INTRAUTERINE GROWTH IN ACTIVE TISSUE MASS OF THE HUMAN FETUS, WITH PARTICULAR REFERENCE TO THE UNDERGROWN BABY

PEDIATRICS ◽  
1966 ◽  
Vol 38 (1) ◽  
pp. 48-62
Author(s):  
John C. Sinclair ◽  
William A. Silverman
Keyword(s):  
Body Weight ◽  
Oxygen Consumption ◽  
Birth Weight ◽  
Cell Size ◽  
Gestational Age ◽  
Cell Mass ◽  
Weight Ratio ◽  
In Utero ◽  
Tissue Mass ◽  
Intrauterine Growth

Oxygen consumption of babies born after various lengths of gestation, measured between 2 to 10 days of post-natal life under resting, thermoneutral conditions, has been used as an index of intrauterine growth in "active tissue mass." A curve was constructed describing the median increase in oxygen consumption with increasing gestational age in babies who had experienced usual rates of growth in utero. Babies who have grown normally in utero exhibit, with increasing birth weight and with increasing gestational age, an increase in oxygen consumption per kilogram birth weight. This phenomenon is proposed to result from changes in fetal body composition with increasing maturity whereby the cell mass constitutes an increasing percentage of total body weight as length of gestation increases. Babies who have been undergrown in utero consume, as a group, more oxygen per kilogram body weight than do normally grown babies of similar birth weight; the degree of hypermetabolism is correlated with the degree of undergrowth. Undergrown babies, as a group, do not have a higher oxygen consumption per kilogram than normally grown babies of similar gestational age, although there is a tendency for those most undergrown to be hypermetabolic even for duration of gestation. The relative hypermetabolism of undergrown neonates is proposed to depend on a dual etiology: a cell mass/body weight ratio characteristic of maturity rather than size, and, in the most undergrown subjects, an increased cell number/cell mass ratio as would occur with reduction in cell size. A model is developed which relates observations by others of changes in organ size and cell size, in malnutrition, to the present metabolic measurements. Additional observations include external dimension—oxygen consumption relationship, colon—skin temperature gradients, and acid-base parameters, in babies either normally grown or undergrown in utero. Further study is needed of increments in oxygen consumption during the neonatal period in these two kinds of babies.

scholarly journals The Thin But Fat Phenotype is Uncommon at Birth in Indian Babies

2019 ◽  
Vol 150 (4) ◽  
pp. 826-832 ◽  
Author(s):  
Rebecca Kuriyan ◽  
Saba Naqvi ◽  
Kishor G Bhat ◽  
Santu Ghosh ◽  
Suman Rao ◽  
...  
Keyword(s):  
Body Weight ◽  
Birth Weight ◽  
Body Fat ◽  
Gestational Age ◽  
Cell Mass ◽  
Adult Life ◽  
Whole Body ◽  
Noncommunicable Diseases ◽  
Normal Birth Weight ◽  
Normal Birth

ABSTRACT Background Indian babies are hypothesized to be born thin but fat. This has not been confirmed with precise measurements at birth. If it is true, it could track into later life and confer risk of noncommunicable diseases (NCDs). Objectives Primarily, to accurately measure percentage of body fat (%BF) and body cell mass (BCM) in Indian babies with normal birth weight, compare them across different gestational ages and sex, and test the hypothesis of the thin but fat phenotype in Indian babies. Secondarily, to examine the relation between body weight and body fat in Indian babies. Methods Term newborns (n = 156) weighing ≥2500 g, from middle socioeconomic status mothers were recruited in Bengaluru, India, and their anthropometry, %BF (air displacement plethysmography), and BCM (whole-body potassium counter) were measured. Maternal demography and anthropometry were recorded. The mean %BF and its dispersion were compared with earlier studies. The relation between newborn %BF and body weight was explored by regression analysis. Results Mean birth weight was 3.0 ± 0.3 kg, with mean %BF 9.8 ± 3.5%, which was comparable to pooled estimates of %BF from published studies (9.8%; 95% CI: 9.7, 10.0; P > 0.05). Appropriate-for-gestational age (AGA) babies had higher %BF (1.8%) compared to small-for-gestational age (SGA) babies (P < 0.01). Mean %BCM of all babies at birth was 35.4 ± 10.5%; AGA babies had higher %BCM compared to SGA babies (7.0%, P < 0.05). Girls in comparison to boys had significantly higher %BF and lower %BCM. Body weight was positively associated with %BF. Conclusion Indian babies with normal birth weight did not demonstrate the thin but fat phenotype. Body weight and fat had positive correlation, such that SGA babies did not show a preservation of their %BF. These findings will have relevance in planning optimal interventions during early childhood to prevent NCDs risk in adult life.

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.

