Nitrogen balance in dairy cows fed low-nitrogen diets based on various proportions of fresh grass and maize silage

To ensure sustainable and efficient production, dairy farms must reduce their environmental impacts and nitrogen losses, which are sources of pollution, while increasing their feed self-sufficiency. Grass-based dairy systems, frequently combine fresh grass with maize silage when grass is scarce or during dietary transitions. However, the effects of combining fresh grass and maize silage on cow performance and N excretion are poorly known. This study aimed to quantify the effects of increasing the proportion of maize silage in a fresh grass diet on cow N flows and metabolism, in the context of grass-based dairy systems. Four proportions of maize silage in a fresh grass diet (objectives of 0, 17, 34 and 51% DM of maize silage) were investigated. The experiment was performed in a 4 × 3 Latin square design using eight lactating cows during three 3-week periods. DM intake (DMI), milk yield, faeces and urine outputs, and their N concentrations were measured for each cow. The fresh grass CP concentration was lower than planned (106 ± 13.0 g/kg DM). This resulted in very low dietary CP concentration, which decreased from 108 to 86 g/kg DM when maize silage in the diet increased from 0 to 51% DM, respectively. DM intake and milk yield both decreased linearly by 3.3 kg/day from 0 to 51% DM of maize silage in the diet. Thus, N intake decreased linearly by 100 g/day from 0 to 51% DM of maize silage in the diet. The N concentration of milk was highest for the diet with 0% DM of maize silage. Nitrogen excreted in faeces and urine decreased linearly by 29 and 23 g/day, respectively, from 0 to 51% DM of maize silage in the diet. The low dietary N concentration resulted in low ruminal NH3-N concentrations (8 mg/L, on average) and urinary urea excretion (down to 8% urea N in urinary N). Increasing the proportion of maize silage in an unusually low-N grass diet, without protein-rich concentrates, induced highly N-deficient diets with minimal N losses in faeces and urine but large and unsustainable decreases in DMI and milk yield.

Effects of corn silage supplementation strategy and grazing intensity on herbage intake, milk production, and behavior of dairy cows

Effects of corn silage supplementation on milk production of grazing dairy cows depend in part on the substitution rate between the 2 forages, which may be influenced by grazing management. The aim of this study was to compare 2 grazing management strategies for measuring substitution rate between herbage and corn silage, in interaction with grazing intensity. Six treatments were compared, with 2 grazing intensities and 3 supplementation strategies investigated at both grazing intensities. The 2 grazing intensities were severe and light grazing, defined by either (1) herbage allowance (HA) of 15 (severe) or 30 (light) kg dry matter (DM)/cow per d at 3 cm above ground level or (2) postgrazing sward height, depending on the supplementation strategy. The 3 supplementation strategies were as follows: (U) an unsupplemented treatment, (A) 5 kg DM/d of corn silage offered at a similar HA as in U, and (H) 5 kg DM/d of corn silage offered at a similar postgrazing sward height as in U. Thirty-six multiparous Holstein cows were used in a randomized complete block design and divided in 2 groups for the entire experiment, one for each grazing intensity. Within each grazing intensity group, the corn silage supplementation strategy was studied using a 3 × 3 Greco-Latin square design, with 3 periods of 14 d. Supplementing cows with corn silage increased total DM intake only for severe grazing by 1.7 kg DM/d. The substitution rate between corn silage and grazed herbage was lower for severe than for light grazing, averaging 0.63 and 1.23, respectively. Herbage dry matter intake was lower by 1.2 kg/d for strategy H than A, leading to lower substitution rates (0.81 vs. 0.99, respectively), irrespective of grazing intensity. Milk production increased with silage supplementation for severe grazing (+1.0 kg/d milk) and was unaffected by silage supplementation for light grazing (-0.4 kg/d milk). The milk production response to corn silage supplementation averaged +0.23 and -0.08 kg of milk per kg DM of silage for severe and light grazing, respectively. Fat-corrected milk production tended to be lower by 0.4 kg/d for strategy H than A, leading to lower milk production response (+0.00 vs. +0.12 kg of milk per kg DM of silage, respectively). Milk protein concentration increased with silage supplementation for severe grazing (+1.0 g/kg) but decreased with silage supplementation for light grazing (-0.6 g/kg). Milk fat concentration did not differ among treatments. On average, daily grazing time (-47 min/d, i.e., -9%) and herbage intake rate (-4.9 g of DM/min, i.e., -14%) decreased when cows were supplemented, with greater grazing time reduction at severe than light grazing, and greater herbage intake rate reduction at light than severe grazing. In conclusion, the greater substitution rate and the lower 4% fat-corrected milk production when corn silage was provided at a similar postgrazing sward height rather than at a similar HA to those of unsupplemented cows explain why supplementing grazing dairy cows with conserved forages has no strong effect in practice from a production point of view.

