WEIGHT AND LENGTH AT BIRTH OF INFANTS OF DIABETIC MOTHERS

1955 ◽  
Vol 18 (4) ◽  
pp. 553-554 ◽  
Author(s):  
Jørgen Pedersen
Keyword(s):  
Birth Weight ◽  
Blood Sugar ◽  
Inverse Correlation ◽  
Glucose Consumption ◽  
Maternal Blood ◽  
Control Group ◽  
Average Weight ◽  
Turn Over ◽  
Diabetic Mothers

SUMMARY Birth weight and length of 122 surviving babies of diabetics, born in Rigshospitalet, Copenhagen 1926–1947, was compared to a control group of 122 infants of non-diabetics (matched controls). The groups were comparable, especially as to foetal age and parity of the mother, severe complications in the mothers, etc. The average foetal age was 261 days (range 237–301). The average weight and length for the infants of non-diab. controls was 3045 gm. and 49.5 cm., for infants of diabetics 3600 gm. and 51.0 cm. Thus on average infants of diabetics weigh 550 gm. more and are 1.5 cm. longer than are infants of non-diab. Differences of the same magnitude were found in primiparae and in multiparae with and without obesity. The frequency distribution curves for weight and length are nearly normal, but placed at higher levels than are those of non-diab. infants. Diabetics get big and small infants as others, but the whole population is bigger than that of non-diabetics' infants. There is an actual overgrowth. In a personal series from 1946–1953 75 infants of long-term treated (1. t.) were compared to 91 infants of short-term treated (sh. t.) diabetics. The foetal age was 237 days or more, on average 260 days. Average weight and length for 1. t. infants was 3380 gm. and 50.5 cm., for sh. t. 3570 gm. and 51.3 cm. Thus the 1. t. infants on average weighed 190 gm. less and were 0.8 cm. shorter than sh. t. infants. So far these differences are not statistically significant, but an inverse correlation between the length of the last consecutive stay of the mother in Department B and the infants' weight and length could be demon I. Published in extenso in Acta endocrinol. 16, 330, 1954. strated. As the length of stay increases, weight and length decreases. This indicates the differences found to be due to the length of our treatment. As there is a positive correlation between the maternal pregnancy level of blood sugar (foetal glucose supply) during the last 6–7 weeks of pregnancy and the birth weight and length of infants of non-diabetic controls, 1. t. and sh. t. diabetics, the maternal pregnancy level may play a part of its own for the differences found in weight and length of the infants in these 3 groups. The maternal blood sugar level may influence weight and length of the infants directly (foetal glucose consumption) but also indirectly (foetal insulin turn-over rising with a rising supply of glucose), as foetal insulin may act as a growth stimulating factor.

scholarly journals Effects of nano mineral-supplemented diet on sow productivity

2019 ◽  
Vol 41 (4) ◽  
Author(s):  
Hoang Nghia Son
Keyword(s):  
Birth Weight ◽  
Reproductive Performance ◽  
Metal Content ◽  
Mineral Content ◽  
Control Group ◽  
Average Weight ◽  
Group Iii ◽  
Newborn Piglets ◽  
Group I ◽  
Significant Difference

This study aimed to evaluate the effects of nano mineral-supplemented diet on sow productivity. The data were estimated by several parameters consisting of piglet live ratio at newborn stage and weaning stage, piglet weight at newborn stage and weaning stage, metal content in piglet livers. The results showed that live ratio of newborn piglets in group III was highest (93.44 ± 2.83%) comparing with other groups. However, there was no significant difference of live ratio in piglets at weaning stage between nano mineral-supplemented groups with control. The birth weight of piglets in nano mineral-supplemented groups was similar to control group. The birth weight of piglets in nano mineral-supplemented groups was ranged from 1,361.61 ± 47.37 grams (group II) to 1,410.48 ± 44.28 grams (group I). However, the average weight of weaned pigs in groups III and IV was higher than other groups (6,772.92 ± 105.47 grams and 6,818.87 ± 89.59 grams). Moreover, the amount of Fe, Cu, Zn, Mn in piglet liver from nano mineral-supplemented groups have been found to be lower than those in control group. These results revealed that the supplement of nano minerals for sows promoted the reproductive performance of sows and reduced mineral content in the liver of piglets. 

