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Xu L, Sheng XJ, Gu LP, Yang ZM, Feng ZT, Gu DF, Gao L. Influence of perinatal factors on full-term low-birth-weight infants and construction of a predictive model. World J Clin Cases 2024; 12:5901-5907. [DOI: 10.12998/wjcc.v12.i26.5901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 07/09/2024] [Accepted: 07/12/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Being too light at birth can increase the risk of various diseases during infancy.
AIM To explore the effect of perinatal factors on term low-birth-weight (LBW) infants and build a predictive model. This model aims to guide the clinical management of pregnant women’s healthcare during pregnancy and support the healthy growth of newborns.
METHODS A retrospective analysis was conducted on data from 1794 single full-term pregnant women who gave birth. Newborns were grouped based on birth weight: Those with birth weight < 2.5 kg were classified as the low-weight group, and those with birth weight between 2.5 kg and 4 kg were included in the normal group. Multiple logistic regression analysis was used to identify the factors influencing the occurrence of full-term LBW. A risk prediction model was established based on the analysis results. The effectiveness of the model was analyzed using the Hosmer–Leme show test and receiver operating characteristic (ROC) curve to verify the accuracy of the predictions.
RESULTS Among the 1794 pregnant women, there were 62 cases of neonatal weight < 2.5 kg, resulting in an LBW incidence rate of 3.46%. The factors influencing full-term LBW included low maternal education level [odds ratio (OR) = 1.416], fewer prenatal examinations (OR = 2.907), insufficient weight gain during pregnancy (OR = 3.695), irregular calcium supplementation during pregnancy (OR = 1.756), and pregnancy hypertension syndrome (OR = 2.192). The prediction model equation was obtained as follows: Logit (P) = 0.348 × maternal education level + 1.067 × number of prenatal examinations + 1.307 × insufficient weight gain during pregnancy + 0.563 × irregular calcium supplementation during pregnancy + 0.785 × pregnancy hypertension syndrome − 29.164. The area under the ROC curve for this model was 0.853, with a sensitivity of 0.852 and a specificity of 0.821. The Hosmer–Leme show test yielded χ2 = 2.185, P = 0.449, indicating a good fit. The overall accuracy of the clinical validation model was 81.67%.
CONCLUSION The occurrence of full-term LBW is related to maternal education, the number of prenatal examinations, weight gain during pregnancy, calcium supplementation during pregnancy, and pregnancy-induced hypertension. The constructed predictive model can effectively predict the risk of full-term LBW.
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Affiliation(s)
- Liang Xu
- Department of Neonatology, Suzhou Ninth People's Hospital, Suzhou 215200, Jiangsu Province, China
| | - Xue-Juan Sheng
- Department of Obstetrics, Suzhou Ninth People's Hospital, Suzhou 215200, Jiangsu Province, China
| | - Lian-Ping Gu
- Department of Obstetrics, Suzhou Ninth People's Hospital, Suzhou 215200, Jiangsu Province, China
| | - Zu-Ming Yang
- Department of Neonatology, Suzhou Municipal Hospital, Suzhou 215008, Jiangsu Province, China
| | - Zong-Tai Feng
- Department of Neonatology, Suzhou Municipal Hospital, Suzhou 215008, Jiangsu Province, China
| | - Dan-Feng Gu
- Department of Neonatology, Suzhou Municipal Hospital, Suzhou 215008, Jiangsu Province, China
| | - Li Gao
- Department of Neonatology, Suzhou Ninth People's Hospital, Suzhou 215200, Jiangsu Province, China
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Namiiro FB, Batte A, Rujumba J, Nabukeera-Barungi N, Kayom VO, Munabi IG, Serunjogi R, Kiguli S. Nutritional status of young children born with low birthweight in a low resource setting: an observational study. BMC Pediatr 2023; 23:520. [PMID: 37858130 PMCID: PMC10585881 DOI: 10.1186/s12887-023-04356-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 10/10/2023] [Indexed: 10/21/2023] Open
Abstract
OBJECTIVE Every year, an estimated 20 million babies are born with low birthweight and this number is increasing globally. Survivors are at risk of lifelong morbidities like undernutrition. We assessed the growth and nutritional status for children born with low birthweight at Mulago Hospital, Uganda. METHODS We conducted a cross sectional study to describe the nutritional status of children aged between 22 and 38 months and born weighing ≤ 2000 g. Anthropometric measurements; weight for height, height for age and weight for age z-scores were generated based on the World Health Organization standards to define wasting, stunting and underweight respectively. Data was collected using a structured questionnaire and analysis was done using STATA version 14. RESULTS Of the 251 children, 129 (51.4%) were male, mean age was 29.7 months SD 4.5) and maternal mean age was 29.9 (SD 5.3). A total of 101(40.2%) had normal nutritional status. The prevalence of wasting, underweight and stunting were: 8 (3.2%), 36 (14.4%) and 106 (42.2%) respectively. CONCLUSION Six of ten children born with low birthweight were at risk of undernutrition in early childhood: underweight and stunting were higher than the national prevalence. Targeted interventions are needed for children with very low birth weight.
