Identification of Growth Patterns in Low Birth Weight Infants from Birth to 5 Years of Age: Nationwide Korean Cohort Study

This study aimed to investigate the nationwide growth pattern of infants in Korea according to the birth-weight group and to analyze the effect of growth on development. A total of 430,541 infants, born in 2013 and who received the infant health check-up regularly from 6 months to 60 months of age, were included. The weight, height, head circumferences percentiles, and neurodevelopment using screening tests results were compared among the birth-weight groups. Using longitudinal analysis, the study found a significant difference in height, weight, and head circumference, respectively, according to age at health check-up, birth weight group, and combination of age and birth weight (p < 0.001). The growth parameters at 60 months of age showed a significant correlation with those at 6 months of age especially in extremely low birth weight infants. The incidence of suspected developmental delay was significantly higher in infants with growth below the 10th percentiles than in those with growth above the 10th percentiles. Among 4571 (1.6%) infants with suspected developmental delay results at 60 months of age, birth weight, sex, and poor growth parameters were confirmed as associated factors. This nationwide Korean study shows that poor growth and neurodevelopment outcomes persisted among low-birth-weight infants at 60 months of age. Our findings provide guidance for developing a nationwide follow-up program for infants with perinatal risk factors in Korea.

Delivery of cesarean section tends to reduce umbilical zinc levels in healthy newborns

Background: Indonesia is estimated to be among countries with deficiencies in zinc intake. Zinc deficiency increase the risk of immune deficiency, preterm birth, retarded fetal growth, duration of infection healing, and stunting. Umbilical cord zinc levels can reflect zinc levels of newborns. Research on newborn zinc in Indonesia is still limited.Objective: Look for factors related to zinc levels of the newborns umbilical cord. The factors studied included maternal/newborn characteristics, and mode of delivery.Methods: A Cross sectional study of 88 healthy newborns at term pregnancy with their healthy mothers. Zinc samples were taken from cord blood immediately after birth. Measurement of zinc levels with Atomic Absorption Spectrophotometer. Chi-Square test was used to prove the relationship between low zinc levels (< 65μ/dl) with characteristics of both mother and newborn. The Mann-Whitney test was used to prove differences in zinc levels between groups according to characteristics, mode of delivery, and birth weight. Software SPSSstatistic 21.Results: There was no significant relationship between mother and newborn characteristics with low umbilical cord zinc levels (<65μg/dl), with a p value > 0.05. There was a significant difference in mean umbilical cord zinc levels between the two groups (p=0.015), that cesarean section delivery had a mean rank of lower zinc levels (41.5μg/ dl) median 79.8 (min.50.9-max.140.3 μg/dl) compared to spontaneous vaginal delivery (59.3μg/dl) median 97.7 (min.57.6-max.132.9μg/dl). Umbilical cord zinc levels from 2500 - < 2800 g birth weight group have lower mean rank (37.7μg/dl) compared to 2800 - 3900 g birth weight group (48.2μg/dl), with a p value = 0.028.Conclusions: There is a tendency to decrease zinc levels in healthy newborns from cesarean delivery. Decreased zinc levels in healthy newborns may cause lower birth weight.International Journal of Human and Health Sciences Vol. 04 No. 04 October’20 Page : 298-304

Severity of Cerebral Palsy—The Impact of Associated Impairments

Objective This article describes associated impairments in children with cerebral palsy (CP) and its subtypes. Method Children born between 1990 and 2006 recorded in the Surveillance of Cerebral Palsy in Europe common database were studied. An “impairment index” characterized severity of impairments and their combinations. Results Amongst the 11,015 children analyzed, 56% (n = 5,968) could walk unaided, 54% (4,972) had normal or near-normal intellect (intelligence quotient ≥ 70). Except for ataxic CP, associated impairments were less frequent when walking ability was preserved. The impairment index was low (walking unaided and normal or near-normal intellect) in 30% of cases; 54% (n = 1,637) in unilateral spastic, 24% (n = 79) in ataxic, 18% (n = 913) in bilateral spastic, and 7% (n = 50) in dyskinetic CP. Around 40% had a high impairment index (inability to walk and/or severe intellectual impairment ± additional impairments)—highest in dyskinetic (77%, n = 549) and bilateral spastic CP (54%, n = 2,680). The impairment index varied little in birth weight and gestational age groups. However, significantly fewer cases in the birth weight group ≤ 1,000 g or gestational age group ≤ 27 weeks had a low impairment index compared to the other birth weight and gestational age groups (23 and 24% vs. between 27 and 32%). Conclusion Thirty percent of the children with CP had a low impairment index (they were able to walk unaided and had a normal or near-normal intellect). Severity in CP was strongly associated to subtype, whereas the association was weak with birth weight or gestational age.

