Chest circumference as an indicator of intrauterine growth retardation

Assessment of maternal phthalate exposure in urine across three trimesters and at delivery (umbilical cord blood and placenta) and its influence on birth anthropometric measures

Phthalates, commonly used in plastic manufacturing, have been linked to adverse reproductive effects. Our research from the Saudi Early Autism and Environment Study (2019-2022), involving 672 participants, focused on the impacts of maternal phthalate exposure on birth anthropometric measures. We measured urinary phthalate metabolites in 390 maternal samples collected during each of the three trimesters of pregnancy and in cord serum and placental samples obtained at delivery. We employed various statistical methods to analyze our data. Intraclass correlation coefficients were used to assess the consistency of phthalate measurements, generalized estimating equations were used to explore temporal variations across the trimesters, and linear regression models, adjusted for significant confounders and Bonferroni correction, were used for each birth outcome. Exposure to six phthalates was consistently high across trimesters, with 82 %-100 % of samples containing significant levels of all metabolites, except for mono-benzyl phthalate. We found a 3.15 %-3.73 % reduction in birth weight (BWT), 1.39 %-1.69 % reduction in head circumference (HC), and 3.63 %-5.45 % reduction in placental weight (PWT) associated with a one-unit increase in certain urinary di(2-ethylhexyl) phthalate (DEHP) metabolites during the first trimester. In the second trimester, exposure to MEP, ∑7PAE, and ∑LMW correlated with a 3.15 %-4.5 % increase in the APGAR 5-min score and increases in PWT by 8.98 % for ∑7PAE and 9.09 % for ∑LMW. Our study also highlighted the maternal-to-fetal transfer of DEHP metabolites, indicating diverse impacts on birth outcomes and potential effects on developmental processes. Our study further confirmed the transfer of DEHP metabolites from mothers to fetuses, evidenced by variable rates in the placenta and cord serum, with an inverse relationship suggesting a passive transfer mechanism. Additionally, we observed distinct phthalate profiles across these matrices, adversely impacting birth outcomes. In serum, we noticed increases associated with DEHP metabolites, with birth gestational age rising by 1.01 % to 1.11 %, HC by 2.84 % to 3.67 %, and APGAR 5-min scores by 3.77 % to 3.87 %. Conversely, placental analysis revealed a different impact: BWT decreased by 3.54 % to 4.69 %, HC reductions ranged from 2.57 % to 4.69 %, and chest circumference decreased by 7.13 %. However, the cephalization index increased by 3.67 %-5.87 %. These results highlight the complex effects of phthalates on fetal development, indicating their potential influence on crucial developmental processes like sexual maturation and brain development.

A Genome-Wide Association Study of the Chest Circumference Trait in Xinjiang Donkeys Based on Whole-Genome Sequencing Technology

Animal genotyping by means of genome-wide association studies is important for connecting phenotypes of interest with their underlying genetics in livestock. However, the use of whole genome sequencing to investigate chest circumference (CC) in donkeys has rarely been reported. We aimed to use the genome-wide association study approach to detect significant single nucleotide polymorphisms (SNPs) and key genes associated with chest circumference traits in Xinjiang donkeys. We assessed 112 Xinjiang donkeys in this study. The chest circumference of each was measured 2 h before milking. We re-sequenced blood samples from the Xinjiang donkeys, and genome-wide association study analyses were performed using a mixed model with the PLINK, GEMMA, and REGENIE programs. We tested 38 donkeys for candidate SNPs for genome-wide association study using three software programs. Additionally, 18 SNP markers reached genome-wide significance (p < 1.61 × 10^-9). On the basis of these, 41 genes were identified. Previously proposed candidate genes for CC traits were supported by this study, including NFATC2 (Nuclear Factor of Activated T Cells 2), PROP1 (PROP Paired-Like Homeobox 1), UBB (Ubiquitin B), and HAND2 (Heart and Neural Crest Derivatives Expressed 2). These promising candidates provide a valuable resource for validating potential meat production genes and will facilitate the development of high-yielding Xinjiang donkey breeds through marker-assisted selection or gene editing.