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Affiliation(s)
- Flaviah B Namiiro
- Department of Paediatrics & Child Health, Mulago National Referral Hospital, Kampala, Uganda.
| | - Anthony Batte
- Child Health and Development Center, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Joseph Rujumba
- Department of Paediatrics & Child Health, Makerere University College of Health Sciences, Kampala, Uganda
| | | | - Violet O Kayom
- Department of Paediatrics & Child Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ian G Munabi
- Department of Anatomy, Makerere University College of Health Sciences, Kampala, Uganda
| | - Robert Serunjogi
- Makerere University-John Hopkins University Institute, Kampala, Uganda
| | - Sarah Kiguli
- Department of Paediatrics & Child Health, Makerere University College of Health Sciences, Kampala, Uganda
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Weerakoon SM, Chen B, Harrell MB, Vidot DC, Messiah SE. Longitudinal effect of prenatal polydrug use and birthweight status on pediatric growth. CHILDRENS HEALTH CARE 2022. [DOI: 10.1080/02739615.2022.2078826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Sitara M. Weerakoon
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
- Center for Pediatric Population Health, Children’s Health System of Texas and UTHealth School of Public Health, Dallas, TX, USA
| | - Baojiang Chen
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
- Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health, Austin, TX, USA
| | - Melissa B. Harrell
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
- Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health, Austin, TX, USA
| | - Denise C. Vidot
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Sarah E. Messiah
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
- Center for Pediatric Population Health, Children’s Health System of Texas and UTHealth School of Public Health, Dallas, TX, USA
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Michaelis IA, Krägeloh-Mann I, Mazinu M, Jordaan E. Growth of a cohort of very low birth weight and preterm infants born at a single tertiary health care center in South Africa. Front Pediatr 2022; 10:1075645. [PMID: 36741095 PMCID: PMC9889837 DOI: 10.3389/fped.2022.1075645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/28/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Very low birth weight (VLBW) and extremely low birth weight (ELBW) infants are known to be at high risk of growth failure and developmental delay later in life. The majority of those infants are born in low and middle income countries. AIM Growth monitoring in a cohort of infants born with a VLBW up to 18 months corrected age was conducted in a low resource setting tertiary hospital. METHODS In this prospective cohort study, 173 infants with a birth weight below 1,501 g admitted within their first 24 h of life were recruited and the 115 surviving until discharged were asked to follow up at 1, 3, 6, 12 and 18 months. Weight, height and head circumferences were recorded and plotted on WHO Z-score growth charts. RESULTS Of the 115 discharged infants 89 were followed up at any given follow-up point (1, 3, 6, 12 and/or 18 months). By 12 months of corrected age another 15 infants had demised (13.0%). The infants' trends in weight-for-age z-scores (WAZ) for corrected age was on average below the norm up to 12 months (average estimated z-score at 12 months = -0.44; 95% CI, -0.77 to -0.11), but had reached a normal range on average at 18 months = -0.24; 95% CI, -0.65 to 0.19) with no overall difference in WAZ scores weight between males and female' infants (p > 0.7). Similar results were seen for height at 12 months corrected age with height-for-age z-scores (HAZ) of the study subjects being within normal limits (-0.24; 95% CI, -0.63 to 0.14). The mean head circumference z-scores (HCZ) initially plotted below -1.5 standard deviations (S.D.), but after 6 months the z-scores were within normal limits (mean z-score at 7 months = -0.19; 95% CI, -0.45 to 0.06). CONCLUSION Weight gain, length and head circumferences in infants with VLBW discharged showed a catch-up growth within the first 6-18 months of corrected age, with head circumference recovering best. This confirms findings in other studies on a global scale, which may be reassuring for health systems such as those in South Africa with a high burden of children born with low birth weights.
