University School of Basic Medical Sciences, Wuhan 430071, China
| | - Man Fang
- Department of Obstetrics and Gynaecology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Guanghui Chen
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China
| | - Jiangang Cao
- Department of Pharmacology, Wuhan University School of Basic Medical Sciences, Wuhan 430071, China
| | - Hui Qu
- Department of Pharmacology, Wuhan University School of Basic Medical Sciences, Wuhan 430071, China
| | - Hui Wang
- Department of Pharmacology, Wuhan University School of Basic Medical Sciences, Wuhan 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China.
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Shagaro SS, Mulugeta BT, Kale TD. Complementary feeding practices and associated factors among mothers of children aged 6-23 months in Ethiopia: Secondary data analysis of Ethiopian mini demographic and health survey 2019. Arch Public Health 2021; 79:205. [PMID: 34809724 PMCID: PMC8607675 DOI: 10.1186/s13690-021-00725-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/30/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Optimal nutrition in early child's life plays a vital role in improving mental and motor development, reduces the possibility of contracting various infectious diseases and related deaths, decreases the risk of obesity, and fosters better overall development. However, 45% of deaths in children under five years of age that occur globally is attributed to nutrition-related factors and the majority of these deaths occur in low-and middle-income countries. Therefore, this study aims to assess complementary feeding practices and associated factors among mothers of children aged 6-23 months in Ethiopia. METHOD The study used the Ethiopian mini demographic and health survey 2019 data. A two-stage stratified cluster sampling technique was used to select 1465 mothers of children aged 6-23 months in Ethiopia. Two-level multilevel mixed-effects logistic regression model analysis was computed, and variables with p-value of less than 5% and an adjusted odds ratio with a 95% confidence interval in the final model were reported as statistically significant factors with appropriate complementary feeding practice. RESULT The overall prevalence of appropriate complementary feeding practice among mothers of children aged 6-23 months was 9.76%. In our study, mothers who attended primary[AOR = 2.72; 95%CI: 1.47-5.01], secondary[AOR = 2.64; 95%CI: 1.18-5.92] and higher school[AOR = 5.39; 95%CI: 2.29-12.64], being from medium income household[AOR = 2.89; 95%CI: 1.41-5.92], attended 1-3 times ANC visits in index pregnancy[AOR = 0.41; 95%CI: 0.18-0.89], mothers who have 12-17 months[AOR = 1.96; 95%CI: 1.16-3.33] and 18-23 months old children[AOR = 2.61; 95%CI: 1.49-4.54], currently breastfeeding mothers[AOR = 3.69; 95%CI: 1.73-7.91], mothers from pastoralist contextual regions[AOR = 0.29; 95%CI: 0.09-0.91], and mothers who have resided in rural areas[AOR = 0.49; 95%CI: 0.25-0.97] were factors significantly associated with appropriate complementary feeding practice. CONCLUSION This study showed low prevalence of appropriate complementary feeding practice. Therefore, the concerned health authorities need to strengthen the existing approaches designed for provision of nutrition education particularly targeting mothers who are unschooled, who have 6-11 months old children, live in pastoralist regions and reside in rural parts of the country, and create strategies that improve maternal job opportunities.
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Affiliation(s)
- Sewunet Sako Shagaro
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
| | - Be'emnet Tekabe Mulugeta
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Temesgen Dileba Kale
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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89
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Gleason JL, Yeung E, Sundaram R, Mendola P, Bell EM, Vafai Y, Robinson SL, Putnick DL, Grantz KL. Developmental outcomes in small-for-gestational age twins using a singleton vs twin birthweight reference in Upstate KIDS. Am J Obstet Gynecol MFM 2021; 3:100465. [PMID: 34416423 DOI: 10.1016/j.ajogmf.2021.100465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 08/04/2021] [Accepted: 08/11/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Limited data exist about the potential developmental delays in appropriately grown twins; furthermore, twins may be at higher risk of developmental delay than singletons. Small-for-gestational age is a risk factor for developmental delay and is based on singleton birthweight references, which may misclassify small-for-gestational age in a subset of appropriately grown twins. OBJECTIVE This study aimed to evaluate the risk of developmental delay in twins classified as small-for-gestational age according to the twin and singleton birthweight references (<10th percentile). STUDY DESIGN In a birth cohort (2008-2010) of twins (n=1790) and singletons (n=3829) where parents completed Ages & Stages Questionnaires for child development between 4 and 36 months, we used a US population-based birthweight reference to categorize singletons and twins as small-for-gestational age. Uncertain small-for-gestational age twins were defined as small-for-gestational age by a singleton reference (<10th percentile) and not by a twin reference, and twin-reference small-for-gestational age twins were defined as small-for-gestational age by a twin reference. Adjusted generalized linear mixed-effects models were used to estimate the odds of failure on any Ages & Stages Questionnaires domain and on each of the 5 domains (fine motor, gross motor, communication, personal-social, and problem-solving domains); random intercepts accounted for repeated measures and twin clustering. RESULTS Compared with non-small-for-gestational age twins (>10th percentile), uncertain small-for-gestational age twins did not have higher odds of Ages & Stages Questionnaires failure (adjusted odds ratio, 1.28; 95% confidence interval, 0.91-1.80). Compared with non-small-for-gestational age singletons, both twin-reference and uncertain small-for-gestational age twins had higher odds of Ages & Stages Questionnaires failure, with the highest risk conferred to twin-reference small-for-gestational age twins (twin-reference adjusted odds ratio, 3.14 [95% confidence interval, 1.94-5.10]; uncertain adjusted odds ratio, 2.35 [95% confidence interval, 1.69-3.26]; P<.01 for trend). Results remained consistent when limiting analyses to term births (≥37 weeks' gestation). CONCLUSION Although a singleton reference may overestimate small-for-gestational age in twins, the findings indicated that a singleton birthweight reference may be appropriate for twins because it identifies more twins at risk of developmental delay than a twin reference.
