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Prasad Gupta M, Gupta D, Usman A. Post-term Birth and Developmental Coordination Disorder: A Narrative Review of Motor Impairments in Children. Cureus 2024; 16:e63211. [PMID: 39070519 PMCID: PMC11278065 DOI: 10.7759/cureus.63211] [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] [Accepted: 06/26/2024] [Indexed: 07/30/2024] Open
Abstract
A prevalent long-term medical condition in children that is rarely understood and acknowledged in educational contexts is developmental coordination disorder (DCD), which is one of the most prevalent conditions in school-aged children. Mild-to-severe abnormalities in muscle tone, posture, movement, and the learning of motor skills are associated with motor disorders. Early detection of developmental abnormalities in children is crucial as delayed motor milestones during infancy might indicate a delay in both physical and neurological development. To overcome the current condition of motor impairment, obstructing their risk factors is important to prevent the development of disability, which is already determined in the prenatal and perinatal period. Concerning the relationship with gestational age, the majority of the studies reported a relationship between DCD and preterm children. However, the entire range of gestational age, including post-term birth, has not been studied. The risk of developmental consequences such as cognitive impairments, major mental diseases, attention-deficit/hyperactivity disorder, autism spectrum disorder, and other behavioral and emotional problems increases in post-term birth, according to prior studies. Thus, this review aims to provide an overview of information linking post-term birth to children's motor impairment, with a focus on DCD. A thorough systemic review was conducted on online databases, and only a few studies were found on the association with post-term children. Insufficient evidence made it necessary to examine more post-term cohorts in adolescence to fully determine the long-term health concerns and develop therapies to mitigate the detrimental effects of post-term deliveries.
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Affiliation(s)
- Manish Prasad Gupta
- Pediatrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, CHN
| | - Dhiraj Gupta
- Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Ali Usman
- General Surgery, Nishtar Medical University, Multan, PAK
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包 梦, 乔 秀, 张 新, 张 子, 赵 菲, 陈 新. [Neuropsychological development of large for gestational age infants at the age of 12 months]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:1246-1252. [PMID: 38112142 PMCID: PMC10731971 DOI: 10.7499/j.issn.1008-8830.2307040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/27/2023] [Indexed: 12/20/2023]
Abstract
OBJECTIVES To investigate the level of neuropsychological development in large for gestational age (LGA) infants at the age of 12 months. METHODS The infants, aged 12 to <13 months, who attended the Outpatient Service of Child Care in the First Affiliated Hospital of Shandong First Medical University from December 2021 to June 2023, were enrolled as subjects. According to the gestational age and birth weight, they were divided into preterm appropriate for gestational age (AGA) group, preterm LGA group, early term AGA group, early term LGA group, full-term AGA group, and full-term LGA group. A modified Poisson regression analysis was used to investigate the association between LGA and neuropsychological development outcome at 12 months of age. RESULTS After adjustment for confounding factors, compared with the full-term AGA group at the age of 12 months, the full-term LGA group had a significant increase in the risk of language deficit (RR=1.364, 95%CI: 1.063-1.750), the early term LGA group had significant increases in the risk of abnormal gross motor, fine motor, language, and the preterm LGA group had significant increases in the risk of abnormal language, social behavior, and total developmental quotient (P<0.05); also, the early term AGA group had higher risks of developmental delay across all five attributes and in total developmental quotient at the age of 12 months (P<0.05); except for the language attribute, the preterm AGA group had higher risks of developmental delay in the other 4 attributes (P<0.05). CONCLUSIONS The neuropsychological development of LGA infants with different gestational ages lags behind that of full-term AGA infants at 12 months of age, and follow-up and early intervention of such infants should be taken seriously in clinical practice.