Progressive inclusion of pearl millet herbage as a supplement for dairy cows fed mixed rations: Effects on methane emissions, dry matter intake, and milk production

The inclusion of grazing in dairy feeding systems can improve animal welfare and reduce feed costs and labor for animal care and manure management. This work aimed to evaluate the effects of including pearl millet herbage (Pennisetum glaucum 'Campeiro') as a supplement for dairy cows fed total mixed rations (TMR). The treatments included 100% TMR offered ad libitum (control, TMR₁₀₀), 75% TMR ad libitum intake + access to grazing of a pearl millet pasture between the morning and afternoon milkings (7 h/d; pTMR₇₅), and 50% TMR ad libitum intake + access to grazing of a pearl millet pasture between the morning and afternoon milkings (7 h/d; pTMR₅₀). Nine multiparous Holstein and F₁ Jersey × Holstein cows were distributed in a replicated 3 × 3 Latin square design with 3 periods of 21 d (a 16-d adaptation period and a 5-d measurement period). Cows in the TMR₇₅ and TMR₅₀ groups strip-grazed a pearl millet pasture with pre- and postgrazing sward height targets of 60 and 30 cm, respectively. The herbage dry matter intake (DMI) increased with decreasing mixed ration supplies, and the total DMI decreased linearly from 19.0 kg/d in the TMR₁₀₀ group to 18.0 kg/d in the pTMR₅₀ group. Milk production decreased linearly from 24.0 kg/d in the TMR₁₀₀ group to 22.4 kg/d in the pTMR₅₀ group, and energy-corrected milk (ECM) production decreased linearly from 26.0 kg/d to 23.6 kg/d. Enteric methane (CH₄) emissions decreased linearly from 540 g/d in the TMR₁₀₀ group to 436 g/d in the pTMR₅₀ group, and CH₄ yields (g/kg of DMI) tended to decrease linearly. The CH₄ intensity was similar between treatments, averaging 20 g of CH₄/kg of ECM. The inclusion of pearl millet herbage in the dairy cow diets decreased the total DMI and milk production to a small extent without affecting CH₄ intensity (g/kg of ECM).

Intake, milk yield and grazing behaviour of strip-grazing Alpine dairy goats in response to daily pasture allowance

Grazing management has an important impact on dairy ruminants' performance. References on the intake and milk yield of dairy goats under strip-grazing systems in temperate regions are scarce. In order to study the effect of pasture allowance on pasture intake (PI), milk yield and grazing behaviour, a trial was carried out in spring with 36 Alpine goats in mid-lactation. Three daily pasture allowances (PA=1.7, 2.6 and 3.5 kg dry matter (DM)/day, namely Low, Medium and High, respectively) were compared in a 3 × 3 Latin square design replicated six times during three successive 14-day periods. Goats individually received 268 g DM of concentrate twice daily at each milking and had access 11 h/day to pasture (from 0830 to 1600 h and from 1730 to 2100 h). Pasture intake increased with PA, and more so between Low and Medium than between Medium and High (+216 v. +101 g DM/kg DM of PA). Milk yield was lower on Low than on Medium and High (2.79 v. 3.13 kg/day), as were milk fat and protein yields. Grazing time averaged 476 min/day and was lowest on Low and greatest on Medium. Pasture intake rate was 30 g DM/h lower on Low and Medium than on High. It is concluded that under temperate conditions, when goats are supplemented with 536 g DM of concentrate and have enough access time to pasture (11 h/day), a medium pasture allowance close to 2.6 kg DM/day may be sufficient to maximise milk yield.

