Comparison of Fenton Versus Intergrowth-21 Growth Charts for Preterm Neonates

2021 ◽  
Vol 35 (3) ◽  
pp. 131-137
Author(s):  
Dipen Vasudev Patel ◽  
Vaishali Upadhyay ◽  
Ajay G. Phatak ◽  
Biraj Thakker ◽  
Somashekhar M. Nimbalkar
Keyword(s):  
Growth Parameters ◽  
Preterm Neonates ◽  
Growth Charts ◽  
Anthropometric Parameters ◽  
Z Scores ◽  
Gestational Age At Birth ◽  
Developed World ◽  
Diverse Nations ◽  
Preterm Newborns

Background: Fenton charts from developed world are commonly used for growth assessment of preterm newborns. Recently prescribed Intergrowth-21 (IG-21) charts look more promising as they include mixed population from economically diverse nations. Objective: We compared IG-21 with Fenton charts for birth size classification and extrauterine growth in preterm infants. Study design: A prospective collection of growth parameters. Participants: Preterm newborns (<37 weeks). Intervention: Weight (W), length (L), and head circumference (HC) were collected at weekly interval during the stay as well as follow-up. Outcomes: Growth of preterm newborns at birth and last follow-up was assessed using Fenton and IG-21 charts. Agreement between Fenton and IG-21 for percentiles and z-scores of growth parameters was assessed using Bland-Altman plot. Results: A total of 301 preterm newborns were enrolled in the study. Mean (standard deviation [SD]) gestational age at birth was 34.08 (1.84) weeks, while at last follow-up (N = 296) it was 37.62 (1.85) weeks. The mean (SD) of birth W, L, and HC were 1889.24 (418.9) g, 44.69 (3.03) cm, and 30.6 (1.84) cm, respectively, while for last follow-up, they were 2114.76 (397.7) g, 47.64 (2.97) cm, and 32.65 (1.7) cm, respectively. The agreement of z-score/percentile between the 2 growth charts was not good for all the anthropometric parameters. Overall, Fenton reported more intrauterine (42.9% vs 36.9%) and extrauterine (92.9% vs 73%) growth restriction as compared to IG-21. Conclusion: The agreement between the 2 charts was poor. More proportions of the preterm population were growth restricted using Fenton charts.

scholarly journals Is there an association between thyrotropin levels within the normal range and birth growth parameters in full-term newborns?

2018 ◽  
Vol 31 (9) ◽  
pp. 1001-1007
Author(s):  
Pantea Nazeri ◽  
Mamak Shariat ◽  
Yadollah Mehrabi ◽  
Parvin Mirmiran ◽  
Fereidoun Azizi
Keyword(s):  
Birth Weight ◽  
Growth Parameters ◽  
Full Term ◽  
World Health ◽  
Normal Range ◽  
Anthropometric Parameters ◽  
Cross Sectional ◽  
Z Scores ◽  
Term Newborns ◽  
Weight For Age

AbstractBackgroundIt has been suggested that thyroid hormone concentration at birth may have some role in regulating foetal growth. The aim of this study was to provide seminal data regarding any association between thyrotropin (TSH) concentration within the normal range and growth parameters at birth in full-term newborns.MethodsIn this cross-sectional study conducted in Tehran, Iran, 314 mother-newborn pairs were randomly selected from health care centres responsible for congenital hypothyroidism screening. Neonatal TSH concentration was measured using a heel-prick blood sample taken from all neonates 3–5 days after birth, as part of the routine neonate screening. Anthropometrics, including birth weight, length and head circumference were obtained from the birth record of each neonate. The z-score values for weight-for-age, weight-for-length, length-for-age and head-for-age were calculated using the World Health Organisation growth standards.ResultsThe median interquartile range neonatal TSH values were 0.9 mIU/L (0.4–1.7 mIU/L). Neonates in the top tertile of TSH values had higher birth weights and weight-for-age z-scores than those in the bottom tertile (p<0.05). In addition, neonatal TSH was associated with weight-for-age z-scores in unadjusted (β=0.113, p=0.020) and adjusted (β=0.122, p=0.013) analysis. However, in both unadjusted and adjusted analysis, no association was observed between TSH concentrations of neonates and weight-for-length, length-for-age and head-for-age z-scores.ConclusionsOur findings indicate a positive association between the normal range of neonatal screening TSH concentration and birth weight; however, this association was not observed for other anthropometric parameters at birth.

