Growth from Birth to 30 months for Infants Born with Congenital Gastrointestinal Anomalies and Disorders

2020 ◽  
Author(s):  
Katie M. Strobel ◽  
Isabell Purdy ◽  
Tahmineh Romero ◽  
Kara L. Calkins
Keyword(s):  
Head Circumference ◽  
Growth Failure ◽  
Intestinal Atresia ◽  
Gastrointestinal Disorders ◽  
Z Scores ◽  
Catch Up ◽  
By Catch ◽  
Congenital Gastrointestinal Anomalies ◽  
Severe Growth ◽  
Over Time

Abstract Objective This study aimed to investigate growth among neonates with gastrointestinal disorders. Study Design Inclusion criteria included neonates with gastroschisis, omphalocele, intestinal atresia, tracheoesophageal fistula, Hirschsprung's disease, malabsorption disorders, congenital diaphragmatic hernia, and imperforate anus born between 2010 and 2018. Anthropometrics were collected for the first 30 months, and a subgroup analysis was performed for gastroschisis infants. Results In 61 subjects, 13% developed severe growth failure within the first month. One-, four-, and nine-month weight and length z-scores were less than birth weight in all infants (p < 0.05). In infants with gastroschisis, a similar pattern was observed for weight z-scores only (p < 0.05). From birth to 15 months, head circumference z-score increased over time in all infants (p = 0.001), while in gastroschisis infants, weight, length, and head circumference z-scores increased over time (p < 0.05). Conclusion In a cohort of infants with gastrointestinal disorders, growth failure was followed by catch-up growth.

scholarly journals The Nutritional Status of Individuals Adopted Internationally as Children: A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 245
Author(s):  
Richard Ivey ◽  
Marko Kerac ◽  
Michael Quiring ◽  
Hang T. Dam ◽  
Susie Doig ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Nutritional Status ◽  
Body Mass ◽  
Head Circumference ◽  
Older Children ◽  
Z Scores ◽  
Catch Up ◽  
Height For Age ◽  
Weight For Age

Since 1955, international adoption has been a way of finding homes for children who have been orphaned or abandoned. We aimed to describe the nutritional status of individuals adopted internationally and their long-term nutritional and health outcomes. We searched four databases for articles published from January 1995 to June 2020, which included information on anthropometric or micronutrient status of children adopted internationally (CAI). Mean Z-scores on arrival to adoptive country ranged from −2.04 to −0.31 for weight for age; −0.94 to 0.39 for weight for height; −0.7 to 0 for body mass index; −1.89 to −0.03 for height for age; −1.43 to 0.80 for head circumference for age. Older children, those adopted from institutionalized care or with underlying disability, were more likely to be malnourished. Though long-term data was scarce, mean Z-scores post-adoption ranged from −0.59 to 0.53 for weight for age; −0.31 to 1.04 for weight for height; 0.39 to 1.04 for body mass index; −1.09 to 0.58 for height for age; −0.06 to 1.23 for head circumference for age. We conclude that though CAI are at high risk of malnutrition at baseline, marked catch-up growth is possible, including for those older than two years of age on arrival. This has implications not only for CAI but for the wider population of malnourished children worldwide. Research on how to optimize catch-up growth is a priority.

scholarly journals Catch-up growth and nutritional status of preterms born at a Ugandan tertiary hospital: An Observational study.

2020 ◽  
Author(s):  
Flaviah Namiiro ◽  
Anthony Batte ◽  
Joseph Rujumba ◽  
Nicolette Nabukeera ◽  
Ian Munabi ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Nutritional Status ◽  
Head Circumference ◽  
Maternal Age ◽  
Anthropometric Measurements ◽  
World Health ◽  
Z Scores ◽  
The Mean ◽  
Catch Up