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Affiliation(s)
- Jessica L Gleason
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (Drs Gleason, Yeung, Mendola, Vafai, Robinson, Putnick, and Grantz)
| | - Edwina Yeung
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (Drs Gleason, Yeung, Mendola, Vafai, Robinson, Putnick, and Grantz)
| | - Rajeshwari Sundaram
- Biostatistics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (Dr Sundaram)
| | - Pauline Mendola
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (Drs Gleason, Yeung, Mendola, Vafai, Robinson, Putnick, and Grantz)
| | - Erin M Bell
- Departments of Environmental Health Sciences and Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, NY (Dr Bell)
| | - Yassaman Vafai
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (Drs Gleason, Yeung, Mendola, Vafai, Robinson, Putnick, and Grantz)
| | - Sonia L Robinson
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (Drs Gleason, Yeung, Mendola, Vafai, Robinson, Putnick, and Grantz)
| | - Diane L Putnick
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (Drs Gleason, Yeung, Mendola, Vafai, Robinson, Putnick, and Grantz)
| | - Katherine L Grantz
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (Drs Gleason, Yeung, Mendola, Vafai, Robinson, Putnick, and Grantz).
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90
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Chen X, Koivuaho E, Piltonen TT, Gissler M, Lavebratt C. Association of maternal polycystic ovary syndrome or anovulatory infertility with obesity and diabetes in offspring: a population-based cohort study. Hum Reprod 2021; 36:2345-2357. [PMID: 34046665 PMCID: PMC8289324 DOI: 10.1093/humrep/deab112] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/09/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Are children of mothers with polycystic ovary syndrome (PCOS) or anovulatory infertility at increased risks of obesity or diabetes? SUMMARY ANSWER Maternal PCOS/anovulatory infertility is associated with an increased risk of offspring obesity from early age and diabetes in female offspring from late adolescence. WHAT IS KNOWN ALREADY Women with PCOS often have comorbid metabolic disorders such as obesity and diabetes, and children of mothers with PCOS have an increased risk of subtle signs of cardiometabolic alterations. STUDY DESIGN, SIZE, DURATION This was a nationwide cohort study of all live births (n = 1 105 997) during 1996-2014 in Finland, excluding those with maternal diagnoses sharing signs and symptoms with PCOS (n = 8244). A total of 1 097 753 births were included and followed up until 31 December 2018. PARTICIPANTS/MATERIALS, SETTING, METHODS National registries were linked to identify births with maternal PCOS or anovulatory infertility (n = 24 682). The primary outcomes were diagnoses of obesity (ICD-10: E65, E66) and diabetes (ICD-10: E10-E14) in offspring recorded in the Finnish Care Register for Health Care. Cox proportional hazards regression was modeled to analyze the risk of offspring obesity and diabetes in relation to prenatal exposure to maternal PCOS/anovulatory infertility. Differently adjusted models and stratified analyses were used to assess whether the risk was modified by maternal obesity or diabetes diagnoses, pre-pregnancy BMI, fertility treatment or perinatal problems. MAIN RESULTS AND THE ROLE OF CHANCE Exposure to maternal PCOS/anovulatory infertility was associated with a higher cumulative incidence of obesity in the children (exposed: 1.83%; 95% CI 1.66-2.00% vs unexposed: 1.24%; 95% CI 1.22-1.26%). Accounting for birth factors and maternal characteristics such as obesity and diabetes diagnoses, the hazard ratio (HR) for obesity was increased in offspring below 9 years of age (HR 1.58; 95% CI 1.30-1.81), and in those 10-16 years of age (HR 1.37; 95% CI 1.19-1.57), but not in those aged 17-22 years (HR 1.24; 95% CI 0.73-2.11). Sex-stratified analyses revealed similar risk estimates for boys (HR 1.48; 95% CI 1.31-1.68) and girls (HR 1.45; 95% CI 1.26-1.68). Notably, the joint effect of PCOS/anovulatory infertility and BMI-based pre-pregnancy obesity on offspring obesity (HR 8.89; 95% CI 7.06-11.20) was larger than that of either PCOS/anovulatory infertility or obesity alone. Furthermore, PCOS/anovulatory infertility was associated with offspring obesity in children without perinatal problems (HR 1.27; 95% CI 1.17-1.39), with larger effect size for maternal PCOS/anovulatory infertility and joint perinatal problems (HR 1.61; 95% CI 1.35-1.91). However, the risk estimates were comparable between maternal PCOS/anovulatory infertility with (HR 1.54; 95% CI 1.17-2.03) and without fertility treatment (HR 1.46; 95% CI 1.32-1.61). For offspring diabetes, the HR was increased only between 17 and 22 years of age (HR 2.06; 95% CI 1.23-3.46), and specifically