scholarly journals Influence of glucose homeostasis on maturation and ontogenesis of fetus

2011 ◽  
Vol 64 (11-12) ◽  
pp. 552-556
Author(s):  
Ivan Hrabovski ◽  
Ljubomir Milasnovic ◽  
Zorica Grujic ◽  
Ilija Grujic
Keyword(s):  
Body Weight ◽  
Glucose Homeostasis ◽  
Body Height ◽  
Control Group ◽  
Average Weight ◽  
Microbiological Analysis ◽  
Respiratory Disorders ◽  
Group I ◽  
Brain Ultrasound ◽  
Diabetic Mothers

Introduction. The aim of the paper is to examine the incidence and the rate of cardio respiratory disorders in mothers of newborns with diabetes mellitus in pregnancy as well as their influence on the perinatal outcome. Material and methods. A prospective and random study included 102 newborns, 31 newborns of mothers with glucose homeostasis disorder (group I) and 71 newborns of healthy mothers (group II). The average age, body height, body weight, body mass index, parity and illness duration of the pregnant women were recorded as well as the delivery method. Every newborn underwent physical examination in order to determine the Apgar score, body weight and length. Electrocardiogram, brain ultrasound and the basic hematology biochemical and microbiological analysis were done as well. Results. The average weight and obesity incidence were higher in diabetic women than in the control group and their newborns were heavier and of lower gestational age.Heart failures were diagnosed in 5 (1612%) newborns of diabetic mothers and in 1 (1.4%) of a healthy pregnant woman (p<0.01). Respiratory disorders were diagnosed in 48.4% of newborns of diabetic mothers and 12.64% of healthy mothers (p<0.01). Additional oxygen was needed by 42% of newborns of diabetic mothers and 19.7% of newborns of healthy mothers. Conclusion. Congenital anomalies of cardiovascular system and respiratory disorders were 6-8 times more frequent in newborns of diabetic mothers than in newborns of healthy mothers.

scholarly journals GROWTH, NEURODEVELOPMENT IN EXTREMELY LOWBIRTH BABIES AT TWO YEAR OF CORRECTED AGE

2019 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr. Ashok Kumar ◽  
Dr. Kanya Mukhopadhyay ◽  
Dr. Prabhjot Malhi ◽  
Dr. Anil Kumar Bhalla
Keyword(s):  
Birth Weight ◽  
Neurological Examination ◽  
Gestational Age ◽  
Head Circumference ◽  
Control Group ◽  
Case Group ◽  
Significant Difference ◽  
Catch Up

According to national neonatal perinatal data (NNPD) the survival of ELBW babies has improved from 37% in 2000 to 45% in 2002-3 reports. In our neonatal unit in PGIMER the survival of ELBW babies has been 54-56% in last 5 years, however unfortunately there is very scanty reports of long term outcome of ELBW babies from India. There is very scanty report of long term growth outcome of VLBW and ELBW Babies in our country, we reported VLBW and ELBW babies in our follow up had poor catch up growth, though some catch-up was observed at 6 month but subsequent lag in growth probably reflects poor weaning at 1 year.  Infants with extremely low birth weights (ELBWs) are more susceptible to all of the possible complications of premature birth, both in the immediate neonatal period and after discharge from the nursery. These babies are at risk of poor growth and developmental. in the present study a total of 39 cases of ELBW Babies were enrolled during one year study period from July 2011- June2012 attending the neonatal follow up clinic attained 2year±3month of corrected age. Their detail birth data and postnatal illnesses retrieved from their initial hospital files and unit discharge record. A similar number of babies enrolled at 2yrs±3months of age in the control group. In the presence study, we assessed the growth, and neurological out come in extremely low birth baby attained 2yrs±3 months of corrected age. The study population consisted of 39 children of ELBW baby born during 2009 -10 at PGIMER & same number of normal birth weight children at 2yr±3 months of corrected age who satisfied the inclusion and exclusion criteria. These children were enrolled from neonatal follow up clinic who were already undergoing long term follow up. For growth outcome, we used weight, height & head circumference measurement of child, for neurological and developmental outcome used clinical neurological examination and DP-III .Base line demographic characteristics of our ELBW babies (Cases) where as follows.   Mean (S.D) gestational age of  ELBW babies was 29.87±2.3 week. Mean (S.D) birth weight 867±71.1 grams, Mean (S.D) lenght35±2.1cm & head circumference was 25.76±1.9 cm. Mean hospital stay in the ELBW babies was 48.6±19.9 days. Mean birth weight and gestational age of control group where 2684±166.2grm and 39.03±0.9 weeks. At 2year of corrected age we found  - Weight was similar in both in case group & control group. (10.04±1.4 Vs 10.75±1.1). Height and head circumference were smaller in cases than control group. (81.4±4.3 Vs 84.4±3.3 and 45.9±1.6 Vs 46.8±1.5. 5% Babies had cerebral palsy in case group (N=2/39) and none in control group. Gross development score(GDS) in Development profile-III in both study group (cases & controls) was  similar  (72.49±8.08 Vs 73.54±9.3,p=0.596). Significant difference in domains physical (84.5±7.8 Vs.90±3.5, p=0.000) and domains adaptive (81±6.7 Vs. 85.3±5.4,p= 0.003) in cases as compared to controls. There was no difference between SGA and AGA among cases in growth and neurological development. There was no difference between male and female in case group in any parameter .There is very scanty data from our country on longterm follow up of ELBW babies. Our data shows that our ELBW cohort remained small in height and had smaller head circumference though weight was similar as compared to normal control babies.  Key words: ELBW, VLBW, birth weight, neurological examination.