Use of Head and Chest Circumference Ratio as an Index of Fetal Growth Retardation in Preterm Infants

We evaluated the relationship between fetal growth in preterm babies using the head circumference (HC)/chest circumference (CC) ratio and other anthropometric parameters at birth and at school age. Data were collected from 187 very low birth weight (VLBW) children born at less than 30 weeks of gestational age (GA) at birth and at 6 years. We assessed the correlation between the HC/CC ratio and body weight (BW), body length (BL), and HC z-scores at birth, and BW, body height (BH), and body mass index (BMI) z-scores at 6 years. Multiple regression analysis showed that BW z-score, BL z-score, and HC z-score at birth were significantly associated with HC/CC at birth. The BMI z-score at 6 years was also significantly associated with HC/CC at birth. The HC/CC ratio at birth is a reliable parameter for evaluating fetal growth restriction and a possible predictor of physical growth in VLBW children.

Chest circumference and birth weight are good predictors of lung function in preschool children from an e-waste recycling area

The purpose of this study was to investigate the associations between birth weight, chest circumference, and lung function in preschool children from e-waste exposure area. A total of 206 preschool children from Guiyu (an e-waste recycling area) and Haojiang and Xiashan (the reference areas) in China were recruited and required to undergo physical examination, blood tests, and lung function tests during the study period. Birth outcome such as birth weight and birth height were obtained by questionnaire. Children living in the e-waste-exposed area have a lower birth weight, chest circumference, height, and lung function when compare to their peers from the reference areas (all p value <0.05). Both Spearman and partial correlation analyses showed that birth weight and chest circumference were positively correlated with lung function levels including forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV₁). After adjustment for the potential confounders in further linear regression analyses, birth weight, and chest circumference were positively associated with lung function levels, respectively. Taken together, birth weight and chest circumference may be good predictors for lung function levels in preschool children.

Modeling birth weight neonates and associated factors

Background:

Neonate with abnormal weight is at risk of increased mortality and morbidity. Many factors affect pregnancy outcome. Because of the importance and vital role in birth weight, in this study, some of the factors associated with birth weight in a sample of Iranians neonates were investigated.

Materials and Methods:

In this cross-sectional study, 245 newborns in a sample of Iranians neonates in the year 2013 were selected, and characteristics of neonate and their mothers were derived. Birth weights were registered by the neonatal scale. To identify the direct and indirect factors affecting birth weight, we used path analysis (PA) and IBM AMOS and SPSS software.

Results:

The mean ± standard deviation of weight in girls (3200 ± 421) g less than boys (3310 ± 444) g significantly (P = 0.04). Gestational age (P < 0.001), birth rank (P = 0.012), distance from a previous pregnancy (P = 0.028), and mother weight (P = 0.04) had a statistical significant relationship with birth weight. In the final PA model, gestational age has a highest total effect, type of delivery with gestational age-mediated had the highest indirect effect and type of delivery, and gestational age had the greatest total impact on the birth weight.

Conclusion:

Gestational age, sex, distance from a previous pregnancy, maternal weight, type of delivery, number of abortion, and birth rank were related with birth weight. Due to the termination of pregnancy and avoid unnecessary deliveries through cesarean section and other related factors should be further consideration by childbirth experts. In addition, factors affecting these variables are carefully identified and prevented as much as possible.

Intergenerational changes in chest size and proportions in children and adolescents aged 3-18 from Kraków (Poland), within the last 70 years

OBJECTIVES

The size and proportions of the human body change continuously in response to social change and economic development. As reported by papers on intergenerational changes in chest size, this part of the human body is also influenced by environmental factors. The aim of this study was to assess changes in the dimensions and proportions of the chest of children and adolescents over a span of 70 years.

METHODS

In 2010 an anthropological study was conducted on 3878 children and adolescents aged 3-18 years living in Kraków (Poland). Data on chest dimensions (breadth, depth, circumference, chest index) were compared to data from 1938 (3719 children) and 1983 (6464 children).