for Type 1 diabetes in females (HR 3.23; 95% CI 1.41-7.40). LIMITATIONS, REASONS FOR CAUTION The prevalence of PCOS/anovulatory infertility in this study was 2.2%, lower than that reported in previous studies. In addition, the incidence of obesity in offspring was lower than that reported in studies based on measured or self-reported weight and height and may include mainly moderate and severe obesity cases who needed and/or actively sought medical care. Moreover, mothers with PCOS/anovulatory infertility were identified based on ICD codes, with no information on PCOS phenotypes. Furthermore, maternal pre-pregnancy BMI was available only from 2004. The PCOS/anovulatory infertility association with female offspring diabetes was based on only a few cases. Mothers' weight gain during pregnancy, use of fertility treatment other than fresh or frozen IVF/ICSI, offspring lifestyle, as well as fathers' age, medical disorders or medication prescriptions were not available for this study. WIDER IMPLICATIONS OF THE FINDINGS These findings support that prenatal PCOS/anovulatory infertility exposure influences metabolic health in the offspring from early age. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by Shandong Provincial Natural Science Foundation, China [ZR2020MH064 to X.C.], Shandong Province Medical and Health Technology Development Plan [2018WS338 to X.C.], the joint research funding of Shandong University and Karolinska Institute [SDU-KI-2019-08 to X.C. and C.L.], the Finnish Institute for Health and Welfare: Drug and Pregnancy Project [M.G.], the Swedish Research Council [2014-10171 to C.L.], the regional agreement on medical training and clinical research (ALF) between Stockholm County Council and Karolinska Institute Stockholm County Council [SLL20170292 and SLL20190589 to C.L.], the Swedish Brain Foundation [FO2018-0141 and FO2019-0201 to C.L.]. X.C. received grants from the China Scholarship Council at the beginning of the study. The authors have no competing interests to disclose. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Xinxia Chen
- School of Nursing, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Emilia Koivuaho
- Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Terhi T Piltonen
- Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Mika Gissler
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.,Department of Information Services, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Catharina Lavebratt
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
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91
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Marcovecchio ML, Gorman S, Watson LPE, Dunger DB, Beardsall K. Catch-Up Growth in Children Born Small for Gestational Age Related to Body Composition and Metabolic Risk at Six Years of Age in the UK. Horm Res Paediatr 2021; 93:119-127. [PMID: 32702692 DOI: 10.1159/000508974] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/15/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To determine differences in body composition and glucose metabolism according to childhood growth outcomes in a population-based sample of children born small for gestational age (SGA). METHODS A single-centre study of 259 children born SGA identified through hospital records and contacted when aged 4-7 years. Questionnaire data on pre/perinatal history and growth parameters during childhood was collected from the parents, and in a subgroup of 150 children face-to-face assessments were performed, including anthropometric parameters, lean and fat mass, blood pressure, fasting glucose, and C-peptide. RESULTS Based on the questionnaires, few children had formal clinic follow-up of growth, but 7% of the cohort showed a height and weight of <-2SDS during childhood, and only 2 children met the criteria for growth hormone therapy. Out of the 150 children assessed at a mean age of 6.1 ± 0.8 years, 122 (81%) showed a catch-up growth in weight. Compared to those without weight catch-up, these children had a higher fat mass index (3.13 ± 1.36 vs. 2.56 ± 0.91 kg/m2, p = 0.04), trunk-to-limb fat mass ratio (0.63 ± 0.14 vs. 0.56 ± 0.08, p = 0.002), systolic blood pressure SDS (0.09 ± 0.71 vs. -0.32 ± 0.63, p = 0.008), fasting glucose (4.5 ± 0.5 vs. 4.3 ± 0.5 mmol/L, p = 0.03), and C-peptide (306 ± 116 vs. 256 ± 112 pmol/L, p = 0.08). Among children with weight catch-up growth, those with less height gain had a lower limb lean mass index (4.25 ± 0.48 vs. 4.48 ± 0.56 kg/m2, p = 0.02) and fat mass index (1.57 ± 0.59 vs. 1.83 ± 0.77 kg/m2, p = 0.04). CONCLUSIONS Within this population-based sample of SGA children, catch-up growth in weight was associated with higher abdominal fat mass, blood pressure and glycemia; furthermore, in these children, less height gain was associated with reduced limb lean and fat mass.
