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Holgersen K, Rasmussen MB, Zamir I, Aunsholt L, Zachariassen G, Sangild PT. Glucose-regulatory hormones and growth in very preterm infants fed fortified human milk. Pediatr Res 2024; 96:713-722. [PMID: 38580842 PMCID: PMC11499248 DOI: 10.1038/s41390-024-03166-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 03/01/2024] [Accepted: 03/15/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Bovine colostrum (BC) contains a range of milk bioactive components, and it is unknown how human milk fortification with BC affects glucose-regulatory hormones in very preterm infants (VPIs). This study aimed to investigate the associations between hormone concentrations and fortification type, birth weight (appropriate/small for gestational age, AGA/SGA), milk intake, postnatal age, and body growth. METHODS 225 VPIs were randomized to fortification with BC or conventional fortifier (CF). Plasma hormones were measured before, one and two weeks after start of fortification. ΔZ-scores from birth to 35 weeks postmenstrual age were calculated. RESULTS Compared with CF, infants fortified with BC had higher plasma GLP-1, GIP, glucagon, and leptin concentrations after start of fortification. Prior to fortification, leptin concentrations were negatively associated with growth, while IGF-1 concentrations associated positively with growth during fortification. In AGA infants, hormone concentrations generally increased after one week of fortification. Relative to AGA infants, SGA infants showed reduced IGF-1 and leptin concentrations. CONCLUSION Fortification with BC increased the plasma concentrations of several glucose-regulatory hormones. Concentrations of IGF-1 were positively, and leptin negatively, associated with growth. Glucose-regulatory hormone levels were affected by birth weight, milk intake and postnatal age, but not closely associated with growth in VPIs. IMPACT Little is known about the variation in glucose-regulatory hormones in the early life of very preterm infants (VPIs). This study shows that the levels of glucose-regulatory hormones in plasma of VPIs are highly variable and modified by birth weight (appropriate or small for gestational age, AGA or SGA), the type of fortifier, enteral nutritional intake, and advancing postnatal age. The results confirm that IGF-1 levels are positively associated with early postnatal growth in VPIs, yet the levels of both IGF-1 and other glucose-regulatory hormones appeared to explain only a small part of the overall variation in growth rates.
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MESH Headings
- Humans
- Infant, Newborn
- Milk, Human/chemistry
- Food, Fortified
- Leptin/blood
- Female
- Insulin-Like Growth Factor I/metabolism
- Insulin-Like Growth Factor I/analysis
- Male
- Colostrum/chemistry
- Infant, Premature/growth & development
- Infant, Premature/blood
- Animals
- Cattle
- Glucagon/blood
- Gastric Inhibitory Polypeptide/blood
- Birth Weight
- Glucagon-Like Peptide 1/blood
- Blood Glucose/metabolism
- Blood Glucose/analysis
- Infant Nutritional Physiological Phenomena
- Gestational Age
- Infant, Extremely Premature/blood
- Infant, Extremely Premature/growth & development
- Infant, Very Low Birth Weight/growth & development
- Infant, Very Low Birth Weight/blood
- Infant, Small for Gestational Age
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Affiliation(s)
- Kristine Holgersen
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
- Comparative Pediatrics and Nutrition, Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Martin Bo Rasmussen
- Comparative Pediatrics and Nutrition, Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Itay Zamir
- Department of Clinical Sciences, Pediatrics unit, Umeå University, Umeå, Sweden
| | - Lise Aunsholt
- Department of Neonatology, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Gitte Zachariassen
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient data Explorative Network, Region of Southern Denmark, Odense, Denmark
| | - Per Torp Sangild
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
- Comparative Pediatrics and Nutrition, Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark.
- Department of Neonatology, Rigshospitalet, Copenhagen, Denmark.
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
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Nguyen PT, Nguyen PH, Tran LM, Khuong LQ, Nguyen SV, Young MF, Ramakrishnan U. Growth patterns of preterm and small for gestational age children during the first 10 years of life. Front Nutr 2024; 11:1348225. [PMID: 38468696 PMCID: PMC10925699 DOI: 10.3389/fnut.2024.1348225] [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: 12/02/2023] [Accepted: 02/16/2024] [Indexed: 03/13/2024] Open
Abstract
Background Preterm and small for gestational age (SGA) remain significant public health concerns worldwide. Yet limited evidence exists on their growth patterns during childhood from low-or middle-income countries. Objectives We investigated the postnatal growth patterns of preterm and SGA compared to term appropriate for gestational age (AGA) children from birth to 10-11y, and examined the impact of birth status on child nutritional status during the school age years. Methods Children born to women who participated in a double-blinded randomized controlled trial of preconception micronutrient supplementation in Vietnam were classified into three groups: preterm AGA (n = 130), full-term SGA (n = 165) and full-term AGA (n = 1,072). Anthropometric data (weight and height) were collected prospectively at birth, 3, 6, 12, 18, 24 months and at 6-7 and 10-11y. We used ANOVA and multiple regression models to examine the differences in growth patterns from birth to 10-11y as well as child undernutrition and overnutrition by birth status. Results Children who were born preterm exhibited rapid postnatal growth, but still had lower HAZ at 1y and 2y and showed catch up to the AGA group at 6y. Compared to those born AGA, SGA infants had higher risk of thinness (BMIZ < -2) at 2y and 6y (adjusted Odds Ratio, AOR [95% CI] 2.5 [1.0, 6.1] and 2.6 [1.4, 4.6], respectively); this risk reduced at 10-11y (1.6 [0.9, 2.8]). The risk of stunting (HAZ < -2) was also 2.4 [1.5, 3.8] and 2.3 times [1.2, 4.1] higher in SGA than AGA group at ages 2y and 6-7y, respectively, with no differences at 10y. Although preterm children had higher rates of thinness and stunting at 2y compared to AGA children, these differences were not statistically significant. No associations were found between preterm or SGA and overweight /obesity at age 10-11y. Conclusion Children who were born term-SGA continued to demonstrate deficits in weight and height during childhood whereas those born preterm showed catch-up growth by age 6-7y. Additional efforts to reduce the burden of these conditions are needed, particularly during school-age and early adolescents when children are exposed to challenging environments and have higher demands for nutrition.
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Affiliation(s)
- Phuong Thi Nguyen
- Department of Pediatric, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - Phuong Hong Nguyen
- Department of Pediatric, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
- Department of Nutrition, Diets, and Health, International Food Policy Research Institute, Washington, DC, United States
| | - Lan Mai Tran
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
| | - Long Quynh Khuong
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - Son Van Nguyen
- Department of Pediatric, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - Melissa F. Young
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
| | - Usha Ramakrishnan
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
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Hansen C, Davison B, Singh GR. Small for gestational age and anthropometric body composition from early childhood to adulthood: the Aboriginal Birth Cohort study. Front Public Health 2024; 12:1349040. [PMID: 38450125 PMCID: PMC10915257 DOI: 10.3389/fpubh.2024.1349040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/09/2024] [Indexed: 03/08/2024] Open
Abstract
Background In Australia the estimated rate of small for gestational age (SGA) births is 9% among non-Indigenous births compared to 14% among Aboriginal and Torres Strait Islanders. There is limited research investigating the effect of being born SGA on body composition later in life in Indigenous Australians. Methods Using data from the Aboriginal Birth Cohort longitudinal study, we compared the body composition of those born SGA to non-SGA by analysing anthropometric measures (height, weight, waist circumference, fat percentage [FAT%], body mass index [BMI], waist-to-height ratio, and A body shape index [ABSI]) collected at four follow-up periods (from childhood to adult). For cross-sectional analyses, linear regression models were employed to assess factors associated with anthropometric measures. For longitudinal analyses linear mixed models were employed to assess differences in anthropometric measures among SGA versus non-SGA individuals while adjusting for repeated measures. Results The analytic baseline cohort were those who participated in Wave 2 (n = 570). In cross-sectional analyses, across all waves those born SGA had smaller anthropometric z-scores compared to non-SGA individuals (β ranging from -0.50 to -0.25). Participants residing in urban environments were significantly larger in Waves 2 to 4 (β ranged 0.26 to 0.65). Those born SGA had higher ABSI scores in Waves 2 and 4 (β 0.26 and 0.37, respectively). In longitudinal analyses, those born SGA had smaller measures of body composition across the life course; these differences were larger in urban communities. In remote communities those born SGA had significantly higher ABSI scores during adolescence and young adulthood, and this difference was not observed in urban communities. Conclusion Indigenous Australians born SGA are smaller anthropometrically later in life compared to their non-SGA counterparts. In remote communities, those born SGA had higher levels of central adiposity compared to non-SGA.
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Affiliation(s)
- Craig Hansen
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Belinda Davison
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Gurmeet R. Singh
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Northern Territory Medical Program, Flinders University, Darwin, Darwin, NT, Australia
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Cauzzo C, Chiavaroli V, Di Valerio S, Chiarelli F. Birth size, growth trajectory and later cardio-metabolic risk. Front Endocrinol (Lausanne) 2023; 14:1187261. [PMID: 37342257 PMCID: PMC10277632 DOI: 10.3389/fendo.2023.1187261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/19/2023] [Indexed: 06/22/2023] Open
Abstract
There is increasing evidence of a strong association between intrauterine growth and subsequent development of chronic disease in adult life. Birth size and growth trajectory have been demonstrated to have an impact on cardio-metabolic health, both in childhood and adult life. Hence, careful observation of the children's growth pattern, starting from the intrauterine period and the first years of life, should be emphasized to detect the possible onset of cardio-metabolic sequelae. This allows to intervene on them as soon as they are detected, first of all through lifestyle interventions, whose efficacy seems to be higher when they are started early. Recent papers suggest that prematurity may constitute an independent risk factor for the development of cardiovascular disease and metabolic syndrome, regardless of birth weight. The purpose of the present review is to examine and summarize the available knowledge about the dynamic association between intrauterine and postnatal growth and cardio-metabolic risk, from childhood to adulthood.
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Affiliation(s)
- Chiara Cauzzo
- Department of Pediatrics, University of Chieti, Chieti, Italy
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Domin A, Mazur A. Nutritional status of a group of polish children with FASD: A retrospective study. Front Nutr 2023; 10:1111545. [PMID: 37252249 PMCID: PMC10213223 DOI: 10.3389/fnut.2023.1111545] [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: 11/29/2022] [Accepted: 03/29/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Fetal alcohol spectrum disorders (FASDs) are a leading preventable cause of developmental and psychosocial disorders. Prenatal alcohol exposure can be a cause of growth impairment and metabolic problems. In this study, we analyzed data on the growth, weight, and nutritional status of children with FASD. Methods Patients were recruited from the Department of Pediatrics, Pediatric Endocrinology and Diabetology, and the Outpatient Endocrinology Clinic in Rzeszów, Poland. Each person referred for evaluation had a diagnosis of FASD based on the recommendations of Polish experts. The population consisted of 59 subjects with measurements of weight and height, and the IGF-1 level test was performed. Results Children with FAS had consistently lower height and weight measurements than children with ND-PAE. In the FAS group, children (<3 percentile) accounted for 42.31%, and in the ND-PAE group - 18.18%. The analysis of the whole group showed the highest prevalence of low body weight (below the third percentile) among subjects with FAS - 53.85%. The prevalence of low body weight and short stature (both parameters <3rd centile) was found to be 27.11% in the whole group. Lower mean BMI values were related to the FAS group (21.71 kg/m2) compared to the ND-PAE group (39.62 kg/m2). In the study group, BMI below the fifth percentile was found in 28.81% of the children, normal weight (5th-85th percentile) in 67.80%. Discussion During the care of children with FASD, a continuous evaluation of nutritional status, height, and weight is necessary. This group of patients is often affected by low birth weight, short stature and weight deficiency, which require differential diagnosis and appropriate dietary and therapeutic management.
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Mistry JN, Silvennoinen S, Zaman F, Sävendahl L, Mariniello K, Hall C, Howard SR, Dunkel L, Sankilampi U, Guasti L. The crosstalk between FGF21 and GH leads to weakened GH receptor signaling and IGF1 expression and is associated with growth failure in very preterm infants. Front Endocrinol (Lausanne) 2023; 14:1105602. [PMID: 37251684 PMCID: PMC10213667 DOI: 10.3389/fendo.2023.1105602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/28/2023] [Indexed: 05/31/2023] Open
Abstract
Background Fibroblast growth factor 21 (FGF21) is an essential metabolic regulator that adapts to changes in nutritional status. Severe childhood undernutrition induces elevated FGF21 levels, contributing to growth hormone (GH) resistance and subsequent linear growth attenuation potentially through a direct action on chondrocytes. Methods In this study, we assessed expression of the components of both GH and FGF21 pathways in rare and unique human growth plates obtained from children. Moreover, we investigated the mechanistic interplay of FGF21 on GH receptor (GHR) signaling in a heterologous system. Results Chronic FGF21 exposure increased GH-induced GHR turnover and SOCS2 expression, leading to the inhibition of STAT5 phosphorylation and IGF-1 expression. The clinical significance of FGF21 signaling through GH receptors was tested in nutritionally driven growth failure seen in very preterm (VPT) infants right after birth. VPT infants display an immediate linear growth failure after birth followed by growth catch-up. Consistent with the in vitro model data, we show that circulating FGF21 levels were elevated during deflection in linear growth compared to catch-up growth and were inversely correlated with the length velocity and circulating IGF1 levels. Conclusions This study further supports a central role of FGF21 in GH resistance and linear growth failure and suggests a direct action on the growth plate.