RESULTS

In boys, chests became increasingly deep; in boys 18 years of age, the chest index increased by 4.8 units, unlike girls, whose chests markedly flattened. The chest index in girls 18 years of age decreased by 4.2 units. In almost all age categories these differences were statistically significant. Also, in all age categories, children studied in 2010 had a significantly bigger chest circumference than boys and girls surveyed in 1983, respectively, by averages of 3.6 cm and 3 cm.

CONCLUSIONS

The main reason for these changes may be the socio-economic transformation, which has been especially strong in recent decades. These results may have practical importance in many areas of knowledge, including medicine, nutritional science, and sports. They can also be important for informing preventive measures that should be taken in order to increase the physical activity of children and youth, especially boys.

Diagnostic markers in combination improve the identification of growth-restricted neonates

BACKGROUND

The identification of growth-restricted neonates is hampered by the lack of an appropriate diagnostic tool.

AIM

To determine the value of combining diagnostic markers in detecting growth-restricted neonates.

METHODS

A set of anthropometric indices, nutritional status and placental weight were assessed in the study population soon after birth. Insulin-like growth factor I (IGF-I) and its binding protein 3 (IGFBP-3) were assayed in cord blood. Babies having low values (≤25th centile for gestational age) in 0, 1 or more of four anthropometric indices were classified as Group(25)0, Group(25)1 and Group(25)2, respectively. For statistical evaluation the Mann-Whitney test and a multiple regression analysis were performed.

RESULTS

One hundred-eighty (180) singleton babies of over 36 weeks of gestational age (GA) were studied. IGF-I, IGFBP-3 levels and placental weight were significantly lower in Group(25)2 than both Group(25)0 (P<0.0001) and Group(25)1 (p<0.0001 to p = 0.03). Group(25)1 and Group(25)0 did not differ significantly regarding IGF-I and IGFBP-3 levels (p values 0.09 and 0.13, respectively). The combination of anthropometric indices enhanced their ability to predict IGF-I, IGFBP-3 levels and placental weight; the nutritional status of the babies added power to all individual models in predicting the three outcome variables. Analogous results were obtained when the 10th (instead of the 25th) centile for GA was used for the anthropometric indices.

CONCLUSION

The combination of simple diagnostic markers of growth restriction can define a reference test with enhanced diagnostic potential compared to the potential of the same markers in isolated use.

Approaching the diagnosis of growth-restricted neonates: a cohort study

BACKGROUND

The consequences of in utero growth restriction have been attracting scholarly attention for the past two decades. Nevertheless, the diagnosis of growth-restricted neonates is as yet an unresolved issue. Aim of this study is the evaluation of the performance of simple, common indicators of nutritional status, which are used in the identification of growth-restricted neonates.

METHODS

In a cohort of 418 consecutively born term and near term neonates, four widely used anthropometric indices of body proportionality and subcutaneous fat accretion were applied, singly and in combination, as diagnostic markers for the detection of growth-restricted babies. The concordance of the indices was assessed in terms of positive and negative percent agreement and of Cohen's kappa.

RESULTS

The agreement between the anthropometric indices was overall poor with a highest positive percent agreement of 62.5% and a lowest of 27.9% and the kappa ranging between 0.19 and 0.58. Moreover, 6% to 32% of babies having abnormal values in just one index were apparently well-grown and the median birth weight centile of babies having abnormal values of either of two indices was found to be as high as the 46th centile for gestational age (95%CI 35.5 to 60.4 and 29.8 to 63.9, respectively). On the contrary, the combination of anthropometric indices appeared to have better distinguishing properties among apparently and not apparently well-grown babies. The median birth weight centile of babies having abnormal values in two (or more) indices was the 11th centile for gestational age (95%CI 6.3 to 16.3).

CONCLUSIONS

Clinical assessment and anthropometric indices in combination can define a reference standard with better performance compared to the same indices used in isolation. This approach offers an easy-to-use tool for bedside diagnosis of in utero growth restriction.