Abstract Introduction Advances in neonatal care have led to the increasing survival of preterm/low birth weight infants worldwide. However, there is limited data on growth outcomes following preterm births especially in low and middle income countries. We assessed the catch-up growth, nutritional status and associated factors of Ugandan children who were born preterm/ low birth weight at Mulago National Referral Hospital.Methods: We enrolled children aged 22-38 months who had been born as preterm with low birth weight and their mothers. Participants were identified and recruited from the follow up clinic for preterm babies discharged from the neonatal unit of Mulago Hospital. Anthropometric measurements for mothers and children were taken. The children’s weight for height z-scores, height for age z-scores, weight for age z-scores, head circumference and mid upper arm circumference (MUAC) were taken and the mothers’ body mass index were generated based on the World Health Organization standards. Results: Of the 251 children and mother pairs recruited, 129 children (51.4%) were male, the mean age was 29.7 months (SD±4.5) and the mean maternal age was 29.9 (SD±5.3). 101(40.1%) of the children enrolled had attained catch up growth on the normal anthropometric measurements for their age. Among the participants, the prevalence of wasting, underweight and stunting was: 8 (3.2%), 36 (14.4%) and 106 (42.2%) respectively. Factors associated with stunting were male sex (AOR 2.36, 95% CI 1.42 to 3.95); p=0.001), maternal age ≤ 25years: AOR 2.27 (95%CI 1.13, 4.52); p= 0.020, and maternal height <150cm: AOR 5.57(95%CI 1.90, 16.94); P=0.002. Associations with underweight in the children were; birth weight ≤1500 gms: AOR 2.38(95%CI 1.14, 4.95); p=0.020 and post-natal hospitalization of more than 14 days: AOR 5.93(95%CI 1.96, 17.90); p=0.002. For 246 (98.8%) participants, MUAC was normal (≥ 12.5 cm) and for 216 (86.8%) the head circumference was within normal range for age.Conclusion: Of the children born preterm/LBW 40.1% of the participants had attained the expected catch up growth at 2 to 3 years of age, 42.2% were observed to be stunted while 14.4% were underweight both higher than the national levels. Targeted interventions are specifically needed for children born with very low birth weight, those requiring long postnatal hospitalization, males and those born to short or young mothers.

scholarly journals Growth and nutrition in children with ataxia telangiectasia

2016 ◽  
Vol 101 (12) ◽  
pp. 1137-1141 ◽  
Author(s):  
Emma Stewart ◽  
Andrew P Prayle ◽  
Alison Tooke ◽  
Sara Pasalodos ◽  
Mohnish Suri ◽  
...  
Keyword(s):  
Ataxia Telangiectasia ◽  
Tube Feeding ◽  
Growth Failure ◽  
Oral Intake ◽  
Multisystem Disease ◽  
Endoscopic Gastrostomy ◽  
Z Scores ◽  
Progressive Growth ◽  
Nested Case Control ◽  
Over Time

BackgroundAtaxia telangiectasia (A-T) is a rare multisystem disease with high early mortality from lung disease and cancer. Nutritional failure adversely impacts outcomes in many respiratory diseases. Several factors influence nutrition in children with A-T. We hypothesised that children with A-T have progressive growth failure and that early gastrostomy tube feeding (percutaneous endoscopic gastrostomy, PEG) is a favourable management option with good nutritional outcomes.MethodsData were collected prospectively on weight, height and body mass index (BMI) at the national paediatric A-T clinic. Adequacy and safety of oral intake was assessed. Nutritional advice was given at each multidisciplinary review.Results101 children (51 girls) had 222 measurements (32 once, 32 twice, 24 thrice) between 2009 and 2016. Median (IQR) age was 9.3 (6.4 to 13.1) years. Mean (SD) weight, height and BMI Z-scores were respectively −1 (1.6), −1.2 (1.2) and −0.4 (1.4). 35/101 children had weight Z-scores below −2 on at least one occasion. Weight, height and BMI Z-scores declined over time. Decline was most obvious after 8 years of age. 14/101 (14%) children had a PEG, with longitudinal data available for 12. In a nested case control study, there was a trend for improvement in weight in those with a PEG (p=0.10).ConclusionsPatients with A-T decline in growth over time. There is an urgent need for new strategies, including an understanding of why growth falters. We suggest early proactive consideration of PEG from age 8 years onwards to prevent progressive growth failure.

scholarly journals Growth to early adulthood following extremely preterm birth: the EPICure study

2020 ◽  
Vol 105 (5) ◽  
pp. 496-503 ◽  
Author(s):  
Yanyan Ni ◽  
Joanne Beckmann ◽  
Rashmi Gandhi ◽  
John R Hurst ◽  
Joan K Morris ◽  
...  
Keyword(s):  
Head Circumference ◽  
Pubertal Development ◽  
Early Adulthood ◽  
Multilevel Modelling ◽  
Growth Data ◽  
Extremely Preterm ◽  
Birth Characteristics ◽  
Z Scores ◽  
Catch Up ◽  
The Uk

