Ponderal Index: A Better Definition of the ‘At Risk’ Group With Intrauterine Growth Problems than Birth-weight for Gestational Age in Term Infants

1991 ◽  
Vol 31 (1) ◽  
pp. 17-19 ◽  
Author(s):  
Roger A. Fay ◽  
Philip L. Dey ◽  
Christopher M.J. Saadie ◽  
Janice A. Buhl ◽  
Val J. Gebski
Keyword(s):  
At Risk ◽  
Birth Weight ◽  
Gestational Age ◽  
Risk Group ◽  
Ponderal Index ◽  
Term Infants ◽  
Intrauterine Growth ◽  
Definition Of

scholarly journals Early Postnatal Metabolic Profile in Neonates With Different Birth Weight Status: A Pilot Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Serdar Beken ◽  
Saygin Abali ◽  
Neslihan Yildirim Saral ◽  
Bengisu Guner ◽  
Taha Dinc ◽  
...  
Keyword(s):  
Birth Weight ◽  
Amino Acid ◽  
Energy Metabolism ◽  
Gestational Age ◽  
Weight Status ◽  
Newborn Infants ◽  
Ponderal Index ◽  
Large For Gestational Age ◽  
Metabolic Disturbances ◽  
Intrauterine Growth

Introduction: Restricted or enhanced intrauterine growth is associated with elevated risks of early and late metabolic problems in humans. Metabolomics based on amino acid and carnitine/acylcarnitine profile may have a role in fetal and early postnatal energy metabolism. In this study, the relationship between intrauterine growth status and early metabolomics profile was evaluated.Materials and Methods: A single-center retrospective cohort study was conducted. Three hundred and sixty-one newborn infants were enrolled into the study, and they were grouped according to their birth weight percentile as small for gestational age (SGA, n = 69), appropriate for gestational age (AGA, n = 168), and large for gestational age (LGA, n = 124) infants. In all infants, amino acid and carnitine/acylcarnitine profiles with liquid chromatography-tandem mass spectrometry (LC-MS/MS) were recorded and compared between groups.Results: LGA infants had higher levels of glutamic acid and lower levels of ornithine, alanine, and glycine (p < 0.05) when compared with AGA infants. SGA infants had higher levels of alanine and glycine levels when compared with AGA and LGA infants. Total carnitine, C0, C2, C4, C5, C10:1, C18:1, C18:2, C14-OH, and C18:2-OH levels were significantly higher and C3 and C6-DC levels were lower in SGA infants (p < 0.05). LGA infants had higher C3 and C5:1 levels and lower C18:2 and C16:1-OH levels (p < 0.05). There were positive correlations between free carnitine and phenylalanine, arginine, methionine, alanine, and glycine levels (p < 0.05). Also, a positive correlation between ponderal index and C3, C5-DC, C14, and C14:1 and a negative correlation between ponderal index and ornithine, alanine, glycine, C16:1-OH, and C18:2 were shown.Conclusion: We demonstrated differences in metabolomics possibly reflecting the energy metabolism in newborn infants with intrauterine growth problems in the early postnatal period. These differences might be the footprints of metabolic disturbances in future adulthood.

Heterogeneous Growth and Mental Development of Intrauterine Growth-Retarded Infants During the First 3 Years of Life

PEDIATRICS ◽  
1984 ◽  
Vol 74 (5) ◽  
pp. 783-791 ◽  
Author(s):  
J. Villar ◽  
V. Smeriglio ◽  
R. Martorell ◽  
C. H. Brown ◽  
R. E. Klein
Keyword(s):  
Birth Weight ◽  
Total Sample ◽  
Postnatal Growth ◽  
Ponderal Index ◽  
Normal Birth Weight ◽  
Term Infants ◽  
Developmental Patterns ◽  
Intrauterine Growth ◽  
Normal Birth ◽  
Catch Up

Postnatal growth and development were studied in two groups of term infants with intrauterine growth retardation (IUGR) and one group of infants with normal birth weight up to 3 years of age (total sample, 205 infants). Infants with IUGR were classified as having low ponderal index (IUGR-LPI) or adequate ponderal index (IUGR-API). At birth, the two groups of infants with IUGR had similar birth weight, but length and head circumference measurements were significantly different. Overall, the IUGR-API infants remained lighter and shorter and had smaller head circumferences up to 30 months of age. The IUGR-LPI infants experienced catch-up growth in weight during the first months, because of greater fat deposition. At 24 months of age, the IUGR-API infants scored below the others on mental items. At 3 years of age the IUGR-API infants had the lowest values on seven of eight developmental measures and on the composite score; at these two time periods, the group with normal birth weight scored the highest, and the IUGR-LPI infants obtained intermediate values. It is concluded that infanst with IUGR tend to follow postnatal growth and developmental patterns that are associated with their physical characteristics at birth.