Corn silage supplementation for dairy cows grazing annual ryegrass at two pasture allowances

ABSTRACT Corn silage supplementation for dairy cows grazing in temperate annual pastures has rarely been investigated. The aim of this study is to compare two supplementation levels (0 and 4kg dry matter [DM]/day of a 7:1 mixture of corn silage and soybean meal) in dairy cows strip-grazing annual ryegrass (Lolium multiflorum Lam.) at two pasture allowances (PA, low= 25 and high = 40kg DM/d at ground level). The study was carried out according to an incomplete 4 × 3 Latin square design, using 12 cows and three experimental periods of 12 days. The green leaves allowances were only 4.9 and 8.5kg DM/d at the low and high PA, respectively. The total DM intake and milk production increased in supplemented cows compared to un-supplemented cows at the low PA, but were similar between supplementation levels at the high PA. The PI was unaffected by the PA, whereas the substitution rate was 0.68 in cows at the low PA and 1.35 in cows at the high PA. Corn silage supplementation may improve the total DM intake and milk production of dairy cows grazing in temperate annual pastures, but only at a low PA.

Pasture intake and milk production of dairy cows rotationally grazing on multi-species swards

Increasing plant species diversity has been proposed as a means for enhancing annual pasture productivity and decreasing seasonal variability of pasture production facing more frequent drought scenarios due to climate change. Few studies have examined how botanical complexity of sown swards affects cow performance. A 2-year experiment was conducted to determine how sward botanical complexity, from a monoculture of ryegrass to multi-species swards (MSS) (grasses-legumes-forb), affect pasture chemical composition and nutritive value, pasture dry matter (DM) intake, milk production and milk solids production of grazing dairy cows. Five sward species: perennial ryegrass (L as Lolium), white clover and red clover (both referred to as T as Trifolium because they were always sown together), chicory (C as Cichorium) and tall fescue (F as Festuca) were assigned to four grazing treatments by combining one (L), three (LT), four (LTC) or five (LTCF) species. Hereafter, the LT swards are called mixed swards as a single combination of ryegrass and clovers, whereas LTC and LTCF swards are called MSS as a combination of at least four species from three botanical families. The experimental area (8.7 ha) was divided into four block replicates with a mineral nitrogen fertilisation of 75 kg N/ha per year for each treatment. In total, 13 grazing rotations were carried out by applying the same grazing calendar and the same pasture allowance of 19 kg DM/cow per day above 4 cm for all treatments. Clover represented 20% of DM for mixed and MSS swards; chicory represented 30% of DM for MSS and tall fescue represented 10% of DM for LTCF swards. Higher milk production (+1.1 kg/day) and milk solids production (+0.08 kg/day) were observed for mixed swards than for ryegrass swards. Pasture nutritive value and pasture DM intake were unaffected by the inclusion of clover. Pasture DM, organic matter and NDF concentrations were lower for MSS than for mixed swards. Higher milk production (+0.8 kg/day), milk solids production (+0.04 kg/day) and pasture DM intake (+1.5 kg DM/day) were observed for MSS than for mixed swards. These positive effects of MSS were observed for all seasons, but particularly during summer where chicory proportion was the highest. In conclusion, advantages of grazing MSS on cow performance were due to the cumulative effect of improved pasture nutritive value and increased pasture DM intake that raised milk production and milk solids production.

Energy supplementation and herbage allowance effects on daily intake in lactating mares

Little is known about how to manage grazing horses, including the thresholds under which energy supplementation is required. Here we investigated the effects of daily herbage allowance (DHA) and energy supplementation (ES) on daily herbage intake in lactating mares of light breeds grazing high-quality regrowth during summer. Three contrasting DHA, low (LOW), medium (MED), and high (HIGH), that is, 35.0, 52.5, and 70.0 g DM∙kg BW(-1)∙d(-1), respectively, were obtained by adjusting pasture strip width. Eighteen Anglo-Arab and French Saddle lactating mares were either supplemented with 2.6 kg DM barley/d (SUP group; n= 9) or left nonsupplemented (NSUP group; n = 9) throughout the experiment. For 3 successive 2-wk periods, 3 groups of SUP mares (n = 3) and 3 groups of NSUP mares (n = 3) grazed each DHA according to a 3 × 3 Latin square design. Pregrazing sward surface height (SSH) was similar between treatments (26.6 cm), but postgrazing SSH differed significantly between each DHA (2.9, 4.4, and 5.7 cm for LOW, MED, and HIGH, respectively; P < 0.001). Herbage DMI (HDMI) increased linearly from 18.5 to 23.4 g DM∙kg BW(-1)∙d(-1) with increasing DHA (i.e., 0.13 kg DM eaten/kg DM of herbage offered; P < 0.001) independently of ES and with no significant ES × DHA interaction. This increase in HDMI resulted from an increase in grazing time between LOW (961 min/d) and MED and HIGH (1,021 min/d; P < 0.01) and from an increase in intake rate between LOW and MED (11.8 g DM/min) and HIGH (13.6 g DM/min; P < 0.01). Total digestible DMI (TDDMI) and NE intake (NEI) increased linearly from 12.3 to 15.2 g DM∙kg BW∙(-1)d(-1) and from 136.6 to 165.8 kJ∙kg BW(-1)∙d (-1)with increasing DHA (P < 0.001), respectively. Total digestible DMI and NEI were significantly lower for NSUP than for SUP mares: 12.5 vs. 14.9 g DM∙kg BW(-1)∙d(-1) (P < 0.01) and 134.6 vs. 166.5 kJ∙kg BW(-1)∙d(-1) (P < 0.001), respectively. Whereas SUP mares always met their energy requirements, NSUP mares no longer met theirs when DHA fell below 66 g DM∙kg BW(-1)∙d(-1) (i.e., 39 kg DM∙mare(-1)∙d(-1)).