ObjectiveTo investigate growth trajectories from age 2.5 to 19 years in individuals born before 26 weeks of gestation (extremely preterm; EP) compared with term-born controls.MethodsMultilevel modelling of growth data from the EPICure study, a prospective 1995 birth cohort of 315 EP participants born in the UK and Ireland and 160 term-born controls recruited at school age. Height, weight, head circumference and body mass index (BMI) z-scores were derived from UK standards at ages 2.5, 6, 11 and 19 years.Results129 (42%) EP children were assessed at 19 years. EP individuals were on average 4.0 cm shorter and 6.8 kg lighter with a 1.5 cm smaller head circumference relative to controls at 19 years. Relative to controls, EP participants grew faster in weight by 0.06 SD per year (95% CI 0.05 to 0.07), in head circumference by 0.04 SD (95% CI 0.03 to 0.05), but with no catch-up in height. For the EP group, because of weight catch-up between 6 and 19 years, BMI was significantly elevated at 19 years to +0.32 SD; 23.4% had BMI >25 kg/m2 and 6.3% >30 kg/m2 but these proportions were similar to those in control subjects. EP and control participants showed similar pubertal development in early adolescence, which was not associated with height at 19 years in either study group. Growth through childhood was related to birth characteristics and to neonatal feeding practices.ConclusionsEP participants remained shorter and lighter and had smaller head circumferences than reference data or controls in adulthood but had elevated BMI.

scholarly journals Different Blood Metabolomics Profiles in Infants Consuming a Meat- or Dairy-Based Complementary Diet

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 388
Author(s):  
Minghua Tang ◽  
Nicholas E. Weaver ◽  
Lillian M. Berman ◽  
Laura D. Brown ◽  
Audrey E. Hendricks ◽  
...  
Keyword(s):  
Amino Acids ◽  
Dietary Intervention ◽  
Principal Component ◽  
Essential Amino Acids ◽  
Infant Growth ◽  
Serum Samples ◽  
Z Scores ◽  
Protein Rich ◽  
Over Time ◽  
Complementary Diet

Background: Research is limited in evaluating the mechanisms responsible for infant growth in response to different protein-rich foods; Methods: Targeted and untargeted metabolomics analysis were conducted on serum samples collected from an infant controlled-feeding trial that participants consumed a meat- vs. dairy-based complementary diet from 5 to 12 months of age, and followed up at 24 months. Results: Isoleucine, valine, phenylalanine increased and threonine decreased over time among all participants; Although none of the individual essential amino acids had a significant impact on changes in growth Z scores from 5 to 12 months, principal component heavily weighted by BCAAs (leucine, isoleucine, valine) and phenylalanine had a positive association with changes in length-for-age Z score from 5 to 12 months. Concentrations of acylcarnitine-C4, acylcarnitine-C5 and acylcarnitine-C5:1 significantly increased over time with the dietary intervention, but none of the acylcarnitines were associated with infant growth Z scores. Quantitative trimethylamine N-oxide increased in the meat group from 5 to 12 months; Conclusions: Our findings suggest that increasing total protein intake by providing protein-rich complementary foods was associated with increased concentrations of certain essential amino acids and short-chain acyl-carnitines. The sources of protein-rich foods (e.g., meat vs. dairy) did not appear to differentially impact serum metabolites, and comprehensive mechanistic investigations are needed to identify other contributors or mediators of the diet-induced infant growth trajectories.

scholarly journals In Utero Exposure to Δ9-Tetrahydrocannabinol Leads to Postnatal Catch-Up Growth and Dysmetabolism in the Adult Rat Liver

2021 ◽  
Vol 22 (14) ◽  
pp. 7502
Author(s):  
Shelby L. Oke ◽  
Kendrick Lee ◽  
Rosemary Papp ◽  
Steven R. Laviolette ◽  
Daniel B. Hardy
Keyword(s):  
Mitochondrial Dysfunction ◽  
Animal Studies ◽  
Weight Ratio ◽  
Wistar Rat ◽  
Hepatic Function ◽  
Fetal Life ◽  
Adult Rat ◽  
Catch Up ◽  
By Catch