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Affiliation(s)
| | - Samantha Gorman
- The Weston Centre, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
| | - Laura P E Watson
- National Institute for Health Research (NIHR) Cambridge Clinical Research Facility, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
| | - David B Dunger
- Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom.,Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
| | - Kathryn Beardsall
- Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom.,Neonatal Unit, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
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92
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Workicho A, Biadgilign S, Kershaw M, Gizaw R, Stickland J, Assefa W, Abuye C, Woldegiorgis B, Berhanu L, Kennedy E. Social and behaviour change communication to improve child feeding practices in Ethiopia. MATERNAL AND CHILD NUTRITION 2021; 17:e13231. [PMID: 34132054 PMCID: PMC8476421 DOI: 10.1111/mcn.13231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 04/08/2021] [Accepted: 05/26/2021] [Indexed: 11/29/2022]
Abstract
Social and behaviour change communication (SBCC) interventions can positively affect optimal nutritional practices. This study evaluated the added value of a virtual facilitator tool to an enhanced community conversation (ECC) programme to improve infant and young child feeding (IYCF) practice among children under the Growth through Nutrition Activity programme in Ethiopia. The study used a quasi-experimental design with a control group. Pregnant and/or lactating women were the study population for both study groups. The intervention (ECC + VF) group received all the same components as the control group but had the addition of in-person ECC meetings supplemented with audio-recorded virtual facilitators (VF) sessions designed to complement the monthly meeting lesson or topic. A difference in difference analysis was employed using generalized linear mixed model (GLMM) in Stata version 15.0 (Stata Corporation, College Station, TX). A p-value of less than or equal to 0.05 was considered significant for all tests. Accordingly, a 13.6% change in iron folic acid (IFA) intake for 3 months and above was observed in the intervention group. Even though not statistically significant, large to moderate positive changes in child minimum diet diversity (20%), minimum acceptable diet (18%) and women diet diversity (7.9%) were observed in the intervention group. This study identified the use of virtual facilitators as a modality to transmit standard nutrition messages during ECC programmes for optimal IYCF practices. The findings strengthen the notion that using a combination of SBCC approaches has advantage over a single method in improving important nutritional practices.
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Affiliation(s)
- Abdulhalik Workicho
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Sibhatu Biadgilign
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Meghan Kershaw
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Rahel Gizaw
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Jennifer Stickland
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Wossen Assefa
- Growth through Nutrition, Save the Children International, Addis Ababa, Ethiopia
| | - Cherinet Abuye
- Growth through Nutrition, Save the Children International, Addis Ababa, Ethiopia
| | - Behailu Woldegiorgis
- Growth through Nutrition, Save the Children International, Addis Ababa, Ethiopia
| | - Lioul Berhanu
- Growth through Nutrition, Save the Children International, Addis Ababa, Ethiopia
| | - Eileen Kennedy
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
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93
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Rustogi D, Synnes A, Alshaikh B, Hasan S, Drolet C, Masse E, Murthy P, Shah PS, Yusuf K. Neurodevelopmental outcomes of singleton large for gestational age infants <29 weeks' gestation: a retrospective cohort study. J Perinatol 2021; 41:1313-1321. [PMID: 34035448 DOI: 10.1038/s41372-021-01080-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 04/05/2021] [Accepted: 04/28/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To compare neurodevelopmental outcomes of large and appropriate for gestational age (LGA, AGA) infants <29 weeks' gestation at 18-24 months of corrected age. STUDY DESIGN Retrospective cohort study using the Canadian Neonatal Network and Canadian Neonatal Follow-Up Network databases. Primary outcome was a composite of death or significant neurodevelopmental impairment (NDI), defined as severe cerebral palsy, Bayley III cognitive, language and motor scores of <70, need for hearing aids or cochlear implant and bilateral visual impairment. Univariate and multivariable logistic analyses were applied for outcomes. RESULTS The study cohort comprised 170 LGA and 1738 AGA infants. There was no difference in significant NDI or individual components of the Bayley III between LGA and AGA groups. LGA was associated with the increased risk of death by follow-up, 44/170 (25.9%) vs. 320/1738 (18.4%) (aOR: 1.60 95% CI: 1.00-2.54). CONCLUSIONS Risk of NDI was similar between LGA and AGA infants.