scholarly journals STUDY OF MORPHOLOGY AND HISTOLOGY OF PLACENTA AND ITS CORRELATION WITH MATERNAL PARAMETERS AND BIRTH WEIGHT OF NEWBORN IN ANAEMIC MOTHERS

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Nisha Gajbhiye ◽  
Sachin Gajbhiye
Keyword(s):  
Birth Weight ◽  
Maternal Blood ◽  
Placental Weight ◽  
Control Group ◽  
Study Group ◽  
Cross Sectional ◽  
Medical College ◽  
Accessory Lobe ◽  
Placental Volume ◽  
Placental Thickness

Abstract: The aim of this study was to determine whether maternal anaemia [Hb <11gm/dl]would affect the morphology  and histology of placenta and and  correlate it with maternal parameters and birth weight of newborn and compare this with that of non-anaemic mothers. It was a cross-sectional comparative study carried out at the maternity ward and anatomy department of NSCB MEDICAL COLLEGE JABALPUR.  Background & Method: Background & Method: The study was carried out on 100 placentae, mothers and their babies. The placenta was collected from Obstetrics and Gynaecology, Department of NSCB Medical College, Jabalpur. Out of 100 placentae 50 from anaemic and 50 from NON anaemic mothers.  As soon as the placenta was delivered, the umblical cord was cut it was put into formal saline. It was kept in a tray, to the membranes were trimmed off cord was cut about 10 cm from the insertion. The blood clots adherent to maternal surface were picked up. Morphological parameters like placental weight, volume. diameter, thickness, no of cotyledons were measured .Any abnormality like calcification, accessory lobe, haematoma, etc were noted. histological slides were made and stained with H and stain and Masson’s Trichrome stain. Result: A Macroscopic study of the placenta revealed placental weight, placental volume, diameter, placental thickness were more than non anaemic group and number of cotyledons were less in study group. Mean placental weight in study group was 474gm and in control group was 425 (p<0.05). Mean placental volume in study group & control group were 393.23and352 ml respectively (p<0.05). Mean number of cotyledons were 13.24and 16 in study & control group significant[p<0.05] and mean diameter 18.30cms and17.05cms in study and control group. Mean placental thickness 2.4cms in study and 2.1 in control group respectively. There was an accessory lobe present in one patient of anaemic group. All morphometric parameters of placenta weight, volume, diameter, thickness were increased ,no of cotyledons were reduced .Histological findings were placental tissues shows intense congestion of septal capillaries.In the present study age, parity, height, weight, built, doesn’t found to be related with morphology of placenta. Maternal blood Hb found to be +vely correlated with weight, volume, diameter, thickness and –vely correlated with no of cotyledons and birth weight of baby. Conclusion: From the study it is concluded anaemia in pregnancy affects morphology and histology of placenta and it is correlated with various maternal parameters and birth weight of baby. Keywords: morphology, histology, placenta, anaemia, birth weight & mothers.