Meta-analysis of the effect of pasture allowance on pasture intake, milk production, and grazing behavior of dairy cows grazing temperate grasslands

Daily pasture allowance (PA) is defined as the product of pregrazing pasture mass and offered area, and is the major grazing management factor determining pasture utilization per unit area and daily performance of grazing dairy cows. The objective of the present study was to perform a meta-analysis reviewing the effect of PA on pasture intake, milk production, milk composition, and grazing behavior of dairy cows. Experiments studying the effect of PA on pasture intake or milk production, which eventually included milk composition or grazing behavior data, or both, were selected to create a database. Papers were selected only if at least 2 PA were compared under the same experimental conditions, particularly the same pasture mass (i.e., where PA levels were only obtained through changes in daily offered area). The final database included 97 PA comparisons reported in 56 papers. For analytical purposes, the database was subdivided into 3 subsets that varied according to the estimation height (EH) at which PA was determined; that is, PA above ground level (PA₀ subset), PA above 2.5 to 3.5 cm (PA₃ subset), and PA above 4 to 5 cm (PA₅ subset). Statistical analyses were conducted independently on the PA₀, PA₃, and PA₅ subsets and on the whole database (global analysis) by using linear and nonlinear mixed-model procedures. The curves, either exponential, quadratic, or linear, describing the effects of PA on pasture intake, milk production, or grazing behavior of dairy cows are conceptually similar, whatever the EH. The equations describing these curves are, however, specific for each EH. Accordingly, from typical low to high PA, the increase in pasture intake (0.13 vs. 0.21 vs. 0.28 kg/kg of PA), milk production (0.11 vs. 0.17 vs. 0.24 kg/kg of PA), and milk solids production (0.008 vs. 0.010 vs. 0.013 kg/kg of PA) per kilogram of increase in PA was lower for PA₀ than for PA₃, and for PA₃ than for PA₅. Grazing time increased from low to medium PA and did not vary from medium to high PA. Pasture intake rate seemed to increase from low to medium PA because of greater bite mass, whereas it increased from medium to high PA because of greater biting rate. The present meta-analysis demonstrated that the general relationship between PA and any dependent variable is quite strong and independent of EH. This suggests no specific relationship for some parts of the world or methodology approach, with a high portability of the global equations calculated here. These results are useful for improving grazing management and modeling on pasture-based dairy systems.

N-alkanes v. ytterbium/faecal index as two methods for estimating herbage intake of dairy cows fed on diets differing in the herbage: maize silage ratio and feeding level