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Affiliation(s)
- Jayna N. Mistry
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Sanna Silvennoinen
- Department of Pediatrics, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - Farasat Zaman
- Department of Women’s and Children’s Health, Karolinska Institutet and Karolinska University, Solna, Sweden
| | - Lars Sävendahl
- Department of Women’s and Children’s Health, Karolinska Institutet and Karolinska University, Solna, Sweden
| | - Katia Mariniello
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Charlotte Hall
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Sasha R. Howard
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Leo Dunkel
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Ulla Sankilampi
- Department of Pediatrics, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - Leonardo Guasti
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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7
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Vesel L, Bellad RM, Manji K, Saidi F, Velasquez E, Sudfeld CR, Miller K, Bakari M, Lugangira K, Kisenge R, Salim N, Somji S, Hoffman I, Msimuko K, Mvalo T, Nyirenda F, Phiri M, Das L, Dhaded S, Goudar SS, Herekar V, Kumar Y, Koujalagi MB, Guruprasad G, Panda S, Shamanur LG, Somannavar M, Vernekar SS, Misra S, Adair L, Bell G, Caruso BA, Duggan C, Fleming K, Israel-Ballard K, Fishman E, Lee ACC, Lipsitz S, Mansen KL, Martin SL, Mokhtar RR, North K, Pote A, Spigel L, Tuller DE, Young M, Semrau KEA. Feeding practices and growth patterns of moderately low birthweight infants in resource-limited settings: results from a multisite, longitudinal observational study. BMJ Open 2023; 13:e067316. [PMID: 36792338 PMCID: PMC9933750 DOI: 10.1136/bmjopen-2022-067316] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVES To describe the feeding profile of low birthweight (LBW) infants in the first half of infancy; and to examine growth patterns and early risk factors of poor 6-month growth outcomes. DESIGN Prospective observational cohort study. SETTING AND PARTICIPANTS Stable, moderately LBW (1.50 to <2.50 kg) infants were enrolled at birth from 12 secondary/tertiary facilities in India, Malawi and Tanzania and visited nine times over 6 months. VARIABLES OF INTEREST Key variables of interest included birth weight, LBW type (combination of preterm/term status and size-for-gestational age at birth), lactation practices and support, feeding profile, birthweight regain by 2 weeks of age and poor 6-month growth outcomes. RESULTS Between 13 September 2019 and 27 January 2021, 1114 infants were enrolled, comprising 4 LBW types. 363 (37.3%) infants initiated early breast feeding and 425 (43.8%) were exclusively breastfed to 6 months. 231 (22.3%) did not regain birthweight by 2 weeks; at 6 months, 280 (32.6%) were stunted, 222 (25.8%) underweight and 88 (10.2%) wasted. Preterm-small-for-gestational age (SGA) infants had 1.89 (95% CI 1.37 to 2.62) and 2.32 (95% CI 1.48 to 3.62) times greater risks of being stunted and underweight at 6 months compared with preterm-appropriate-for-gestational age (AGA) infants. Term-SGA infants had 2.33 (95% CI 1.77 to 3.08), 2.89 (95% CI 1.97 to 4.24) and 1.99 (95% CI 1.13 to 3.51) times higher risks of being stunted, underweight and wasted compared with preterm-AGA infants. Those not regaining their birthweight by 2 weeks had 1.51 (95% CI 1.23 to 1.85) and 1.55 (95% CI 1.21 to 1.99) times greater risks of being stunted and underweight compared with infants regaining. CONCLUSION LBW type, particularly SGA regardless of preterm or term status, and lack of birthweight regain by 2 weeks are important risk identification parameters. Early interventions are needed that include optimal feeding support, action-oriented growth monitoring and understanding of the needs and growth patterns of SGA infants to enable appropriate weight gain and proactive management of vulnerable infants. TRIAL REGISTRATION NUMBER NCT04002908.
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Affiliation(s)
- Linda Vesel
- Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Roopa M Bellad
- Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, India
| | - Karim Manji
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Friday Saidi
- University of North Carolina Project Malawi, Lilongwe, Malawi
| | - Esther Velasquez
- Department of Epidemiology and Population Health, Stanford University, Palo Alto, California, USA
| | - Christopher R Sudfeld
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Katharine Miller
- Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Mohamed Bakari
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Kristina Lugangira
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Rodrick Kisenge
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Nahya Salim
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Sarah Somji
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Irving Hoffman
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Kingsly Msimuko
- University of North Carolina Project Malawi, Lilongwe, Malawi
| | - Tisungane Mvalo
- University of North Carolina Project Malawi, Lilongwe, Malawi
- Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Fadire Nyirenda
- University of North Carolina Project Malawi, Lilongwe, Malawi
| | - Melda Phiri
- University of North Carolina Project Malawi, Lilongwe, Malawi
| | - Leena Das
- Department of Paediatrics, SCB Medical College & Hospital, Cuttack, Orissa, India
| | - Sangappa Dhaded
- Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, India
| | - Shivaprasad S Goudar
- Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, India
| | - Veena Herekar
- Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, India
| | - Yogesh Kumar
- Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, India
| | - M B Koujalagi
- Department of Paediatrics, JJM Medical College, Davangere, Karnataka, India
| | - Gowdar Guruprasad
- Department of Paediatrics, JJM Medical College, Davangere, Karnataka, India
| | | | - Latha G Shamanur
- Department of Paediatrics, SS Institute of Medical Sciences and Research Center, Davangere, Karnataka, India
| | - Manjunath Somannavar
- Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, India
| | - Sunil S Vernekar
- Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, India
| | - Sujata Misra
- Department of Paediatrics, SCB Medical College & Hospital, Cuttack, Orissa, India
| | - Linda Adair
- Department of Nutrition, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Griffith Bell
- Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Bethany A Caruso
- Hubert Department of Global Health, Emory University School of Public Health, Atlanta, Georgia, USA
| | - Christopher Duggan
- Center for Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Katelyn Fleming
- Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | - Eliza Fishman
- Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Anne C C Lee
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Stuart Lipsitz
- Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Kimberly L Mansen
- Maternal, Newborn, Child Health and Nutrition Program, PATH, Seattle, Washington, USA
| | - Stephanie L Martin
- Department of Nutrition, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Rana R Mokhtar
- Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Krysten North
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Arthur Pote
- Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Lauren Spigel
- Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Danielle E Tuller
- Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Melissa Young
- Hubert Department of Global Health, Emory University School of Public Health, Atlanta, Georgia, USA
| | - Katherine E A Semrau
- Ariadne Labs, Harvard T.H. Chan School of Public Health / Brigham and Women's Hospital, Boston, Massachusetts, USA
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8
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Pfäffle R, Knüpfer M, Göbert M, Vogel M, Gausche R, Beger C, Keller E, Körner A, Thome U, Kiess W. Growth Patterns of Children With Short Stature in Adulthood According to Auxological Status and Maturity at Birth. J Clin Endocrinol Metab 2022; 107:3320-3327. [PMID: 36099499 DOI: 10.1210/clinem/dgac510] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT Prematurity carries a risk for impaired postnatal growth and long-term growth restriction. Especially children born SGA seem vulnerable for poor growth, as a persistent short stature can be observed in app 10-15% of these children. OBJECTIVE In this study we aimed to recognize differences in growth patterns of children according to sex, maturity, and auxological status at birth facilitating earlier identification of small-for-gestational-age (SGA) children with adult short stature. METHODS The growth data of 44 791 infants born between January 1, 1980, and December 30, 2012, among 2 pediatric cohorts with follow-up through December 31, 2020, were analyzed. A total of 5698 children with birth data had measurements at near final height (nfh) and at least 2 further points. RESULTS Preterm children (gestational age < 37 weeks) had a significantly lower mean nfh SDS than term children (preterm, -0.61; term, -0.18) and a higher likelihood of nfh < third percentile (preterm, 20.5%; term, 12.2%). SGA born children also had a lower mean nfh SD score (SDS) than children born appropriate for gestational age (AGA) (SGA, -1.06; AGA, -0.15) and a higher likelihood of nfh < third percentile (SGA, 28.2%; AGA 10.1%). Of 1204 SGA children, 672 (56%) showed successful catch-up growth (CUG) to nfh greater than or equal to the 10th percentile (SGA-CU), and 532 children (44%) did not (SGA-S). The difference in their mean nfh SDS (SGA-CU, -0.12; SGA-S -2.26) can only partly be explained by the differences in mean mid-parental height SDS (SGA-CU, -0.3; SGA-S, -1.19). During the first year, SGA-CU showed higher CUG (SGA-CU, +1.2 SDS; SGA-S, +0.45 SDS), which helps to discriminate between groups earlier. CONCLUSION Final growth outcome was influenced by prematurity and auxological status at birth, but not by sex. Height/length SDS increments during year 1 are instrumental to discern SGA children with later normal or short stature. While observing CUG until year 2 and 3 can add specificity, discrimination thereafter becomes difficult.
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Affiliation(s)
- Roland Pfäffle
- Hospital for Children and Adolescents, University of Leipzig, 04103 Leipzig, Germany
- CrescNet Database, University of Leipzig, 04103 Leipzig, Germany
| | - Matthias Knüpfer
- Hospital for Children and Adolescents, University of Leipzig, 04103 Leipzig, Germany
- Department of Neonatology, Hospital for Children and Adolescents, University of Leipzig, 04103 Leipzig, Germany
| | - Melanie Göbert
- Hospital for Children and Adolescents, University of Leipzig, 04103 Leipzig, Germany
| | - Mandy Vogel
- LIFE-Child-Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany
- Centre of Pediatric Research (CPL), University of Leipzig, 04103 Leipzig, Germany
| | - Ruth Gausche
- CrescNet Database, University of Leipzig, 04103 Leipzig, Germany
| | - Christoph Beger
- CrescNet Database, University of Leipzig, 04103 Leipzig, Germany
| | - Eberhard Keller
- CrescNet Database, University of Leipzig, 04103 Leipzig, Germany
| | - Antje Körner
- Hospital for Children and Adolescents, University of Leipzig, 04103 Leipzig, Germany
- LIFE-Child-Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany
- Centre of Pediatric Research (CPL), University of Leipzig, 04103 Leipzig, Germany
| | - Ulrich Thome
- Hospital for Children and Adolescents, University of Leipzig, 04103 Leipzig, Germany
- Department of Neonatology, Hospital for Children and Adolescents, University of Leipzig, 04103 Leipzig, Germany
- Centre of Pediatric Research (CPL), University of Leipzig, 04103 Leipzig, Germany
| | - Wieland Kiess
- Hospital for Children and Adolescents, University of Leipzig, 04103 Leipzig, Germany
- LIFE-Child-Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany
- Centre of Pediatric Research (CPL), University of Leipzig, 04103 Leipzig, Germany
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Lucaccioni L, Iughetti L, Berardi A, Predieri B. Challenges in the growth and development of newborns with extra-uterine growth restriction. Expert Rev Endocrinol Metab 2022; 17:415-423. [PMID: 35941822 DOI: 10.1080/17446651.2022.2110468] [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] [Received: 04/03/2022] [Accepted: 08/03/2022] [Indexed: 10/16/2022]
Abstract
INTRODUCTION Extra-uterine growth restriction (EUGR) is a condition caused by the failure of very preterm infants to reach their potential growth during the NICU hospital stay. Despite enormous improvements in nutritional support and strategies, the growth pattern of preterm infants is still far from the one expected. AREAS COVERED This review focuses on what EUGR is, highlighting controversial aspects of this topic. EUGR is still missing a univocal definition, and the international debate is also open on what is the best growth chart to use. Moreover, professionals in NICU may not be trained on how to perform anthropometric measurements, increasing the risk of over- or underestimation, especially for length assessment. EUGR has recently been described as one of the main comorbidities in NICU, influencing growth, metabolism, and neurodevelopment later in life. EXPERT OPINION There is still much to investigate about what the best growth pattern in the NICU should be. What is known so far is that the majority of preterm neonates develop EUGR, and this leads to several short- and long-term consequences. It is imperative that neonatologists and pediatric endocrinologists work together, to modulate growth in the NICU.