scholarly journals Gestational Diabetes Mellitus: Impact of Maternal Blood Sugar Level and BMI on Foetal Birth Weight

2019 ◽  
Vol 4 (02) ◽  
Author(s):  
Dr. Bipul Prasad Deka ◽  
Dr. Dimpy Begum
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Fasting Blood Glucose ◽  
Maternal Blood ◽  
Overweight And Obesity ◽  
Medical College ◽  
Control Study ◽  
Diabetic Mothers

Gestational diabetes mellitus (GDM) is defined as glucose intolerance of variable degrees with an onset, or first recognized, during pregnancy. About 15-45% of babies born to diabetic mothers can have macrosomia. This prospective case control study was conducted in the department of Obstetrics and Gynaecology of Gauhati medical college and hospital, Guwahati, Assam during the period of 2013-2015. A total of 160 patients were included in the study. 100 patients without any glucose abnormality were taken as control and 60 patients with gestational diabetes mellitus were included in the study as cases. In this study it was found that mean birth weight in GDM cases is more than normoglycemic control. The overweight and obesity group (BMI>25) have maximum birth weight. In this study it was found that the fasting blood glucose level is maximum in mothers with baby birth weight >3.5 kg.

ASPECTS OF CARBOHYDRATE METABOLISM IN NEWBORN INFANTS OF DIABETIC MOTHERS. I

1972 ◽  
Vol 69 (1) ◽  
pp. 174-188 ◽  
Author(s):  
Lars Mølsted-Pedersen
Keyword(s):  
Birth Weight ◽  
Glucose Tolerance ◽  
Linear Regression Analysis ◽  
Newborn Infants ◽  
Maternal Blood ◽  
Intravenous Glucose ◽  
K Value ◽  
Positive Correlation ◽  
The Mean ◽  
Diabetic Mothers

ABSTRACT Glucose tolerance, in terms of the K value (disappearance rate of glucose) during intravenous glucose tolerance tests, was determined in 50 infants of diabetic and 60 infants of non-diabetic mothers 1–6 hours after birth. Newborn infants of insulin-treated diabetic women had a mean K value of 2.18, infants of non-insulin-treated diabetics 1.20, and infants of non-diabetic mothers 0.99. The mean K value in infants of insulin-treated diabetic mothers was significantly higher than in the other two groups. In infants of non-insulin-treated diabetic mothers the mean K value tends to be higher than in the normal group, but the difference was not significant. In infants of insulin-treated diabetic mothers there was a negative correlation between the K value and fasting plasma level of glucose 3 hours after birth. Linear regression analysis of the birth weight against the K value showed a positive correlation between these quantities in the infants of normal and of non-insulin-treated diabetic mothers. In the infants of insulin-treated diabetic mothers the significant positive correlation between K value and birth weight was less marked. The positive correlation between K value and birth weight might indicate that a growth impulse acts through the foetal glucose-insulin system. This growth impulse, present in all infants, might be caused by the maternal blood sugar level during pregnancy.

scholarly journals Greater Attendance at a Community Weight Loss Programme over the First 12 Weeks Predicts Weight Loss at 2 Years

Obesity Facts ◽  
2020 ◽  
Vol 13 (4) ◽  
pp. 349-360
Author(s):  
Carmen Piernas ◽  
Fiona MacLean ◽  
Paul Aveyard ◽  
Amy L. Ahern ◽  
Jenny Woolston ◽  
...  
Keyword(s):  
Weight Loss ◽  
Linear Model ◽  
Control Group ◽  
Average Weight ◽  
Face To Face ◽  
Session Attendance ◽  
Weight Loss Programme ◽  
The Cost ◽  
To Receive