Impact of prenatal exercise on neonatal and childhood outcomes: a systematic review and meta-analysis

2018 ◽  
Vol 52 (21) ◽  
pp. 1386-1396 ◽  
Author(s):  
Margie H Davenport ◽  
Victoria L Meah ◽  
Stephanie-May Ruchat ◽  
Gregory A Davies ◽  
Rachel J Skow ◽  
...  
Keyword(s):  
Systematic Review ◽  
Body Weight ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Body Fat ◽  
Gestational Age ◽  
Fat Body ◽  
Meta Analysis ◽  
Prenatal Exercise ◽  
Frequency Intensity

ObjectiveWe aimed to identify the relationship between maternal prenatal exercise and birth complications, and neonatal and childhood morphometric, metabolic and developmental outcomes.DesignSystematic review with random-effects meta-analysis and meta-regression.Data sourcesOnline databases were searched up to 6 January 2017.Study eligibility criteriaStudies of all designs were eligible (except case studies and reviews) if published in English, Spanish or French, and contained information on the relevant population (pregnant women without contraindication to exercise), intervention (subjective/objective measures of frequency, intensity, duration, volume or type of exercise, alone (‘exercise-only’) or in combination with other intervention components (eg, dietary; ‘exercise+cointervention’)), comparator (no exercise or different frequency, intensity, duration, volume, type or trimester of exercise) and outcomes (preterm birth, gestational age at delivery, birth weight, low birth weight (<2500 g), high birth weight (>4000 g), small for gestational age, large for gestational age, intrauterine growth restriction, neonatal hypoglycaemia, metabolic acidosis (cord blood pH, base excess), hyperbilirubinaemia, Apgar scores, neonatal intensive care unit admittance, shoulder dystocia, brachial plexus injury, neonatal body composition (per cent body fat, body weight, body mass index (BMI), ponderal index), childhood obesity (per cent body fat, body weight, BMI) and developmental milestones (including cognitive, psychosocial, motor skills)).ResultsA total of 135 studies (n=166 094) were included. There was ‘high’ quality evidence from exercise-only randomised controlled trials (RCTs) showing a 39% reduction in the odds of having a baby >4000 g (macrosomia: 15 RCTs, n=3670; OR 0.61, 95% CI 0.41 to 0.92) in women who exercised compared with women who did not exercise, without affecting the odds of growth-restricted, preterm or low birth weight babies. Prenatal exercise was not associated with the other neonatal or infant outcomes that were examined.ConclusionsPrenatal exercise is safe and beneficial for the fetus. Maternal exercise was associated with reduced odds of macrosomia (abnormally large babies) and was not associated with neonatal complications or adverse childhood outcomes.

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 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 &lt; 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 &lt; 0.05). LGA infants had higher C3 and C5:1 levels and lower C18:2 and C16:1-OH levels (p &lt; 0.05). There were positive correlations between free carnitine and phenylalanine, arginine, methionine, alanine, and glycine levels (p &lt; 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.

scholarly journals Morphofunctional features of platelets in premature newborns with very low and extremely low body weight

2021 ◽  
Vol 12 (2) ◽  
pp. 35-41
Author(s):  
Anastasia V. Budalova ◽  
Natalia V. Kharlamova ◽  
Galina N. Kuzmenko
Keyword(s):  
Body Weight ◽  
Platelet Count ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Gestational Age ◽  
Growth Retardation ◽  
Intrauterine Growth Retardation ◽  
Distress Syndrome ◽  
Premature Newborns ◽  
Intrauterine Growth

Background. Currently, the development of medicine in the field of perinatology is aimed at improving the quality of medical care for newborns, especially those born prematurely. Premature newborns are most likely to develop hemorrhagic disorders, which often aggravates their condition and determines high morbidity and mortality. On modern hematological analyzers, it has become possible to evaluate a larger number of blood parameters, including platelet parameters, however, there are a small number of studies devoted to the study of platelet parameters in premature newborns. The aim was to study the morphofunctional features of platelets in premature newborns with very low and extremely low body weight. Materials and methods. The study included 78 newborns born at 2534 weeks of gestation, with a body weight of less than 1500 grams. On the 3rd5th day of life, a clinical blood test was performed on the Advia 2120i hematological analyzer (Siemens), with the determination of platelet parameters: PLT, 103 cells/l, PCT, %, PDW, %, Large Plt, 103 cells/l, MPC, g/dl, MRM, pg. Results. In newborns with ELBW, a decrease in the number and granularity of platelets in the blood, an increase in the average dry mass of platelets was found. Newborns with intrauterine growth retardation have a reduced platelet count and reduced thrombocrit. In premature newborns with a gestational age of 2527 weeks, blood circulation of platelets with a reduced volume was established, and in newborns who were born at a gestational age of 3234 weeks with increased granularity. In the absence of antenatal prevention of respiratory distress syndrome in newborns, there is a decrease in thrombocrit, the number of platelets, including large forms in the blood. In premature newborns born in a state of severe asphyxia, a decrease in platelet granularity was noted. The use of high concentrations of O2 in the oxygen-air mixture during respiratory therapy leads to a decrease in the number of platelets in the blood. Conclusions. Factors determining the morphofunctional state of platelets in premature newborns were established: the presence of a full course of antenatal prevention of respiratory distress syndrome of newborns, gestational age, the severity of asphyxia at birth, as well as the concentration of O2 in the oxygen-air mixture used in respiratory therapy. Newborns with ELBW have a reduced platelet count, low-granulated platelets, and an increased average dry platelet mass. Newborns with intrauterine growth retardation have a reduced number of platelets and thrombocrit in the blood. The revealed morphofunctional features of platelets allow us to clarify the nature of changes in the platelet link of hemostasis in premature newborns for the timely prevention of complications during the underlying disease.

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.

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