Assess the Prevalence of Low-Birth-Weight Babies and Its Risk Factors among Postnatal Mothers in Wardha District

BACKGROUND Babies of low birth weight (LBW) include 2,499 g or less weight as stated by WHO. LBW consists of VLBW which is below 1500 g and extremely low birth weight which is lesser than 1000 g. The normal gross weight of the infant at the time of delivery is 2500 - 4200 g. The cause of LBW is preterm birth or a slow prenatal growth rate. The survival rate is determined by the baby’s birth weight. Several risk factors are also associated such as multiple pregnancies, poor nutrition, hypertension, drug addiction or intake of alcohol. It is very necessary to prevent LBW rather than treating it after birth. The present study was done to assess the prevalence of lowbirth-weight babies and its risk factors among postnatal mothers in the Wardha district. METHODS A descriptive research design was undertaken, and 35 postnatal mothers in the Wardha district were selected for the study, the data was collected with the help of a structured questionnaire and a risk factor assessment scale was used for postnatal mothers. RESULTS The result of the study shows the prevalence rate of LBW babies among postnatal mothers as 49.18 %, and there was an assessment of risk factors among postnatal mothers from selected areas and association of prevalence of low birth with selected demographic variables. There was no association of prevalence of lowbirth-weight babies among postnatal mothers in relation to demographic variables. CONCLUSIONS This study concludes that there is a good prevalence of LBW babies but mothers didn’t have adequate knowledge regarding LBW of babies and risk factors that affect the mother as well as the foetus. KEY WORDS Low Birth Weight, Preterm, Gestation, Dehydration, Hyperthermia, Hypothermia

Mercury and Prenatal Growth: A Systematic Review

The intrauterine environment is critical for healthy prenatal growth and affects neonatal survival and later health. Mercury is a toxic metal which can freely cross the placenta and disrupt a wide range of cellular processes. Many observational studies have investigated mercury exposure and prenatal growth, but no prior review has synthesised this evidence. Four relevant publication databases (Embase, MEDLINE/PubMed, PsycINFO, and Scopus) were systematically searched to identify studies of prenatal mercury exposure and birth weight, birth length, or head circumference. Study quality was assessed using the NIH Quality Assessment Tool, and results synthesised in a narrative review. Twenty-seven studies met the review criteria, these were in 17 countries and used 8 types of mercury biomarker. Studies of birth weight (total = 27) involving populations with high levels of mercury exposure, non-linear methods, or identified as high quality were more likely to report an association with mercury, but overall results were inconsistent. Most studies reported no strong evidence of association between mercury and birth length (n = 14) or head circumference (n = 14). Overall, our review did not identify strong evidence that mercury exposure leads to impaired prenatal growth, although there was some evidence of a negative association of mercury with birth weight.

Short Stature Syndromes: Case Series from India

Syndromes causing short stature include Noonan syndrome (NS), Williams syndrome, and Silver–Russell syndrome (SRS). SRS is a primordial dwarfism with genetic heterogeneity. The SRS children present with prenatal growth retardation, neonatal hypoglycemia, feeding difficulties, physical asymmetry, with scoliosis and cardiac defect in some cases. The incidence is up to 1 in 100,000. Uniparental disomy, methylation abnormalities, and variants in some genes have been found underlying such phenotype. Growth hormone therapy has been used to improve the height gain in these patients. NS has genetic heterogeneity and most patients present with short stature with or without cardiac defect. Multiple genetic variants, mostly autosomal dominant, contribute to the phenotype. With the availability of next-generation sequencing, more and more genetic disorders causing short stature are being identified in different ethnic populations like Kabuki syndrome and Nance–Horan syndrome. Here, we present some cases of SRS and other additional syndromes with dysmorphism seen in past 5 years.

The Role of Fetal, Infant, and Childhood Nutrition in the Timing of Sexual Maturation

Puberty is a crucial developmental stage in the life span, necessary to achieve reproductive and somatic maturity. Timing of puberty is modulated by and responds to central neurotransmitters, hormones, and environmental factors leading to hypothalamic-pituitary-gonadal axis maturation. The connection between hormones and nutrition during critical periods of growth, like fetal life or infancy, is fundamental for metabolic adaptation response and pubertal development control and prediction. Since birth weight is an important indicator of growth estimation during fetal life, restricted prenatal growth, such as intrauterine growth restriction (IUGR) and small for gestational age (SGA), may impact endocrine system, affecting pubertal development. Successively, lactation along with early life optimal nutrition during infancy and childhood may be important in order to set up timing of sexual maturation and provide successful reproduction at a later time. Sexual maturation and healthy growth are also influenced by nutrition requirements and diet composition. Early nutritional surveillance and monitoring of pubertal development is recommended in all children, particularly in those at risk, such as the ones born SGA and/or IUGR, as well as in the case of sudden weight gain during infancy. Adequate macro and micronutrient intake is essential for healthy growth and sexual maturity.