scholarly journals The effect of routine probiotics supplementation on preterm newborn health: a regression discontinuity analysis

2020 ◽  
Vol 112 (5) ◽  
pp. 1219-1227 ◽  
Author(s):  
Christian Bommer ◽  
Sebastian Horn ◽  
Sebastian Vollmer
Keyword(s):  
Regression Discontinuity ◽  
Late Onset ◽  
Preterm Neonates ◽  
Preterm Newborn ◽  
Late Onset Sepsis ◽  
Z Scores ◽  
Moderately Preterm ◽  
Preterm Newborns ◽  
Height For Age ◽  
Weight For Age

ABSTRACT Background Despite ongoing debate about the health impact of probiotics, rigorous evidence assessing the use of probiotics in routine preterm newborn care is lacking. Objectives We aimed to estimate the causal effect of routine probiotics supplementation on moderately preterm newborns’ anthropometric development (weight-for-age and height-for-age z scores) and risk of late-onset sepsis. Methods This study used a regression discontinuity analysis based on hospital guidelines that recommended routine probiotics supplementation for neonates born before 34 completed weeks of gestation. Data for this study came from electronic medical records of a level III neonatal care center in Germany and were collected between 2013 and 2019. Newborns born between 30 to 38 completed weeks of gestation without severe congenital defects were eligible for inclusion. Outcomes were weight-for-age and height-for-age z scores at discharge as well as late-onset sepsis. Results Study participants included 1734 preterm neonates. The results showed no significant intention-to-treat effect on weight-for-age (effect: −0.033 SD; 95% CI: −0.220, 0.155), length-for-age (−0.133 SD; 95% CI: −0.380, 0.114), or late-onset sepsis probability (−1.175 percentage points; 95% CI: −6.556, 4.205). There was no evidence for significant effects of probiotics for any of the study's endpoints on those complying with the hospital guidelines (local average treatment effect). Conclusions Routine treatment of moderately preterm newborns with probiotics is unlikely to improve anthropometric outcomes. Complier-level analysis suggested that this finding was not simply driven by a lack of physician compliance with hospital guidelines but by an overall absence of large health effects from the treatment itself. Moreover, overall sepsis risk was low and did not change significantly as a result of probiotics supplementation. The findings of this study therefore do not support the routine use of probiotics for improving growth or preventing late-onset sepsis in moderately preterm neonates.

scholarly journals Early surgical management and long-term surgical outcome for intraventricular hemorrhage–related posthemorrhagic hydrocephalus in shunt-treated premature infants

2018 ◽  
Vol 22 (1) ◽  
pp. 61-67 ◽  
Author(s):  
Hans Christoph Bock ◽  
Jacqueline Feldmann ◽  
Hans Christoph Ludwig
Keyword(s):  
Surgical Outcome ◽  
Shunt Revision ◽  
Preterm Neonates ◽  
Shunt Insertion ◽  
Posthemorrhagic Hydrocephalus ◽  
The Mean ◽  
Shunt Survival ◽  
Preterm Newborns