The aim of this study was to compare the n-alkanes and the ytterbium (Yb)/faecal index techniques as two methods for estimating the herbage intake of dairy cows fed indoors on different herbage : supplement ratios and feeding levels. The supplement was a mixture of maize silage and soyabean meal (ratio of 87 : 13 on a dry matter (DM) basis). In all, four treatments were studied. The herbage : supplement ratio in the diet was 25 : 75, 50 : 50, 75 : 25 and 50 : 50 for treatments 1, 2, 3 and 4, respectively. Animals were offered for treatments 1, 2 and 3, 100% of ad libitum intake measured before the experiment and 70% of ad libitum intake for treatment 4. Cows were fed herbage in the morning and supplement in the evening. A total of six lactating Holstein dairy cows were used in a 4 × 4 Latin square with four 14-day periods. Herbage and supplement intakes, faecal output (FO), in vivo organic matter (OM) digestibility and faecal recovery of markers were measured on the last 5 days of each period. Intake was estimated with the two methods and from two faecal sampling techniques, that is, total faecal collection v. grab sampling during milking. Mean herbage intake as fed, or estimated from n-alkanes or from the Yb/faecal index was 7.7, 8.1 and 10.2 kg DM, respectively. The mean prediction error, expressed as a fraction of actual herbage intake, was 0.10 and 0.50 for the n-alkanes and Yb/faecal index methods, respectively. The n-alkanes method clearly showed much better accuracy than the Yb/faecal index method for estimating intake, irrespective of the faecal sampling method, herbage : silage proportion or feeding level. For the n-alkanes method, herbage intake was slightly overestimated (7%) when herbage proportion in the diet was high, due to a ratio of faecal C33 : C32 recovery >1. The high bias for the Yb/faecal index was due to the cumulative effect of overestimation of FO (mean recovery of Yb = 0.92) and underestimation of the diet indigestible fraction (-8%). Between-treatment variations of FO were on average well estimated by Yb. Between-treatment variations of OM digestibility estimated using the faecal index technique were lower than those observed in vivo. It is concluded that intake of grazing dairy cows receiving high levels of maize silage supplement should be estimated using the n-alkanes method.

Substitution rate and milk yield response to corn silage supplementation of late-lactation dairy cows grazing low-mass pastures at 2 daily allowances in autumn

Feed costs in dairy production systems may be decreased by extending the grazing season to periods such as autumn when grazing low-mass pastures is highly probable. The aim of this autumn study was to determine the effect of corn silage supplementation [0 vs. 8 kg of dry matter (DM) of a mixture 7:1 of corn silage and soybean meal] on pasture intake (PI), milk production, and grazing behavior of dairy cows grazing low-mass ryegrass pastures at 2 daily pasture allowances (PA; low PA=18 vs. high PA=30 kg of DM/cow above 2.5 cm). Twelve multiparous Holstein cows were used in a 4 × 4 Latin square design with 14-d periods. Pre-grazing pasture mass and pre-grazing plate meter pasture height averaged 1.8 t of DM/ha (above 2.5 cm) and 6.3 cm, respectively. The quality of the offered pasture (above 2.5 cm) was low because of dry conditions before and during the experiment (crude protein=11.5% of DM; net energy for lactation=5.15 MJ/kg of DM; organic matter digestibility=61.9%). The interaction between PA and supplementation level was significant for PI but not for milk production. Supplementation decreased PI from 11.6 to 7.6 kg of DM/d at low PA and from 13.1 to 7.3 kg of DM/d at high PA. The substitution rate was, therefore, lower at low than at high PA (0.51 vs. 0.75). Pasture intake increased with increasing PA in unsupplemented treatments, and was not affected by PA in supplemented treatments. Milk production averaged 13.5 kg/d and was greater at high than at low PA (+1.4 kg/d) and in supplemented than unsupplemented treatments (+5.2 kg/d). Milk fat concentration averaged 4.39% and was similar between treatments. Milk protein concentration increased from 3.37 to 3.51% from unsupplemented to supplemented treatments, and did not vary according to PA. Grazing behavior parameters were only affected by supplementation. On average, daily grazing time decreased (539 vs. 436 min) and daily ruminating time increased (388 vs. 486 min) from 0 to 8 kg of supplement DM. The PI rate was 6g of DM/min lower in supplemented than in unsupplemented treatments (17 vs. 23 g of DM/min). The high milk yield response to supplementation may be related to a cumulative effect of the low-mass pasture (low PI) and the low quality of the pasture, which strongly limited energy supply in unsupplemented cows.