The rates of gestational cannabis use have increased despite limited evidence for its safety in fetal life. Recent animal studies demonstrate that prenatal exposure to Δ9-tetrahydrocannabinol (Δ9-THC, the psychoactive component of cannabis) promotes intrauterine growth restriction (IUGR), culminating in postnatal metabolic deficits. Given IUGR is associated with impaired hepatic function, we hypothesized that Δ9-THC offspring would exhibit hepatic dyslipidemia. Pregnant Wistar rat dams received daily injections of vehicular control or 3 mg/kg Δ9-THC i.p. from embryonic day (E) 6.5 through E22. Exposure to Δ9-THC decreased the liver to body weight ratio at birth, followed by catch-up growth by three weeks of age. At six months, Δ9-THC-exposed male offspring exhibited increased visceral adiposity and higher hepatic triglycerides. This was instigated by augmented expression of enzymes involved in triglyceride synthesis (ACCα, SCD, FABP1, and DGAT2) at three weeks. Furthermore, the expression of hepatic DGAT1/DGAT2 was sustained at six months, concomitant with mitochondrial dysfunction (i.e., elevated p66shc) and oxidative stress. Interestingly, decreases in miR-203a-3p and miR-29a/b/c, both implicated in dyslipidemia, were also observed in these Δ9-THC-exposed offspring. Collectively, these findings indicate that prenatal Δ9-THC exposure results in long-term dyslipidemia associated with enhanced hepatic lipogenesis. This is attributed by mitochondrial dysfunction and epigenetic mechanisms.

Comparison of aesthetic outcomes between open and endoscopically treated sagittal craniosynostosis

2021 ◽  
pp. 1-7
Author(s):  
Jacob Lepard ◽  
S. Hassan A. Akbari ◽  
James Mooney ◽  
Anastasia Arynchyna ◽  
Samuel G. McClugage III ◽  
...  
Keyword(s):  
Head Circumference ◽  
Endoscopic Treatment ◽  
Open Repair ◽  
Perioperative Outcomes ◽  
Subjective Rating ◽  
Cephalic Index ◽  
Sagittal Synostosis ◽  
Sagittal Craniosynostosis ◽  
Subjective Assessments ◽  
Z Scores

OBJECTIVE In the last several decades, there has been much debate regarding the ideal treatment for sagittal synostosis. The purpose of this study was to compare perioperative, anthropometric, and subjective assessments of cosmetic outcomes between open and endoscopic management of isolated sagittal synostosis. METHODS At their routine postoperative follow-up, pediatric patients with sagittal craniosynostosis were recruited to undergo digital cranial measurement and standardized photography for objective and subjective assessments of perioperative outcomes. Age-normalized z-scores for cephalic index, head circumference, euryon-euryon diameter (Eu-Eu), and glabella-opisthocranion diameter (G-Op) were calculated for each patient. Faculty surgeons, surgical trainees, nurses, and laypersons were asked to rate the normalcy of craniofacial appearances using a 5-point Likert scale. Outcomes were compared between patients treated with endoscopic correction and those treated with open repair. RESULTS A total of 50 patients were included in the study. Thirty-one had undergone open surgical correction, and 19 had undergone endoscopic treatment. Endoscopic repair involved significantly lower operative time, blood loss, transfusion rate, and hospital length of stay than those with open repair (p < 0.001). There was no significant difference between groups in terms of z-scores for head circumference (p = 0.22), cephalic index (p = 0.25), or Eu-Eu (p = 0.38). Endoscopic treatment was associated with a significantly lower G-Op (p = 0.009). Additionally, the average subjective rating of head shape was higher for endoscopic treatment when corrected for age, gender, and ethnicity (p = 0.02). CONCLUSIONS The study findings suggest that patients who are treated endoscopically may have an overall more normal appearance in skull morphology and cosmesis, although these results are limited by poor reliability.

HEAD CIRCUMFERENCE, MENTAL RETARDATION, AND GROWTH FAILURE

PEDIATRICS ◽  
1965 ◽  
Vol 36 (1) ◽  
pp. 62-66
Author(s):  
Edward J. O'Connell ◽  
Robert H. Feldt ◽  
Gunnar B. Stickler
Keyword(s):  
Mental Retardation ◽  
Head Circumference ◽  
Growth Failure ◽  
Clinical Impression ◽  
Severe Mental Retardation ◽  
Small Head ◽  
The Mean ◽  
Standard Deviations ◽  
Mental Subnormality ◽  
Age And Sex

