Breastfeeding in children born small for gestational age and future nutritional and metabolic outcomes: a systematic review

Newborns with congenital heart defects tend to have a higher risk of growth restriction, which can be an independent risk factor for adverse outcomes. To date, a systematic review of the relation between congenital heart defects (CHD) and growth restriction at birth, most commonly estimated by its imperfect proxy small for gestational age (SGA), has not been conducted. Objective: To conduct a systematic review and meta-analysis to estimate the proportion of children born with CHD that are small for gestational age (SGA). Methods: The search was carried out from inception until 31 March 2019 on Pubmed and Embase databases. Studies were screened and selected by two independent reviewers who used a predetermined data extraction form to obtain data from studies. Bias was assessed using the Critical Appraisal Skills Programme (CASP) checklist. The database search identified 1783 potentially relevant publications, of which 38 studies were found to be relevant to the study question. A total of 18 studies contained sufficient data for a meta-analysis, which was done using a random effects model. Results: The pooled proportion of SGA in all CHD was 20% (95% CI 16%–24%) and 14% (95% CI 13%–16%) for isolated CHD. Proportion of SGA varied across different CHD ranging from 30% (95% CI 24%–37%) for Tetralogy of Fallot to 12% (95% CI 7%–18%) for isolated atrial septal defect. The majority of studies included in the meta-analysis were population-based studies published after 2010. Conclusion: The overall proportion of SGA in all CHD was 2-fold higher whereas for isolated CHD, 1.4-fold higher than the expected proportion in the general population. Although few studies have looked at SGA for different subtypes of CHD, the observed variability of SGA by subtypes suggests that growth restriction at birth in CHD may be due to different pathophysiological mechanisms.

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First trimester screening of maternal placental protein 13 for predicting preeclampsia and small for gestational age: In-house study and systematic review

Placenta ◽

10.1016/j.placenta.2012.05.012 ◽

2012 ◽

Vol 33 (9) ◽

pp. 735-740 ◽

Cited By ~ 22

Author(s):

F.J. Schneuer ◽

N. Nassar ◽

A.Z. Khambalia ◽

V. Tasevski ◽

A.W. Ashton ◽

...

Keyword(s):

Systematic Review ◽

Gestational Age ◽

Small For Gestational Age ◽

First Trimester ◽

First Trimester Screening ◽

Trimester Screening ◽

Placental Protein

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O640 Umbilical artery Doppler to predict small for gestational age and compromise of fetal/neonatal wellbeing: Systematic review and bivariate meta-analysis

International Journal of Gynecology & Obstetrics ◽

10.1016/s0020-7292(09)61013-4 ◽

2009 ◽

Vol 107 ◽

pp. S275-S276

Author(s):

R. Morris ◽

G. Malin ◽

S. Robson ◽

J. Kleijnen ◽

J. Zamora ◽

...

Keyword(s):

Systematic Review ◽

Gestational Age ◽

Small For Gestational Age ◽

Umbilical Artery ◽

Meta Analysis ◽

Umbilical Artery Doppler

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Premature small for gestational age infants fed an exclusive human milk-based diet achieve catch-up growth without metabolic consequences at 2 years of age

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2017-314547 ◽

2018 ◽

Vol 104 (3) ◽

pp. F242-F247 ◽

Cited By ~ 4

Author(s):

Chonnikant Visuthranukul ◽

Steven A Abrams ◽

Keli M Hawthorne ◽

Joseph L Hagan ◽

Amy B Hair

Keyword(s):

Insulin Resistance ◽

Body Composition ◽

Birth Weight ◽

Human Milk ◽

Premature Infants ◽

Gestational Age ◽

Small For Gestational Age ◽

Insulin Level ◽

Metabolic Outcomes ◽

Catch Up

ObjectiveTo compare postdischarge growth, adiposity and metabolic outcomes of appropriate for gestational age (AGA) versus small for gestational age (SGA) premature infants fed an exclusive human milk (HM)-based diet in the neonatal intensive care unit.DesignPremature infants (birth weight ≤1250 g) fed an exclusive HM-based diet were examined at 12–15 months corrected gestational age (CGA) (visit 1) for anthropometrics, serum glucose and non-fasting insulin, and at 18–22 months CGA (visit 2) for body composition by dual-energy X-ray absorptiometry.ResultsOf 51 children, 33 were AGA and 18 were SGA at birth. The SGA group had weight gain (g/day) equal to AGA group during the follow-up period. SGA had a significantly greater body mass index (BMI) z-score gain from visit 1 to visit 2 (0.25±1.10 vs −0.21±0.84, p=0.02) reflecting catch-up growth. There were no significant differences in total fat mass (FM) and trunk FM between groups. SGA had significantly lower insulin level (5.0±3.7 vs 17.3±15.1 µU/mL, p=0.02) and homeostatic model of assessment-insulin resistance (1.1±0.9 vs 4.3±4.1, p=0.02). Although regional trunk FM correlated with insulin levels in SGA (r=0.893, p=0.04), they had lower insulin level compared with AGA and no difference in adiposity.ConclusionsSGA premature infants who received an exclusive HM-based diet exhibited greater catch-up growth without increased adiposity or elevated insulin resistance compared with AGA at 2 years of age. An exclusive HM-based diet may improve long-term body composition and metabolic outcomes of premature infants with ≤1250 g birth weight, specifically SGA.

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