OBJECTIVEPerinatal intraventricular hemorrhage (IVH) in premature neonates may lead to severe neurological disability and lifelong treatment requirement for consecutive posthemorrhagic hydrocephalus (PHHC). Early CSF diversion as a temporizing measure, or a permanent ventriculoperitoneal shunt (VPS), is the treatment of choice. Preterm neonates are not only at high risk for different perinatal but also for treatment-related complications. The authors reviewed their institutional neurosurgical management for preterm neonates with IVH-related PHHC and evaluated shunt-related surgical outcome for this particular hydrocephalus etiology after completion of a defined follow-up period of 5 years after initial shunt insertion.METHODSThe authors retrospectively analyzed early surgical management for preterm newborns who presented with IVH and PHHC between 1995 and 2015. According to the guidelines, patients received implantation of a ventricular access device (VAD) for temporizing measures or direct VPS insertion as first-line surgical treatment. Surgical outcome was evaluated for a subgroup of 72 patients regarding time to first shunt revision and the mean number of shunt revisions during a time span of 5 years after initial shunt insertion. Gestational age (GA), extent of IVH, and timing and modality of initial surgical intervention were analyzed for potential impact on corresponding surgical outcome.RESULTSA total cohort of 99 preterm newborns with GAs ranging from 22 to 36 weeks (mean 28.3 weeks) with perinatal IVH-related PHHC and a median follow-up duration of 9.9 years postpartum could be selected for further investigation. Extent of perinatal IVH was defined as grade III or as periventricular hemorrhagic infarction in 75% of the patient cohort. Seventy-six patients (77%) underwent VAD insertion and temporizing measures as initial surgical treatment; for 72 (95%) of these a later conversion to permanent ventriculoperitoneal shunting was performed, and 23 patients received direct VPS insertion. Etiological and treatment-related variables revealed no significant impact on revision-free shunt survival but increased the mean numbers of shunt revisions after 5 years for low GA, higher-order IVH in the long term.CONCLUSIONSLow GA and higher-order IVH in preterm neonates with PHHC who are treated with VPSs show no significant impact on time to first shunt revision (i.e., revision-free shunt survival), but marked differences in mean revision rates evaluated after completion of 5 years of follow-up. Temporizing measures via a VAD represent a rational strategy to gain time and decision guidance in preterm patients with PHHC before permanent VPS insertion.

scholarly journals Factors associated with preterm birth at Wachemo University Nigist Eleni Mohammed memorial hospital, southern Ethiopia: case-control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Negeso Gebeyehu Gejo ◽  
Melaku Tesfaye W/mariam ◽  
Biruk Assefa Kebede ◽  
Ritbano Ahmed Abdo ◽  
Abebe Alemu Anshebo ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Antenatal Care ◽  
Medical Records ◽  
Case Control Study ◽  
Southern Ethiopia ◽  
Preterm Neonates ◽  
Factors Associated ◽  
Induced Hypertension ◽  
Control Study

Abstract Background Preterm birth is defined as the birth of a baby before 37 completed weeks of gestation. Worldwide, prematurity is the second foremost cause of death in children under the age of 5 years. Preterm birth also gives rise to short and long term complications. Therefore, the primary aim of this study was to identify the factors associated with preterm birth in Wachemo University Nigist Eleni Mohammed Memorial referral hospital, Hadiya Zone, Southern Ethiopia. Methods An institution-based unmatched case-control study was conducted from July 01, 2018 to June 30, 2019 among mothers who gave birth in Wachemo University Nigest Eleni Mohammed Memorial referral hospital. A retrospective one-year data was retrieved from medical records of mothers with their index neonates. Simple random sampling technique was employed to recruit study participants. SPSS version 20 software was used for data entry and computing statistical analysis. Both bivariable and multivariable logistic regression analyses were used to determine the association of each independent variable with the dependent variable. Odds ratio with their 95% confidence intervals was computed to identify the presence and strength of association, and statistical significance was affirmed if p < 0.05. Result The current study evaluated 213 medical records of mothers with index neonates (71 cases and 142 controls). Urban residency [AOR = 0.48; 95% Cl; 0.239, 0.962], antenatal care follow up [AOR = 0.08; 95 Cl; 0.008, 0.694], premature rupture of membranes [AOR = 3.78; 95% Cl; 1.467, 9.749], pregnancy induced hypertension [AOR = 3.77; 95% Cl; 1.408, 10.147] and multiple pregnancies [AOR = 5.53; 95% Cl; 2.467, 12.412] were the factors associated with preterm birth. More than one-third (36.6%) preterm neonates died in the present study. Conclusions The present study found that urban residency, antenatal care follow up, premature rupture of membranes, pregnancy induced hypertension and multiple pregnancies were factors associated with preterm birth. The mortality among preterm neonates is high. Enhancing antenatal care follow up and early detection and treatment of disorders among pregnant women during antenatal care and undertaking every effort to improve outcomes of preterm birth and reduce neonatal mortality associated with prematurity is decisive.

scholarly journals Bone mineral density and explanatory factors in children and adults with juvenile dermatomyositis at long term follow-up; a cross sectional study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Henriette Schermacher Marstein ◽  
Kristin Godang ◽  
Berit Flatø ◽  
Ivar Sjaastad ◽  
Jens Bollerslev ◽  
...  
Keyword(s):  
Bone Turnover ◽  
Inflammatory Markers ◽  
Juvenile Dermatomyositis ◽  
Inflammatory Myopathy ◽  
Disease Onset ◽  
Whole Body ◽  
Mineral Density ◽  
Z Scores