The purpose of this study was to re-affirm our clinical impression that non-institutionalized children whose head circumference was below minus 2 standard deviations were mentally subnormal and frequently had growth failure. A group of 134 children with a head circumference below minus 2 standard deviations from the mean were studied, and all but one were mentally subnormal. The most severe mental retardation was noted in the group of children with a head circumference of minus 4 standard deviations or below. We found, as have others, that children with mental retardation have height and weights below the expected norm and that children with a head circumference below minus 2 standard deviations have even lower mean heights and weights. The head circumference of 31 children with growth failure and normal intelligence was normal for age and sex, therefore disproving the concept that the abnormally small child has a proportionally small head. In the child with growth failure, should the head be proportionally small (below minus 2 standard deviations), mental subnormality should be suspected. We feel that the head circumference measurement has taken on new clinical significance in that our data support its use in suspecting the association of mental subnormality in children with growth failure and a head circumference of below minus 2 standard deviations from the mean for age and sex.

Enteral Nutrition in Infants With Congenital Heart Disease and Growth Failure

PEDIATRICS ◽  
1990 ◽  
Vol 86 (3) ◽  
pp. 368-373
Author(s):  
Steven M. Schwarz ◽  
Michael H. Gewitz ◽  
Cynthia C. See ◽  
Stuart Berezin ◽  
Mark S. Glassman ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Nutritional Status ◽  
Congenital Heart ◽  
Growth Failure ◽  
Z Scores ◽  
Group 3 ◽  
Group 2 ◽  
Calorie Density ◽  
Group 1

To determine an effective nutritional regimen for management of growth failure in infants with congenital heart disease and congestive heart failure, the authors studied 19 infants with cardiac anomalies who were not candidates for early corrective surgery. Patients were randomly assigned to one of three feeding groups: group 1 (n = 7) received continuous, 24-hour nasogastric alimentation; group 2 (n = 5) received overnight, 12-hour nasogastric infusions plus daytime oral feedings as tolerated; and group 3 (n = 7) received oral feedings alone. For all patients, commercial infant formula (cow's milk or soy protein) was supplemented to a calorie density of approximately 1 kcal/mL. During a 5.25 ± 0.45 month study period, only group 1 infants achieved intakes &gt; 140 kcal/kg per day (mean = 147 kcal). Serial anthropometric measurements demonstrated that only 24-hour infusions (group 1) were associated with significantly improved nutritional status, when assessed by z scores for weight (P &lt; .01) and length (P &lt; .05). Group 1 infants also showed marked increases in midarm muscle circumference and triceps and subscapular skinfold thicknesses (P &lt; .01, compared with groups 2 and 3). These data suggest that infants with congenital cardiac defects complicated by malnutrition manifest increased nutrient requirements for growth and weight gain. Continuous, 24-hour, nasogastric alimentation is a safe and effective method for achieving both increased nutrient intake and improved overall nutritional status in these infants.

scholarly journals Using Incentives to Reduce Bycatch and Discarding: Results Under the West Coast Catch Share Program

2019 ◽  
Author(s):  
Lisa Pfeiffer
Keyword(s):  
West Coast ◽  
Bottom Trawl ◽  
The West ◽  
Annual Variability ◽  
Environmental Objectives ◽  
By Catch ◽  
Groundfish Fishery ◽  
Dover Sole ◽  
Ecosystem Benefits ◽  
Over Time

Catch share management was implemented in the bottom trawl sector of the West Coast Groundfish fishery in 2011 to address a range of issues including high bycatch and discard rates. The catch share programwas designed to remove the incentives to discard through full catch accounting, tradeable quotas, increased flexibility in fishing, and penalties for catch overages. We assess the effectiveness of the program in meeting its environmental objectives by comparing discard weights, proportions, and variability from 2004–2010 with 2011–2016. We analyzed these metrics for species managed using quota, including historically overfished stocks, as well as for non-quota species caught in the fishery. Discard amounts decreased over time for all species and declined to historic lows after the implementation of the program, remaining low through 2016 with much less inter-annual variability. Mean annual discards of two highly-targeted quota species, sablefishand Dover sole, showed the greatest decreases, falling by 97 and 86%, respectively. The discard proportion of overfished quota species fell by 50% on average. The unanticipated decline in discards of non-quotaspecies as well as the decreased variability in discard amounts for all species indicate that the incentives produced by catch share management provided additional ecosystem benefits.

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