<b><i>Background:</i></b> There is considerable heterogeneity in long-term weight loss among people referred to obesity treatment programmes. It is unclear whether attendance at face-to-face sessions in the early weeks of the programme is an independent predictor of long-term success. <b><i>Objective:</i></b> To investigate whether frequency of attendance at a community weight loss programme over the first 12 weeks is associated with long-term weight change. <b><i>Methods:</i></b> Participants were randomised to receive brief support only (control, <i>n</i> = 211), or a weight loss programme for 12 weeks (<i>n</i> = 530) or 52 weeks (<i>n</i> = 528). This study included participants with data on session attendance over the first 12 weeks (<i>n</i> = 889) compared to the control group. The association between attendance (continuously) and weight loss was explored using a linear model. A multi-level mixed-effects linear model was used to investigate whether attendance (categorised as 0, 1, 2–5, 6—9, and 10–12 sessions) was associated with weight loss at 3, 12, and 24 months compared to the control. <b><i>Results:</i></b> For every session attended in the first 12 weeks, the average weight loss was –0.259 kg/session at 24 months (<i>p</i> = 0.005). Analysis by attendance group found only those attending 10–12 sessions had significantly greater weight loss (–7.5 kg [95% CI –8.1 to –6.9] at 12 months; –4.7 kg [95% CI –5.3 to –4.1] at 24 months) compared to the control group (–3.4 [95% CI –4.5 to –2.4] at 12 months, –2.5 [95% CI –3.5 to –1.5] at 24 months). Early attendance was higher for people ≥70 years, but there was no evidence of a difference by gender, ethnicity, education, or income. <b><i>Conclusions:</i></b> Greater attendance at a community weight loss programme in the first 12 weeks is associated with enhanced weight loss up to 24 months. Regular attendance at a programme could be used as a criterion for continued provision of weight loss services to maximise the cost-effectiveness of interventions.

scholarly journals Long-Term Outcome of Monochorionic Twins after Fetoscopic Laser Therapy Compared to Matched Dichorionic Twins

2020 ◽  
Vol 47 (12) ◽  
pp. 947-954
Author(s):  
Ladina Rüegg ◽  
Margaret Hüsler ◽  
Franziska Krähenmann ◽  
Roland Zimmermann ◽  
Giancarlo Natalucci ◽  
...  
Keyword(s):  
Birth Weight ◽  
Free Time ◽  
Control Group ◽  
Event Free Survival ◽  
Monochorionic Twins ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Free Survival ◽  
School Career

<b><i>Introduction:</i></b> The only causal therapy is fetoscopic laser surgery (FLS). The aims of this study were to analyze the long-term outcome of monochorionic twins treated by FLS, including their school career, need for therapy and special aid equipment, and free-time activities, and compare their outcome to matched dichorionic twins. <b><i>Material and Methods:</i></b> Among the 57 women treated at a single fetal treatment center between 2008 and 2017 with FLS because of twin-to-twin transfusion syndrome, 25 women with 42 children were included in the FLS group. The control group consisted of 16 dichorionic twin pairs matched for birth year, gestational age (GA), birth weight, and sex. The long-term outcome was assessed by a parental questionnaire and a standardized neurodevelopmental examination for children born before 32 gestational weeks or with a birth weight lower than 1500 g. They were also registered into the Swiss Neonatal Network database. The primary outcome was event-free survival, defined as normal neurology, behavior, vision, and hearing. The secondary outcomes were school career, need for therapy and special aid equipment, and free-time activities. <b><i>Results:</i></b> An event-free survival was found in 32 children (76%) in the laser and in 24 children (75%) in the control group (<i>p</i> = 0.91). Neurological anomalies were found in 5 children (12%) in the laser group and 3 children (9%) in the control group (<i>p</i> = 1.00). Multiple logistic regression analysis showed that GA at delivery was the only predictive factor for event-free survival. There were no significant differences regarding school career, therapies, or special aid equipment between the 2 groups. We found that children without FLS were involved in more free-time activities and needed fewer breaks during physical activity than children with FLS during pregnancy. <b><i>Conclusion:</i></b> The outcome of monochorionic twins treated with FLS is comparable to the outcome of dichorionic twins. Long-term neurodevelopment in the cohort was mainly dependent on GA at birth.

scholarly journals Preventive effect of ursodeoxycholic acid on parenteral nutrition-associated liver disease in infants

2014 ◽  
Vol 142 (3-4) ◽  
pp. 184-188 ◽  
Author(s):  
Dusica Simic ◽  
Irina Milojevic ◽  
Dragana Bogicevic ◽  
Miodrag Milenovic ◽  
Vladimir Radlovic ◽  
...  
Keyword(s):  
Birth Weight ◽  
Parenteral Nutrition ◽  
Ursodeoxycholic Acid ◽  
Average Duration ◽  
Surgical Patients ◽  
Control Group ◽  
Surgical Patient ◽  
Significant Difference ◽  
The Difference