Categories of intrauterine growth retardation

1993 ◽  
Vol 5 (4) ◽  
pp. 203-212 ◽  
Author(s):  
Roger A Fay ◽  
David A Ellwood
Keyword(s):  
Soft Tissue ◽  
Fetal Growth ◽  
Gestational Age ◽  
Growth Retardation ◽  
Large Scale ◽  
Intrauterine Growth Retardation ◽  
Low Birthweight ◽  
Ponderal Index ◽  
Intrauterine Growth ◽  
Different Types

Originally all low birthweight infants were considered to be premature. When prematurity was redefined in terms of gestational age (SGA) and not preterm. With the large scale collection of obstetric data the distributions of birthweight at different gestational ages were described and from these, infants who were SGA could be defined. SGA became synonymous with terms such as growth retardation, but it soon became appearent that the two were not necessarily interchangeable. Scott and Usher found that it was the degree of soft tissue wasting rather than birthweight that related to poor perinatal outcome. Miller and Hassanein stated that: “birthweight by itself is not a valid measure of fetal growth impairment”. They used Rorher’s Ponderal Index (weight (g) × 100/length (cm)) to diagnose the malnourished or excessively wasted infants with reduced soft tissue mass. Most studies of intrauterine growth retardation (IUGR) still use low birthweight for gestational age centile as their only definition of IUGR or only study infants who have a low birthweight. Altman and Hytten expressed disquiet about this definition and stated: “There is now an urgent need to establish true measures of fetal growth from which deviations indicating genuine growth retardation can be derived” and that “it is particularly important that some reliable measures of outcome should be established”. In large series of term deliveries published recently, two groups of IUGR infants with different growth patterens have been identified. These studies confirm that birthweight alone is inadequate to define the different types of IUGR. They established that low Ponderal Index (PI) is a measure of IUGR associated with an increased incidence of perinatal problems and that it is time to re-evaluate IUGR in terms of the different types of aberrant fetal growth.

scholarly journals Gestational Age, Birth Weight, Intrauterine Growth, and the Risk of Epilepsy

2007 ◽  
Vol 167 (3) ◽  
pp. 262-270 ◽  
Author(s):  
Y. Sun ◽  
M. Vestergaard ◽  
C. B. Pedersen ◽  
J. Christensen ◽  
O. Basso ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Intrauterine Growth

Comparison of Phototherapy Results in Small-for-Gestational-Age and Appropriate-for-Gestational-Age Infants Weighing Less Than 2,000 Grams

PEDIATRICS ◽  
1985 ◽  
Vol 75 (2) ◽  
pp. 413-441
Author(s):  
Joan E. Hodgman ◽  
Paul Y. K. Wu ◽  
Nathaniel B. White ◽  
Dolores A. Bryla
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Congenital Defects ◽  
Intrauterine Growth ◽  
Appropriate For Gestational Age ◽  
Study Population ◽  
Similar Weight ◽  
Gestational Age At Birth ◽  
Evaluation Techniques

The infant who is small for gestational age (SGA) is more mature at birth than similar weight infants who are appropriate for gestational age (AGA). Whether the SGA infant behaves as does the larger gestationally equivalent infant, or whether there are specific changes related to intrauterine growth retardation is a matter of some interest in the understanding of the special needs of these infants. The National Institute of Child Health and Human Development (NICHD) phototherapy study provided a large newborn population for whom birth weight, gestational age at birth, and, thereby, intrauterine growth were carefully assessed. Infants who weighed 2,000 g or more at birth were included in the study only when they became jaundiced, whereas infants who weighed less than 2,000 g at birth were routinely entered into the study. Consequently, this report will be limited to the lowbirth-weight population selected by birth weight. Too few SGA babies were present in the groups with greater birth weight to allow meaningful comparisons. PATIENT SELECTIQN All infants whose birth weight was less than 2,000 g were entered into the study at 24 ± 12 hours. Those excluded from the study were: (1) infants who died before 24 hours, (2) infants with serious congenital defects, and (3) infants whose mothers refused consent for study. The study population consisted of 922 infants surviving at 24 hours. Gestational age was calculated from the first day of the last menstrual period obtained from maternal history and also by the evaluation techniques of Dubowitz.25 Intrauterine growth was determined by plotting birth weight and gestational age on the Denver Intrauterine Growth Curves8; infants below the 10th percentile were considered SGA.