Prenatal intrauterine growth restriction and risk of retinopathy of prematurity

Low birthweight and decreased postnatal weight gain are known predictors of worse retinopathy of prematurity (ROP) but the role of prenatal growth patterns in ROP remains inconclusive. To distinguish small for gestational age (SGA) from intrauterine growth restriction (IUGR) as independent predictors of ROP, we performed a retrospective cohort study of patients who received ROP screening examinations at a level IV neonatal intensive care unit over a 7-year period. Data on IUGR and SGA status, worst stage of and need for treatment for ROP, and postnatal growth was obtained. 343 infants were included for analysis (mean gestational age = 28.6 weeks and birth weight = 1138.2 g). IUGR infants were more likely to have a worse stage of ROP and treatment-requiring ROP (both p < 0.0001) compared to non-IUGR infants. IUGR infants were more likely to be older at worst stage of ROP (p < 0.0001) and to develop postnatal growth failure (p = 0.01) than non-IUGR infants. Independent of postnatal growth failure status, IUGR infants had a 4–5 × increased risk of needing ROP treatment (p < 0.001) compared to non-IUGR infants. SGA versus appropriate for gestational age infants did not demonstrate differences in retinopathy outcomes, age at worst ROP stage, or postnatal growth failure. These findings emphasize the importance of prenatal growth on ROP development.

Physical Activity in 6.5-Year-Old Children Born Extremely Preterm

Physical activity (PA) can prevent cardiovascular diseases. Because of increased risks of impairments affecting motor activity, PA in children born preterm may differ from that in children born at term. In this prospective cohort study, we compared objectively measured PA in 71 children born extremely preterm (<27 weeks gestational age), to their 87 peers born at term, at 6.5 years of age. PA measured with accelerometer on the non-dominant wrist for 7 consecutive days was compared between index and control children and analyzed for associations to prenatal growth, major neonatal brain injury, bronchopulmonary dysplasia and neonatal septicemia, using ANOVA. Boys born extremely preterm spent on average 22 min less time per day in moderate to vigorous physical activity (MVPA) than control boys (95% CI: −8, −37). There was no difference in girls. Amongst children born extremely preterm, major neonatal brain injury was associated with 56 min less time in MVPA per day (95%CI: −88, −26). Subgroups of children born extremely preterm exhibit lower levels of physical activity which may be a contributory factor in the development of cardiovascular diseases as adults.

Linear growth and mid-childhood cognitive outcomes in three birth cohorts of term-born children: an approach to integrating three growth models to explore critical windows

ObjectiveTo illustrate that a mediation framework can help integrate inferences from three growth models to enable a comprehensive view of the associations between growth during specific developmental windows and mid-childhood IQ.DesignWe analysed direct and indirect associations between mid-childhood IQ and length/height growth in five early-life age intervals bounded by conception, birth, early, mid and late infancy, and mid-childhood using estimates from three growth models (lifecourse, conditional change and change score) applied to three historical birth cohorts.Participants and setting12 088 term-born children from the Collaborative Perinatal Project (CPP) in the USA (n=2170), the Promotion of Breastfeeding Intervention Trial (PROBIT) in Belarus (n=8275) and the Cebu Longitudinal Health and Nutrition Survey (CLHNS) in the Philippines (n=1643).Primary outcome measureMid-childhood IQ.ResultsOur analyses revealed cross-cohort and cross-interval variations in the direct and indirect effects of foetal and early childhood physical growth on mid-childhood IQ. For example, in CPP, there was a direct association of prenatal growth with IQ that was not evident in the other cohorts, whereas in PROBIT and CLHNS, we observed that foetal and early growth-IQ associations were mediated through size in later periods.ConclusionLifecourse, conditional change and change score growth models yield complementary inferences when appropriately interpreted. Future longitudinal studies of associations of early-life growth with later outcomes would benefit from adopting a causal mediation framework to integrate inferences from multiple complementary growth models.

The Effect of Foetal And Early Childhood Growth on Metabolic Derangements of Sri Lankan Children

Background Studies have shown that accelerated postnatal growth plays a significant role on the onset of adult metabolic diseases. The aim of this study was to identify the effects of intrauterine and later growth on metabolic derangements among children in Colombo, Sri Lanka Materials: A school-based cross-sectional study was conducted among 5–15 year old children selected using a two-stage probability-proportionate-to-size cluster sampling technique. Birthweight (BW) was extracted from records to denote prenatal growth; and body mass index (BMI) and fat mass (FM) measured to denote the current growth of children. As metabolic parameters, fasting and random blood glucose, lipid profile and blood pressure (BP) were measured. The sample was stratified by age (5–10 years and 11–15 years); and each age group further categorized into tertiles of BW and BMI. Based on these two parameters, metabolic parameters were evaluated within each age category. Results The sample comprised 833 (494 boys). Metabolic parameters did not significantly differ by sex or across BW tertiles of each BMI tertile. However, significant increases were noted in all except FBS across the BMI tertiles of each BW tertile. Children belonging to the lowest BW and highest BMI tertiles had worst metabolic profiles, while those in the lowest BW as well as BMI tertile were protected. Changes were more significant in the older age category. Irrespective of BW, fat deposition rather than nutritional growth seemed to move children to higher BMI tertiles. Conclusion Poor prenatal growth is not the sole risk factor for abnormal metabolic profile found in childhood. Those who gain weight during early childhood are at higher risk than those who remain small. This favours the accelerated postnatal growth hypothesis.