Introduction. Parenteral nutrition-associated cholestasis is well recognized phenomenon in the term and preterm infant receiving long-term parenteral nutrition. Objectives. The aim of this study was to evaluate the effect of ursodeoxycholic acid (UDCA) use on cholestasis in newborns on prolonged TPN. Methods. A total of 56 infants were enrolled in this retrospective study: control group consisted of lower (1500 g) birth weight infants (n=30), as well as the group of pediatric (n=11) and surgical patients (n=15) treated with UDCA. Blood chemistries were obtained two times weekly. Results. All of 56 newborns developed cholestasis but duration of parenteral nutrition (PN) before onset of cholestasis was significantly longer in UDCA treated patients. Average duration of PN before the onset of cholestasis in control group of patients was 25 days in distinction from treated pediatric and surgical patients (39 and 34 days, respectively). The peak serum conjugated bilirubin (CB), AST, ALT and alkaline phosphatase (AP) levels were significantly lower in the treated groups. There was no significant difference among treated pediatric and surgical patients and between lower and higher birth weight infants considering the CB, ALT, AST and AP peak. Duration of cholestasis was significantly decreased in all treated groups. There was a significant difference in time needed to achieve complete enteral intake between pediatric and surgical patient group. Conclusion. Cholestasis developed significantly later in treated groups than in the controls. UDCA appears to be very successful in reducing the symptoms of cholestasis. The difference in efficacy of UDCA treatment between lower and higher birth weight infants could not be proven.

scholarly journals The Association Between High Birth Weight and Long-Term Outcomes—Implications for Assisted Reproductive Technologies: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 9 ◽  
Author(s):  
Åsa Magnusson ◽  
Hannele Laivuori ◽  
Anne Loft ◽  
Nan B. Oldereid ◽  
Anja Pinborg ◽  
...  
Keyword(s):  
Systematic Review ◽  
Birth Weight ◽  
Psychiatric Disorders ◽  
Reproductive Technologies ◽  
Risk Of Bias ◽  
Control Group ◽  
High Birth Weight ◽  
Long Term Outcome ◽  
Meta Analyses

Background: Studies have shown that the prevalence of children born with high birth weight or large for gestational age (LGA) is increasing. This is true for spontaneous pregnancies; however, children born after frozen embryo transfer (FET) as part of assisted reproductive technology (ART) also have an elevated risk. In recent years, the practice of FET has increased rapidly and while the perinatal and obstetric risks are well-studied, less is known about the long-term health consequences.Objective: The aim of this systematic review was to describe the association between high birth weight and LGA on long-term child outcomes.Data Sources: PubMed, Scopus, and Web of Science were searched up to January 2021. Exposure included high birth weight and LGA. Long-term outcome variables included malignancies, psychiatric disorders, cardiovascular disease, and diabetes.Study Selection: Original studies published in English or Scandinavian languages were included. Studies with a control group were included while studies published as abstracts and case reports were excluded.Data Extraction: The methodological quality, in terms of risk of bias, was assessed by pairs of reviewers. Robins-I (www.methods.cochrane.org) was used for risk of bias assessment in original articles. For systematic reviews, AMSTAR (www.amstar.ca) was used. For certainty of evidence, we used the GRADE system. The systematic review followed PRISMA guidelines. When possible, meta-analyses were performed.Results: The search included 11,767 articles out of which 173 met the inclusion criteria and were included in the qualitative analysis, while 63 were included in quantitative synthesis (meta-analyses). High birth weight and/or LGA was associated with low to moderately elevated risks for certain malignancies in childhood, breast cancer, several psychiatric disorders, hypertension in childhood, and type 1 and 2 diabetes.Conclusions: Although the increased risks for adverse outcome in offspring associated with high birth weight and LGA represent serious health effects in childhood and in adulthood, the size of these effects seems moderate. The identified risk association should, however, be taken into account in decisions concerning fresh and frozen ART cycles and is of general importance in view of the increasing prevalence in high birthweight babies.

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