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Affiliation(s)
- Laura Lucaccioni
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Lorenzo Iughetti
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Alberto Berardi
- Neonatology Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Barbara Predieri
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
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Jima BR, Hassen HY, Bahwere P, Gebreyesus SH. Diagnostic ability of mid-upper arm circumference-to-length ratio in detecting wasting among infants aged 1-6 months in Ethiopia. J Nutr Sci 2022; 11:e23. [PMID: 35399552 PMCID: PMC8943582 DOI: 10.1017/jns.2022.21] [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: 12/11/2021] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 11/26/2022] Open
Abstract
Mid-upper arm circumference (MUAC) is an age-sensitive anthropometric measurement in infants. However, exact age is difficult to know, particularly in low-income countries. We evaluated the diagnostic accuracy of an age-independent mid-upper arm circumference-to-length (MUAC/L) ratio measurement in detecting wasting among infants aged 1-6 months in Ethiopia. A facility-based diagnostic accuracy study was conducted on 467 in-patient infants aged 1-6 months from March to May 2019. The receiver operating characteristic (ROC) curve was used to evaluate the ability of MUAC/L to detect wasting. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and positive and negative predictive values were calculated. The magnitude of severe wasting was 21⋅6 % and moderate wasting was 13⋅0 %. The area under the ROC curve (AUC) of MUAC/L was 0⋅77 (95 % CI 0⋅73, 0⋅81) for detecting moderate wasting and 0⋅92 (95 % CI 0⋅89, 0⋅94) for detecting severe wasting. MUAC/L had a sensitivity of 91⋅1 % (95 % CI 81⋅3, 94⋅4), a specificity of 84⋅7 % (95 % CI 80⋅6, 88⋅2), a positive likelihood ratio of 5⋅82 (95 % CI 4⋅53, 7⋅48) and a negative likelihood ratio of 0⋅13 (95 % CI 0⋅07, 0⋅22) in total infants. The optimal MUAC/L cut-off was <0⋅190 for boys and <0⋅185 for girls. MUAC/L had an AUC of 0⋅77 and 0⋅92 in predicting moderate and severe wasting in infants aged 1-6 months, respectively. Using MUAC/L to treat Ethiopian infants with severe wasting and infants with similar characteristics in other countries could improve treatment coverage.
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Affiliation(s)
- Beshada Rago Jima
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Hamid Yimem Hassen
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Paluku Bahwere
- Centre of Research in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Free University of Brussels, 808, Route de Lennik, 1070Brussels, Belgium
| | - Seifu Hagos Gebreyesus
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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11
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Mackay CA, Smit JS, Khan F, Dessai F, Masekela R. IL-6 Predicts Poor Early Post-Natal Growth in Very Low-Birth-Weight Infants in a Low-Middle Income Setting. J Trop Pediatr 2021; 67:6133218. [PMID: 33575806 DOI: 10.1093/tropej/fmaa132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Extra-uterine growth restriction (EUGR) is common in preterms and may be associated with elevated pro-inflammatory cytokines. OBJECTIVE Describe postnatal growth in a cohort of very low-birth-weight (VLBW) infants and determine the association of interleukin-6 (IL-6) and tumour necrosis factor alpha (TNF-α) in umbilical cord blood with growth at 40 weeks and 12 months postmenstrual age (PMA). METHODS Single-centre, prospective cohort study conducted from 1 June 2017 to 31 January 2019 with follow-up to 31 March 2020. Infants <1500 g at birth were enrolled, cord blood collected for IL-6 and TNF-α assays and postnatal care, including anthropometry, provided to 12 months PMA. Informed consent and ethics approval were obtained. RESULTS In total, 279 patients were enrolled; 84 (30.1%) died before 12 months and 91 (32.6%) lost to follow-up. Anthropometry was available for 151 infants at 40 weeks and 105 at 12 months. Z-Scores at 40 weeks for males and females combined were -2.5, -2.1 and -1.2 for weight, length and head circumference. EUGR occurred in 103/113 (91.2%), 98/107 (91.6%) and 70/109 (64.2%) participants for weight, length and head circumference. Elevated IL-6 was associated with restricted weight (56.0 vs. 14.5 pg/ml, p = 0.02) and length (60.4 vs. 7.3 pg/ml, p = 0.01) at 40 weeks. There was no difference in IL-6 at 12 months and no difference in TNF-α at 40 weeks or 12 months. CONCLUSION The study reports significant EUGR. Elevated IL-6 was associated with growth restriction at 40 weeks but not 12 months PMA.
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Affiliation(s)
- Cheryl Anne Mackay
- Department of Paediatrics, Dora Nginza Hospital, Nelson Mandela Bay, Port Elizabeth 6070, South Africa
| | - James Stephanus Smit
- Department of Paediatrics, Dora Nginza Hospital, Nelson Mandela Bay, Port Elizabeth 6070, South Africa
| | - Farhaad Khan
- Department of Paediatrics, Dora Nginza Hospital, Nelson Mandela Bay, Port Elizabeth 6070, South Africa
| | - Fazana Dessai
- Clinical Medicine Laboratory, University of Kwazulu-Natal, Durban, South Africa
| | - Refiloe Masekela
- Department of Paediatrics and Child Health, University of Kwazulu-Natal, Durban, South Africa
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Durá-Travé T, Martín-García IS, Gallinas-Victoriano F, Chueca-Guindulain MJ, Berrade-Zubiri S. Catch-up growth and associated factors in very low birth weight infants. An Pediatr (Barc) 2020. [DOI: 10.1016/j.anpede.2019.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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13
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Durá-Travé T, San Martín-García I, Gallinas-Victoriano F, Chueca Guindulain MJ, Berrade-Zubiri S. [Catch-up growth and associated factors in very low birth weight infants]. An Pediatr (Barc) 2020; 93:282-288. [PMID: 31983650 DOI: 10.1016/j.anpedi.2019.06.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/19/2019] [Accepted: 06/28/2019] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The characteristics of catch-up growth in very low birth weight infants (VLBW) have not been clearly established. The aim of this study was to analyse the height catch-up and some associated factors in a cohort of VLBW (birth weight<1,500g) from birth to age 14 years. METHODS We obtained retrospective data on weight and height at birth and ages one, 2, 3, 4, 6, 8, 10, 12 and 14 years in a cohort of 170 VLBW. We compared these anthropometric values with those documented in a control group. RESULTS Thirty-seven children (21.8%) were born with an extremely low birth weight and 32 (18.8%) extremely preterm. At 10 years of age, 7% of VLBW (1,000-1,500g) and 35% of extremely low birth weight (<1,500g) children had short stature (P=.001). Almost all VLBW children who had a normal height at ages 2, 4 and 10 years had exhibited adequate weight catch-up in previous evaluations. We found that extremely low birth weight and extremely preterm were independent predictors for inadequate height catch-up. CONCLUSION The growth pattern of VLBW children has specific characteristics. The catch-up in weight seems to be an important factor for catch-up in height, and therefore a thorough nutritional follow-up is recommended in these children.
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Affiliation(s)
- Teodoro Durá-Travé
- Departamento de Pediatría, Facultad de Medicina, Universidad de Navarra, Pamplona, Navarra, España; Servicio de Pediatría, Complejo Hospitalario de Navarra, Pamplona, Navarra, España; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, España.
| | | | | | - María Jesús Chueca Guindulain
- Servicio de Pediatría, Complejo Hospitalario de Navarra, Pamplona, Navarra, España; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, España
| | - Sara Berrade-Zubiri
- Servicio de Pediatría, Complejo Hospitalario de Navarra, Pamplona, Navarra, España; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, España
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Deng Y, Yang F, Mu D. First-year growth of 834 preterm infants in a Chinese population: a single-center study. BMC Pediatr 2019; 19:403. [PMID: 31684894 PMCID: PMC6827211 DOI: 10.1186/s12887-019-1752-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 09/27/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to follow the growth and hematological indicators of preterm infants during their first year. METHODS Neonates below 37 gestational weeks had routine follow-ups up through 1 year from January 2012 to December 2015 at West China 2nd University Hospital, Sichuan University. Weight, length and head circumference (HC) were measured monthly during the first 6 months, followed by monitoring every second month until 12 months. The catch-up growth defined as a gain of Z-score > 0.67 according to previous study. All preterm infants were prescribed iron prophylaxis based on national guideline. The hemoglobin concentration was examined at 6 and 12 months. RESULTS Altogether, 132 very-low-birth-weight (VLBW), 504 low-birth-weight (LBW) and 198 normal-birth-weight (NBW) infants were followed. The rates of catch-up growth for weight, length and HC 12 months of corrected age (CA) were 22.6, 29.1 and 14.6%, respectively. SGA and VLBW infants showed higher catch-up growth rates. The overall prevalence of anemia was 6.8% at 6 months and 7.8% at 12 months. The Z-scores for weight-for-length, length and HC were lower in the VLBW and SGA preterm infant groups than in the other preterm groups throughout the first year of life. The incidences of stunting, microcephaly and wasting changed from 5, 1.3 and 3.7% to 2, 1.1, 0.9 and 2.4%, respectively, during the first year. However, the incidences of wasting and stunting were higher for the VLBW infants than for the LBW and NBW infants at 12 months (9.3% vs. 1.4%, p < 0.01; 9.3% vs. 1%, p < 0.01,respectively; 4.7% vs. 0.8%, p < 0.01, 4.7% vs. 0%, p < 0.01,respectively). Similar results were observed between SGA and AGA infants (8.7% vs. 1.5%, p < 0.01; 5.8% vs. 0.4%, p < 0.01). Logistic regression revealed SGA and VLBW as risk factors for poor growth (WLZ < -2SD) at 12 months (OR = 5.5, 95% CI: 2.1-14.8, p < 0.01: OR = 4.8, 95% CI: 1.8-12.8, p < 0.01, respectively). CONCLUSION The VLBW and SGA preterm infants showed significant catch-up growth during their first year of life. However, SGA and VLBW were risk factors for poor growth during the preterm infants' first year of life. Prophylactic iron supplementation in preterm infants appears to reduce the prevalence of anemia.
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Affiliation(s)
- Ying Deng
- Department of Pediatrics, West China Second University Hospital, Chengdu, Sichuan Province China
- Key Laboratory of Birth Defects and Related Disease of Women and Children, Ministry of Education, Sichuan University, Chengdu, 610041 Sichuan Province China
| | - Fan Yang
- Department of Pediatrics, West China Second University Hospital, Chengdu, Sichuan Province China
- Key Laboratory of Birth Defects and Related Disease of Women and Children, Ministry of Education, Sichuan University, Chengdu, 610041 Sichuan Province China
| | - Dezhi Mu
- Department of Pediatrics, West China Second University Hospital, Chengdu, Sichuan Province China
- Key Laboratory of Birth Defects and Related Disease of Women and Children, Ministry of Education, Sichuan University, Chengdu, 610041 Sichuan Province China
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Toftlund LH, Halken S, Agertoft L, Zachariassen G. Early nutrition and signs of metabolic syndrome at 6 y of age in children born very preterm. Am J Clin Nutr 2019; 107:717-724. [PMID: 29722837 DOI: 10.1093/ajcn/nqy015] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 01/18/2018] [Indexed: 11/14/2022] Open
Abstract
Background In term-born infants, the risk of developing metabolic syndrome (MetS) has been shown to be associated with formula feeding and early rapid growth. Breastfeeding, however, seems to be associated with a lower risk of MetS among term-born infants. Objective The possible association between type of early nutrition, early growth, and possible influence on different metabolic outcomes at 6 y of age was investigated in very-preterm-born children. Design This study is a 6-y follow-up of 281 very-preterm-born infants with a gestational age of ≤32 wk. Infants breastfed at discharge from the hospital were randomly assigned to receive unfortified or fortified mother's milk, whereas those who were not breastfed received a preterm formula. The intervention lasted until 4 mo of corrected age. At 6 y of age, height, weight, and body mass index were measured and a dual-energy X-ray absorptiometry scan and blood sampling were performed. Results In total, 239 children participated in the follow-up. No differences were found between the 2 breastfed groups. Formula-fed children were more often predisposed to obesity and from families with a lower social status than were children who were breastfed only. Early rapid growth (crossing of weight percentiles with >1 SD in either direction) was seen in 53% of the children from 34 wk of postmenstrual age and until 2 mo of corrected age and was significantly correlated with several metabolic outcomes at 6 y of age. Conclusions Children fed a preterm formula postdischarge more often showed early rapid growth than did breastfed children, and early rapid growth was correlated with early signs of MetS at 6 y of age. However, all of the values were within normal ranges. This trial was registered at as NCT02078687.