Abstract Background Juvenile dermatomyositis (JDM) is the most common idiopathic inflammatory myopathy in children and adolescents. Both the disease and its treatment with glucocorticoids may negatively impact bone formation. In this study we compare BMD in patients (children/adolescence and adults) with long-standing JDM with matched controls; and in patients, explore how general/disease characteristics and bone turnover markers are associated with BMD. Methods JDM patients (n = 59) were examined median 16.8y (range 6.6–27.0y) after disease onset and compared with 59 age/sex-matched controls. Dual-energy X-ray absorptiometry (DXA) was used to measure BMD of the whole body and lumbar spine (spine) in all participants, and of ultra-distal radius, forearm and total hip in participants ≥20y only. Markers of bone turnover were analysed, and associations with outcomes explored. Results Reduced BMD Z-scores (<−1SD) were found in 19 and 29% of patients and 7 and 9% of controls in whole body and spine, respectively (p-values < 0.05). BMD and BMD Z-scores for whole body and spine were lower in all patients and for < 20y compared with their respective controls. In participants ≥20y, only BMD and BMD Z-score of forearm were lower in the patients versus controls. In patients, BMD Z-scores for whole body and/or spine were found to correlate negatively with prednisolone use at follow-up (yes/no) (age < 20y), inflammatory markers (age ≥ 20y) and levels of interferon gamma-induced protein 10 (IP-10) (both age groups). In all patients, prednisolone use at follow-up (yes/no) and age ≥ 20y were independent correlates of lower BMD Z-scores for whole body and spine, respectively. Conclusion In long-term JDM, children have more impairment of BMD than adults in spine and whole-body. Associations with BMD were found for both prednisolone and inflammatory markers, and a novel association was discovered with the biomarker of JDM activity, IP-10.

scholarly journals „Z”-scores of anthropometric and motor parameters of girls in aerobic gymnastics

2014 ◽  
Vol 61 (2) ◽  
pp. 55-58
Author(s):  
M. Tibenská ◽  
H. Medeková
Keyword(s):  
Body Weight ◽  
Body Height ◽  
Sport Performance ◽  
Z Score ◽  
Anthropometric Parameters ◽  
Percentage Of Body Fat ◽  
Standing Long Jump ◽  
Z Scores ◽  
Long Jump ◽  
Shuttle Run

Abstract This study presents the evaluation of chosen anthropometric and motor parameters in group of female junior competitors throughout the course of 2-year preparation of aerobic gymnastics by means of Z-scores. The observed group consisted of 12 girls (average age at the beginning of observance 14.08 ± 1.19 years). Evaluation of anthropometric (body height, body weight, body mass index, percentage of body fat, acting body weight) and motor parameters (sit-ups in 30 seconds and 60 seconds, pull-ups to bar, modified push-ups, standing long jump, backwards tandem walking, shuttle run 4×10 m, Jacík’s test) was carried out in standard conditions in nine girls at 3-month intervals. It has been confirmed that female probands with higher Z-score of motor parameters together with lower Z-score of anthropometric parameters achieved higher sport performance during the 2-year observance at competitions, with an exception of one such proband.

GROWTH OF NEGRO PREMATURE INFANTS

PEDIATRICS ◽  
1959 ◽  
Vol 24 (1) ◽  
pp. 13-22
Author(s):  
Flora F. Cherry ◽  
Huldah Bancroft ◽  
William T. Newsom
Keyword(s):  
Birth Weight ◽  
Premature Infants ◽  
Growth Charts ◽  
Tabular Form ◽  
Follow Up Care ◽  
Males And Females

A series of measurements of weight, length, head, and chest circumferences in Negro prematures from birth through 1 year of age has been presented. All cases were managed by standardized hospital and follow-up care routines. The data are presented in tabular form for males and females in two birth weight categories—1,001 to 1,500 gm and 1,501 to 2,000 gm. In the graphic presentations, sexes were considered together because differences were small. The growth charts depict usual ranges and limits encountered in weights, lengths, and head circumferences. Head and chest measurements are also compared. It is felt that this material will be useful to clinicians following the progress of individual premature infants.