INFANTS OF LOW BIRTH WEIGHT AMONG 5,000 DELIVERIES

PEDIATRICS ◽  
1964 ◽  
Vol 34 (2) ◽  
pp. 157-162
Author(s):  
Peter Gruenwald
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Perinatal Mortality ◽  
Gestational Age ◽  
Intrauterine Growth ◽  
Normal Standards

Among 5,000 consecutive deliveries there were 536 infants of low birth weight (401-2,500 gm). Those weighing more than 1,000 gm are analyzed according to stated gestational age and normal standards of birth weight for gestational age. The incidence of chronologically mature infants, and of those retarded in intrauterine growth, was determined for infants weighing 1,001-2,000 gm, 1,001-2,250 gm, and 1 001-2,500 gm. Perinatal mortality figures for the various types of infants of low birth weight are given.

scholarly journals Stillbirths - Determining the associated factors and causes according to relevant condition at death: an experience from Pokhara, Nepal

2018 ◽  
Vol 6 (2) ◽  
pp. 58-65
Author(s):  
Junu Shrestha ◽  
Rami Shrestha ◽  
Sonam Gurung
Keyword(s):  
Birth Weight ◽  
Antenatal Care ◽  
Amniotic Fluid ◽  
Gestational Age ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Intrauterine Growth ◽  
Factors Associated ◽  
Relevant Condition ◽  
Cord Prolapse

Background: Stillbirth contributes significantly to perinatal mortality. This study was conducted with aim to determine various factors associated with it and to define the causes of stillbirth according to relevant condition at birth.Materials and Methods :This is prospective cross-sectional study conducted in the Department of Obstetrics and Gynaecology of Manipal Teaching Hospital from July 2015 to June 2017. All cases of stillbirth occurring during antenatal or intrapartum period after 28 weeks of gestation or fetus weighing 1000 grams or more were included. Detailed demographic parameters were noted. After delivery, fetus, placenta, umbilical cord and amniotic fluid were noted in detail. Data was entered in SPSS version 16 and analysis done.Results: The stillbirth rate was 22 per 1000 births. Low educational level of women, lack of antenatal care, multiparous status, gestational age less than 34 weeks, low birth weight and male gender of fetus were found to be significantly associated with stillbirths. The cause of fetal death could be identified according to relevant condition at death in 84% of cases. Only in 16%, the cause of stillbirth was not identified. Intrauterine growth restriction was the commonest cause of stillbirth (22%), followed by congenital anomalies (15%) and hypertensive disorders of pregnancy (14%). Other causes were abruptio (7%), intrapartum asphyxia (7%) and rupture uterus (5%). Other minor causes were anemia, diabetes, cord prolapse and amniotic fluid abnormalities.Conclusion :Low level of education, lack of quality antenatal care, multiparity, low gestational age and birth weight and male sex of fetus were factors associated with stillbirth. The cause of stillbirth was identified in most of the cases and largely was due to intrauterine growth restriction.Journal of Nobel Medical CollegeVolume 6, Number 2, Issue 11, July-December 2017, 58-65

scholarly journals Gestational Age Specific Postnatal Growth Curves for Singleton Babies in Tertiary Hospital of Western Nepal

2017 ◽  
Vol 56 (207) ◽  
pp. 325-330
Author(s):  
Santosh Pathak ◽  
Nagendra Chaudhary ◽  
Prativa Dhakal ◽  
Shyam Kumar Mahato ◽  
Sandeep Shrestha ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Economic Status ◽  
Tertiary Care ◽  
Growth Curves ◽  
Tertiary Hospital ◽  
Care Hospital ◽  
Cross Sectional ◽  
Intrauterine Growth ◽  
Geographical Regions

Introduction: Measurement of birth weight (BW), crown heel length (CHL), head circumference (HC) and chest circumference used to assess the intrauterine growth of a baby vary with altitude, race, gender, socio economic status, maternal size, and maternal diseases. The study aimed to construct centile charts for BW, CHL and HC for new born at different gestational ages in western Nepal. Methods:  This was a descriptive cross sectional study done over a period of 15 months in a tertiary care hospital of western Nepal. BW, length, HC and CC were measured within 12-24 hours of birth. Gestational age was estimated from first day of last menstrual period, maternal ultrasonology and New Ballard’s scoring system. Microsoft 2007 Excel and SPSS-16 was used for data analysis. Cole’s Lambda Mu Sigma method was used for constructing centile curves. Results: Out of 2000 babies analysed, 1910 samples were used to construct smoothed intrauterine growth curve of BW, CHL, and HC from 33-42 weeks of gestation. 57.35% (1147) were male, mean gestational age was 38.13 ±2.44 weeks, where 21.5% were preterm and 1.7% post term. The means of BW, CHL, HC and CC were 2744.78 gm, 47.80 cm, 33.18 cm, and 30.20 cm with standard deviations of 528.29, 3.124, 1.78, and 2.35 respectively. These data vary as compared to the Kathmandu data, in case of birth weight for 10th and 90th centiles, and at 90th centile in case of length. Conclusions: This necessitates the update in the existing growth charts and develop in different geographical regions of a country.

