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 MATERNAL HYPERTENSION AS A RISK FACTOR ASSOCIATED WITH LOW BIRTH WEIGHT

2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Simone Seixas da Cruz ◽  
Isaac Suzart ◽  
Johelle De Santana Passos-Soares ◽  
Luise Maria Souza ◽  
Ana Claudia Morais Godoy Figueiredo ◽  
...  
Keyword(s):  
Risk Factor ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Descriptive Analysis ◽  
Study Groups ◽  
Control Group ◽  
Case Group ◽  
Significant Difference ◽  
Maternal Hypertension

Objective: to investigate the association between maternal hypertension and low birth weight, in a public hospital in Petrolina, Pernambuco, Brazil. Methods: A case-control study was conducted on 317 individuals, such that the case group was composed of 87 mothers of children born with a weight of less than 2500 g and/or gestational age less than 37 weeks, and the control group was composed of 230 mothers of newborns of weight greater than or equal to 2500 g and gestational age greater than or equal to 37 weeks. Descriptive analysis and logistic regression were applied to the data gathered. Results: The results showed a statistically significant difference in maternal age between the study groups. The use of medications and number of prenatal consultations were also shown to be associated with low birth weight. After appropriate adjustments, the association between maternal hypertension and low birth weight was demonstrated to be strong and statistically significant (OR = 3.84; 95% CI: 1.92 – 7.68). Conclusions: The findings indicate that maternal hypertension is a possible risk factor for low birth weight.

scholarly journals Growth and Specialized Growth Charts of Children with Congenital Hypothyroidism Detected by Neonatal Screening in Isfahan, Iran

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Awat Feizi ◽  
Mahin Hashemipour ◽  
Silva Hovsepian ◽  
Zeynab Amirkhani ◽  
Roya Kelishadi ◽  
...  
Keyword(s):  
Head Circumference ◽  
Relative Frequency ◽  
Screening Program ◽  
Control Group ◽  
Growth Charts ◽  
Healthy Children ◽  
Growth Status ◽  
Catch Up ◽  
Growth Development

Objectives. The aim of the current study was to investigate the growth status of CH, generate specialized growth charts of CH infants, and compare them with their counterparts of regional normal infants. Methods. In this prospective cohort study, 760 (345 girls and 415 boys) neonates born in 2002–2009 diagnosed by neonatal CH screening program in Isfahan were followed up from the time of diagnosis. 552 healthy children were recruited as a control group. The empirical 3rd, 15th, 50th, 85th, and 97th percentiles for height, weight, and head circumference of both sexes were determined and compared with their counterpart values of the control group. The relative frequency of patients with impaired growth for each studied variable was determined. Also, specialized growth charts of CH patients were generated. Results. The percentiles of weight, height, and head circumference of studied patients are significantly different from regional healthy children (P<0.001). The relative frequency of impaired head circumference was decreased to less than 3% at the 3rd year of age and for height it reached gradually 3% and 9% at the 5th year of age for boys and girls, respectively (P<0.05); however for weight still it was statistically more than 3% in both sexes. Conclusion. CH patients had impaired growth development which was improved during follow up, but the catch-up time was earlier for head circumference and later for weight.

scholarly journals The Management and Outcome of Higher Order Multifetal Pregnancies: Obstetric, Neonatal and Follow-up Data

Twin Research ◽  
2001 ◽  
Vol 4 (1) ◽  
pp. 4-11
Author(s):  
Mark H. Yudin ◽  
Elizabeth V. Asztalos ◽  
Ann Jefferies ◽  
Jon F.R. Barrett
Keyword(s):  
Statistical Analysis ◽  
Motor Skills ◽  
Gestational Age ◽  
Neurodevelopmental Outcome ◽  
Higher Order ◽  
Neurodevelopmental Outcomes ◽  
Significant Difference ◽  
Before And After

AbstractThe objective of this study was to describe current obstetric, neonatal, and long-term neurodevelopmental outcomes of higher order multifetal gestations (≥ 3 fetuses) in the 1990s. We also intended to identify a target gestational age at which neonatal and neurodevelopmental morbidities are low. Records from all multifetal pregnancies (≥ 3 viable fetuses ≥ 20 weeks gestation) delivered at the two perinatal centers in Toronto, Ontario, Canada during the study period (January 1, 1990–December 31, 1996) were reviewed. Data were collected on obstetric, neonatal, and long-term neurodevelopmental outcomes. Follow up data were gathered regarding the presence of a severe deficit in four categories (vision, hearing, cognition, and motor skills). Statistical analysis was performed to determine a gestational age at which a significant decrease in deficit occurred. During the study period 165 multifetal pregnancies were delivered. This resulted in 511 fetuses, of which 496 were live births. Of these 496 infants, 453 survived to discharge. Follow up data were obtained on 332 (73.3 per cent) infants. Infant survival increased with gestational age, and was approximately 90 per cent or greater at 26 weeks or more. Of all infants followed, the proportion of those without deficit increased with increasing gestational age, such that the per cent without deficit was 96.9 at 31 weeks or greater. Of all infants followed, 301 (90.7 per cent) had no deficit. Statistical analysis revealed a significant difference in long-term neurodevelopmental outcome between infants born before and after 28 weeks gestation. The incidence of a major deficit was 44.1 per cent for those born earlier than and 5.4 per cent for those born later than this gestational age (p = 0.001). In our cohort, survival figures were high. Even in lower gestational groupings, survival was high, but not without serious concerns about severe morbidity. This information is useful when counseling parents of higher order multifetal pregnancies.