Effects of Rumen or Duodenal Glucose Infusions on Intake in Dairy Cows Fed Fresh Perennial Ryegrass Indoors

The aim of this study was to determine whether the intake of fresh highly digestible ryegrass could be limited by the total amount of energy absorbed. Moreover, it investigated whether the limitation was more specific to energy absorbed as volatile fatty acids in the rumen compared with energy absorbed in the lower gastrointestinal tract. Four treatments were compared: infusion of 1.25 kg of glucose into the rumen (R1.25), infusion of 2.5 kg of glucose into the rumen (R2.5), infusion of 1.5 kg of glucose into the duodenum (D1.5), and a control treatment consisting of water and salts. Treatments R2.5 and D1.5 were assumed to supply about 16.5 MJ of net energy for lactation. All treatments consisted of 2 infusions, one into the rumen and the other into the duodenum, with one of these infusions being a control. All infused solutions were isoosmotic with osmolarities around 340 and 330 mmol/L for rumen and duodenum, respectively. Treatments were compared using 4 dairy cows in mid lactation according to a 4 x 4 Latin square design replicated twice during 8 periods of 7 d each. Cows were housed in tie stalls and fed ad libitum with fresh perennial ryegrass cut every morning during the spring at 28 d of regrowth. Intake and feeding behavior were measured, as well as concentrations of ruminal fermentation products and some blood metabolites. The pepsin-cellulase organic matter digestibility of the offered herbage averaged 0.76 +/- 0.011. The average dry matter intake of herbage was 15.5 +/- 0.52 kg/d. The glucose infusions decreased dry matter intake by 0.95 kg/d compared with the control, but had the same satiating effect regardless of site or dose of infusion. The average concentration of volatile fatty acids in rumen fluid was 97.9 +/- 2.03 mmol/L and the molar proportion of propionate was 21.6 +/- 0.19 mmol/100 mmol. Glucose infusions into the rumen led to a decrease in the molar proportions of acetate from 64.4 on the control treatment to 60.9 mmol/100 mmol on R2.5 and increased the molar proportions of butyrate from 10.2 (control) to 13.5 mmol/100 mmol on R2.5, and minor acids (valerate and caproate), from 1.27 (control) to 2.54 mmol/100 mmol on R2.5, proportionally to the dose infused. These results suggested that energy nutrients can limit intake in dairy cows fed high-digestibility ryegrass and that butyrate and minor acids would have a limited satiating effect compared with propionate.

Suivi à long terme des enfants avec clarté nucale augmentée et caryotype normal

The aim of this study was to investigate outcome at the age of two years for infants without known chromosomal anomalies who presented increased nuchal translucency (NT) at first trimester ultrasound examinations. One hundred fifty-one infants with NT measuring 3mm or more, between 12 and 16 weeks gestation, were followed for at least 24 months. A homogeneous pediatric examination was applied. Among these 151 infants, thirteen (8%) had a major isolated malformation. Five infants (3.3%) had chromosomal anomalies which were unrecognized on fetal karyotype owing to tissue mosaic in two and to cryptic chromosomal anomalies in three. At the age of two years, 16 children (10%) presented psychomotor retardation as part of a genetic syndrome, half of them had an associated cardiac malformation. We did not find any specific ultrasound characteristics which could be used to distinguish fetuses with impaired neurological prognosis. Newborns who presented NT at the first trimester ultrasound examination constitute a high risk population, particularly for psychomotor retardation which is not always recognized during the neonatal period. Careful pediatric follow up is required during childhood.

[Pregnancy outcome and infant follow-up after diagnosis of nuchal anomalies at the 1st or 2nd trimester ultrasound examination]

OBJECTIVES

The aim of this study was to determine pregnancy outcome and investigate infant follow-up after diagnosis of nuchal anomalies at the first or second trimester ultrasound examination in order to identify prognosis factors and improve prenatal counseling.

PATIENTS AND METHODS

Between January 1994 and June 2000, double skin fold 3mm or cystic hygroma at the first trimester ultrasound, or thicken nuchal anomaly at second trimester ultrasound explorations were diagnosed at the Robert Debré maternity ward.

RESULTS

One hundred fifty-nine pregnancies were terminated and 131 infants were delivered and followed with four pediatric examinations during the first two years of life. Among the 131 newborns, 104 (79%) progressed normally, 16 had a major malformation (heart, kidney, skeletal; 9 (6.8%) with a unique anomaly and 7 (5.3%) with malformation syndromes), and 14 (10.6%) presented nonspecific retardation of psychomotor development either alone (7 cases) or associated with an identified genetic syndrome (7 cases).

DISCUSSION

Neonates who presented a nuchal anomaly during pregnancy are a high-risk population, particularly for retardation of psychomotor development which is not always diagnosed during the neonatal period. Careful postnatal follow-up is required to identify developmental disorders undiagnosed at birth.

CONCLUSION

This series is the largest reported in the literature in terms of number of infants and also for postnatal pediatric follow-up and homogeneous pedratrician follow-up.