Validity of Random Triglyceride Levels in Infants Receiving Parenteral Nutrition

Background: Intravenous lipid emulsions (IL) are an important part of parenteral nutrition (PN) to meet essential fatty acid (EFA) requirements and metabolic demands of neonates and preterm infants. Some critically-ill neonates may not metabolize IL effectively which can lead to hypertriglyceridemia. Risks associated with this include increased pulmonary vascular resistance, displaced bilirubins, and platelet or macrophage dysfunction. Serum triglyceride (TG) concentration is used as a marker for lipid tolerance and predictor of potential complications involved with IL administration, but the clinical significance of this is still debated. Management of TG levels with regard to timing of laboratory tests, the ideal goal range, and duration of infusion of IL varies across institutions and is not standardized.Methods: Single-center, retrospective study of newborn infants receiving parenteral nutrition (PN). Fasting and non-fasting TG levels were drawn during the same lipid infusion of 2–3g/kg/day. The primary outcome was the difference between fasting and non-fasting TG levels. Statistical assessment of continuous data was done with student t-test and nominal data was evaluated using X2-test and logistic regression.Results: Forty infants were included with mean gestational age at birth of 29.5 ± 3.4 weeks and mean birth weight of 1.3 ± 0.5 kg. Mean time between lab draws while on same IL dose was 11.6 ± 0.2 h with resulting mean fasting and non-fasting (random) TG levels 82 ± 40 mg/dL (95% CI 68.4, 97.6) and 101 ± 40 mg/dL (95% CI 88.5, 115.8), respectively. Mean difference between TG levels during lipid-free interval and during infusion was −18.6 ± 51.2 mg/dL (95% CI −35.0, −2.3; p = 0.03).Conclusion: We concluded there is no difference in the management of IL, when TG level was drawn randomly or as fasting sample. Obtaining TG level during routine lab draws is appropriate. We extrapolated that the administration of IL over 24 h will not interfere with TG level.

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One-year outcomes following surgery for necrotising enterocolitis: a UK-wide cohort study

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2017-313113 ◽

2017 ◽

Vol 103 (5) ◽

pp. F461-F466 ◽

Cited By ~ 8

Author(s):

Benjamin Saul Raywood Allin ◽

Anna-May Long ◽

Amit Gupta ◽

Kokila Lakhoo ◽

Marian Knight

Keyword(s):

Cohort Study ◽

Parenteral Nutrition ◽

Gestational Age ◽

Surgical Intervention ◽

Necrotising Enterocolitis ◽

Post Intervention ◽

Risk Of Death ◽

The Uk ◽

Gestational Age At Birth ◽

Age At Birth

ObjectiveThe objective was to describe outcomes and investigate factors affecting prognosis at 1 year post intervention for infants with surgical necrotising enterocolitis (NEC).DesignUsing the British Association of Paediatric Surgeons Congenital Anomalies Surveillance System, we conducted a prospective, multicentre cohort study of every infant reported to require surgical intervention for NEC in the UK and Ireland between 1 March 2013 and 28 February 2014. Association of independent variables with 1-year mortality was investigated using multivariable logistic regression analysis.SettingAll 28 paediatric surgical centres in the UK and Ireland.PatientsInfants were eligible for inclusion if they were diagnosed with NEC and deemed to require surgical intervention, regardless of whether that intervention was delivered.OutcomesPrimary outcome was mortality within 1 year of the decision to intervene surgically.Results236 infants were included in the study. 208 (88%) infants had 1-year follow-up. 59 of the 203 infants with known survival status (29%, 95% CI 23% to 36%) died within 1 year of the decision to intervene surgically. Following adjustment, key factors associated with reduced 1-year mortality included older gestational age at birth (adjusted OR (aOR) 0.87, 95% CI 0.78 to 0.96). Being small for gestational age (SGA) (aOR 3.6, 95% CI 1.4 to 9.5) and requiring parenteral nutrition at 28 days post-decision to intervene surgically (aOR 3.5, 95% CI 1.1 to 11.03) were associated with increased 1-year mortality.ConclusionsParents of infants undergoing surgery for NEC should be counselled that there is approximately a 1:3 risk of death in the first post-operative year but that the risk is lower for infants who are of greater gestational age at birth, who are not SGA and who do not require parenteral nutrition at 28 days post-intervention.

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Gestational Age at Birth, 1994 and 2004

PsycEXTRA Dataset ◽

10.1037/e411542008-001 ◽

2006 ◽

Keyword(s):

Gestational Age ◽

Gestational Age At Birth ◽

Age At Birth

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Faculty Opinions recommendation of Effects of gestational age at birth on health outcomes at 3 and 5 years of age: population based cohort study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.14264188.15777343 ◽

2012 ◽

Author(s):

Mark Sullivan

Keyword(s):

Cohort Study ◽

Health Outcomes ◽

Gestational Age ◽

Population Based ◽

Gestational Age At Birth ◽

Age At Birth

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Prenatal household air pollutant exposure is associated with reduced size and gestational age at birth among a cohort of Ghanaian infants

Environment International ◽

10.1016/j.envint.2021.106659 ◽

2021 ◽

Vol 155 ◽

pp. 106659

Author(s):

Ashlinn K. Quinn ◽

Irene Apewe Adjei ◽

Kenneth Ayuurebobi Ae-Ngibise ◽

Oscar Agyei ◽

Ellen Abrafi Boamah-Kaali ◽

...