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Affiliation(s)
- Deepika Rustogi
- Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Anne Synnes
- Division of Neonatology, Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Belal Alshaikh
- Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Shabih Hasan
- Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | | | - Edith Masse
- CHU de Sherbrooke, University of Sherbrooke, Quebec, Canada
| | - Prashanth Murthy
- Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | | | - Kamran Yusuf
- Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Alberta, Canada.
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94
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Zhou S, Lin L, Bao Z, Meng T, Wang S, Chen G, Li Q, Liu Z, Bao H, Han N, Wang H, Guo Y. The association of prenatal exposure to particulate matter with infant growth: A birth cohort study in Beijing, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 277:116792. [PMID: 33721799 DOI: 10.1016/j.envpol.2021.116792] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 06/12/2023]
Abstract
Limited studies examined the associations of prenatal exposure to particulate matter (PM) and children's growth with inconsistent results, and no study focused on PM1. We matched a birth cohort (10,547 children) with daily PM1 and PM2.5 concentrations by maternal home addresses. Air pollution concentrations were predicted by satellite remote sensing data, meteorological factors, and land use information. The weight and length of children in the birth cohort were measured at approximately one year old. We calculated the Z-score of weight for length (WFL) and body mass index (BMI) and then defined overweight and obesity (OWOB) based on WHO Standards. Generalized linear regression and modified Poisson regression were used to identify the association of prenatal exposure to PM1 or PM2.5 with anthropometric measurements and risk of OWOB. We also determined the mediation effect of preterm birth on the associations. Results showed that a 10 μg/m3 increase in prenatal exposure to PM1 and PM2.5 was significantly associated with a 0.105 [95% confidence interval (CI): 0.067, 0.144] and 0.063 (95% CI: 0.029, 0.097) increase in WFL Z-score for one-year-old children. Similar associations were found for BMI Z-score. A 10 μg/m3 increase in prenatal PM1 and PM2.5 exposure was significantly associated with 1.012 (95%CI: 1.003, 1.021) and 1.010 (95%CI: 1.002, 1.018) times higher risk of OWOB. . Preterm birth mediated 7.5% [direct effect (DE) = 0.106, P < 0.001; indirect effect (IE) = 0.009, P < 0.001)] and 9.9% (DE = 0.064, P < 0.001; IE = 0.007, P < 0.001) of the association between prenatal PM1 and PM2.5 exposure and WFL Z-score of the children. The association of prenatal PM1 and PM2.5 exposure with BMI Z-score of children was also mediated by preterm birth by 6.6% (DE = 0.111, P < 0.001; IE = 0.008, P < 0.001) and 9.1% (DE = 0.064, P < 0.001; IE = 0.006, P < 0.001). These results remained robust in the sensitivity analyses. In conclusion, prenatal exposure to PM1 and PM2.5 increased WFL, BMI Z-scores and higher risk of OWOB for one-year-old children. The associations were partially mediated by preterm birth. These findings call for the urgent action on air pollution regulation to protect early-life health among children.
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Affiliation(s)
- Shuang Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Lizi Lin
- Department of Maternal and Child Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China; Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment; Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Zheng Bao
- Tongzhou Maternal and Child Health Hospital, Beijing, 101101, China
| | - Tong Meng
- Tongzhou Maternal and Child Health Hospital, Beijing, 101101, China
| | - Shanshan Wang
- Tongzhou Maternal and Child Health Hospital, Beijing, 101101, China
| | - Gongbo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment; Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Qin Li
- Department of Maternal and Child Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China; Reproductive Medical Centre, Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing, 100191, China
| | - Zheng Liu
- Department of Maternal and Child Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Heling Bao
- Department of Maternal and Child Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Na Han
- Tongzhou Maternal and Child Health Hospital, Beijing, 101101, China
| | - Haijun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China.