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Affiliation(s)
- Line Hedegaard Toftlund
- Hans Christian Andersen Children's Hospital, Odense University Hospital, and Faculty of Health, University of Southern Denmark, Odense, Denmark
| | - Susanne Halken
- Hans Christian Andersen Children's Hospital, Odense University Hospital, and Faculty of Health, University of Southern Denmark, Odense, Denmark
| | - Lone Agertoft
- Hans Christian Andersen Children's Hospital, Odense University Hospital, and Faculty of Health, University of Southern Denmark, Odense, Denmark
| | - Gitte Zachariassen
- Hans Christian Andersen Children's Hospital, Odense University Hospital, and Faculty of Health, University of Southern Denmark, Odense, Denmark
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16
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Olbertz DM, Mumm R, Wittwer-Backofen U, Fricke-Otto S, Pyper A, Otte J, Wabitsch M, Gottmann P, Schwab KO, Scholten M, Gerstmann K, Voigt M. Identification of growth patterns of preterm and small-for-gestational age children from birth to 4 years - do they catch up? J Perinat Med 2019; 47:448-454. [PMID: 30759068 DOI: 10.1515/jpm-2018-0239] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 01/08/2019] [Indexed: 11/15/2022]
Abstract
Background A legitimate indication for growth hormone (GH) therapy in children born too light or short at birth [small-for-gestational age (SGA)] exists in Germany and the European Union only if special criteria are met. Methods We conducted a longitudinal, multi-centered study on full-term appropriate-for-gestational age (AGA, n=1496) and pre-term born SGA (n=173) and full-term SGA children (n=891) in Germany from 2006 to 2010. We analyzed height, weight, body mass index (BMI) and head circumference. Results Pre-term or full-term born SGA children were shorter, lighter and had a lower BMI from birth until 3 years of age than full-term AGA children. The growth velocity of the analyzed anthropometric measurements was significantly higher in pre-term and full-term SGA children exclusively in the first 2 years of life than in AGA children. The criteria for GH treatment were fulfilled by 12.1% of pre-term SGA children compared to only 1.3% of full-term SGA children. Conclusion For children that do not catch up growth within the first 2 years of life, an earlier start of GH treatment should be considered, because a catch-up growth later than 2 years of life does not exist. Pre-term SGA-born children more frequently fulfill the criteria for GH treatment than full-term SGA children.
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Affiliation(s)
- Dirk Manfred Olbertz
- Department of Neonatology, Klinikum Südstadt, Rostock, Germany.,Center for Medicine and Society, University of Freiburg, Freiburg, Germany
| | - Rebekka Mumm
- Biological Anthropology, Faculty of Medicine, University of Freiburg, Hebelstr. 29, Freiburg 79104, Germany.,Center for Medicine and Society, University of Freiburg, Freiburg, Germany, Tel.: +49761 203 5525, Fax: +49761 203 6896
| | - Ursula Wittwer-Backofen
- Center for Medicine and Society, University of Freiburg, Freiburg, Germany.,Biological Anthropology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - Anke Pyper
- Department of Pediatrics, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Johannes Otte
- Evangelisches Krankenhaus Bielefeld, Bielefeld, Germany
| | - Martin Wabitsch
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, University of Ulm, Ulm, Germany
| | - Petra Gottmann
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, University of Ulm, Ulm, Germany
| | - Karl Otfried Schwab
- Department of Pediatrics and Adolescent Medicine, University Medical Center, Freiburg, Germany
| | | | | | - Manfred Voigt
- Center for Medicine and Society, University of Freiburg, Freiburg, Germany.,Department of Pediatrics and Adolescent Medicine, University Medical Center, Freiburg, Germany
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Mwangome M, Ngari M, Bwahere P, Kabore P, McGrath M, Kerac M, Berkley JA. Anthropometry at birth and at age of routine vaccination to predict mortality in the first year of life: A birth cohort study in BukinaFaso. PLoS One 2019; 14:e0213523. [PMID: 30921335 PMCID: PMC6438502 DOI: 10.1371/journal.pone.0213523] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 02/24/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The World Health Organization currently defines severe acute malnutrition (SAM) in infants aged under 6 months of age using weight-for-length Z score (WLZ). Given widespread use of mid-upper arm circumference (MUAC) for identifying SAM in older children and weight-for-age (WAZ) for growth monitoring, there is increasing debate about the optimal anthropometric criteria to best identify infants u6m at-risk of mortality. OBJECTIVE To determine the discriminatory value for mortality during the first 12 months of life of anthropometry taken at birth and at age two months (approximate age of routine vaccination). DESIGN Data were analyzed from a birth cohort recruited between April and December of 2004 at four health facilities within Bansalogho District in Burkina Faso. Infants were followed up for 12 months. Mortality risks were estimated using hazards ratios (HR). Discriminatory value was assessed using receiver operating characteristic curves. RESULTS Of 1,103 infants, 227 (21%) were low birthweight (LBW). During 12 months, 86 (7.8%) infants died; 38 (44%) among the LBW group. At birth, MUAC<9.0cm, weight<2.5kg, length<44.2cm and incalculable WLZ were associated with mortality. Sixty (70%) deaths occurred after the age of two months; 26 (43%) among LBW infants. At age two months, any MUAC <11.5cm, weight <3.8kg (WAZ<-3) and length <52.4cm (LAZ<-3) were associated with risk of mortality. WLZ was not associated with mortality at any threshold. Birth weight did not modify the effect of the association between month two MUAC and one-year mortality (P = 0.33). CONCLUSION Infants at heightened risk of mortality and are better identified during early infancy by MUAC or WFA than by WLZ. LBW infants with low anthropometry at the age of routine immunizations remain at elevated risk than normal birth weight (NBW)infants and require intervention. Effectiveness, cost-effectiveness and coverage of applying proposed thresholds should be investigated as a priority to inform policy and practice.
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Affiliation(s)
- Martha Mwangome
- KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya
- The Childhood Acute Illness and Nutrition Network, Nairobi, Kenya
| | - Moses Ngari
- KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya
- The Childhood Acute Illness and Nutrition Network, Nairobi, Kenya
| | - Paluku Bwahere
- School of Public Health, Center of Research in Epidemiology Biostatistics and Clinical Research, Université Libre de Bruxelles, Brussels, Belgium
- Valid International, Oxford, United Kingdom
| | - Patrick Kabore
- Africa Regional office, World Health Organisation, Brazzaville, Republic of Congo
| | | | - Marko Kerac
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
| | - James A. Berkley
- KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya
- The Childhood Acute Illness and Nutrition Network, Nairobi, Kenya
- Centre for Clinical Vaccinology & Tropical Medicine, University of Oxford, Oxford, United Kingdom
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Huang L, Yang S, Yang F, Xiong F. A prospective study about physical growth of children from birth to 2 years old born full-term small-for-gestational-age. J Paediatr Child Health 2019; 55:199-204. [PMID: 30066971 DOI: 10.1111/jpc.14162] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 06/22/2018] [Accepted: 07/03/2018] [Indexed: 01/12/2023]
Abstract
AIM To evaluate the growth trend of children from birth to 2 years old born full-term small-for-gestational-age (SGA) in Chengdu, China. METHODS Full-term SGA infants were prospectively followed from birth to 2 years of age. The weight, length and head circumference were monitored at 3, 6, 12, 18 and 24 months. Catch-up growth and growth velocity were measured by using standardised z-score and Δz-score. Growth deviation was analysed. RESULTS A total of 850 full-term SGA infants were involved in our study. There were no significant differences in weight or length at birth between male and female infants. Full catch-up growth was seen in 95.85% of SGA infants within 2 years of life, with no gender differences. The z-score and Δz-score for weight at 3 months were less than those at other ages (P < 0.05). The z-score and Δz-score for length at 3 and 6 months were less than those at other ages (P < 0.05). Smaller z-score for head circumference was seen at 3 and 6 months (P < 0.05). The z-score for body mass index at 6 months was the largest over the period of follow-up. The total prevalence of being overweight or obese fluctuated around 10% at different follow-up stages. Males had a faster growth velocity for length at 12 months compared to females (P < 0.05). The proportion of those who were underweight, of short stature or had a head circumference z-score < -2 significantly decreased between 3 and 6 months. At 24 months, there was an increase in z-score of 0.67 standard deviation for both weight and length in most full-term SGA infants, and the proportion of underweight and short stature was 2.97 and 2.67%, respectively. CONCLUSIONS Most full-term SGA infants undergo catch-up growth during the first year of life. Regardless of gender, the catch-up velocity for weight exceeded that for length at each visit. Additional follow-up studies are needed to determine long-term growth outcomes for full-term SGAs.
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Affiliation(s)
- Lili Huang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan, China
| | - Sufei Yang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan, China
| | - Fan Yang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan, China
| | - Fei Xiong
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan, China
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Takayanagi T, Shichijo A, Egashira M, Egashira T, Mizukami T. Extrauterine growth restriction was associated with short stature and thinness in very low birthweight infants at around six years of age. Acta Paediatr 2019; 108:112-117. [PMID: 29863767 DOI: 10.1111/apa.14433] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 03/23/2018] [Accepted: 05/31/2018] [Indexed: 11/28/2022]
Abstract
AIM The effect that intrauterine or extrauterine growth restriction (EUGR) had on the build of very low birthweight (VLBW) infants was investigated before Japanese children started school. METHOD Between 2005 and 2017, the National Hospital Organization, Saga, Japan, carried out preschool checks on 322 children born with a VLBW at approximately six years of age. Growth restriction was defined as being born small for gestational age (SGA) or EUGR if they were born at term. The prevalence of short stature, thinness and obesity was determined, and associations between SGA or EUGR and subsequent body build were investigated. RESULTS In this study, 77 of 322 (23.9%) infants were SGA and 153 of 322 (47.5%) were EUGR: 14 of 77 (18.2%) SGA infants caught up in growth to the 169 non-EUGR infants, while 90 of 245 (36.7%) appropriate for gestational age infants subsequently demonstrated EUGR. There were 38 (11.8%) short stature, 38 (11.8%) thin and six (1.9%) obese subjects in the total cohort and growth hormone deficiencies in nine (2.8%) cases. We found significant associations between EUGR and both short stature and thinness. CONCLUSION Extrauterine growth restriction was significantly associated with short stature and thinness in VLBW infants at around six years, irrespective of the degree of SGA.
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Affiliation(s)
| | - Akinori Shichijo
- Department of Pediatrics National Hospital Organization Saga Hospital Saga Japan
| | - Masakazu Egashira
- Department of Pediatrics National Hospital Organization Saga Hospital Saga Japan
| | - Tomoko Egashira
- Department of Pediatrics National Hospital Organization Saga Hospital Saga Japan
| | - Tomoko Mizukami
- Department of Pediatrics National Hospital Organization Saga Hospital Saga Japan
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Mbusa-Kambale R, Mihigo-Akonkwa M, Francisca-Isia N, Zigabe-Mushamuka S, Bwija-Kasengi J, Nyakasane-Muhimuzi A, Battisti O, Mungo-Masumbuko B. Somatic growth from birth to 6 months in low birth weight, in Bukavu, South Kivu, Democratic Republic of the Congo. Rev Epidemiol Sante Publique 2018; 66:245-253. [PMID: 29857923 DOI: 10.1016/j.respe.2017.11.011] [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: 06/29/2017] [Revised: 11/05/2017] [Accepted: 11/30/2017] [Indexed: 09/30/2022] Open
Abstract
BACKGROUND Low birth weight (LBW) is one of the leading causes of perinatal and infant morbidity and mortality, as well as of impaired growth and neurocognitive development. This study aimed to evaluate the evolution of anthropometric parameters and the nutritional status of LBW infants and to analyze factors influencing the growth failure during their first 6 months of life (or adjusted age). METHODS This was a prospective cohort study for 6 months, including 100 infants born with LBW and 100 infants born at full-term and with normal weight. The z-scores weight for age, height for age, head circumference for age and weight for height were computed with the software Epinut and WHO Anthro 2005. Descriptive statistics, bivariate analysis and multivariable logistic regression analyses were employed to identify factors associated with growth failure. Growth failure was defined as a decrease in weight z-score (standard deviation score) of over 0.67 during one of the study's periods. The statistical significance threshold was fixed at 0.05. FINDINGS At 6 months of life (or adjusted age), 15.3% of LBW were underweight, 51.4% were stunted, 4.2% had an emaciation and 25% had a head circumference for age<-2 z-scores. Risk factor for growth failure was male sex (OR=1.56 [95% CI: 1.03-2.23]). The symmetrical intra-uterine growth retardation was a protector factor for growth failure (OR=0.49 [95% CI: 0.25-0.98]). CONCLUSION In the short term, LBW infants may have growth disorders. It is necessary to emphasize the importance of growth assessment of LBW children and proper education of their mothers about nutrition of their children for early and timely diagnosis and management of growth retardation and prevention of subsequent problems.
