Risk factors and neonatal/infant mortality risk of small-for-gestational-age and preterm birth in rural Nepal

Background and objectivePaediatric intestinal failure (IF) is a disease entity characterised by gut insufficiency often related to short bowel syndrome. It is commonly caused by surgical removal of a large section of the small intestine in association with necrotising enterocolitis (NEC), which usually affects premature infants. This study investigated the incidence and risk of IF in preterm infants with or without NEC.DesignA matched cohort study to investigate the incidence and risk factors for IF in a population-based setting in Sweden from 1987 to 2009 using the Swedish Patient Register.ParticipantsInfants with a diagnosis of NEC (n=720) were matched for gestational age and year of birth with reference individuals without NEC (n=3656). The study cohort was censored at death, IF or at end of follow-up (2 years of age). We calculated HRs with 95%CIs for IF using Cox regression, adjusting for pertinent perinatal factors.ResultsIF was 15 times more common in the infants with NEC compared with the reference infants (HR=7.2, with 95% CI 3.7 to 14.0). Other risk factors for IF were small for gestational age, extreme preterm birth and abdominal surgery. Neonatal mortality in infants with NEC decreased from 20.6% in 1987–1993 to 10.4% in 2007–2009.ConclusionIF was more common in the infants with NEC but was also linked to extreme preterm birth, a history of abdominal surgery and small for gestational age. IF was more common at the end of the study period, indicating that it increases when more preterm infants with NEC survive the neonatal period.

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Maternal short stature and under-weight status are independent risk factors for preterm birth and small for gestational age in rural Bangladesh

European Journal of Clinical Nutrition ◽

10.1038/s41430-018-0237-4 ◽

2018 ◽

Vol 73 (5) ◽

pp. 733-742 ◽

Cited By ~ 5

Author(s):

Rasheda Khanam ◽

Anne CC Lee ◽

Dipak K. Mitra ◽

Malathi Ram ◽

Sushil Das Gupta ◽

...

Keyword(s):

Risk Factors ◽

Preterm Birth ◽

Short Stature ◽

Gestational Age ◽

Small For Gestational Age ◽

Weight Status ◽

Rural Bangladesh ◽

Independent Risk Factors

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Promoter Methylation Changes in the Placental DIO3 and CRH Genes Are Involved in the Second Trimester Maternal Depression Induced Preterm Birth and Small for Gestational Age Birth

10.21203/rs.3.rs-209636/v1 ◽

2021 ◽

Author(s):

Jianhui Yang ◽

Yumin Zhang ◽

Jiahui Deng ◽

Xuemei Lin ◽

Lili Xie ◽

...

Keyword(s):

Risk Factors ◽

Preterm Birth ◽

Pregnant Women ◽

Maternal Depression ◽

Gestational Age ◽

Small For Gestational Age ◽

Depression Scale ◽

Hypertensive Disorder ◽

Second Trimester ◽

Promoter Regions

Abstract Background Recent studies suggest that the incidence of preterm birth and SGA birth related to maternal depression, but the mechanism is unclear. The aim of this study was to explore the placental epigenetic changes involved in maternal depression induced preterm birth and small for gestational age birth. Methods Three hundred forty-five pregnant women were enrolled in this cohort study. Maternal depression in the second and third trimesters was assessed using a self-rating depression scale (SDS). We selected placental samples from pregnant women with depression and an equivalent number for samples from pregnant women without depression. Methylation of the promoter regions of the placental DIO3 and CRH genes was determined using next generation sequencing based on bisulfite sequencing PCR (NGS-BSP). Results There were 97 (28.1%) and 95 (27.5%) pregnant women who had depression in the second trimester and third trimester, respectively. The risk factors of preterm birth were older maternal age (RR = 1.43, 95%CI = 1.01–2.03), uterine infection (RR = 129.31, 95%CI = 2.16-7725.55), and maternal depression in the second trimester (RR = 79.97, 95%CI = 3.57-1792.56). The risk factors of SGA birth were low maternal BMI (RR = 0.71, 95%CI = 0.54ཞ0.92), hypertensive disorder complicating pregnancy (HDCP, RR = 4.7, 95%CI = 1.18ཞ18.72), and maternal depression in the second trimester (RR = 3.71, 95%CI = 1.31ཞ12.16). Pregnant women with depression had higher placental methylation of CRH and DIO3 genes, and there was a correlation between placental methylation of CRH and DIO3 genes. Conclusion Our study suggested that the changes in the promoter region of the placental DIO3 and CRH genes were involved in maternal depression in the second trimester induced preterm birth and small for gestational age birth.

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