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Affiliation(s)
| | - 秀芸 乔
- 山东第一医科大学第一附属医院/山东省千佛山医院护理部,山东济南250013
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Lee S, Han Y, Lim MK, Lee HJ. Impact of moderate-to-late preterm birth on neurodevelopmental outcomes in young children: Results from retrospective longitudinal follow-up with nationally representative data. PLoS One 2023; 18:e0294435. [PMID: 37972123 PMCID: PMC10653423 DOI: 10.1371/journal.pone.0294435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023] Open
Abstract
This study investigated the relationship between moderate-to-late preterm (MLPT) birth and the risk of neurodevelopmental impairments (NIs) in young children compared with the risks associated with very preterm (VPT) and full-term (FT) birth based on nationally representative large-scale population data. Retrospective follow-up was conducted over 71 months for 738,733 children who were born and participated in the Korean National Health Screening Program for Infants and Children (NHSPIC) between 2011 and 2013. Using a data linkage between the NHSPIC and Korean healthcare claim information, data on birth year, sex, delivery type, birth weight, growth abnormality, gestational age, breastfeeding history, maternal age, NIs, multiple gestation, preterm labor, premature rupture of membranes (PROM), gestational diabetes, gestational hypertension, smoking during pregnancy, and socioeconomic status were collected and included in the final analysis. Cox proportional hazards models were applied to identify the impact of gestational age on NI risk, with all variables adjusted as appropriate. Overall, 0.9% and 3.8% rates of VPT and MLPT births were identified, respectively. NI incidence was highest among VPT children (34.7%), followed by MLPT (23.9%) and FT (18.2%) children. Both VPT (hazard ratio [HR], 1.45; 95% confidence interval [CI], 1.03 to 2.05) and MLPT (HR, 1.21; 95% CI, 1.04 to 1.41) births were associated with increased NI risk. Low birth weight, PROM, and smoking during pregnancy were also associated with increased NI risk, while longer breastfeeding and higher socioeconomic status were associated with decreased risk. Special attention must be given to NIs for both VPT and MLPT children.
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Affiliation(s)
- Sangmi Lee
- Department of Nursing, College of Nursing, Dongyang University, Yeongju-si, Gyeongsangbuk-do, Republic of Korea
| | - Yuri Han
- Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Min Kyung Lim
- Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Hun Jae Lee
- Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, Republic of Korea
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Feng T, Guo J, Dill SE, Zhang D, Liu Y, Ma Y, Pappas L, Rozelle S. Factors of parental investment in the home language environment in peri-urban China: A mixed methods study. PLoS One 2023; 18:e0294158. [PMID: 37956186 PMCID: PMC10642838 DOI: 10.1371/journal.pone.0294158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
The home language environment is a critical point of investment in early language skills. However, few studies have quantitatively measured the home language environment of low-socioeconomic-status households in non-western settings. This mixed methods study describes the home language environment and early child language skills among households in a low-socioeconomic-status, peri-urban district of Chengdu, China, and identifies factors influencing parental investment in the home language environment. Audio recordings were collected from 81 peri-urban households with children ages 18-24 months and analysed using the Language Environment Analysis (LENATM) system. The Mandarin version of the MacArthur-Bates Communicative Development Inventory was administered to each child's primary caregiver. The quantitative results revealed large variation in home language environments and child language skills among the sample, with relatively low average scores when compared to other Chinese samples. Qualitative interviews with a subset of 31 caregivers revealed that many caregivers face constraints on their knowledge of interactive parenting, compounded, in some households, by time constraints due to work or household responsibilities. The findings indicate a need for increased sources of credible parenting information for peri-urban caregivers of young children to promote investment in the home language environment.
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Affiliation(s)
- Tianli Feng
- School of Management and Economics, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Jingruo Guo
- School of Management and Economics, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Sarah-Eve Dill
- Stanford Center on China’s Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Palo Alto, California, United States of America
| | - Dongming Zhang
- Stanford Center on China’s Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Palo Alto, California, United States of America
| | - Yuchen Liu
- Stanford Center on China’s Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Palo Alto, California, United States of America
| | - Yue Ma
- Stanford Center on China’s Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Palo Alto, California, United States of America
| | - Lucy Pappas
- Stanford Center on China’s Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Palo Alto, California, United States of America
| | - Scott Rozelle
- Stanford Center on China’s Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Palo Alto, California, United States of America