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Affiliation(s)
- R Mbusa-Kambale
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo; Department of Pediatrics, Reference Provincial General Hospital of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo.
| | - M Mihigo-Akonkwa
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo
| | - N Francisca-Isia
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo; Department of Pediatrics, Reference Provincial General Hospital of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo
| | - S Zigabe-Mushamuka
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo; Department of Pediatrics, Reference Provincial General Hospital of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo
| | - J Bwija-Kasengi
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo; Department of Pediatrics, Reference Provincial General Hospital of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo
| | - A Nyakasane-Muhimuzi
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo; Department of Pediatrics, Reference Provincial General Hospital of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo
| | - O Battisti
- Department of Pediatrics, Reference Provincial General Hospital of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo; Department of Pediatrics, University of Liege, Belgium
| | - B Mungo-Masumbuko
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo; Department of Pediatrics, Reference Provincial General Hospital of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo
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Christmann V, van der Putten ME, Rodwell L, Steiner K, Gotthardt M, van Goudoever JB, van Heijst AFJ. Effect of early nutritional intake on long-term growth and bone mineralization of former very low birth weight infants. Bone 2018; 108:89-97. [PMID: 29289790 DOI: 10.1016/j.bone.2017.12.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 12/11/2017] [Accepted: 12/21/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Preterm infants are at risk for impaired bone mineralization and growth in length later in life due to inadequate nutritional intake in the early postnatal period. OBJECTIVE To investigate whether increased nutritional supplementation of calcium, phosphate and protein in Very Low Birth Weight (VLBW) infants during the first 14days after birth was associated with improvement in length and bone development until 9-10years of age. DESIGN Observational follow-up study of VLBW infants (birth weight<1500g or gestational age<32weeks) born in two consecutive years (eligible infants: 2004 n: 63 and 2005: n: 66). Cohort 2005 received higher intake of calcium, phosphate and protein with parenteral nutrition compared to Cohort 2004. Anthropometric data were collected during standard follow-up visits until five years, and additionally at 9-10years of age including measurements of bone mineral content, bone mineral density of the whole body and lumbar spine determined by dual-energy X-ray absorptiometry. Long-term growth trajectories of both cohorts were evaluated separately for participants born appropriate (AGA) and small for gestational age (SGA), stratified by gender. Multivariate linear regression was used to examine the effect of nutritional intake and clinical covariates on length and bone mineralization. RESULTS Both cohorts achieved a catch-up in length to SDS within the normal range by 6months (length SDS: estimated mean (95% confidence interval (CI): 6months: Cohort 2004: -0.7 (-1.1, -0.3) Cohort 2005: -0.5 (-0.8, -0.2)). Bone mineral content and density were within the normal range and not different between the cohorts. SGA children achieved a catch-up in length at 5years with bone mineralization comparable to AGA children. Only for girls birth weight was significantly associated with length SDS (per gram: β 0.001; 95% CI (0.000, 0.003); p=0.03) There was no evidence of an association between early nutritional intake and bone mineralization. CONCLUSION Children born as appropriate or small for gestational age preterm infants are able to catch up in length after the postnatal period, and achieve a normal length and bone mineralization at age nine-ten years. An improvement of calcium and phosphate intake during the first 14days after birth was not associated with improvement in length and bone development.
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Affiliation(s)
- V Christmann
- Department of Pediatrics, Subdivision of Neonatology, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands.
| | - M E van der Putten
- Department of Pediatrics, Subdivision of Neonatology, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands; Department of Pediatrics, Subdivision of Neonatology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - L Rodwell
- Department for Health Evidence, Radboud Institute for Health Science, Subdivision of Biostatistics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - K Steiner
- Department of Pediatrics, Subdivision of Neonatology, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands
| | - M Gotthardt
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J B van Goudoever
- Department of Pediatrics, VU University Medical Center Amsterdam, Amsterdam, The Netherlands; Department of Pediatrics, Emma Children's Hospital - AMC Amsterdam, Amsterdam, The Netherlands
| | - A F J van Heijst
- Department of Pediatrics, Subdivision of Neonatology, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands
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Pokhrel K, Nanishi K, Poudel KC, Pokhrel KG, Tiwari K, Jimba M. Undernutrition Among Infants and Children in Nepal: Maternal Health Services and Their Roles to Prevent it. Matern Child Health J 2017; 20:2037-49. [PMID: 27236701 DOI: 10.1007/s10995-016-2023-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives Appropriate infant and young child feeding (IYCF) for children aged 6-23 months includes adequate dietary diversity, appropriate meal frequency, and continued breastfeeding. Mothers receiving antenatal care (ANC) and postnatal care (PNC) may adopt better IYCF. This study examined the association of ANC or PNC attendance with IYCF and child nutrition status. Methods A cross-sectional study was performed on 400 mother-child pairs in rural Nepal. Mothers were interviewed about their history of ANC and PNC attendance and IYCF; the height and weight of their children were measured. IYCF was measured with infant and child feeding index (ICFI) aggregating scores of dietary diversity, meal frequency, continued breastfeeding, and dietary variety. Lower ICFI scores indicated poorer IYCF practices. Multiple regression and logistic regression examined the association of ANC and PNC attendance with ICFI scores and undernutrition, respectively. Results Absence of ANC (β = -1.01, P = 0.011) and absence of PNC (β = -1.01, P = 0.011) were negatively associated with ICFI scores. Additionally, absence of ANC was positively associated with underweight (AOR 3.37; 95 % CI 1.42-9.92 for children 6-11 months, AOR 3.43; 95 % CI 1.41-8.32 for children 12-23 months) and stunting (AOR 6.51; 95 % CI 2.11-20.10 for children 6-11 months, AOR 3.32; 95 % CI 1.50-7.31 for children 12-23 months). Similarly, children tended to be underweight and stunted if their mothers did not receive any PNC. Conclusion Absence of ANC and PNC were associated with poor IYCF, underweight, and stunting in children.
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Affiliation(s)
- Khem Pokhrel
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Keiko Nanishi
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Krishna C Poudel
- Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | | | - Kalpana Tiwari
- Nepali Technical Assistance Group, Maitighar, Kathmandu, Nepal
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Workman M, Kelly K. Heavier birth weight associated with taller height but not age at menarche in US women born 1991-1998. Am J Hum Biol 2017; 29. [PMID: 28343369 DOI: 10.1002/ajhb.22999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 02/01/2017] [Accepted: 03/05/2017] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Heavier birth weight predicts taller adult height, but it remains unknown the extent to which this additional height increment results from a faster average growth rate versus an extension of the growth period. Aiming to distinguish these effects, this study examined associations between birth weight (BW), age at menarche (an established proxy for growth duration), and near-adult height in a cohort of US young women born in the 1990s. METHODS Multiple regression evaluated age-adjusted height as an outcome of BW, age at menarche, indicators of family socioeconomic status, and other potential confounders in a sample of US teens who participated in the National Health and Nutrition Examination Survey between 2007 and 2012 (N = 342). Relevant interactions were also evaluated. RESULTS Mean ± SD was 11.9 ± 1.2 years and 3262 ± 592 g for age at menarche and BW, respectively. BW did not predict age at menarche (β = -.01, p = .838). Girls were 1.3 cm taller per year delay in menarche (p < .001) and 2.9 cm taller per 1 kg increase in BW (p < .001). Additionally, the greatest gain in height associated with delayed menarche was observed among the heaviest BW quartile. CONCLUSIONS Girls born heavier were taller but experienced menarche at similar ages to girls born lighter. To the extent that age at menarche reflected growth duration, these results demonstrate faster average growth among heavier-born girls. Consistent with fetal programming of average growth rate, these results held after adjustment for confounders of postnatal growth like family socioeconomic status.
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Affiliation(s)
- Megan Workman
- Department of Biology, Pima Community College, Tucson, Arizona
| | - Karina Kelly
- Department of Biology, Pima Community College, Tucson, Arizona
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Nutrient-enriched Infant Formula Is Associated With Higher Weight Gain for Low Birth Weight Infants. J Pediatr Gastroenterol Nutr 2017; 64:975-978. [PMID: 28541261 DOI: 10.1097/mpg.0000000000001465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVE Nutrient-enriched formulas were developed to provide extra nutrients and facilitate optimal growth for low birth weight infants. This study examined the association between use of nutrient-enriched formulas and weight gain among low birth weight infants (birth weight 1500-2500 g). METHODS This retrospective cohort study used data from infants enrolled in the Illinois Special Supplemental Nutrition Program for Women, Infants, and Children. Analyses were limited to infants born in 2010 with low birth weight (1500-2500 g, n = 3130). We examined weight gain by use of nutrient-enriched versus standard term formula, which was assigned to the infant by the Women, Infants, and Children program during the first month of life. The analyses used a multilevel mixed-effects linear regression model with random intercepts to determine the association between use of enriched versus standard term formula and weight gain while simultaneously adjusting for confounders including gestational age, birth weight, and history of breast-feeding. RESULTS Among 670 infants in the 1500 to 1999 g birth weight group, those fed enriched formula gained 46.4 g (95% confidence interval 7.4-85.3, P < 0.05) more per month in the first 6 months, and 34.0 g (95% confidence interval -0.4 to 68.3, P = 0.05) more per month >6 to 12 months of age compared with infants using standard term infant formula after adjustment for covariates. Similar findings were noted among the 2460 infants in the 2000 to 2500 g birth weight group. CONCLUSIONS Use of nutrient-enriched formulas is associated with higher weight gain in low birth weight infants.
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Boguszewski MCDS, Cardoso-Demartini ADA. MANAGEMENT OF ENDOCRINE DISEASE: Growth and growth hormone therapy in short children born preterm. Eur J Endocrinol 2017; 176:R111-R122. [PMID: 27803030 DOI: 10.1530/eje-16-0482] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 10/25/2016] [Accepted: 11/01/2016] [Indexed: 11/08/2022]
Abstract
Approximately 15 million babies are born preterm across the world every year, with less than 37 completed weeks of gestation. Survival rates increased during the last decades with the improvement of neonatal care. With premature birth, babies are deprived of the intense intrauterine growth phase, and postnatal growth failure might occur. Some children born prematurely will remain short at later ages and adult life. The risk of short stature increases if the child is also born small for gestational age. In this review, the effects of being born preterm on childhood growth and adult height and the hormonal abnormalities possibly associated with growth restriction are discussed, followed by a review of current information on growth hormone treatment for those who remain with short stature during infancy and childhood.
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Relations between neighbourhood socioeconomic status and birth outcomes are mediated by maternal weight. Soc Sci Med 2017; 175:143-151. [DOI: 10.1016/j.socscimed.2016.12.041] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 12/24/2016] [Accepted: 12/28/2016] [Indexed: 12/22/2022]
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Maeyama K, Morioka I, Iwatani S, Fukushima S, Kurokawa D, Yamana K, Nishida K, Ohyama S, Fujioka K, Awano H, Taniguchi-Ikeda M, Nozu K, Nagase H, Nishimura N, Shirai C, Iijima K. Gestational age-dependency of height and body mass index trajectories during the first 3 years in Japanese small-for-gestational age children. Sci Rep 2016; 6:38659. [PMID: 27934914 PMCID: PMC5146673 DOI: 10.1038/srep38659] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 11/11/2016] [Indexed: 02/07/2023] Open
Abstract
Gestational age (GA) is thought to affect height growth in small-for-gestational age (SGA) children. However, the GA-specific trajectories in body mass index (BMI) and early appearances of adiposity rebound (AR) have not been fully investigated in a cohort of Japanese SGA children. A longitudinal cohort study was conducted with 1063 SGA children born in Kobe, Japan, with sufficient records from birth to 3 years of age. Subjects were divided into subgroups based on GA: 39–41 weeks GA (n = 723), 37–38 weeks GA (n = 256), 34–36 weeks GA (n = 62), and <34 weeks GA (n = 22). Height and BMI were assessed at 4 months, 9 months, 1.5 years, and 3 years of age. The catch-up rate for height was GA-dependent. Most children with 39–41 weeks GA (91%) caught up by 4 months of age; however, lower GA was associated with a slower elevation in the catch-up rate. The BMI trajectory during the first 3 years was also GA-dependent, with a change in GA dependency at a boundary of 37 weeks GA. Approximately 7% of SGA children had already developed AR before 3 years of age. In conclusion, growth patterns during infancy and early childhood in SGA children differ depending on GA.
