Neonatal Hyperviscosity: I. Incidence

PEDIATRICS ◽  
1979 ◽  
Vol 63 (6) ◽  
pp. 833-836
Author(s):  
Frederick H. Wirth ◽  
Karen E. Goldberg ◽  
Lula O. Lubchenco

Capillary hematocrits were performed on 790 infants during the first four hours after birth. These infants were delivered between August 8 and December 7, 1974, at the University of Colorado Medical Center, which is at an altitude of 1,061 m above sea level. When the capillary hematocrit was 7% or greater, venous hematocrit and blood viscosity were determined. Capillary hematocrits obtained from warmed heels in the first hour after birth were spuriously high and not consistently related to venous hematocrit. Venous polycythemia, defined as a hematocrit of 65% or greater, occurred in 4% of the newborn population. Hyperviscosity (2 SD above the mean for newborns) occurred in 5% of the newborn infants. At a venous hematocrit of 65% or greater, hyperviscosity was predictable, but some infants with venous hematocrits between 60% and 64% also had hyperviscosity of the blood. The incidence of polycythemia and hyperviscosity was further related to birth weight and gestational age. The infants who were small for gestational age were at highest risk of polycythemia and hyperviscosity, followed by infants who were large for gestational age. However, the greatest number of infants with hvperviscosity were term appropriate for gestational age. Preterm infants with gestational ages of less than 34 weeks were not affected.

Author(s):  
Shulian Zhang ◽  
Guanpeng Zhai ◽  
Jin Wang ◽  
Wenjing Shi ◽  
Rong Zhang ◽  
...  

AbstractLow birth weight is associated with an increased risk of adverse outcomes in many diseases in adult life. We investigated the expression of IGF-II and the status of differentially methylated regions (DMR) in small for gestational age (SGA) infants after birth.Plasma IGF-II, IGF-II receptor (IGF2R), IGF-I, and IGF-binding protein 3 (IGFBP3) levels were measured after birth in 150 newborn infants. These included 30 term appropriate for gestational age (AGA), 30 term SGA, 30 term large for gestational age (LGA), 30 preterm AGA, and 30 preterm SGA infants.Plasma IGF-II levels after birth were lower in both term SGA (435.1±33.82 vs. 620.4±44.79, p=0.002) and LGA infants (483.7±33.8 vs. 620.42±44.79, p=0.018) than in term AGA infants. The expression ofIGF-II was associated with birth weight and expressed at high levels, which suggests that IGF-II may continue to play an important role after birth.


2021 ◽  
Vol 9 ◽  
Author(s):  
Serdar Beken ◽  
Saygin Abali ◽  
Neslihan Yildirim Saral ◽  
Bengisu Guner ◽  
Taha Dinc ◽  
...  

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.


PEDIATRICS ◽  
1981 ◽  
Vol 68 (6) ◽  
pp. 814-819
Author(s):  
Paul Y. K. Wu ◽  
Gary Rockwell ◽  
Linda Chan ◽  
Shu-Mei Wang ◽  
Vikram Udani

Colloid osmotic pressure (COP) of blood was measured directly at birth with the Wescor membrane colloid osmometer (model 4100) in 91 appropriately grown, 11 large, and nine small for gestational age "well" newborn infants. COP correlated directly with birth weight (r = .726, P < .00001) and gestational age (r = .753, P < .00001). COP values for small for gestational age (SGA) and large for gestational age (LGA) infants were found to fall within the 95% prediction interval with regard to birth weight and gestational age for appropriate for gestational age (AGA) infants. Simultaneous measurements of COP, total serum solids, and central arterial mean blood pressure were made. The results showed that COP correlated directly with total serum solids (r = .89, P < .0001) and mean arterial blood pressure (r = .660, P < .001). Among the factors evaluated, total serum solids was the best predictor of COP.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
José G. B. Derraik ◽  
Sarah E. Maessen ◽  
John D. Gibbins ◽  
Wayne S. Cutfield ◽  
Maria Lundgren ◽  
...  

AbstractWhile there is evidence that being born large-for-gestational-age (LGA) is associated with an increased risk of obesity later in life, the data are conflicting. Thus, we aimed to examine the associations between proportionality at birth and later obesity risk in adulthood. This was a retrospective study using data recorded in the Swedish Birth Register. Anthropometry in adulthood was assessed in 195,936 pregnant women at 10–12 weeks of gestation. All women were born at term (37–41 weeks of gestation). LGA was defined as birth weight and/or length ≥2.0 SDS. Women were separated into four groups: appropriate-for-gestational-age according to both weight and length (AGA – reference group; n = 183,662), LGA by weight only (n = 4,026), LGA by length only (n = 5,465), and LGA by both weight and length (n = 2,783). Women born LGA based on length, weight, or both had BMI 0.12, 1.16, and 1.08 kg/m2 greater than women born AGA, respectively. The adjusted relative risk (aRR) of obesity was 1.50 times higher for those born LGA by weight and 1.51 times for LGA by both weight and height. Length at birth was not associated with obesity risk. Similarly, women born LGA by ponderal index had BMI 1.0 kg/m2 greater and an aRR of obesity 1.39 times higher than those born AGA. Swedish women born LGA by weight or ponderal index had an increased risk of obesity in adulthood, irrespective of their birth length. Thus, increased risk of adult obesity seems to be identifiable from birth weight and ignoring proportionality.


Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 866 ◽  
Author(s):  
Małgorzata Lewandowska ◽  
Jan Lubiński

Excessive birth weight has serious perinatal consequences, and it “programs” long-term health. Mother’s nutritional status can be an important element in fetal “programming”; microelements such as selenium (Se), zinc (Zn), copper (Cu), and iron (Fe) are involved in many metabolic processes. However, there are no studies assessing the relationship of the microelements in the peri-conceptual period with the risk of excessive birth weight. We performed a nested case control study of serum microelements’ levels in the 10–14th week of pregnancy and assessed the risk of large-for-gestational age (LGA) newborns using the data from a prospective cohort of pregnant women recruited in 2015–2016 in Poznań, Poland. Mothers delivering LGA newborns (n = 66) were examined with matched mothers delivering appropriate-for-gestational age (AGA) newborns (n = 264). Microelements’ levels were quantified using mass spectrometry. The odds ratios of LGA (and 95% confidence intervals) were calculated by multivariate logistic regression. In the whole group, women with the lowest quartile of Se had a 3 times higher LGA risk compared with women in the highest Se quartile (AOR = 3.00; p = 0.013). Importantly, the result was sustained in the subgroup of women with the normal pre-pregnancy BMI (AOR = 4.79; p = 0.033) and in women with a male fetus (AOR = 6.28; p = 0.004), but it was not sustained in women with a female fetus. There were no statistical associations between Zn, Cu, and Fe levels and LGA. Our study provides some preliminary evidence for the relationships between lower serum Se levels in early pregnancy and a higher risk of large-for-gestational age birth weight. Appropriate Se intake in the periconceptual period may be important for optimal fetal growth.


2017 ◽  
Vol 35 (08) ◽  
pp. 703-706
Author(s):  
Katherine Himes ◽  
Adriane Haragan

Objective Clinicians use estimated fetal weight (EFW) as a proxy for birth weight (BW) in the antenatal period. Our objective was to compare the accuracy of EFW obtained by ultrasound to BW among infants born during the periviable period and determine if accuracy of EFW varied among small for gestational age (SGA) versus appropriate for gestational age (AGA) grown neonates. Study Design We included women who delivered between 230/7 and 256/7 weeks' gestation and had an EFW within 7 days of delivery. Mean percentage difference and median absolute percentage difference between EFW and BW were calculated. Results Our cohort included 226 neonates with a mean gestational age of 241/7 ± 0.8 weeks and median BW of 653 g (interquartile range [IQR]: 580–750 g). The median absolute percentage difference between EFW and BW of fetal weight estimates was 9.2% (IQR: 3.6–17.2). EFW overestimated BW for 75% (n = 171) of the cohort. Among SGA infants, the mean percentage difference in EFW and BW was 16.2 ± 19.4% versus 6.9% ± 13.1% in AGA infants (p = 0.019). Conclusion EFW overestimated BW in this cohort. In addition, ultrasound was less accurate among infants born SGA. These data are important to consider when counseling families facing periviable delivery.


2000 ◽  
pp. 623-629 ◽  
Author(s):  
HJ Wolf ◽  
CF Ebenbichler ◽  
O Huter ◽  
J Bodner ◽  
M Lechleitner ◽  
...  

OBJECTIVE: To determine whether fetal leptin levels correlate with fetal weight and whether such correlation is direct or indirect via insulin or human placental lactogen (hPL), respectively. DESIGN: Cross-sectional study of offspring at term (n=175) with over-representation of large-for-gestational age (LGA; n=70) and small-for-gestational age (SGA; n=23) cases in a population of Caucasian women with no pregnancy pathology. METHODS: Fetal cord blood was collected after delivery. In several cases (n=62) paired mother-fetus blood samples were obtained. Leptin, insulin and hPL levels were measured by RIA. Anthropometric data (birth weight, body mass index, placental weight) were recorded. RESULTS AND CONCLUSIONS: Maternal insulin, hPL and leptin levels were higher than fetal concentrations. Cord blood leptin levels positively correlated with the anthropometric data with stronger correlations in female (0.54<r<0.66) than in male (0.32<r<0.39) neonates. Cord blood leptin levels did not differ between appropriate-for-gestational age (AGA; n=82) and SGA (n=23) neonates, but were higher (P<0.001) by 83% in LGA (n=70) than in AGA neonates. Among the different weight classes the correlations between fetal leptin and anthropometric data were only observed in LGAs, but not in AGAs or SGAs. Fetal, but not maternal, leptin levels strongly correlated with fetal insulin (r=0.56; P<0.001). After accounting for this close relationship insulin could no longer be used to predict birth weight (r=0.15, P=0.051). We suggest that the correlation of cord blood insulin with neonatal weight in LGAs is, in addition to insulin's direct anabolic action, indirectly mediated via leptin. It is hypothesized that fetal insulin stimulates fetal adipocyte leptin production.