The association between intrauterine growth restriction in the full-term infant and high blood pressure at age 7 years: results from the Collaborative Perinatal Project

OBJECTIVE

To use neonatal and placental anthropometry as proxy measures of intrauterine growth restriction (IUGR) and to relate these to blood pressure later in childhood.

STUDY DESIGN

A post hoc analysis of full-term white and black children from the Collaborative Perinatal Project, followed from birth until age 7 years (n = 29,710). Blood pressure above the 90th percentile by gender and race was considered high blood pressure. Anthropometric measures at birth included birth weight, ponderal index (PI, birth weight/birth length(3)), head to chest circumference (HCC) ratio, and placental ratio percentage (PRP, placental weight(*)100/birth weight).

RESULTS

Among anthropometric measures, PI, HCC, and birth weight were not associated with high systolic blood pressure at age 7 years, but PRP was. In multiple logistic regression, high systolic blood pressure and widened pulse pressure were both predicted by increased PRP [odds ratio (OR) 1.03 and 1.04, P < 0.001] but not by birth weight, when adjusted for gender, race, and maternal education. High diastolic blood pressure was weakly predicted by birth weight (OR 1.10, P = 0.05) but not by PRP.

CONCLUSIONS

PRP is associated with an increased risk for high systolic blood pressure and pulse pressure later in childhood, whereas birth weight, PI, and HCC are not. The proportion of placental weight to birth weight is a useful marker of IUGR for studying the developmental origins of adult disease hypothesis.

Trunk anthropometry of Hong Kong Chinese infants

BACKGROUND

Disturbed growth of the trunk may result in abnormal sternocostal relationship and a variety of pectus deformities.

AIMS

The purposes of this study were to establish norms of trunk anthropometry for dysmorphology identification in the newborns and to evaluate chest circumference as a predictor for low birth weight for outborn infants where weighing scales were unavailable.

STUDY DESIGN AND SUBJECTS

A total of 10,339 Chinese infants (5478 males, 4861 females) with gestation 24-42 weeks from 12 hospitals were included. The anthropometric measurements analyzed included chest circumference, inter-nipple distance, sternal length and abdominal circumference.

OUTCOME MEASURES

The LMS method using maximum penalized likelihood was used to perform model fitting of the anthropometric centiles for these physical parameters.

RESULTS

References tables of the four physical parameters for newborns were constructed. Chest circumference showed the highest correlation with birth weight (male: r = 0.866, female: r = 0.883). The cut-off points for chest circumference of 295 (male) and 299 mm (female) were the best predictor for low birth weight. There were also racial differences in these parameters. When compared with French infants, Chinese newborns had smaller chest circumference.

CONCLUSION

These physical parameters provide useful references and aid dysmorphology diagnosis in newborns of ethnic Chinese origin.

Maternal fish consumption and infant birth size and gestation: New York State Angler Cohort Study

BACKGROUND

The scientific literature poses a perplexing dilemma for pregnant women with respect to the consumption of fish from natural bodies of water. On one hand, fish is a good source of protein, low in fat and a rich source of other nutrients all of which have presumably beneficial effects on developing embryos and fetuses. On the other hand, consumption of fish contaminated with environmental toxicants such as polychlorinated biphenyls (PCBs) has been associated with decrements in gestation and birth size.

METHODS

2,716 infants born between 1986-1991 to participants of the New York State Angler Cohort Study were studied with respect to duration of maternal consumption of contaminated fish from Lake Ontario and its tributaries and gestation and birth size. Hospital delivery records (maternal and newborn) were obtained for 92% of infants for the ascertainment of gestation (weeks), birth size (weight, length, chest, and head circumference) and other known determinants of fetal growth (i.e., maternal parity, history of placental infarction, uterine bleeding, pregnancy loss or cigarette smoking and infant's race, sex and presence of birth defect). Duration of maternal fish consumption prior to the index infant's birth was categorized as: none; 1-2, 3-7, 8+ years, while birth weight (in grams), birth length (in centimeters), and head and chest circumference (in centimeters) were left as continuous variables in multiple linear regression models. Birth size percentiles, ponderal indices and head to chest circumference ratios were computed to further assess proportionality and birth size in relation to gestational age.