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Affiliation(s)
| | | | - Mikateko Mazinu
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
| | - Esme Jordaan
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
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González García L, García López E, Fernández Colomer B, Mantecón Fernández L, Lareu Vidal S, Suárez Rodríguez M, Arias Llorente R, Solís Sánchez G. Predicción del crecimiento a los dos años utilizando las gráficas de Fenton e Intergrowth-21 en menores de 1.500 g. An Pediatr (Barc) 2021. [DOI: 10.1016/j.anpedi.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Ornoy A, Becker M, Weinstein-Fudim L, Ergaz Z. Diabetes during Pregnancy: A Maternal Disease Complicating the Course of Pregnancy with Long-Term Deleterious Effects on the Offspring. A Clinical Review. Int J Mol Sci 2021; 22:ijms22062965. [PMID: 33803995 PMCID: PMC7999044 DOI: 10.3390/ijms22062965] [Citation(s) in RCA: 97] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 02/28/2021] [Accepted: 03/11/2021] [Indexed: 12/12/2022] Open
Abstract
In spite of the huge progress in the treatment of diabetes mellitus, we are still in the situation that both pregestational (PGDM) and gestational diabetes (GDM) impose an additional risk to the embryo, fetus, and course of pregnancy. PGDM may increase the rate of congenital malformations, especially cardiac, nervous system, musculoskeletal system, and limbs. PGDM may interfere with fetal growth, often causing macrosomia, but in the presence of severe maternal complications, especially nephropathy, it may inhibit fetal growth. PGDM may also induce a variety of perinatal complications such as stillbirth and perinatal death, cardiomyopathy, respiratory morbidity, and perinatal asphyxia. GDM that generally develops in the second half of pregnancy induces similar but generally less severe complications. Their severity is higher with earlier onset of GDM and inversely correlated with the degree of glycemic control. Early initiation of GDM might even cause some increase in the rate of congenital malformations. Both PGDM and GDM may cause various motor and behavioral neurodevelopmental problems, including an increased incidence of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Most complications are reduced in incidence and severity with the improvement in diabetic control. Mechanisms of diabetic-induced damage in pregnancy are related to maternal and fetal hyperglycemia, enhanced oxidative stress, epigenetic changes, and other, less defined, pathogenic mechanisms.
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Affiliation(s)
- Asher Ornoy
- Adelson School of Medicine, Ariel University, Ariel 40700, Israel;
- Laboratory of Teratology, Department of Medical Neurobiology, Hebrew University Hadassah Medical School, Jerusalem 91120, Israel; (L.W.-F.); (Z.E.)
- Correspondence: ; Tel.: +972-(2)-675-8329
| | - Maria Becker
- Adelson School of Medicine, Ariel University, Ariel 40700, Israel;
| | - Liza Weinstein-Fudim
- Laboratory of Teratology, Department of Medical Neurobiology, Hebrew University Hadassah Medical School, Jerusalem 91120, Israel; (L.W.-F.); (Z.E.)
| | - Zivanit Ergaz
- Laboratory of Teratology, Department of Medical Neurobiology, Hebrew University Hadassah Medical School, Jerusalem 91120, Israel; (L.W.-F.); (Z.E.)
- Medical Center, Hadassah Hebrew University, Mount Scopus, Jerusalem 91240, Israel
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