Keyword(s):

Gestational Age ◽

Air Pollutant ◽

Gestational Age At Birth ◽

Age At Birth

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Coeliac disease presenting atypically: A much wider spectrum

Tropical Doctor ◽

10.1177/0049475521991348 ◽

2021 ◽

pp. 004947552199134

Author(s):

Avinash Lomash ◽

Abhinaya Venkatakrishnan ◽

Meenakshi Bothra ◽

Bhavna Dhingra ◽

Praveen Kumar ◽

...

Keyword(s):

Coeliac Disease ◽

Gestational Age ◽

Dermatitis Herpetiformis ◽

Mode Of Delivery ◽

Gastrointestinal Symptoms ◽

Stunted Growth ◽

Significant Difference ◽

High Index Of Suspicion ◽

Gestational Age At Birth ◽

Age At Birth

Atypical coeliac disease in young children is frequently missed when it presents atypically as non-gastrointestinal presentations to different specialties. There was a greater delay (54 months) in establishing the diagnosis in those with atypical coeliac disease (p < 0.001). No difference was observed in the mode of delivery or duration of breast feeding, but significant difference was observed between gestational age at birth (p < 0.001). Most cases showed stunted growth and underweight. Irritability, anaemia, rickets, dermatitis herpetiformis, alopecia and intussusception were other common predictors of atypical coeliac disease. Because of a myriad spectrum of non-gastrointestinal symptoms, at any age with diverse presentation, a high index of suspicion is therefore required.

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Intermodal Enhancement of Stimulus Localisation in Infants Born Prematurely

Perceptual and Motor Skills ◽

10.2466/pms.1989.69.1.43 ◽

1989 ◽

Vol 69 (1) ◽

pp. 43-50 ◽

Cited By ~ 2

Author(s):

Nigel Foreman ◽

Alistair Fielder

Keyword(s):

Visual Fields ◽

Visual Stimuli ◽

Peripheral Stimulus ◽

Term Infants ◽

Visual Enhancement ◽

Sensory Space ◽

Near Term ◽

Gestational Age At Birth ◽

Age At Birth ◽

Prematurely Born Infants

The interaction of auditory and visual modalities in the enhancement of orientation was examined in premature and near-term infants by presenting them auditory or visual stimuli or auditory-visual stimulus combinations at various positions in sensory space. In 4.5–15-mo.-olds, brisk orienting responses could be elicited to very peripheral stimulus positions but only when the stimulus consisted of a spatially coherent auditory-visual combination (i.e., where a sound and a light occurred at the same point in space). This occurred for all infants, irrespective of age or gestational age at birth. First, the result shows that infants can respond to visual stimuli at eccentric positions, beyond the supposed limits of their effective visual fields as measured by standard perimetry. Second, the result extends earlier studies showing that intersensory integration and stimulus localisation develop relatively normally in prematurely born infants. The auditory-visual enhancement test as used here may have a number of further uses and applications in the clinic and laboratory.

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Maternal biological age assessed in early pregnancy is associated with gestational age at birth

Scientific Reports ◽

10.1038/s41598-021-94281-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Eva E. Lancaster ◽

Dana M. Lapato ◽

Colleen Jackson-Cook ◽

Jerome F. Strauss ◽

Roxann Roberson-Nay ◽

...

Keyword(s):

Risk Factors ◽

Preterm Birth ◽

Early Pregnancy ◽

Gestational Age ◽

Cellular Aging ◽

Biological Age ◽

Potential Candidate ◽

A Genome ◽

Gestational Age At Birth ◽

Age At Birth

AbstractMaternal age is an established predictor of preterm birth independent of other recognized risk factors. The use of chronological age makes the assumption that individuals age at a similar rate. Therefore, it does not capture interindividual differences that may exist due to genetic background and environmental exposures. As a result, there is a need to identify biomarkers that more closely index the rate of cellular aging. One potential candidate is biological age (BA) estimated by the DNA methylome. This study investigated whether maternal BA, estimated in either early and/or late pregnancy, predicts gestational age at birth. BA was estimated from a genome-wide DNA methylation platform using the Horvath algorithm. Linear regression methods assessed the relationship between BA and pregnancy outcomes, including gestational age at birth and prenatal perceived stress, in a primary and replication cohort. Prenatal BA estimates from early pregnancy explained variance in gestational age at birth above and beyond the influence of other recognized preterm birth risk factors. Sensitivity analyses indicated that this signal was driven primarily by self-identified African American participants. This predictive relationship was sensitive to small variations in the BA estimation algorithm. Benefits and limitations of using BA in translational research and clinical applications for preterm birth are considered.

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