RESULTS

Analysis of variance failed to identify significant mean differences in gestation or any measure of birth size in relation to duration of maternal lifetime fish consumption. Multiple linear regressions identified gestational age, male sex, number of daily cigarettes, parity and placental infarction, as significant determinants of birth size.

CONCLUSIONS

The results support the absence of an adverse relation between Lake Ontario fish consumption and reduced birth size as measured by weight, length and head circumference. Biological determinants and maternal cigarette smoking during pregnancy remain important determinants of birth size.

Maternal and neonatal anthropometry

Anthropometric measurements were assessed in 434 Brazilian mother-baby pairs (263 appropriate-for-gestational-age [AGA] and 171 intrauterine growth-retarded [IUGR]) to compare their distribution and to evaluate associations in AGA and IUGR pairs. Mothers who delivered IUGR babies were thinner and shorter than mothers of AGA babies; the cut-off points of risk for delivering an IUGR baby were 50 kg for weight (OR = 3.8, p < 0.001) and 150 cm for height (OR = 3.6, p < 0.001). IUGR mothers also tended to gain less weight in pregnancy than AGA mothers, presenting a risk 6.1 times higher for weight gain < or = 7 kg (p < 0.001). There were weak though statistically significant correlations between AGA mother-baby pairs, and a few weak correlations between IUGR mother-baby pairs. The larger number of statistically significant correlations between anthropometric measurements in AGA mother-baby pairs than in IUGR pairs shows that in this region of the country, where maternal malnutrition has a low prevalence, probably other factors are associated with IUGR. It seems that the influence of maternal nutrition on a baby's size at birth is more important in populations with moderate-to-severe malnutrition. In Brazil, as in some other developing countries, overweight is becoming an important issue and the prevalence of malnutrition has decreased. In this study, there were few mothers (n = 17) with a body mass index (BMI) < or = 20. On the other hand, there were many (n = 209) overweight (BMI 25-30) and obese (BMI > 30) mothers. We advise further large epidemiological studies to assess the diet of pregnant women and its relationship to maternal weight, weight gain and low birthweight (particularly IUGR) in countries with a considerable prevalence of maternal undernutrition and maternal overweight/obesity.

Umbilical blood flow and neonatal morphometry: a multivariate analysis

OBJECTIVE

To study the relation between the state of umbilical blood flow and neonatal morphometry.

STUDY DESIGN

We have recorded data from 460 pregnant women. Umbilical systolic to diastolic ratio was measured within the 3 days prior to the birth. Weight, height, head and chest circumferences, ponderal and head to chest circumferences ratio were considered for the study.

RESULTS

In a univariate analysis, the best correlated variable to S/D ratio was the weight (r=-0.35). However, a forward stepwise multiple regression analysis demonstrated that the best predictors of S/D ratio were height and ponderal index. Small-for-gestational-age fetuses with placental insufficiency (n=20) had a significant more pronounced decrease of weight, height, head circumference and chest circumference than those with normal placental perfusion (n=31). The degree of decrease of ponderal index and HC/TC was similar in both groups.

CONCLUSIONS

Umbilical blood flow is one important factor determining newborn morphometry. If only one growth variable is considered, the best correlation with umbilical S/D ratio is found to be the weight. The multivariate regression analysis concluded that the two most influential factors by umbilical blood flow are height and ponderal index and the rest of the morphometric parameters lost their significant correlations when adjusted by these variables. The impairment on neonatal morphometry in small-for-gestational-age fetuses associated to placental insufficiency is more severe than that with normal placental perfusion. However, it does not have a more pronounced decrease of ponderal index than the rest of causes of small-for-gestational-age fetuses.