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Affiliation(s)
- Kaori Maeyama
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe 6500017, Japan
| | - Ichiro Morioka
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe 6500017, Japan
| | - Sota Iwatani
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe 6500017, Japan
| | - Sachiyo Fukushima
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe 6500017, Japan
| | - Daisuke Kurokawa
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe 6500017, Japan
| | - Keiji Yamana
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe 6500017, Japan
| | - Kosuke Nishida
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe 6500017, Japan
| | - Shohei Ohyama
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe 6500017, Japan
| | - Kazumichi Fujioka
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe 6500017, Japan
| | - Hiroyuki Awano
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe 6500017, Japan
| | - Mariko Taniguchi-Ikeda
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe 6500017, Japan
| | - Kandai Nozu
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe 6500017, Japan
| | - Hiroaki Nagase
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe 6500017, Japan
| | - Noriyuki Nishimura
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe 6500017, Japan
| | | | - Kazumoto Iijima
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe 6500017, Japan
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Pain coping strategies: Neonatal intensive care unit survivors in adolescence. Early Hum Dev 2016; 103:27-32. [PMID: 27468682 DOI: 10.1016/j.earlhumdev.2016.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 06/16/2016] [Accepted: 07/04/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND Data on long-term consequences of preterm birth on pain coping later in life are limited. AIM To assess whether gestational age, birth weight and neonatal disease severity have effect on pain coping style in adolescents born preterm or with low birth weight. STUDY DESIGN Observational, longitudinal study (Project On Preterm and SGA-infants, POPS-19). SUBJECTS We analyzed data of 537 adolescents at the age of 19 years, who were born at a gestational age <32 weeks or with a birth weight <1500g. OUTCOME MEASURES Participants completed the pain coping questionnaire (PCQ) that assesses pain coping strategies in three higher-order factors: approach ("to deal with pain"), problem-focused avoidance ("to disengage from pain") and emotion-focused avoidance ("expression of pain"). Furthermore, their pain coping effectiveness, pain controllability and emotional reactions to pain were assessed. All participants completed an IQ test. RESULTS Univariate analysis showed no significant correlation between length of stay, sepsis and necrotizing enterocolitis and any of the higher-order factors. Approach was only correlated with IQ. Problem-focused avoidance was, in the multiple regression analysis (including gestational age, IVH and IQ), only correlated with IQ. For emotion-focused avoidance (including birth weight, SGA, IVH, respiratory support and IQ) three independent predictors remained: IVH was positively correlated, while respiratory support and IQ were negatively correlated with emotion-focused avoidance. CONCLUSIONS Early neonatal characteristics and neonatal disease severity have limited effect on pain coping style in adolescence. Higher IQ was associated with the use of adaptive coping strategies, while maladaptive strategies were used less.
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Miles HL, Derraik JGB, Chiavaroli V, Hofman PL, Cutfield WS. Response to IGF-1 Generation Test in Short Prepubertal Children Born Very Preterm or at Term. Horm Res Paediatr 2016; 84:298-304. [PMID: 26347273 DOI: 10.1159/000439233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 07/31/1931] [Indexed: 11/19/2022] Open
Abstract
AIMS To investigate whether short children born very preterm (<32 weeks of gestation) exhibit features of growth hormone (GH) resistance compared to term peers. METHODS We studied 26 prepubertal children (aged 7.0 ± 2.0 years) with short stature (height adjusted for parents' heights <10th percentile), who were born appropriate for gestational age and either very preterm (n = 11) or at term (n = 15). Children underwent insulin-like growth factor-1 (IGF-1) generation test via a daily recombinant human GH (rhGH) dose (0.05 mg/kg/day) over 4 consecutive days. Hormone and binding proteins were measured at baseline and day 5. RESULTS At baseline, preterm children had lower IGF-binding protein 1 (IGFBP-1; -22%; p = 0.049) and IGFBP-3 (-24%; p = 0.013) concentrations than term children. Preterm children also had insulin concentrations that tended to be 39% higher (p = 0.059) than term peers. After stimulation, IGF-1 and IGFBP-3 concentrations increased similarly in term and preterm groups, while GH-binding protein (GHBP) concentrations decreased in both groups. Preterm children had higher GHBP (+50%; p = 0.049), insulin (+86%; p = 0.005), and leptin (+107%; p = 0.020) but lower IGFBP-1 (-47%; p = 0.006) concentrations than term children following rhGH stimulation. CONCLUSIONS Preterm children who are short for genetic height potential show no evidence of GH resistance that would explain their short stature. However, there was indirect evidence of insulin resistance in the preterm children, as previously described in this group.
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Affiliation(s)
- Harriet L Miles
- Liggins Institute, University of Auckland, Auckland, New Zealand
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Handa S, Peterman A. Is there Catch-Up Growth? Evidence from Three Continents. OXFORD BULLETIN OF ECONOMICS AND STATISTICS 2016; 78:470-500. [PMID: 31363301 PMCID: PMC6667180 DOI: 10.1111/obes.12117] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The ability to correct deficiencies in early childhood malnutrition, what is known as catch-up growth, has widespread consequences for economic and social development. While clinical evidence of catch-up has been observed, less clear is the ability to correct for chronic malnutrition found in impoverished environments in the absence of extensive and focused interventions. This paper investigates whether nutritional status at early age affects nutritional status a few years later among children using panel data from China, South Africa and Nicaragua. The key research question is the extent to which state dependence in linear growth exists among young children, and what family and community level factors mediate state dependency. The answer to this question is crucial for public policy due to the long term economic consequences of poor childhood nutrition. Results show strong but not perfect persistence in nutritional status across all countries, indicating that catch-up growth is possible though unobserved household behaviors tend to worsen the possibility of catch-up growth. Public policy that can influence these behaviors, especially when children are under 24 months old, can significantly alter nutrition outcomes in South Africa and Nicaragua.
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Affiliation(s)
- Sudhanshu Handa
- Department of Public Policy, CB #3435 Abernethy Hall, University of North Carolina at Chapel Hill, NC. 27599-3435, United States
| | - Amber Peterman
- International Food Policy Research Institute, 2033 K Street, NW, Washington, DC 20036
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Krishna A, Fink G, Berkman LF, Subramanian SV. Short- and long-run associations between birth weight and children's height. ECONOMICS AND HUMAN BIOLOGY 2016; 21:156-166. [PMID: 26922363 DOI: 10.1016/j.ehb.2016.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 02/04/2016] [Accepted: 02/05/2016] [Indexed: 06/05/2023]
Abstract
Much evidence suggests that the 1000 days spanning from conception to children's second birthdays are critical for physical development. Whether influence of the exposures occurring during this window lasts later in life is unclear. Our study investigates changes in associations between birth weight and height, one measure of physical development, over different life-stages and whether greater household wealth promotes better growth for low birth weight (LBW) children. Using longitudinal data from Young Lives, we analyzed associations between birth weight and physical growth and examined differences across ages and by household wealth for 3999 children from Ethiopia, India, Peru, and Vietnam. At 6-18 months, LBW children had 0.53-SD (Standard error [SE]: 0.08) lower HAZ. Over time, the gap between normal and LBW children narrowed significantly to 0.21-SD (SE: 0.05) and 0.24-SD (SE: 0.05) at 4-5 years and 7-8 years, respectively. Prenatal experiences are most salient in establishing the greatest height deficits within the first year. Although disparities in height are reduced in the first year, height differences at age 4-5 years remain at 7-8 years of age. Even among wealthier families, there was no recovery in height for LBW children during the first year and no catch-up growth for these children in later childhood. These findings suggest that prenatal conditions, reflected in birth weight, are more important in setting height trajectories in comparison to postnatal factors, which do not help children recover fully from early growth deficits.
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Affiliation(s)
- Aditi Krishna
- Child Health Evaluative Sciences and Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada.
| | - Günther Fink
- Harvard T.H. Chan School of Public Health, Department of Global Health and Population, United States; Harvard T.H. Chan School of Public Health, Harvard Center for Population and Development Studies, United States
| | - Lisa F Berkman
- Harvard T.H. Chan School of Public Health, Department of Global Health and Population, United States; Harvard T.H. Chan School of Public Health, Harvard Center for Population and Development Studies, United States; Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, United States; Harvard T.H. Chan School of Public Health, Department of Epidemiology, United States
| | - S V Subramanian
- Harvard T.H. Chan School of Public Health, Harvard Center for Population and Development Studies, United States; Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, United States
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Abstract
OBJECTIVES The prevalence of stunting in Armenia more than doubled since the 1990 s. This study aimed to investigate the prevalence and the predictors of stunting among children younger than 5 years in a rural region of Armenia, Talin, targeted by the World Vision (WV) nutrition interventions. METHODS Anthropometric measurements were conducted among a large representative sample of children 0 to 59 months old to identify the prevalence of stunting. Children identified as stunted were included in a case-control study as cases and compared with normally growing controls randomly selected from the same pool of children. The mothers of cases and controls were interviewed. Logistic regression analysis was applied to identify the predictors of stunting. RESULTS Of 739 measured children, 101 (13.7%) were undernourished, including 94 (12.7%) who were stunted. The fitted logistic regression model identified 7 independent predictors of stunting, of which 4 were protective: mother's height, child's birth length, number of child's hand washings per day, and the full set of WV interventions carried out in the community; whereas 3 were risk factors, that is, never/rarely using soap during hand washing, being the fourth or later child in the family, and family size. CONCLUSIONS The study findings suggest that although WV nutrition interventions have shown impact, there is also a nonnutritional pathway of child stunting in rural Armenia. Thus, antistunting interventions should include sanitation and hygienic measures along with adequate perinatal care and maternal and child nutrition to further reduce childhood stunting, ensuring long-term health benefits for children not only in rural Armenia but also in rural communities in other low/middle-income countries.
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Park HJ, Lee HY, Woo HK, Kim SN, Lee J, Yang HR, Kim BI, Choi CW. The Usefulness of Birth Weight Z-Score as a Predictor of Catch Up Growth in Preterm Infants. NEONATAL MEDICINE 2015. [DOI: 10.5385/nm.2015.22.3.142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Huee Jin Park
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Hae Yun Lee
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Hae Kyung Woo
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Seon Nyo Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Juyoung Lee
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hye Ran Yang
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Beyong Il Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Chang Won Choi
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
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Parets SE, Bedient CE, Menon R, Smith AK. Preterm birth and its long-term effects: methylation to mechanisms. BIOLOGY 2014; 3:498-513. [PMID: 25256426 PMCID: PMC4192624 DOI: 10.3390/biology3030498] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 08/08/2014] [Accepted: 08/12/2014] [Indexed: 01/06/2023]
Abstract
The epigenetic patterns established during development may influence gene expression over a lifetime and increase susceptibility to chronic disease. Being born preterm (<37 weeks of gestation) is associated with increased risk mortality and morbidity from birth until adulthood. This brief review explores the potential role of DNA methylation in preterm birth (PTB) and its possible long-term consequences and provides an overview of the physiological processes central to PTB and recent DNA methylation studies of PTB.
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Affiliation(s)
- Sasha E Parets
- Genetics and Molecular Biology Program, Emory University, Atlanta, GA 30322, USA.
| | - Carrie E Bedient
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA 30322, USA.
| | - Ramkumar Menon
- Division of Maternal-Fetal Medicine Perinatal Research, Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA.
| | - Alicia K Smith
- Genetics and Molecular Biology Program, Emory University, Atlanta, GA 30322, USA.
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Abstract
Approximately 10% of all babies worldwide are born preterm, and preterm birth is the leading cause of perinatal mortality in developed countries. Although preterm birth is associated with adverse short- and long-term health outcomes, it is not yet clear whether this relationship is causal. Rather, there is evidence that reduced foetal growth, preterm birth and the long-term health effects of both of these may all arise from a suboptimal intrauterine environment. Further, most infants born preterm also experience suboptimal postnatal growth, with potential adverse effects on long-term health and development. A number of interventions are used widely in the neonatal period to optimise postnatal growth and development. These commonly include supplementation with macronutrients and/or micronutrients, all of which have potential short-term risks and benefits for the preterm infant, whereas the long-term health consequences are largely unknown. Importantly, more rapid postnatal growth trajectory (and the interventions required to achieve this) may result in improved neurological outcomes at the expense of increased cardiovascular risk in later life.
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Hovhannisyan L, Demirchyan A, Petrosyan V. Estimated prevalence and predictors of undernutrition among children aged 5-17 months in Yerevan, Armenia. Public Health Nutr 2014; 17:1046-53. [PMID: 23673150 PMCID: PMC10282360 DOI: 10.1017/s1368980013001171] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 03/19/2013] [Accepted: 03/20/2013] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Child undernutrition is a serious public health problem in many low- and middle-income countries. Data on child undernutrition prevalence and its risk factors in Armenia are limited. The present study aimed to estimate the prevalence and explore the predictors of undernutrition among children aged 5-17 months in Yerevan. DESIGN The study was cross-sectional and employed a review of the ambulatory charts of children selected through a multistage cluster sampling. This phase was followed by a case-control study. The cases were undernourished children identified during the record review and randomly matched with normally growing controls of the same age and gender from the same pool of records. Mothers of cases and controls participated in a telephone interview. The study used conditional logistic regression analysis. SETTING Yerevan, Armenia. SUBJECTS Children aged 5-17 months residing in Yerevan, Armenia. RESULTS Review of 570 ambulatory charts suggested the prevalence of stunting, underweight and wasting among 5-17-month-old children in Yerevan to be 17·9 %, 7·3 % and 3·1 %, respectively. The case-control study of eighty-nine matched pairs identified four significant predictors of child undernutrition: family's socio-economic status score (P = 0·030), child's length at birth (P = 0·027), duration of predominant breast-feeding (P = 0·046) and food diversity score (P = 0·039). CONCLUSIONS The factors determining growth patterns of children in Yerevan are mostly behavioral and environmental, hence modifiable. Reducing poverty and inequalities in food availability, promoting breast-feeding and adequate complementary feeding, and ensuring optimal care before, during and after pregnancy are likely to help reduce child undernutrition in Yerevan, Armenia and societies with similar public health concerns.