Reports ◽  
2020 ◽  
Vol 3 (4) ◽  
pp. 36
Author(s):  
Jane C. Khoury ◽  
Mekibib Altaye ◽  
Shelley Ehrlich ◽  
Suzanne Summer ◽  
Nicholas J. Ollberding ◽  
...  

Women with pre-gestational diabetes have a high rate of large for gestational age (LGA) babies compared to women without diabetes. In particular, there is a high rate of asymmetric LGA defined as ponderal index (PI) > 90th percentile for gestational age. We examined the association of birth weight and PI, with body mass index (BMI) and obesity status in adulthood, in a cohort of offspring of women with pre-gestational diabetes. The women participated in the Diabetes in Pregnancy (DiP) study at the University of Cincinnati from 1978 to 1995. The offspring of these women are the cohort participating in an observational study being conducted at Cincinnati Children’s Hospital Medical Center. Once located, the offspring were invited to come in for a one-day clinic visit to assess anthropometrics, and their metabolic, renal and cardiovascular status. Linear and logistic regression was used to assess the association between birth weight and PI with current BMI. We report on 107 offspring. A statistically significant association was found between offspring current BMI with birth PI (β = 1.89, 95% CI 0.40–3.38), and between offspring current obesity status and birth asymmetric LGA (aOR = 2.44, 95% CI 1.01–5.82). This is consistent with in utero “metabolic programming”.


BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042476
Author(s):  
Xin-xin Huang ◽  
Xiu-Min Jiang ◽  
Qing-Xiang Zheng ◽  
Xiao-Qing Chen ◽  
Yu-Qing Pan

ObjectivesThe primary purpose was to measure the birth weight of infants of mothers with gestational diabetes (IMGDs) at different gestational ages to develop new reference charts and curves for them. A further purpose was to compare them with those of 159 334 infants in China to provide more accurate reference charts for the diagnosis of suspected abnormal birth weight of IMGDs. The final purpose was to evaluate the key periods for such mothers to control their weight in line with the difference of fetal weight of each two neighbouring gestational ages.SettingA specialised hospital in South ChinaParticipantsIMGDs born here from January 2014 to December 2018.Primary and secondary outcome variablesBirth weight, gestational ages of IMGDs, gender and year of birth.ResultsData of 14 311 singleton live births at the gestational weeks 25–42 here were collected. The proportions of low birth weight, normal birth weight and macrosomia were 7.26%, 87.04%, and 5.70%, respectively. The proportions of small for gestational age, appropriate for gestational age and large for gestational age were 5.69%, 84.42% and 9.89%, respectively. In the macrosomia group, the mean of all birth weight in 2017 decreased for the first time since 2014. Both the means of birth weight of male infants at gestational weeks 36–41 and of female at weeks 38–40 were greater than that of the 159 334 infants. The increase of each weekly mean of IMGDs at gestational weeks 27–31 and 33–35 was >10% compared with the former. Based on this, new reference charts of birth weight for IMGDs in terms of different gestational age and gender were formulated.ConclusionThese charts may be applied as reference for more accurate diagnosis and quick treatment of abnormal birth weight. This study showed that the identification of key periods for fetal weight gain was helpful for the management of the weight of women with gestational diabetes.


2019 ◽  
Vol 75 (1) ◽  
pp. 39-46
Author(s):  
Carmem U.P. Esmeraldo ◽  
Maria Eliana P. Martins ◽  
Evanira R. Maia ◽  
Jéssica Lissandra A. Leite ◽  
José Lucas S. Ramos ◽  
...  

Objective: To evaluate vitamin D serum levels of term newborns and relate them to maternal concentrations and birth weight. Methods: Cross-sectional study carried out with 225 mothers and their term newborns. Data collected were maternal health, prenatal care, gestational, and anthropometric data of the newborns. The following laboratory tests were performed: serum levels of 25(OH)D, calcium, phosphorus, magnesium, and alkaline phosphatase. Results: Of the 225 newborns included in the study, 119 (52.9%) were males, the mean birth weight was 3,198 ± 421.4 g, and the gestational age was 39.1 ± 1.1 weeks. Of these, 20 (8.9%) were small and 12 (5.3%) were large for gestational age. A 25(OH)D sufficiency was found in 25.8% of mothers and 92% of newborns. The mean 25(OH)D concentrations of newborns was higher than that of the mothers 48.7 ± 15.2 ng/mL vs. 26.0 ± 6.7 ng/dL (p < 0.001), correlating inversely with birth weight (r = –0.249; p < 0.001). Small for gestational age (SGA) newborns had higher concentrations of 25(OH)D compared to adequate and large for age (p < 0.001). Conclusion: In conclusion, this study showed strong positive correlation between maternal and neonatal 25(OH)D concentrations, with higher values in newborns. The highest 25(OH)D concentrations were found in SGA term infants. We speculated these findings could be influenced by newborn body composition.


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