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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95
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Netchine I, van der Steen M, López-Bermejo A, Koledova E, Maghnie M. New Horizons in Short Children Born Small for Gestational Age. Front Pediatr 2021; 9:655931. [PMID: 34055692 PMCID: PMC8155308 DOI: 10.3389/fped.2021.655931] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/01/2021] [Indexed: 12/26/2022] Open
Abstract
Children born small for gestational age (SGA) comprise a heterogeneous group due to the varied nature of the cause. Approximately 85-90% have catch-up growth within the first 4 postnatal years, while the remainder remain short. In later life, children born SGA have an increased risk to develop metabolic abnormalities, including visceral adiposity, insulin resistance, and cardiovascular problems, and may have impaired pubertal onset and growth. The third "360° European Meeting on Growth and Endocrine Disorders" in Rome, Italy, in February 2018, funded by Merck KGaA, Germany, included a session that examined aspects of short children born SGA, with three presentations followed by a discussion period, on which this report is based. Children born SGA who remain short are eligible for GH treatment, which is an approved indication. GH treatment increases linear growth and can also improve some metabolic abnormalities. After stopping GH at near-adult height, metabolic parameters normalize, but pharmacological effects on lean body mass and fat mass are lost; continued monitoring of body composition and metabolic changes may be necessary. Guidelines have been published on diagnosis and management of children with Silver-Russell syndrome, who comprise a specific group of those born SGA; these children rarely have catch-up growth and GH treatment initiation as early as possible is recommended. Early and moderate pubertal growth spurt can occur in children born SGA, including those with Silver-Russell syndrome, and reduce adult height. Treatments that delay puberty, specifically metformin and gonadotropin releasing hormone analogs in combination with GH, have been proposed, but are used off-label, currently lack replication of data, and require further studies of efficacy and safety.
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Affiliation(s)
- Irène Netchine
- Sorbonne Université, INSERM, UMR_S938 Centre de Recherche Saint Antoine, APHP, Hôpital Armand Trousseau, Explorations Fonctionnelles Endocriniennes, Paris, France
| | - Manouk van der Steen
- Department of Paediatrics, Subdivision of Endocrinology, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Abel López-Bermejo
- Girona Biomedical Research Institute, Dr. Josep Trueta Hospital, Girona, Spain
| | | | - Mohamad Maghnie
- Department of Pediatrics, Institute for Research, Hospitalization and Health Care (IRCCS) Children's Hospital Giannina Gaslini, Genova, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal, and Child Health, University of Genova, Genova, Italy
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96
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He H, Miao H, Liang Z, Zhang Y, Jiang W, Deng Z, Tang J, Liu G, Luo X. Prevalence of small for gestational age infants in 21 cities in China, 2014-2019. Sci Rep 2021; 11:7500. [PMID: 33820960 PMCID: PMC8021546 DOI: 10.1038/s41598-021-87127-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 03/24/2021] [Indexed: 11/18/2022] Open
Abstract
Infants who are small for gestational age (SGA) are at increased risk of neonatal and infant death, non-communicable diseases and growth retardation. However, the epidemiological characteristics of SGA remain unclear. We aim to explore the prevalence of SGA and to examine its socioeconomic associations by using data from 21 cities. 10,515,494 single live birth records between 2014 and 2019 from the Guangdong Women and Children Health Information System were included in the study. Descriptive statistical methods were used to analyze the prevalence trend of SGA and its distribution. We also analyze the associations between the prevalence of SGA and per-capita GDP. The prevalence of SGA in Guangdong Province from the years 2014-2019 was 13.17%, 12.96%, 11.96%, 12.72%, 11.45%, 11.30% respectively, and the overall prevalence was 12.28%. The prevalence of term SGA infants in Guangdong Province was 12.50%, which was much higher than that of preterm SGA (7.71%). There was a significant negative correlation between the SGA prevalence and per-capita GDP in 21 cities of Guangdong Province. The level of economic development may affect the prevalence of SGA. The prevalence of SGA in full term infants is significantly higher than in premature infants, suggesting that most SGA infants may be born at a later gestational age.
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Affiliation(s)
- Hui He
- Guangdong Women and Children Hospital of Guangzhou Medical University, Guangzhou, 511442, China
| | - Huazhang Miao
- Guangdong Women and Children Hospital, Guangzhou, 511442, China
| | - Zhijiang Liang
- Guangdong Women and Children Hospital, Guangzhou, 511442, China
| | - Ye Zhang
- Guangdong Women and Children Hospital, Guangzhou, 511442, China
| | - Wei Jiang
- Guangdong Women and Children Hospital, Guangzhou, 511442, China
| | - Zhi Deng
- Guangdong Women and Children Hospital, Guangzhou, 511442, China
| | - Jie Tang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China
| | - Guocheng Liu
- Guangdong Women and Children Hospital, Guangzhou, 511442, China.
| | - Xianqiong Luo
- Guangdong Women and Children Hospital, Guangzhou, 511442, China.