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Affiliation(s)
- Lilit Hovhannisyan
- College of Health Sciences, American University of Armenia, 40 Marshal Baghramian Avenue, Yerevan 0019, Armenia
| | - Anahit Demirchyan
- College of Health Sciences, American University of Armenia, 40 Marshal Baghramian Avenue, Yerevan 0019, Armenia
| | - Varduhi Petrosyan
- College of Health Sciences, American University of Armenia, 40 Marshal Baghramian Avenue, Yerevan 0019, Armenia
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Sania A, Spiegelman D, Rich-Edwards J, Hertzmark E, Mwiru RS, Kisenge R, Fawzi WW. The contribution of preterm birth and intrauterine growth restriction to childhood undernutrition in Tanzania. MATERNAL AND CHILD NUTRITION 2014; 11:618-30. [PMID: 24720471 DOI: 10.1111/mcn.12123] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objectives were to examine the growth patterns of preterm and growth-restricted infants and to evaluate the associations of prematurity and intrauterine growth restriction (IUGR) with risk of stunting, wasting and underweight. Data from a cohort of HIV-negative pregnant women-infant pairs were collected prospectively in Tanzania. Small for gestational age [SGA, birthweight (BW) <10th percentile] was used as proxy for IUGR. Anthropometry was measured monthly until 18 months. Length-for-age (LAZ), weight-for-length (WLZ), and weight-for-age (WAZ) z-scores were calculated using the 2006 World Health Organization (WHO) Child Growth Standards. Stunting, wasting and underweight were defined as binary outcomes using a cut-off of <-2 SD of the respective z-scores. Multivariate Cox proportional hazard models were used to assess the associations between preterm and SGA to time to stunting, wasting and underweight. The study included 6664 singletons. Preterm and appropriate for gestational age (AGA) infants had slightly better nutritional status than term-SGA infants and despite some catch-up growth, preterm-SGA infants had the poorest nutritional status. The gap in LAZ and WAZ z-scores among the groups remained similar throughout the follow-up. Compared with term-AGA babies, relative risk (RR) of stunting among preterm-AGA babies was 2.13 (95% confidence interval (CI) 1.93-2.36), RR among term-SGA was 2.21 (95% CI 2.02-2.41) and the highest risk was among the babies who were both preterm and SGA (RR = 7.58, 95% CI 5.41-10.64). Similar magnitude of RR of underweight was observed among the three groups. Preterm and SGA infants should be closely monitored for growth failure. Intervention to reduce preterm and SGA birth may lower risk of undernutrition in resource-limited settings.
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Affiliation(s)
- Ayesha Sania
- Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Donna Spiegelman
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.,Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Janet Rich-Edwards
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.,The Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Ellen Hertzmark
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Ramadhani S Mwiru
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Rodrick Kisenge
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts, USA.,Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.,Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA
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Tsopanoglou SP, Davidson J, Goulart AL, Barros MCDM, dos Santos AMN. Functional capacity during exercise in very-low-birth-weight premature children. Pediatr Pulmonol 2014; 49:91-8. [PMID: 23359551 DOI: 10.1002/ppul.22754] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2012] [Accepted: 11/08/2012] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The functional capacity of children born prematurely with very-low-birth weight was compared with that of children born at full-term using the six-minute walk test (6MWT) and the ten-minutes shuttle walk test (10MSWT). The factors affecting walking distance were analyzed. METHODS A cross-sectional study was conducted with two groups of children aged 6-9 years, matched by sex and age. One group included children born before 37 weeks of gestation weighing <1,500 g and the second group included children born at term. Both groups were submitted to the 6MWT and 10MWST, performed on the same day with an interval of 20 min between tests and the sequence of the tests was randomized, by sealed-envelope technique. Physiological parameters were measured at the beginning and end of each test. The walking distance and factors affecting the walking distance were analyzed. RESULTS Thirty-seven children born prematurely and 37 born at term were studied. The premature children walked shorter distances in the 6MWT (480.9 ± 80.5 m vs. 518.3 ± 51.8 m, P = 0.010) than term children, and both groups walked similar distances in the 10MSWT (391.5 ± 99.0 m vs. 406.1 ± 79.2 m, P = 0.487). By multiple linear regression analysis, adjusted for confounders, walking distance was associated with height (OR: 3.6) and oxygen dependency at 28 days (OR: -67.7) in the 6MWT (P < 0.001) and with height (OR: 4.9) and oxygen dependency at 28 days (OR: -91.0) in the 10MSWT (P < 0.001). CONCLUSION In conclusion, this study suggests that children born prematurely with very low birth weight, especially those who had bronchopulmonary dysplasia present limited functional capacity during exercise.
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Increased adiposity in adults born preterm and their children. PLoS One 2013; 8:e81840. [PMID: 24278462 PMCID: PMC3835734 DOI: 10.1371/journal.pone.0081840] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 10/16/2013] [Indexed: 01/08/2023] Open
Abstract
Background Preterm birth is associated with abnormalities in growth, body composition, and metabolism during childhood, but adult data are scarce and none exist for their offspring. We therefore aimed to examine body composition and cardiovascular risk factors in adults born preterm and their children. Methods A cohort of 52 adults (aged 35.7 years, 54% female, 31 born preterm) and their term-born children (n=61, aged 8.0 years, 54% female, 60% from a preterm parent) were studied. Auxology and body composition (whole-body dual-energy X-ray absorptiometry) were measured, and fasting blood samples taken for metabolic and hormonal assessments. Results Adults born preterm had greater abdominal adiposity, displaying more truncal fat (p=0.006) and higher android to gynoid fat ratio (p=0.004). Although women born preterm and at term were of similar weight and BMI, men born preterm (n=8) were on average 20 kg heavier (p=0.010) and of greater BMI (34.2 vs 28.4 kg/m2; p=0.021) than men born at term (n=16). Adults born preterm also displayed a less favourable lipid profile, including lower HDL-C concentrations (p=0.007) and greater total cholesterol to HDL-C ratio (p=0.047). Children of parents born preterm tended to have more body fat than the children of parents born at term (21.3 vs 17.6%; p=0.055). Even after adjustment for mean parental BMI, children of parents born preterm had altered fat distribution, with more truncal fat (p=0.048) and greater android to gynoid fat ratio (p=0.009). Conclusions Adults born preterm, particularly men, have markedly increased fat mass and altered fat distribution. A similar increase in abdominal adiposity was observed in the term born offspring of parents born preterm, indicating that adverse outcomes associated with preterm birth may extend to the next generation.
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Trevisanuto D, Peruzzetto C, Cavallin F, Vedovato S, Cosmi E, Visentin S, Chiarelli S, Zanardo V. Fetal placental inflammation is associated with poor neonatal growth of preterm infants: a case-control study. J Matern Fetal Neonatal Med 2013; 26:1484-90. [PMID: 23560517 DOI: 10.3109/14767058.2013.789849] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To determine whether there is an association between histological chorioamnionitis (HCA) and postnatal growth of preterm infants in the neonatal period. METHOD This case-control study is part of a larger prospective histological study on placentas performed in all deliveries prior to 32 weeks of gestation. Eligible cases involved all placentas with a diagnosis of HCA. Control subjects were those without HCA, matched 1:1 with case subjects according to gestational age (±1 week). Placental inflammatory status and serial weight gain were analyzed for all infants during the first four postnatal weeks. Based on placental inflammation extension, HCA was defined as maternal HCA (MHCA) or fetal HCA (FHCA). RESULTS Of the 320 mother-infant pairs, 71 (22.1%) presented with HCA (27 MHCA and 44 FHCA). Decreases in weight gain at 21 and 28 days were associated with the presence of FHCA (β coefficient ± SE = -4.40 ± 2.21, p = 0.05 and -6.92 ± 2.96, p = 0.02, respectively), whereas no significant differences were found between MHCA and no-HCA groups. FHCA and MHCA were not identified as risk factors of weekly weight gain, after adjusting for possible confounders (maternal ethnicity, parity, smoking during pregnancy, infant gender, IUGR status, SGA status, antenatal steroids, total fluid intake, late-onset sepsis, BPD). CONCLUSIONS We found an association between fetal placental inflammation and poor neonatal growth but we were not able to identify a specific week wherein weight gain could be mostly affected. Placental findings may be used to identify preterm infants at risk of postnatal growth failure.
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Affiliation(s)
- Daniele Trevisanuto
- Pediatric Department, Medical School, University of Padua, Azienda Ospedaliera Padova , Padua , Italy
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Hwang AW, Liao HF, Granlund M, Simeonsson RJ, Kang LJ, Pan YL. Linkage of ICF-CY codes with environmental factors in studies of developmental outcomes of infants and toddlers with or at risk for motor delays. Disabil Rehabil 2013; 36:89-104. [PMID: 23594061 DOI: 10.3109/09638288.2013.777805] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Environmental variables have been explored in studies of the development of young children with motor delays. Linking environmental variables to the International Classification of Functioning, Disability and Health - Children and Youth (ICF-CY), environmental factors (EFs) categories can provide a common language for documenting their contribution to developmental outcomes. This review of studies aimed to (1) link EFs for developmental outcomes in infants with or at risk for motor delays to ICF-CY categories and (2) synthesize the influences of EFs (with ICF-CY linkage) on developmental outcomes. METHOD A systematic literature search was performed of multiple databases. After applying selection criteria, environmental variables in 28 articles were linked to ICF-CY categories and underwent qualitative synthesis. RESULTS Results indicated that physical environmental variables could be linked successfully to ICF-CY EFs categories, but not social environmental variables. Multiple environmental variables were associated with motor and other developmental outcomes. CONCLUSION Difficulties in linking social factors to ICF-CY categories indicate that additional EFs codes may need to be considered in the ICF-CY revision processes. The review provides empirical data on relationships between EFs and developmental outcomes in children with or at risk for motor delay.
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Affiliation(s)
- Ai-Wen Hwang
- Graduate Institute of Early Intervention, College of Medicine, Chang Gung University , Tao-Yuan , Taiwan
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Reynolds SA, Roberts JM, Bodnar LM, Haggerty CL, Youk AO, Catov JM. Newborns of Preeclamptic Women Show Evidence of Sex-Specific Disparity in Fetal Growth. ACTA ACUST UNITED AC 2012; 9:424-35. [DOI: 10.1016/j.genm.2012.10.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Revised: 10/29/2012] [Accepted: 10/31/2012] [Indexed: 01/08/2023]
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Wu LA, Katz J, Mullany LC, Khatry SK, Darmstadt GL, LeClerq SC, Tielsch JM. The association of preterm birth and small birthweight for gestational age on childhood disability screening using the Ten Questions Plus tool in rural Sarlahi district, southern Nepal. Child Care Health Dev 2012; 38:332-40. [PMID: 21375569 DOI: 10.1111/j.1365-2214.2011.01221.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
CONTEXT The Ten Questions tool was developed in 1984 as a low-cost, simple screen for childhood disability and referral for diagnosis in low-resource settings, and its use in Nepal has not been previously evaluated. Preterm birth and intrauterine growth restriction are potential risk factors for child disability and loss of developmental potential, but there are few studies examining this relationship from developing settings. OBJECTIVE To examine the associations of small for gestational age and preterm birth as predictors of Ten Questions Plus positivity. DESIGN, SETTING AND PARTICIPANTS The Ten Questions Plus questionnaire was administered to caregivers of 680 children between 2 and 5 years of age from August 2007 to March 2008 in rural Sarlahi, southern Nepal. Participants had previously been enrolled in a randomized trial of chlorhexidine cleansing at birth. At 1 month of age, children were then enrolled into a randomized 2 × 2 factorial trial of daily iron and zinc supplementation between October 2001 and January 2006. INTERVENTION None. MAIN OUTCOME MEASURE Positive screen on the Ten Questions Plus tool defined as a positive response to one or more questions. RESULTS Of preterm children, 37 (33.6%) had a positive response to at least one question on the Ten Questions Plus and were considered at risk for disability. One hundred and seventy term children (29.8%) were at risk for disability. CONCLUSIONS The Ten Questions Plus tool can be used in this rural Nepali setting to identify children at increased risk for mental and physical disability to be targeted for further examination. The prevalence of parent-reported disabilities is high in this population (almost one-third of children); children who are both preterm and small-for-gestational age are at increased risk for motor milestone delay, reported learning difficulty, speech and behavioural problems. Intrauterine growth restriction may affect child development and result in disabilities later in childhood.
