Intrauterine environment and cognitive development in young twins

2013 ◽  
Vol 4 (6) ◽  
pp. 513-521 ◽  
Author(s):  
E. E. Antoniou ◽  
T. Fowler ◽  
E. Thiery ◽  
T. R. Southwood ◽  
S. van Gestel ◽  
...  
Keyword(s):  
Birth Weight ◽  
Cognitive Development ◽  
Umbilical Cord ◽  
Gestational Age ◽  
Intelligence Quotient ◽  
Shared Environment ◽  
Intrauterine Environment ◽  
Intelligence Scale ◽  
Iq Scores ◽  
Cord Length

Intrauterine factors important for cognitive development, such as birth weight, chorionicity and umbilical cord characteristics were investigated. A total of 663 twin pairs completed the Wechsler Intelligence Scale for Children-Revised and scores were available for Performance, Verbal and Total Intelligence Quotient (IQ). The intrauterine factors examined were birth weight, placental weight and morphology, cord knots, cord length and cord insertion. IQ scores for the varying levels of the intrauterine markers adjusting for gender and gestational age were calculated. The heritability of IQ and the association between IQ and intrauterine environment were examined. Twins with lower birth weight and cord knots had lower IQ scores. The aetiology of IQ is largely distinct from that of birth weight and cord knots, and non-shared environment may influence the observed relationships.

Neonatal Outcomes at Extreme Prematurity by Gestational Age Versus Birth Weight in a Contemporary Cohort

2021 ◽  
Author(s):  
Elizabeth B. Ausbeck ◽  
Phillip Hunter Allman ◽  
Jeff M. Szychowski ◽  
Akila Subramaniam ◽  
Anup Katheria
Keyword(s):  
Birth Weight ◽  
Umbilical Cord ◽  
Gestational Age ◽  
Predictive Value ◽  
Neonatal Death ◽  
Controlled Trial ◽  
Neonatal Morbidity ◽  
Mortality And Morbidity ◽  
Severe Morbidity ◽  
Multicenter Randomized Controlled Trial

Objective The aim of the study is to describe the rates of neonatal death and severe neonatal morbidity in a contemporary cohort, as well as to evaluate the predictive value of birth gestational age (GA) and birth weight, independently and combined, for neonatal mortality and morbidity in the same contemporary cohort. Study Design We performed a secondary analysis of an international, multicenter randomized controlled trial of delayed umbilical cord clamping versus umbilical cord milking in preterm infants born at 23 0/7 to 31 6/7 weeks of gestation. The current analysis was restricted to infants delivered <28 weeks. The primary outcomes of this analysis were neonatal death and a composite of severe neonatal morbidity. Incidence of outcomes was compared by weeks of GA, with planned subanalysis comparing small for gestational age (SGA) versus non-SGA neonates. Multivariable logistic regression was then used to model these outcomes based on birth GA, birth weight, or a combination of both as primary independent predictors to determine which had superior ability to predict outcomes. Results Of 474 neonates in the original trial, 180 (38%) were included in this analysis. Overall, death occurred in 27 (15%) and severe morbidity in 139 (77%) neonates. Rates of mortality and morbidity declined with increasing GA (mortality 54% at 23 vs. 9% at 27 weeks). SGA infants (n = 25) had significantly higher mortality compared with non-SGA infants across all GAs (p < 0.01). There was no difference in the predictive value for neonatal death or severe morbidity between the three prediction options (GA, birth weight, or GA and birth weight). Conclusion Death and severe neonatal morbidity declined with advancing GA, with higher rates of death in SGA infants. Birth GA and birth weight were both good predictors of outcomes; however, combining the two was not more predictive, even in SGA infants. Key Points

scholarly journals DISTRIBUSI FREKUENSI FAKTOR PENYEBAB KEJADIAN ASFIKSIA PADA BAYI BARU LAHIR DI RS. FADHILLAH KOTA PRABUMULIH TAHUN 2017

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Maria Septiana Maria Septiana
Keyword(s):  
Birth Weight ◽  
Umbilical Cord ◽  
Gestational Age ◽  
Maternal Age ◽  
Placenta Previa ◽  
Secondary Data ◽  
Maternal Factors ◽  
Premature Babies ◽  
Severe Infections ◽  
Abnormal Bleeding