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97
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Yu X, Yang X, Zhao Y, Luo XP, Liang Y, Wu W, Ying YQ, Ye F, Hou L. A comparison of the growth status, level of blood glucose, and lipid metabolism in small for gestational age and appropriate for gestational age girls with central precocious puberty: a retrospective study. Transl Pediatr 2021; 10:783-789. [PMID: 34012828 PMCID: PMC8107858 DOI: 10.21037/tp-20-366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND To compare the physical development status, level of blood glucose and lipid metabolism in small for gestational age (SGA) and appropriate for gestational age (AGA) groups with central precocious puberty (CPP). METHODS This was a retrospective study. Three hundred and twenty-two girls with CPP were divided into the AGA group (304 cases) and the SGA group (18 cases). Physical index such as height, weight, and body mass index (BMI), as well as sex hormones, adrenal androgens, blood lipid levels, fasting blood glucose, insulin levels, and homeostasis model assessment of insulin resistance (HOMA-IR) were compared between the two groups. RESULTS Height, weight, and BMI in the SGA group were lower than those in the AGA group (P<0.05). The level of LH/FSH, estradiol, testosterone, DHEA and androstenedione had no significant difference between the SGA group and AGA group (P>0.05). The fasting blood glucose, insulin level, HOMA-IR, high-density lipoprotein (HDL) and the average level of triglycerides were similar between these two groups (P>0.05). There was a statistically significant difference in total cholesterol and low-density lipoprotein (LDL) between the two groups (P<0.05). However, the blood lipids and blood glucose in both groups were within the normal range. CONCLUSIONS The height, weight, BMI, serum cholesterol and LDL of girls in SGA with CPP were significantly lower than that of those girls born AGA.
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Affiliation(s)
- Xiao Yu
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xi Yang
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yue Zhao
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao-Ping Luo
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Liang
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Wu
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan-Qin Ying
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Feng Ye
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ling Hou
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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98
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Luke B, Brown MB, Wantman E, Forestieri NE, Browne ML, Fisher SC, Yazdy MM, Ethen MK, Canfield MA, Nichols HB, Oehninger S, Doody KJ, Sutcliffe AG, Williams C, Eisenberg ML, Baker VL, Sacha CR, Lupo PJ. Risks of nonchromosomal birth defects, small-for-gestational age birthweight, and prematurity with in vitro fertilization: effect of number of embryos transferred and plurality at conception versus at birth. J Assist Reprod Genet 2021; 38:835-846. [PMID: 33547526 PMCID: PMC8079460 DOI: 10.1007/s10815-021-02095-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/27/2021] [Indexed: 12/29/2022] Open
Abstract
PURPOSE Excess embryos transferred (ET) (> plurality at birth) and fetal heartbeats (FHB) at 6 weeks' gestation are associated with reductions in birthweight and gestation, but prior studies have been limited by small sample sizes and limited IVF data. This analysis evaluated associations between excess ET, excess FHB, and adverse perinatal outcomes, including the risk of nonchromosomal birth defects. METHODS Live births conceived via IVF from Massachusetts, New York, North Carolina, and Texas included 138,435 children born 2004-2013 (Texas), 2004-2016 (Massachusetts and North Carolina), and 2004-2017 (New York) were classified by ET and FHB. Major birth defects were reported by statewide registries within the first year of life. Logistic regression was used to estimate adjusted odds ratios (AORs) and 95% CIs of the risks of a major nonchromosomal birth defect, small-for-gestational age birthweight (SGA), low birthweight (LBW), and preterm birth (≤36 weeks), by excess ET, and excess ET + excess FHB, by plurality at birth (singletons and twins). RESULTS In singletons with [2 ET, FHB =1] and [≥3 ET, FHB=1], risks [AOR (95% CI)] were increased, respectively, for major nonchromosomal birth defects [1.13 (1.00-1.27) and 1.18 (1.00-1.38)], SGA [1.10 (1.03-1.17) and 1.15 (1.05-1.26)], LBW [1.09 (1.02-1.13) and 1.17 (1.07-1.27)], and preterm birth [1.06 (1.00-1.12) and 1.14 (1.06-1.23)]. With excess ET + excess FHB, risks of all adverse outcomes except major nonchromosomal birth defects increased further for both singletons and twins. CONCLUSION Excess embryos transferred are associated with increased risks for nonchromosomal birth defects, reduced birthweight, and prematurity in IVF-conceived births.