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Affiliation(s)
- L A Wu
- National Vaccine Program Office, US Department of Health and Human Services, Washington, D.C., USA
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Batista RFL, Silva AAM, Barbieri MA, Simões VMF, Bettiol H. Factors associated with height catch-up and catch-down growth among schoolchildren. PLoS One 2012; 7:e32903. [PMID: 22427907 PMCID: PMC3299714 DOI: 10.1371/journal.pone.0032903] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Accepted: 02/06/2012] [Indexed: 11/18/2022] Open
Abstract
In developed countries, children with intrauterine growth restriction (IUGR) or born preterm (PT) tend to achieve catch-up growth. There is little information about height catch-up in developing countries and about height catch-down in both developed and developing countries. We studied the effect of IUGR and PT birth on height catch-up and catch-down growth of children from two cohorts of liveborn singletons. Data from 1,463 children was collected at birth and at school age in Ribeirão Preto (RP), a more developed city, and in São Luís (SL), a less developed city. A change in z-score between schoolchild height z-score and birth length z-score≥0.67 was considered catch-up; a change in z-score≤−0.67 indicated catch-down growth. The explanatory variables were: appropriate weight for gestational age/PT birth in four categories: term children without IUGR (normal), IUGR only (term with IUGR), PT only (preterm without IUGR) and preterm with IUGR; infant's sex; maternal parity, age, schooling and marital status; occupation of family head; family income and neonatal ponderal index (PI). The risk ratio for catch-up and catch-down was estimated by multinomial logistic regression for each city. In RP, preterms without IUGR (RR = 4.13) and thin children (PI<10th percentile, RR = 14.39) had a higher risk of catch-down; catch-up was higher among terms with IUGR (RR = 5.53), preterms with IUGR (RR = 5.36) and children born to primiparous mothers (RR = 1.83). In SL, catch-down was higher among preterms without IUGR (RR = 5.19), girls (RR = 1.52) and children from low-income families (RR = 2.74); the lowest risk of catch-down (RR = 0.27) and the highest risk of catch-up (RR = 3.77) were observed among terms with IUGR. In both cities, terms with IUGR presented height catch-up growth whereas preterms with IUGR only had height catch-up growth in the more affluent setting. Preterms without IUGR presented height catch-down growth, suggesting that a better socioeconomic situation facilitates height catch-up and prevents height catch-down growth.
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Affiliation(s)
| | - Antônio A. M. Silva
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, Maranhão, Brasil
| | - Marco A. Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brasil
| | - Vanda M. F. Simões
- Departamento de Medicina I, Universidade Federal do Maranhão, São Luís, Maranhão, Brasil
| | - Heloisa Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brasil
- * E-mail:
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45
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Rowe DL, Derraik JGB, Robinson E, Cutfield WS, Hofman PL. Preterm birth and the endocrine regulation of growth in childhood and adolescence. Clin Endocrinol (Oxf) 2011; 75:661-5. [PMID: 21609348 DOI: 10.1111/j.1365-2265.2011.04116.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Poor growth during childhood is a common problem associated with preterm birth, but few studies have examined the associations between linear growth, weight and body composition with the postnatal hormonal milieu in preterm children. We aimed to define the IGF-IGFBP axis in preterm children and its association with growth. DESIGN AND PATIENTS A cohort of healthy 2- to 20-year-old subjects who were born prematurely (<37 weeks gestation) and experienced normal neurological development were recruited. In total, 54 premature and 82 control subjects were included in this study. RESULTS Preterm subjects were relatively shorter (P < 0·001) and leaner (P < 0·05) than their parents in contrast to the term cohort. Preterm children also appeared to fail to reach their genetic height potential (prepuberty: P < 0·01; puberty: P < 0·05). Only IGFBP-2 differed between preterm and term cohorts, with higher levels observed in prepubertal preterm subjects (P < 0·01). In the term group, height SDS was positively associated with IGF-I (P < 0·01) and IGFBP-3 (P < 0·001) concentrations, but no such associations were observed for preterm subjects. CONCLUSION Preterm children are shorter and lighter than controls throughout childhood, remaining below their genetic height potential. Preterm birth appears to alter the endocrine regulation of postnatal growth in childhood and adolescence, so growth is no longer associated with its normal endocrine regulators.
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Affiliation(s)
- Deborah L Rowe
- Liggins Institute, University of Auckland, Auckland, New Zealand
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McCormick MC, Litt JS, Smith VC, Zupancic JAF. Prematurity: an overview and public health implications. Annu Rev Public Health 2011; 32:367-79. [PMID: 21219170 DOI: 10.1146/annurev-publhealth-090810-182459] [Citation(s) in RCA: 165] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The high rate of premature births in the United States remains a public health concern. These infants experience substantial morbidity and mortality in the newborn period, which translate into significant medical costs. In early childhood, survivors are characterized by a variety of health problems, including motor delay and/or cerebral palsy, lower IQs, behavior problems, and respiratory illness, especially asthma. Many experience difficulty with school work, lower health-related quality of life, and family stress. Emerging information in adolescence and young adulthood paints a more optimistic picture, with persistence of many problems but with better adaptation and more positive expectations by the young adults. Few opportunities for prevention have been identified; therefore, public health approaches to prematurity include assurance of delivery in a facility capable of managing neonatal complications, quality improvement to minimize interinstitutional variations, early developmental support for such infants, and attention to related family health issues.
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Affiliation(s)
- Marie C McCormick
- Department of Society, Human Development and Health, School of Public Health, Harvard University, Boston, Massachusetts 02115, USA.
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Claas MJ, de Vries LS, Koopman C, Uniken Venema MMA, Eijsermans MJC, Bruinse HW, Verrijn Stuart AA. Postnatal growth of preterm born children ≤ 750g at birth. Early Hum Dev 2011; 87:495-507. [PMID: 21550187 DOI: 10.1016/j.earlhumdev.2011.04.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2010] [Revised: 04/07/2011] [Accepted: 04/12/2011] [Indexed: 11/26/2022]
Abstract
BACKGROUND Extremely low birth weight (ELBW) infants are at risk of impaired postnatal growth. Impaired postnatal growth has been reported to be associated with delayed cognitive and motor development. AIMS To describe postnatal growth patterns of appropriate and small for gestational age (AGA and SGA) ELBW children in relation to their cognitive and motor outcome at age 5.5. STUDY DESIGN Retrospective cohort study. SUBJECTS One hundred one children with a BW ≤ 750g, born between 1996 and 2005 in the University Hospital Utrecht, The Netherlands. OUTCOME MEASURES Height (Ht), weight (Wt), occipital-frontal circumference (OFC) at birth, 15 months and 2 years corrected age and 3.5 and 5.5 years. Cognitive and motor outcome at 5.5 years of age, classified as normal (Z-score ≥-1), mildly delayed (-2≤Z-score <-1) or severely delayed (Z-score <-2). AGA (Ht, Wt or OFC at birth ≥-2 SDS) infants were compared with SGA (Ht, Wt or OFC at birth <-2 SDS) infants. RESULTS Between birth and 5.5 years catch-up growth in Ht, weight for height (Wt/Ht), Wt and OFC was seen in 72.2%, 55.2%, 28.6% and 68.9% respectively of the SGA infants. For AGA infants we found substantial catch-down growth in Ht (15.4%) and Wt (33.8%). Cognitive and motor outcome was normal in 76.2% and 41.6% of the 101 children. A significantly higher percentage of normal cognitive outcome was found in AGA infants with Wt growth remaining at ≥-2 SDS compared to AGA infants with catch-down growth (83% vs 63%). Next, SGA infants who caught-up in OFC had a higher prevalence of normal cognitive outcome compared to SGA infants who did not catch-up in OFC. Furthermore, a higher percentage of severely delayed motor outcome was found in SGA infants without catch-up growth in Wt compared to SGA infants who caught-up in Wt (61.5% vs 32.2%). CONCLUSIONS Catch-up growth in Ht, Wt/Ht and OFC occurred in the majority of the SGA infants with a BW ≤ 750 g, but was less common in Wt. AGA children who remained their Wt at ≥-2 SDS have a better cognitive and motor developmental outcome at 5.5 years of age. Catch-up growth in OFC was associated with a better cognitive outcome at 5.5 years of age.
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Affiliation(s)
- M J Claas
- Department of Obstetrics, University Medical Centre, Wilhelmina Children's Hospital, Utrecht, The Netherlands
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Boguszewski MCS, Karlsson H, Wollmann HA, Wilton P, Dahlgren J. Growth hormone treatment in short children born prematurely--data from KIGS. J Clin Endocrinol Metab 2011; 96:1687-94. [PMID: 21430029 DOI: 10.1210/jc.2010-1829] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Children born prematurely with growth failure might benefit from GH treatment. OBJECTIVES The aim was to evaluate the first year growth response to GH treatment in short children born prematurely and to identify predictors of the growth response. DESIGN/PATIENTS A total of 3215 prepubertal children born prematurely who were on GH treatment were selected from KIGS (The Pfizer International Growth Database), a large observational database. They were classified according to gestational age as preterm (PT; 33 to no more than 37 wk) and very preterm (VPT; <33 wk), and according to birth weight as appropriate for gestational age [AGA; between -2 and +2 sd score (SDS)] and small for gestational age (SGA; -2 SDS or below). RESULTS Four groups were identified: PT AGA (n = 1928), VPT AGA (n = 629), PT SGA (n = 519), and VPT SGA (n = 139). GH treatment was started at a median age of 7.5, 7.2, 6.7, and 6.0 yr, respectively. After the first year of GH treatment, all four groups presented a significant increase in weight gain and height velocity, with a median increase in height SDS higher than 0.6. Using multiple stepwise regression analysis, 27% of the variation in height velocity could be explained by the GH dose, GH peak during provocative test, weight and age at GH start, adjusted parental height, and birth weight SDS. The first year growth response of the children born PT and SGA could be estimated by the SGA model published previously. CONCLUSION Short children born prematurely respond well to the first year of GH treatment. Long-term follow-up is needed.
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Growth of a cohort of very low birth weight infants in Johannesburg, South Africa. BMC Pediatr 2011; 11:50. [PMID: 21619702 PMCID: PMC3115871 DOI: 10.1186/1471-2431-11-50] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Accepted: 05/29/2011] [Indexed: 12/13/2022] Open
Abstract
Background Little is known about the growth of VLBW infants in South Africa. The aim of this study was to assess the growth of a cohort of VLBW infants in Johannesburg. Methods A secondary analysis of a prospective cohort was conducted on 139 VLBW infants (birth weight ≤1500 g) admitted to Charlotte Maxeke Johannesburg Academic Hospital. Growth measurements were obtained from patient files and compared with the World Health Organization Child Growth Standards (WHO-CGS) and with a previous cohort of South African VLBW infants. The sample size per analysis ranged from 11 to 81 infants. Results Comparison with the WHO-CGS showed initial poor growth followed by gradual catch up growth with mean Z scores of 0.0 at 20 months postmenstrual age for weight, -0.8 at 20 months postmenstrual age for length and 0.0 at 3 months postmenstrual age for head circumference. Growth was comparable with that of a previous cohort of South African VLBW infants in all parameters. Conclusions Initial poor growth in the study sample was followed by gradual catch up growth but with persistent deficits in length for age at 20 months postmenstrual age relative to healthy term infants.
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Zachariassen G, Faerk J, Grytter C, Esberg BH, Hjelmborg J, Mortensen S, Thybo Christesen H, Halken S. Nutrient enrichment of mother's milk and growth of very preterm infants after hospital discharge. Pediatrics 2011; 127:e995-e1003. [PMID: 21402642 DOI: 10.1542/peds.2010-0723] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To determine if the addition of a multinutrient human milk fortifier to mother's milk while breastfeeding very preterm infants after hospital discharge is possible and whether it influences first-year growth. METHODS Of a cohort of 320 infants (gestational age: 24-32 weeks; birth weight: 535-2255 g), breastfed infants (65% [n = 207]) were randomly assigned shortly before hospital discharge to receive either unfortified (n = 102, group A) or fortified (n = 105, group B) mother's milk until 4 months' corrected age (CA). The remaining infants were bottle-fed with a preterm formula (group C). Follow-up was performed at term and at 2, 4, 6, and 12 months' CA. RESULTS Mean duration of breastfeeding after term was not significantly different between groups A and B (11.8 and 10.6 weeks, respectively). Weight, length, and head circumference were not significantly different between groups A and B at 12 months' CA. Compared with groups A and B, infants in group C had a higher increase in weight z score until term and in length z score until 6 months' CA. At 12 months' CA, boys in group C were significantly longer and heavier compared with those in groups A and B, whereas girls in group C were longer and heavier compared with those in group A only. A higher protein intake was related to a higher serum urea nitrogen level and growth. CONCLUSIONS Fortification of mother's milk after hospital discharge while breastfeeding very preterm infants was possible without influencing breastfeeding duration but did not significantly influence growth parameters at 1 year of age compared with unfortified mother's milk.
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Affiliation(s)
- Gitte Zachariassen
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Sdr. Boulevard 29, DK-5000 Odense C, Denmark.
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