Komplikasi yang menjadi penyebab kematian bayi baru lahir yang terbanyak yaitu asfiksia. penyebab terjadinya asfiksia ada 3 yaitu, faktor ibu (preeklamsi dan eklamsia, perdarahan abnormal yang disebabkan karena plasenta previa atau solusio plasenta, partus lama, demam selama persalinan, infeksi berat, kehamilan post matur, usia ibu kurang dari 20 tahun atau lebih dari 35 tahun), faktor bayi (bayi prematur, persalinan sulit, kelainan konginetal, air ketuban bercampur mekonium), faktor tali pusat (lilitan tali pusat, tali pusat pendek, simpul tali pusat dan prolapsus tali pusat) Metode penelitian : Pengambilan data dalam penelitian ini menggunakan data sekunder dengan pendekatan retrospektif. Hasil Penelitian : Faktor penyebab kejadian asfiksia pada bayi baru lahir berdasarkan faktor ibu yaitu mayoritas terjadi pada usia ibu 20-35 tahun sebanyak 16 (51,6%), , paritas10 (32,3%), umur kehamilan 18 (58,1%) dan berdasarkan faktor dari bayi yaitu mayoritas terjadi pada berat lahir bayi >2500 gram sebanyak 12 (38,7%), dan jenis persalinan yang mengalami asfiksia pada persalinan normal sebanyak 10 (32,3%). Kesimpulan : Faktor penyebab kejadian asfiksia pada bayi baru lahir di RS Fadhilah Kota Prabumulih yaitu dari faktor ibu yaitu mayoritas terjadi pada usia ibu 20-35 tahun, paritas multipara, umur kehamilan 37-42 minggu dan dari faktor bayi yaitu bayi dengan berat lahir >2500 gram dan jenis persalinan normal.     ABSTRACT Asphyxia is one of the complications that become the largest cause of death. Therevare three cause of asphyxia, namely, maternal factors (preeclampsia and eclampsia, abnormal bleeding caused by placenta previa or placental abruption, prolonged labor, fever during labor, severe infections, pregnancy post mature, maternal age less than 20 years old or over 35 years ), factor infants (premature babies, difficult delivery, konginetal disorders, meconium-stained amniotic fluid mixes), factor umbilical cord (umbilical cord loops, short umbilical cord, knot the cord and umbilical cord prolapse). Athere are 31 cose of asphyxia in Fadhilah Hospital. Objective : Knowing the factors that cause asphyxia in newborns at RS Fadhilah Prabumulih City. Methods : Collecting data in this study using secondary data with retrospective approach Result: Factors that cause asphyxia in newborns by maternal factors that occur in the majority of maternal age 20-35 years as many as 16 (51.6%), parity 10 (32.3%), gestational age 18 (58.1%) and by factors of which the majority occur in infants birth weight> 2500 g were 12 (38.7%), and the type of delivery that asphyxiated the normal labor as much as 10 (32.3%). Conclusion : Factors that cause asphyxia in newborns at PKU Muhammadiyah Hospital in Bantul 2016 ie from the maternal factors that occur in the majority of maternal age 20-35 years, multiparas parity, gestational age of 37-42 weeks and infant factors that infants with birth weight> 2500 gram and type of normal deliveries.

Routine Indomethacin Prophylaxis: Has the Time Come?

PEDIATRICS ◽  
1996 ◽  
Vol 98 (4) ◽  
pp. 784-785
Author(s):  
Henrietta S. Bada
Keyword(s):  
Cerebral Palsy ◽  
Birth Weight ◽  
Intraventricular Hemorrhage ◽  
Maternal Education ◽  
Severe Form ◽  
Term Outcome ◽  
Intelligence Scale ◽  
Long Term Outcome ◽  
Iq Scores

Periventricular-intraventricular hemorrhage (IVH) remains a significant cause of long-term morbidity among premature infants1. Clinical trials2-4 have shown that prophylactic indomethacin is associated with a decreased incidence of IVH, including the severe form. In this issue of Pediatrics, Ment et al5 report on the long-term outcome of children who received indomethacin prophylaxis for IVH. Incidence of cerebral palsy (8%) was similar between the indomethacin-and placebo-treated groups; mean IQ scores determined from the Stanford-Binet Intelligence Scale (Form L-M, 1972) did not differ. IQ scores were significantly related to IVH, birth weight, and maternal education; ie, lower IQ scores with IVH and higher scores with higher birth weight and years of education.

scholarly journals Cord Malaria Infection, Complement Activation, Oxidative Stress, Gestational Age, and Birth Weight, Characterized by High Plasmodium falciparum Prevalence in Bamenda, Cameroon

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Oumar Mahamat ◽  
Kidio Gisele Ndum ◽  
Sumo Laurentine ◽  
Ntonifor Ngum Helen
Keyword(s):  
Oxidative Stress ◽  
Birth Weight ◽  
Cord Blood ◽  
Umbilical Cord ◽  
Negative Correlation ◽  
Gestational Age ◽  
Blood Samples ◽  
Total Antioxidant ◽  
Weak Negative Correlation ◽  
And Oxidative Stress