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Huang HB, Hicks M, Zhang QS, Watt MJ, Lin F, Wan XQ, Cheung PY. The differential associative relationship between early risk factors, neonatal morbidities and early neurodevelopmental outcome in preterm infants <29 weeks' gestation. Early Hum Dev 2023; 186:105859. [PMID: 37738923 DOI: 10.1016/j.earlhumdev.2023.105859] [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: 04/26/2023] [Revised: 09/03/2023] [Accepted: 09/10/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Very preterm infants of <29 weeks' gestation are at high risk for adverse neurodevelopment due to multiple risk factors in the early stages of life. There is little information regarding the associative effects of risk factors in early life, neonatal morbidities and subsequent neurodevelopmental outcomes. AIMS Investigate the association of early neurodevelopmental outcomes, neonatal complications and the risk factors in the early hours of life in a cohort of preterm infants <29 weeks' gestational age. METHODS We enrolled all surviving preterm neonates born at gestation <29 weeks between January 2015 and June 2021 in the University of Hong Kong-Shenzhen Hospital. Demographic and clinical characteristics were collected from a database of the neonatal intensive care unit. Neurodevelopmental outcomes of the survivors were evaluated using the Ages and Stages Questionnaire (ASQ-3) which were measured at the adjusted age of 12 to 18 months. The multivariate linear regression model was used to determine correlation presented as β coefficient (β) with 95 % confidence intervals (CI). RESULTS In this cohort of 56 survivors <29 weeks' gestation, urine output within the first 12 h of life and Apgar score at 5 min were positively associated with different domains of ASQ-3 score, however male sex and highest fraction of inspired oxygen (FiO2) in the first 12 h of life were negatively related with at least one of neurocognitive domains of ASQ-3 at adjusted age of 12 to 18 months. During hospitalization, in addition to the frequency of packed red cell transfusions, the development of severe necrotizing enterocolitis was inversely associated with both neuromotor and neurocognitive skills (gross motor domain: β = -16.93, CI: -32.04, -1.82; fine motor domain: β = -16.42, CI: -28.82, -4.02; problem solving domain: β = -13.14, CI: -24.45, -1.83; all P < 0.05), whereas severe intraventricular hemorrhage had adverse effects on gross motor only (β = -13.04, CI: -24.42, -1.65; P = 0.03). Bronchopulmonary dysplasia and retinopathy of prematurity were not related with ASQ-3. CONCLUSIONS In this small cohort study of very preterm neonates born at <29 weeks' gestation, risk factors in the early hours of life and neonatal morbidities during hospitalization had differential associative relationships with ASQ-3 at 12-18 months adjusted age. This information may be important for parental counseling and management including early diagnosis and intervention.
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Affiliation(s)
- Hai-Bo Huang
- Department of Pediatrics, University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Matthew Hicks
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Qian-Shen Zhang
- Department of Pediatrics, University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Man Joe Watt
- Department of Pediatrics, University of Hong Kong-Shenzhen Hospital, Shenzhen, China; Department of Pediatrics, Glenrose Rehabilitation Hospital, University of Alberta, Edmonton, AB, Canada; Department of Physical Medicine and Rehabilitation, Glenrose Rehabilitation Hospital, University of Alberta, Edmonton, AB, Canada
| | - Fang Lin
- Department of Pediatrics, University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Xue-Qin Wan
- Department of Pediatrics, University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Po-Yin Cheung
- Department of Pediatrics, University of Hong Kong-Shenzhen Hospital, Shenzhen, China; Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
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Hong J, Crawford K, Odibo AO, Kumar S. Risks of stillbirth, neonatal mortality, and severe neonatal morbidity by birthweight centiles associated with expectant management at term. Am J Obstet Gynecol 2023; 229:451.e1-451.e15. [PMID: 37150282 DOI: 10.1016/j.ajog.2023.04.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND Determining the optimal time of birth at term is challenging given the ongoing risks of stillbirth with increasing gestation vs the risks of significant neonatal morbidity at early-term gestations. These risks are more pronounced in small infants. OBJECTIVE This study aimed to evaluate the risks of stillbirth, neonatal mortality, and severe neonatal morbidity by comparing expectant management with delivery from 37+0 weeks of gestation. STUDY DESIGN This was a retrospective cohort study evaluating women with singleton, nonanomalous pregnancies at 37+0 to 40+6 weeks' gestation in Queensland, Australia, delivered from 2000 to 2018. Rates of stillbirth, neonatal death, and severe neonatal morbidity were calculated for <3rd, 3rd to <10th, 10th to <25th, 25th to <90th, and ≥90th birthweight centiles. The composite risk of mortality with expectant management for an additional week in utero was compared with rates of neonatal mortality and severe neonatal morbidity. RESULTS Of 948,895 singleton, term nonanomalous births, 813,077 occurred at 37+0 to 40+6 weeks' gestation. Rates of stillbirth increased with gestational age, with the highest rate observed in infants with birthweight below the third centile: 10.0 per 10,000 (95% confidence interval, 6.2-15.3) at 37+0 to 37+6 weeks, rising to 106.4 per 10,000 (95% confidence interval, 74.6-146.9) at 40+0 to 40+6 weeks' gestation. The rate of neonatal mortality was highest at 37+0 to 37+6 weeks for all birthweight centiles. The composite risk of expectant management rose sharply after 39+0 to 39+6 weeks, and was highest in infants with birthweight below the third centile (125.2/10,000; 95% confidence interval, 118.4-132.3) at 40+0 to 40+6 weeks' gestation. Balancing the risk of expectant management and delivery (neonatal mortality), the optimal timing of delivery for each birthweight centile was evaluated on the basis of relative risk differences. The rate of severe neonatal morbidity sharply decreased in the period between 37+0 to 37+6 and 38+0 to 38+6 weeks, particularly for infants with birthweight below the third centile. CONCLUSION Our data suggest that the optimal time of birth is 37+0 to 37+6 weeks for infants with birthweight <3rd centile and 38+0 to 38+6 weeks' gestation for those with birthweight between the 3rd and 10th centile and >90th centile. For all other birthweight centiles, birth from 39+0 weeks is associated with the best outcomes. However, large numbers of planned births are required to prevent a single excess death. The healthcare costs and acceptability to women of potential universal policies of planned birth need to be carefully considered.