MRI IN HYPOXIC ISCHEMIC ENCEPHALOPATHY WITH CLINICAL FOLLOW UP

2021 ◽  
pp. 43-48
Author(s):  
M R Shashikumar ◽  
Narasipur Lingaiah Rajendrakumar ◽  
Sanjay P ◽  
Nanjaraj Chakenalli Puttaraj ◽  
Shruti Shruti ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Mr Imaging ◽  
Developmental Disorders ◽  
Brain Mri ◽  
Birth Asphyxia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Preterm Neonates ◽  
Diffusion Restriction ◽  
Ischemic Encephalopathy

Introduction: HIE is often clinically suspected in the setting of a known perinatal stress event arising from a complicated or difcult delivery. The most sensitive and specic imaging technique for examining infants with suspected hypoxicischemic brain injury is MR imaging. It also gives information about the timing and specic patterns of injury and also suggest diagnoses other than HIE such as metabolic disorders and developmental disorders of the brain. MRI is also a useful tool in the determination of prognosis and also follow-up of HIE. Aim: This study was undertaken to evaluate the various MRI appearances of hypoxic ischemic encephalopathy in term and preterm neonates and to correlate the MRI appearances with clinical outcome. Materials and Methods: All neonates with history of birth asphyxia, referred for MRI examination to the Department of Radio-Diagnosis, K. R. Hospital attached to Mysore Medical College and Research Institute, during January 2018 to January 2019. All MRI scans were performed on GE optima MR360 1.5 Tesla. Sequences used were T1W axial, T1 FLAIR axial, T2W axial, T2 FLAIR axial, T1W sag, T2W coronal, T2W GRE axial, DWI axial and ADC maps. Results: 30 babies with clinically suspicion of HIE and positive ndings on MR imaging were evaluated in our study. Out of 30 babies, 18 were term and 12 babies were preterm. Periventricular luecomalacia is most common MRI pattern in preterm and central pattern in term neonates. 16 babies had abnormal developmental outcome at 6 months follow up study. 16 babies with diffusion restriction in corpus callosum, 12 had abnormal outcome. 7 out of 10 babies with loss of normal signal in internal capsule had abnormal outcome. Babies with diffusion restriction in basal ganglia had gross developmental delay. Conclusion: MRI is the modality of choice for evaluation of HIE because of excellent gray – white matter resolution, well-depiction of myelination pattern and multi-planar imaging capabilities. There is a strong relation between the MRI appearances of birth asphyxia and the clinical outcome. Therefore MRI has a strong role in prognosticating lesions.

scholarly journals Association of Whole Blood Fatty Acids and Growth in Southern Ghanaian Children 2–6 Years of Age

Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 954 ◽  
Author(s):  
Mary Adjepong ◽  
William Yakah ◽  
William Harris ◽  
Esi Colecraft ◽  
Grace Marquis ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Growth Parameters ◽  
Dietary Fatty Acids ◽  
Northern Ghana ◽  
Z Score ◽  
Omega 3 ◽  
Omega 6 ◽  
Z Scores ◽  
Height For Age ◽  
Weight For Age

In Ghana, stunting rates in children below 5 years of age vary regionally. Dietary fatty acids (FAs) are crucial for linear growth. The objective of this study was to determine the association between blood FAs and growth parameters in southern Ghanaian children 2–6 years of age. A drop of blood was collected on an antioxidant treated card and analyzed for FA composition. Weight and height were measured and z-scores calculated. Relationships between FAs and growth were analyzed by linear regressions and factor analysis. Of the 209 subjects, 22% were stunted and 10.6% were essential FA deficient (triene/tetraene ratio > 0.02). Essential FA did not differ between stunted and non-stunted children and was not associated with height-for-age z-score or weight-for-age z-score. Similarly, no relationships between other blood fatty acids and growth parameters were observed in this population. However, when blood fatty acid levels in these children were compared to previously reported values from northern Ghana, the analysis showed that blood omega-3 FA levels were significantly higher and omega-6 FA levels lower in the southern Ghanaian children (p < 0.001). Fish and seafood consumption in this southern cohort was high and could account for the lower stunting rates observed in these children compared to other regions.

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