scholarly journals Clinical characteristics of children with congenital Zika syndrome: a case series

2020 ◽  
Vol 78 (7) ◽  
pp. 403-411
Author(s):  
Thais MASSETTI ◽  
Dafne HERRERO ◽  
Julliana ALENCAR ◽  
Talita SILVA ◽  
Cristina MORIYAMA ◽  
...  
Keyword(s):  
Birth Weight ◽  
Motor Function ◽  
Gestational Age ◽  
Head Circumference ◽  
Motor Performance ◽  
Clinical Characteristics ◽  
Gross Motor ◽  
Congenital Zika Syndrome ◽  
Motor Outcomes

ABSTRACT Background: The congenital Zika syndrome involves structural brain changes, including ventriculomegaly, thin cerebral cortices, abnormal gyral pattern, cortical malformations, hypoplasia of the corpus callosum, myelination delay, subcortical diffuse calcifications, brainstem hypoplasia, and microcephaly in newborns. Objective: This study aimed to describe the clinical characteristics of children with congenital Zika syndrome; to compare the outcomes of infants infected in the first (1T, n=20) and second trimesters of pregnancy (2T, n=11); to investigate correlations between birth weight, birth and follow-up head circumference, birth gestational age, and gross motor scores. Methods: Participants were evaluated with Alberta Infant Motor Scale (AIMS) and part A of the Gross Motor Function Measure (GMFM-A). ANOVA compared head circumference, birth gestational age, birth weight, and gross motor performance of 1T and 2T. Results: The correlations were investigated by Pearson correlation coefficients. ANOVA showed differences in birth and follow-up head circumferences. Head circumference was smaller in 1T, compared to 2T. Motor performance was classified as below the fifth percentile in AIMS in all children and 1T showed lower scores in prone, sitting, and total AIMS score, compared to 2T. Children ranged from 8 to 78% on GMFM-A and there was a poorer motor performance of 1T. Nineteen children showed hypertonia, six showed normal tone and six showed hypotonia. Birth head circumference was correlated with AIMS prone postural control. Follow-up head circumference was correlated to prone, supine and total AIMS scores. Smaller head circumference at birth and follow-up denoted poorer postural control. Discussion: Children with congenital Zika syndrome showed microcephaly at birth and follow-up. Smaller head circumferences and poorer motor outcomes were observed in 1T. Infants showed poor visual and motor outcomes. Moderate positive correlations between birth and follow-up head circumference and gross motor function were found.

scholarly journals Weight and Glycemic Control Outcomes of Bariatric Surgery and Pharmacotherapy in Patients With Melanocortin-4 Receptor Deficiency

2022 ◽  
Vol 12 ◽  
Author(s):  
Esphie Grace Fodra Fojas ◽  
Saradalekshmi Koramannil Radha ◽  
Tomader Ali ◽  
Evan P. Nadler ◽  
Nader Lessan
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Glycemic Control ◽  
Therapeutic Interventions ◽  
Control Group ◽  
Short Term ◽  
Melanocortin 4 Receptor ◽  
Significant Difference

BackgroundMelanocortin-4 receptor (MC4R) mutations are the most common of the rare monogenic forms of obesity. However, the efficacy of bariatric surgery (BS) and pharmacotherapy on weight and glycemic control in individuals with MC4R deficiency (MC4R-d) is not well-established. We investigated and compared the outcomes of BS and pharmacotherapy in patients with and without MC4R-d.MethodsPertinent details were derived from the electronic database among identified patients who had BS with MC4R-d (study group, SG) and wild-type controls (age- and sex-matched control group, CG). Short- and long-term outcomes were reported for the SG. Short-term outcomes were compared between the two groups.ResultsSeventy patients were screened for MC4R-d. The SG [six individuals (four females, two males); 18 (10–27) years old at BS; 50.3 (41.8–61.9) kg/m2 at BS, three patients with homozygous T162I mutations, two patients with heterozygous T162I mutations, and one patient with heterozygous I170V mutation] had a follow-up duration of up to 10 years. Weight loss, which varied depending on mutation type [17.99 (6.10–22.54) %] was stable for 6 months; heterogeneity of results was observed thereafter. BS was found superior to liraglutide on weight and glycemic control outcomes. At a median follow-up of 6 months, no significant difference was observed on weight loss (20.8% vs. 23.0%, p = 0.65) between the SG and the CG [eight individuals (four females, four males); 19.0 (17.8–36.8) years old at BS, 46.2 (42.0–48.3) kg/m2 at BS or phamacotherapeutic intervention]. Glycemic control in patients with MC4R-d and Type 2 diabetes improved post-BS.ConclusionOur data indicate efficacious short-term but varied long-term weight loss and glycemic control outcomes of BS on patients with MC4R-d, suggesting the importance of ongoing monitoring and complementary therapeutic interventions.