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Affiliation(s)
- Jesrine Hong
- Mater Research Institute, The University of Queensland, Brisbane, Australia; Mayne Medical School, The University of Queensland, Brisbane, Australia; Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Kylie Crawford
- Mater Research Institute, The University of Queensland, Brisbane, Australia; Mayne Medical School, The University of Queensland, Brisbane, Australia; School of Public Health, The University of Queensland, Brisbane, Australia
| | - Anthony O Odibo
- Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO
| | - Sailesh Kumar
- Mater Research Institute, The University of Queensland, Brisbane, Australia; Mayne Medical School, The University of Queensland, Brisbane, Australia; National Health and Medical Research Council, Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Australia.
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You H, Shi J, Huang F, Wei Z, Jones G, Du W, Hua J. Advances in Genetics and Epigenetics of Developmental Coordination Disorder in Children. Brain Sci 2023; 13:940. [PMID: 37371418 DOI: 10.3390/brainsci13060940] [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: 04/08/2023] [Revised: 06/02/2023] [Accepted: 06/04/2023] [Indexed: 06/29/2023] Open
Abstract
Developmental coordination disorder (DCD) is a developmental disorder characterized by impaired motor coordination, often co-occurring with attention deficit disorder, autism spectrum disorders, and other psychological and behavioural conditions. The aetiology of DCD is believed to involve brain changes and environmental factors, with genetics also playing a role in its pathogenesis. Recent research has identified several candidate genes and genetic factors associated with motor impairment, including deletions, copy number variations, single nucleotide polymorphisms, and epigenetic modifications. This review provides an overview of the current knowledge in genetic research on DCD, highlighting the importance of continued research into the underlying genetic mechanisms. While evidence suggests a genetic contribution to DCD, the evidence is still in its early stages, and much of the current evidence is based on studies of co-occurring conditions. Further research to better understand the genetic basis of DCD could have important implications for diagnosis, treatment, and our understanding of the condition's aetiology.
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Affiliation(s)
- Haizhen You
- Department of Women and Children's Health Care, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 200120, China
| | - Junyao Shi
- Women and Children Health Care Institution of Pudong District, Shanghai 200021, China
| | - Fangfang Huang
- Department of Women and Children's Health Care, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 200120, China
| | - Zhiyun Wei
- Department of Women and Children's Health Care, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 200120, China
| | - Gary Jones
- NTU Psychology, School of Social Sciences, Nottingham Trent University, Nottingham NG1 6AA, UK
| | - Wenchong Du
- NTU Psychology, School of Social Sciences, Nottingham Trent University, Nottingham NG1 6AA, UK
| | - Jing Hua
- Department of Women and Children's Health Care, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 200120, China
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Liu MX, Li HF, Wu MQ, Geng SS, Ke L, Lou BW, Du W, Hua J. Associations of preterm and early-term birth with suspected developmental coordination disorder: a national retrospective cohort study in children aged 3-10 years. World J Pediatr 2023; 19:261-272. [PMID: 36469242 PMCID: PMC9974676 DOI: 10.1007/s12519-022-00648-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/26/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND This study analyzed the motor development and suspected developmental coordination disorder of very and moderately preterm (< 34+0 gestational age), late preterm (34+0-36+6 gestational week), and early-term (37+0-38+6 gestational week) children compared to their full-term peers with a national population-based sample in China. METHODS A total of 1673 children (799 girls, 874 boys) aged 3-10 years old were individually assessed with the Movement Assessment Battery for Children-second edition (MABC-2). The association between gestational age and motor performance of children was analyzed using a multilevel regression model. RESULTS The global motor performance [β = - 5.111, 95% confidence interval (CI) = - 9.200 to - 1.022; P = 0.015] and balance (β = - 5.182, 95% CI = - 5.055 to - 1.158; P = 0.003) for very and moderately preterm children aged 3-6 years old were significantly lower than their full-term peers when adjusting for confounders. Late preterm and early-term children showed no difference. Moreover, very and moderately preterm children aged 3-6 years had a higher risk of suspected developmental coordination disorder (DCD) (≤ 5 percentile of MABC-2 score) when adjusting for potential confounders [odds ratio (OR) = 2.931, 95% CI = 1.067-8.054; P = 0.038]. Late preterm and early-term children showed no difference in motor performance from their full-term peers (each P > 0.05). CONCLUSIONS Our findings have important implications for understanding motor impairment in children born at different gestational ages. Very and moderately preterm preschoolers have an increased risk of DCD, and long-term follow-up should be provided for early detection and intervention.