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Affiliation(s)
- Barbara Luke
- Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, 965 Wilson Road, East Fee Hall, Room 628, East Lansing, MI, 48824, USA.
| | - Morton B Brown
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | - Nina E Forestieri
- Birth Defects Monitoring Program, State Center for Health Statistics, North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - Marilyn L Browne
- Birth Defects Research Section, New York State Department of Health, Albany, NY, USA
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, NY, USA
| | - Sarah C Fisher
- Birth Defects Research Section, New York State Department of Health, Albany, NY, USA
| | - Mahsa M Yazdy
- Massachusetts Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, MA, USA
| | - Mary K Ethen
- Massachusetts Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, MA, USA
| | - Mark A Canfield
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX, USA
| | - Hazel B Nichols
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | | | | | - Alastair G Sutcliffe
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Carrie Williams
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Michael L Eisenberg
- Division of Male Reproductive Medicine and Surgery, Department of Urology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Valerie L Baker
- Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Caitlin R Sacha
- Massachusetts General Hospital Fertility Center and Harvard Medical School, Boston, MA, USA
| | - Philip J Lupo
- Epidemiology Program, Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, TX, USA
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99
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Urinary sodium-to-potassium ratio and plasma renin and aldosterone concentrations in normotensive children: implications for the interpretation of results. J Hypertens 2021; 38:671-678. [PMID: 31790052 DOI: 10.1097/hjh.0000000000002324] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To identify associations among the plasma renin concentration (PRC), plasma aldosterone and urinary sodium (Na)/potassium (K) ratio, and to integrate these variables into a nomogram with the aim of estimating the expected versus observed aldosterone concentration. METHODS We studied 40 healthy normotensive children (5-8 years old, 57.5% girls) who were born at term and were adequate for their gestational age. Following overnight fasting, the PRC and plasma aldosterone in blood samples were measured, and the Na/K ratio was calculated from a simultaneously obtained urinary spot sample. A mathematical function was defined with these three variables, and a nomogram was built that would return the expected aldosterone concentration from the obtained plasma renin and urinary Na/K ratio values. RESULTS The PRC (B = 5.9, P < 0.001) and urinary Na/K ratio (B = -98.1, P = 0.003) were significant independent predictors of plasma aldosterone. The correlation between the observed plasma aldosterone and the expected plasma aldosterone, as obtained from the nomogram, was r = 0.88, P < 0.001. The average difference between the observed and expected plasma aldosterone was -0.89, with a standard deviation of ±30%. CONCLUSION The strong correlation between the urinary Na/K ratio, from urine samples taken at the same as the blood samples, and plasma renin and aldosterone concentrations allowed us to build a nomogram to predict aldosterone levels. This approach may be useful for evaluating the renin-angiotensin-aldosterone system (RAAS) in pediatric patients with hypertension and RAAS dysfunction.
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100
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Yuan X, Wang J, Gao Y, Wang H, Yu B. Impact of maternal thyroid hormone in late pregnancy on adverse birth outcomes: A retrospective cohort study in China. Endocr J 2021; 68:317-328. [PMID: 33115985 DOI: 10.1507/endocrj.ej20-0377] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was to explore the impact of maternal thyroid hormone dysfunction in late pregnancy on birth outcomes in a Chinese population. We retrospectively examined hospitalisation records and laboratory data between April 2016 and March 2017 and obtained results from 11,564 consecutive pregnant women with singleton births in which serum thyroid hormone had been examined together with birth outcomes. We assessed the association between maternal thyroid level and dysfunction with adverse birth outcomes based on regression analysis. Hyperthyroidism was associated with an increased risk of preterm birth (PTB, adjusted OR: 2.41, 95% CI: 1.83-3.17) and hypothyroidism was associated with an increased risk of small for gestational age (SGA, adjusted OR: 1.56, 95% CI: 1.10-2.22), while hyperthyroxinaemia was associated with a decreased risk of large for gestational age (LGA, adjusted OR: 0.64, 95% CI: 0.45-0.90). In addition, compared to women with normal FT3 and TSH (≥the 5th and ≤the 95th percentiles), women with high free triiodothyronine (FT3 >the 95th percentile) and low thyroid-stimulating hormone (TSH <the 95th percentile) had a 4.02- fold higher risk of PTB (95% CI: 2.05-7.88), and women with low FT3 and high TSH had a 4.22- fold greater risk of SGA (95% CI: 1.59-11.23). Our study supports associations between multiple types of maternal thyroid dysfunction in late pregnancy and adverse birth outcomes.
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Affiliation(s)
- Xiaosong Yuan
- Department of Medical Genetics, Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Jing Wang
- Department of Medical Genetics, Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Yanfang Gao
- Department of laboratory medicine, Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Huiyan Wang
- Department of Obstetrics and Gynecology, Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Bin Yu
- Department of Medical Genetics, Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
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