scholarly journals The effect of ladder approach on development of preterm low birth weight infants with HIE-2

2020 ◽  
Vol 7 (3) ◽  
pp. 520
Author(s):  
Tushar R. Jadhav ◽  
Shailaja S. Jaywant
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Premature Infants ◽  
Tertiary Care ◽  
Control Group ◽  
Care Hospital ◽  
Post Intervention ◽  
Low Birth Weight Infants ◽  
Significant Difference

Background: Premature infants with Peri-natal asphyxia leading to a hypoxic-ischemic encephalopathy (HIE) are at greater risk for cerebral palsy. HIE grade II infants have long term neurological complications due to maladaptive brain wiring during NICU stay. Ladder approach, with graded stimulation program is administered by Occupational therapist, plays a vital role to minimize the maladaptive responses to environment. Objective of this study was to effect of Ladder Approach on preterm low birth weight Infants with HIE-2 as compared to conventional treatment. Design of this study was to Prospective Block Randomized Convenient Sampling Control Trial, Experimental design study. The study was carried out in the NICU and PU ward of Tertiary care hospital in metropolitan city from April 2015 to October 2016. The study subjects included a convenient sample of 30 preterm Low birth weight HIE-2 infants randomly selected into study or control groups. Neonatal behavioural Assessment scale (NBAS), Infant Neurological International Battery (INFANIB).Methods: The preterm infants from study group who received Ladder Approach and control group who received routine conventional care only. Outcome measures NBAS was at baseline and first follow up. INFANIB was administered at second follow up to assess neurodevelopment.Results: Showed that the premature infants of the study had significant difference in neuro behavioral status with mean for all subcomponents from to post intervention mean 39.6 in experimental group and from baseline mean of 24.3 to post intervention mean score of 33.2 in control group on neurobehavioral scale. Further neurodevelopmental status showed similar results on INFANIB in experimental group.Conclusions: The premature Infants with HIE grade 2, receiving ladder approach have shown more mature responses resulting into well-organized Neurobehavioral status, and resulted in improved brain wiring as evident in INFANIB.

scholarly journals Influence of the level of maternal education on the long-term neurodevelopmental outcome of Saudi infants with birth weight of 1000-1500 grams at the age of 21-24 months

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Badr Hasan Sobaih
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Maternal Education ◽  
Very Low Birth Weight ◽  
Neurodevelopmental Outcome ◽  
University Hospital ◽  
Vlbw Infants

Background: Advancements in perinatal-neonatal care in the last decades has led to improved survival rates of very-low birth weight (VLBW) infants. An association between the level of maternal education and neurodevelopmental outcome has been demonstrated in many European studies. This study evaluates the influence of maternal education level and socio-demographic status on the long-term development of Saudi VLBW infants with birth weight of 1000-1500 grams at a corrected gestational age of 21-24 months. Method: This retrospective cohort study examined prospectively collected data from the period of 2005 to 2016 from the Neonatal Follow-up Program (NFP) at King Khalid University Hospital in Riyadh, Saudi Arabia. Results: A total of 122 VLBW infants with a mean gestational age of 29.57 weeks and mean birth weight 1265 grams were enrolled. There was no statistically significant association between the level of maternal education and neurodevelopmental screening outcome at the age of 21-24 months according to the Bayley Infant Neurodevelopmental Screener (BINS) (p=0.149). Bronchopulmonary dysplasia (BPD) was highly associated with cerebral palsy (p=0.001) and an abnormal BINS score (p=0.010). Conclusion: There was no significant influence of the level of maternal education on the neurodevelopmental screening outcome of VLBW infants at the corrected age of 21-24 months. BPD was the strongest predictor of adverse neurodevelopmental outcome. Keywords: Bayley Infant Neurodevelopmental Screener (BINS), Neurodevelopmental Outcome, Maternal educational level, Neonatal follow-up program (NFP), Very Low Birth Weight (VLBW) infant.

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