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Affiliation(s)
- Ming-Xia Liu
- The Women's and Children's Department, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Hai-Feng Li
- Department of Rehabilitation, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Mei-Qin Wu
- The Women's and Children's Department, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shan-Shan Geng
- The Women's and Children's Department, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Li Ke
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Bi-Wen Lou
- Leitontech Research Institution, Suzhou, China
| | - Wenchong Du
- Department of Psychology, NTU Psychology, Nottingham Trent University, Nottingham, UK.
| | - Jing Hua
- The Women's and Children's Department, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.
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Irahara M, Nagai T, Takeuchi S, Tayama T, Nii M, Katayama S, Kasai K, Doi N, Okitsu O. Association between early-term birth and hypoglycaemia in large-for-gestational-age neonates:A retrospective cohort study. THE JOURNAL OF MEDICAL INVESTIGATION 2023; 70:476-482. [PMID: 37940535 DOI: 10.2152/jmi.70.476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
BACKGROUND The effect of early-term birth on the development of hypoglycaemia in large-for-gestational-age (LGA) neonates is yet to be clarified. This study aimed to clarify the association between hypoglycaemia and early-term birth in LGA neonates. METHODS This single-centre retrospective cohort study evaluated LGA neonates born at term at Tsurugi Municipal Handa Hospital, Japan. Blood glucose levels were measured immediately and at 1, 2, and 4 hours after birth. The association between early-term birth and hypoglycaemia was evaluated using logistic regression analysis. The prevalence of severe hypoglycaemia and hypoglycaemia according to its timing of development was analysed using Fisher's exact test. RESULTS In total, 295 neonates were included. Among them, 113 neonates (38.3%) were born at early term and 91 infants (30.8%) had hypoglycaemia. Logistic regression analysis showed a significant association between early-term birth and hypoglycaemia (adjusted odds ratio [95% confidence interval]:2.691 [1.597 to 4.535]). However, there was no significant between-group difference among those with severe hypoglycaemia. CONCLUSIONS Among LGA neonates, early-term birth is positively associated with neonatal hypoglycaemia. This indicates that among LGA neonates, those born at early term require more careful observation for hypoglycaemia than do those born at later term. J. Med. Invest. 70 : 476-482, August, 2023.
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Affiliation(s)
- Makoto Irahara
- Department of Pediatrics, Tsurugi Municipal Handa Hospital, Tokushima, Japan
- Department of Pediatrics, Tokushima University Hospital, Tokushima, Japan
- Allergy center, National Center for Child Health and Development, Tokyo, Japan
| | - Takashi Nagai
- Department of Pediatrics, Tokushima Prefectural Hospital, Tokushima, Japan
| | - Shunsuke Takeuchi
- Department of Pediatrics, Tsurugi Municipal Handa Hospital, Tokushima, Japan
| | - Takahiro Tayama
- Department of Pediatrics, Tsurugi Municipal Handa Hospital, Tokushima, Japan
- Department of Pediatrics, Tokushima University Hospital, Tokushima, Japan
| | - Mari Nii
- Department of Obstetrics and Gynecology, Tsurugi Municipal Handa Hospital, Tokushima, Japan
| | - Sachiko Katayama
- Department of Obstetrics and Gynecology, Tsurugi Municipal Handa Hospital, Tokushima, Japan
| | - Kana Kasai
- Department of Obstetrics and Gynecology, Tsurugi Municipal Handa Hospital, Tokushima, Japan
| | - Naoko Doi
- Department of Obstetrics and Gynecology, Tsurugi Municipal Handa Hospital, Tokushima, Japan
| | - Osamu Okitsu
- Department of Obstetrics and Gynecology, Tsurugi Municipal Handa Hospital, Tokushima, Japan
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