Background. It is unknown whether the presence of Plasmodium falciparum malaria parasites in umbilical cord blood denotes activation of complement and oxidative stress to affect the duration of pregnancy and birth weight. Methods. In a cross-sectional study conducted from January to April 2019 in Bamenda, Cameroon, cord blood samples were collected from 300 women at delivery. Parasitaemia was determined microscopically. Babies’ weight and age of gestation were recorded. Plasma levels of complement and oxidative stress were measured by specific tests. Results. Cord blood malaria prevalence was 21.33%. Babies with an infected cord showed a low birth weight and gestation age than those with uninfected cords. More babies with infected cords had LBW (6.25%) compared to the counterparts (5.50%). The levels of parasitaemia and the babies’ weight showed a weak positive correlation. The prevalence of preterm and postterm birth was 4.33% and 24.33% respectively, with a weak negative correlation between the age of gestation and the umbilical cord parasitaemia. There was correlation between cord parasitaemia and levels of complement haemolytic activity titter (CH50) and specific classical pathway activity (CPA) in cord blood. CH50 and CPA levels, however, were significantly higher in infected cord blood samples, compared with uninfected cord blood samples. CH50 showed a negative correlation with the birth weight and gestational age in infected cord blood samples. The levels of total oxidative stress (TOS) and total antioxidant defense were significantly lower in infected cord blood than uninfected. TOS displayed a positive correlation with the density of parasitaemia and a weak negative correlation with the birth weight and gestational age in infected cord blood. Conclusion. Cord blood infection lowers the complement haemolytic titter, oxygen radicals and total antioxidant defense in neonates. This lowering of complement haemolytic titter and oxygen radical compounds in umbilical cord malaria are associated with low birth weight and preterm birth.

Neurodevelopmental outcome in infants with esophageal atresia: risk factors in the first year of life

2020 ◽  
Author(s):  
Bevilacqua Francesca ◽  
Ragni Benedetta ◽  
Conforti Andrea ◽  
Braguglia Annabella ◽  
Gentile Simonetta ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Cognitive Development ◽  
Low Birth Weight ◽  
Multiple Regression ◽  
Esophageal Atresia ◽  
Gestational Age ◽  
Motor Development ◽  
First Year ◽  
First Year Of Life

Summary Data on neurodevelopmental outcomes of infants born with esophageal atresia (EA) are still scarce and controversial. The aims of our study were to evaluate motor and cognitive development during the first year of life, in patients operated on of EA and to investigate potential risk factors for motor and cognitive development both at 6 and 12 months. This is an observational prospective longitudinal study in a selected cohort of type C and D EA infants enrolled in our follow-up program from 2009 to 2017. In order to exclude possible confounding factors, the following exclusion criteria were applied: (i) gestational age ≤ 32 weeks and/or birth weight ≤ 1500 g; (ii) genetic syndrome or chromosomal anomaly known to be associated with neurodevelopmental delay; (iii) neurologic disease; (iv) esophageal gap ≥three vertebral bodies. Patients were evaluated at 6 and 12 months of life (corrected age for infants with a gestational age of 32–37 weeks) with the Bayley Scales of Infant and Toddler Development—3rd Edition. In our selected cohort of EA infants, 82 were evaluated at 6 months and 59 were reevaluated at 12 months. Both Motor and Cognitive average scores were within the norm at both time points. However, we report increased number of infants with motor delay with time: 14% at 6 months and 24% at 12 months. Multiple regression analysis for Motor scores at 6 [F(4,74) = 4.363, P = 0.003] and 12 months [F(6,50) = 2.634, P = 0.027] identified (i) low birth weight, (ii) longer hospital stay and (iii) weight &lt; fifth percentile at 1 year as risk factors. Interestingly, average Cognitive scores also increased with time from 85.2% at 6 months and 96.6% at 12 months. Multiple regression models explaining variance of Cognitive scores at 6 [F(4, 73) = 2.458, P = 0.053] and 12 months [F(6, 49) = 1.232, P = 0.306] were nonsignificant. Our selected cohort of EA patients shows, on the average, Motor and Cognitive scores within the norm both at 6 and 12 months. Nevertheless, the percentage of infants with Motor scores below the average increases regardless gestational age. None of clinical and sociodemographic variables taken into consideration was able to predict cognitive development both at 6 and 12 months whereas risk factors for Motor development change during the first year of life. Healthcare providers should pay particular attention to patients with low birth weight, longer hospital stays and weight under fifth percentile at 1 year. Future studies should include long-term outcomes to reveal possible catch up in motor development and/or possible findings in Cognitive scores.

scholarly journals Impact of umbilical cord arterial pH, gestational age, and birth weight on neurodevelopmental outcomes for preterm neonates