scholarly journals The Presence of the d3-Growth Hormone Receptor Polymorphism Is Negatively Associated with Fetal Growth but Positively Associated with Postnatal Growth in Healthy Subjects

2007 ◽  
Vol 92 (7) ◽  
pp. 2758-2763 ◽  
Author(s):  
Rikke Beck Jensen ◽  
Signe Vielwerth ◽  
Torben Larsen ◽  
Gorm Greisen ◽  
Henrik Leffers ◽  
...  
Keyword(s):  
Birth Weight ◽  
Fetal Growth ◽  
Gestational Age ◽  
Growth Velocity ◽  
Intrauterine Growth Restriction ◽  
Postnatal Growth ◽  
Third Trimester ◽  
Intrauterine Growth ◽  
Prenatal Growth ◽  
Ghr Gene

Abstract Context: A common polymorphism in the GH receptor (GHR) gene has been linked to increased growth response in GH-treated patients. No former study has focused on the association to prenatal growth. Objective: The aim of the study was to evaluate the association between the d3-GHR isoforms and spontaneous pre- and postnatal growth. Design: A prospective study was conducted on third-trimester fetal growth velocity (FGV), birth weight, birth length, and postnatal growth. Setting: The study was conducted at Copenhagen University Hospital. Participants: A total of 115 healthy adolescents were divided into those born small for gestational age (SGA) and appropriate for gestational age with or without intrauterine growth restriction. Main Outcome Measures: FGV was measured by serial ultrasonography, birth weight, birth length, and adolescent height. Isoforms of the d3-GHR gene (fl/fl, d3/fl, and d3/d3) were determined. Results: The prevalence of the d3-GHR isoforms was 50% but differed among the groups (P = 0.006), with a high prevalence (88%) in the group born SGA with verified intrauterine growth restriction. The d3-GRH allele were associated with decreased third-trimester FGV (P = 0.05) in SGA subjects. In the entire cohort, carriers of the d3-GHR allele had a significantly increased height (−0.10 vs. 0.34 sd score; P = 0.017) and change in height from birth to adolescence compared with carriers of the full-length GHR allele (0.57 vs. −0.02 sd score; P = 0.005). Conclusions: This study showed an increased spontaneous postnatal growth velocity in the carriers of the d3-GHR allele. Interestingly, we found the opposite effect on prenatal growth in the SGA group, with a decreased FGV in carriers of the d3-GHR allele.

Necrotizing Enterocolitis in the First 24 Hours of Life

PEDIATRICS ◽  
1984 ◽  
Vol 73 (4) ◽  
pp. 476-480 ◽  
Author(s):  
Elizabeth H. Thilo ◽  
Raul A. Lazarte ◽  
Jacinto A. Hernandez
Keyword(s):  
Birth Weight ◽  
Necrotizing Enterocolitis ◽  
Gestational Age ◽  
Surgical Intervention ◽  
Term Infants ◽  
Large Size ◽  
Disease Occurrence ◽  
Near Term ◽  
Degree Of Maturity ◽  
Minute Apgar Score

Necrotizing enterocolitis (NEC) is commonly thought of as occuring in the sick premature infant, usually in the first one to two weeks of life. A review of NEC at the Children's Hospital of Denver over a 5-year period, found that 13 of 79 infants (16.1%) had onset of NEC during the first day of life. These infants were larger (mean birth weight 2,624 ± 849 g), more mature (mean gestational age 37.9 ± 2.5 weeks), and less asphyxiated as judged by Apgar scores (mean five-minute score 8.15 ± 1.07) than infants with onset of NEC after the first day of life (mean birth weight 1,519 ± 586 g, mean gestational age 32.0 ± 3.5 weeks, P < .001, and mean five-minute Apgar score 6.81 ± 1.84, P < .05). Despite their large size and degree of maturity, eight of these infants (62%) showed signs of respiratory distress; four (31%) were polycythemic; four (31%) had either a partial or double-volume exchange transfusion performed; and 11 (85%) were fed prior to developing NEC. Presenting signs of disease, occurrence of sepsis (31%), requirement for surgical intervention (62%), and mortality (30%) were similar for the two groups of infants. It is suggested that term and near-term infants who have significant illness after delivery be treated more like their premature counterparts with cautious introduction of feedings after an adequate period of stabilization.

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