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12043
Author(s):  
Roksana Malak ◽  
Dorota Sikorska ◽  
Marta Rosołek ◽  
Ewa Baum ◽  
Ewa Mojs ◽  
...  
Keyword(s):  
Birth Weight ◽  
Umbilical Cord ◽  
Gestational Age ◽  
State Regulation ◽  
Preterm Neonates ◽  
Neurodevelopmental Outcomes ◽  
Sensory Stimuli ◽  
Arterial Ph ◽  
The Impact ◽  
Tonic Neck Reflex

Background The aim of this study was to determine the impact of umbilical cord arterial pH, gestational age, and birth weight on neurodevelopmental outcomes for preterm neonates. Methods We examined 112 neonates. Inclusion criteria were: Saturations greater than 88%, and heart rates between 100–205 beats per minute. Measurements We assessed several neurodevelopmental factors as part of the Brazelton Neonatal Behavioral Assessment Scale (NBAS), 4th edition, such as asymmetric tonic neck reflex (ATNR), motor maturity, response to sensory stimuli, habituation, and state regulation. Initial assessment parameters such as APGAR score and umbilical cord arterial pH were used to assess neonates. Results We found a strong correlation between the presence of the sucking reflex and umbilical cord arterial pH (r = 0.32; p = 0.018981). Umbilical cord arterial pH was also correlated with the presence of asymmetric tonic neck reflex (r = 0.27; p = 0.047124), cost of attention (r = 0.31; p = 0.025381) and general motor maturity (r = 0.34; p = 0.011741). Conclusions We found that the sucking reflex may be affected in infants with low umbilical cord arterial pH values. Practitioners and parents can use the NBAS to help determine neurodevelopmental factors and outcomes in preterm infants, possibly leading to safer and more effective feeding practices and interventions.

scholarly journals Umbilical Cord Blood Adiponectin, Leptin, Insulin, and Ghrelin in Premature Infants and Their Association With Birth Outcomes

2021 ◽  
Vol 12 ◽  
Author(s):  
Luyan Han ◽  
Bo Li ◽  
Xiaojing Xu ◽  
Shufang Liu ◽  
Zhenghong Li ◽  
...  
Keyword(s):  
Birth Weight ◽  
Cord Blood ◽  
Preterm Infants ◽  
Umbilical Cord ◽  
Fetal Growth ◽  
Umbilical Cord Blood ◽  
Gestational Age ◽  
Metabolic Diseases ◽  
Term Infants ◽  
Preterm Group

BackgroundPremature/low-birth-weight infants are at significant risk of metabolic diseases in adulthood, which may be related to the levels of fetal adipokine. Here, we investigated the differences in the levels of umbilical cord blood adiponectin, leptin, insulin, and ghrelin in preterm and term infants and sought to elucidate the link between these hormones and fetal growth. We also evaluated the interrelationship among these metabolic hormones in both groups of newborns.MethodsA total of 149 mother–infant pairs (100 in the preterm group and 49 in the term group) were enrolled in the study. The preterm group was further subdivided according to birth weight (≤1,500, 1,501–2,000, 2,001–2,500, and &gt;2,500 g), gestational age (&lt;34 vs. ≥34 weeks), and appropriate for gestational age (AGA) vs. small for gestational age (SGA). The general condition of the mothers and the growth parameters of the newborns at birth were recorded.ResultsThe levels of adiponectin, leptin, and ghrelin were lower in the preterm group than those in the term group (p &lt; 0.05). In the preterm group, the leptin levels of infants with gestational age ≥34 weeks were significantly higher than those of infants with gestational age &lt;34 weeks (mean ln leptin = 0.63 vs. 0.36 ng/ml, p = 0.009). The levels of adiponectin were lower in the SGA group than those in the AGA group (mean ln adiponectin = 2.26 vs. 2.84 µg/ml, p = 0.001), whereas those of ghrelin displayed the opposite trend (mean ln ghrelin = 6.29 vs. 5.71 pg/ml, p &lt; 0.001). Leptin was significantly correlated with insulin both in preterm infants with birth weight (BW) &gt;2,000 g and in term infants. Umbilical cord blood leptin was positively correlated with the BW, birth length, and head circumference of newborns (r = 0.460, 0.311, and 0.310, respectively, all p &lt; 0.05), whereas ghrelin was negatively correlated with the same parameters (r = −0.372, −0.415, and −0.373, respectively, all p &gt; 0.05).ConclusionsThe lack of maturation of adipose tissue and the gastrointestinal tract by the fetus due to prematurity is associated with changes in the levels of cord blood adiponectin, leptin, and ghrelin. The dysregulation of these hormones in preterm infants may be a risk factor for fetal growth and future metabolic diseases.

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