351 Neonatal birth weight effects on gilt development growth and first parity reproductive efficiency

There has been a great deal of interest in gilt development characteristics that predict gilt growth and reproductive traits and which could be measured and manipulated early in the gilt’s lifetime. The objective of the study was to determine neonatal birth weight effects on gilt development growth performance and parity 1 sow reproductive performance traits. Data were collected from 1,052 litters housed at Circle 4 Farms, Milford, UT. A total of 2,960 crossbred Large White x Landrace maternal line gilts entered the research gilt development unit. Gilts were categorized by their individual neonatal birth weight into 3 groups Group I (≤ 1.1 kg; n = 772), Group II (1.2 to 1.5 kg; n = 1,356), and Group III (≥ 1.6 kg; n = 832). Growth and reproductive trait least square means (±SE) for each birth weight group were analyzed and compared among birth weight groups using PROC GLM. Fixed effects in the model included birth weight, farm, and development diet with the random effect of pen within a room. Neonatal birth weight group was a significant (P < 0.05) source of variation for gilt growth in development, number born alive, and litter birth weight at first parity. Gilts from the largest birth weight group had significantly (P < 0.05) larger BW at 100 (45.1 ± 0.3 kg), and BW 200 days (125.7 ± 0.7 kg), faster average daily gain (0.81 ± 0.005 kg), larger BW at puberty (137.7 ± 0.8 kg), larger BW at farrowing (201.1 ± 1.2 kg), larger BW at post-weaning (195.0 ± 1.0 kg), larger number born alive (11.8 ± 0.1), larger litter birth weights (18.2 ± 0.2 kg). The largest birth weight group tended (P > 0.05) to wean more pigs (9.0 ± 0.2) and have greater litter weaning weights (48.8 ± 1.04 kg) at first parity when compared to gilts from the other two birth weight groups. Improving neonatal birth weight will improve gilt development and productivity through first parity.

UPAYA PENGEMBANGAN POPULASI TERNAK BABI MELALUI TEKNIK INSEMINASI BUATAN DIPROVINSI SULAWESI UTARA

ABSTRACTEXPEDIENCY OF INCREASING PIG POPULATION BY ARTIFICIAL INSEMINATION TECHNIQUE IN NORTH SULAWESI PROVINCE.The objective of this study was to evaluate dominant factors affecting pig population breeding by artificial insemination (AI) in North Sulawesi province. Semen of boar (Landrace, Yorkshire and Duroc breeds) were usedto mate the same breeds using AI.Data of 345 piglets from 33 sows were involved in this study. Reproductive data of sows and productivity of piglet form AI were observed at laboratory and field belonging to farmers in Minahasa regency. Pair data of male and female effect were analyzed by t-test for variables.Dominant reproduction factors affecting pig population breeding in North Sulawesi were includingservice per conception, Farrowing rate, AI service efficiency, and Farrowing index.Group of male and superior piglets were higher in productivity that those of female and inferior piglets. Preweaning Average Daily Gain (PW-ADG)groups of inferior (84.85g/h/d)were significantly lower compared with normal (86.59g/h/d), butnot significantly different with PW-ADG of superior birth weight group (85.64 g/h/d).PW-ADG.Thelitter size produced from semen bya boar naturally mated with the same sowsreached the average of 21 piglets per year, while those by a boar mated using AI technique with the same sowsreached the average of 225 piglets per year. Keywords:Artificial insemination. Pig reproduction, North Sulawesi province

Desenvolvimento motor no primeiro ano de vida de crianças prematuras conforme o peso de nascimento

***Motor development in the first year of life of premature infants according to birth weight***AIMS: To assess motor development in the first year of life of children born at 36 weeks' gestational age, comparing two groups, one with birth weight below 2500g and the other with 2500g or more.METHODS: A cross-sectional study evaluated the motor development of children enrolled in the Basic Health Units of Caxias do Sul and Porto Alegre, by the Alberta Infant Motor Scale. The sample consisted of infants born at 36 weeks' gestation, evaluated with a corrected chronological age of 0 to 12 months, divided into two groups: Low Birth Weight group (LBW group: birth weight below 2,500 g) and Adequate Birth Weight group (ABW group: birth weight of 2,500 g or more). The independent t-test, the chi-square test of Pearson and the Eta2 test (strong association> 0.60) were used to analyze the data. P <0.05 was considered significant.RESULTS: We evaluated 42 children, 21 in each group. Fifteen (71.42%) children with low birth weight were classified as small for gestational age. The mean motor development score percentile was 17.90±17.74 for the LBW group and 34.57±25.80 for the ABW group, indicating a better motor development of the second group (p=0.02) . There was a greater number of children with developmental delay in the LBW group (52.4%), whereas in the ABW group most were within the normal range (47.6%). The association was statistically significant between performance categories and birth weight groups, using the chi-square test (p=0.001), with Eta2=0.64 (strong association).CONCLUSIONS: In preterm infants with matched gestational age at 36 weeks, the low birth weight group had worse motor performance in the first year of life compared to the group with adequate birth weight.

Increased birth weight is associated with altered gene expression in neonatal foreskin

Elevated birth weight is linked to glucose intolerance and obesity health-related complications later in life. No studies have examined if infant birth weight is associated with gene expression markers of obesity and inflammation in a tissue that comes directly from the infant following birth. We evaluated the association between birth weight and gene expression on fetal programming of obesity. Foreskin samples were collected following circumcision, and gene expression analyzed comparing the 15% greatest birth weight infants (n=7)v.the remainder of the cohort (n=40). Multivariate linear regression models were fit to relate expression levels on differentially expressed genes to birth weight group with adjustment for variables selected from a list of maternal and infant characteristics. Glucose transporter type 4 (GLUT4), insulin receptor substrate 2 (IRS2), leptin receptor (LEPR), lipoprotein lipase (LPL), low-density lipoprotein receptor-related protein 1 (LRP1), matrix metalloproteinase 2 (MMP2), plasminogen activator inhibitor-1 (PAI-1) and transcription factor 7-like 2 (TCF7L2) were significantly upregulated and histone deacetylase 1 (HDAC1) and thioredoxin (TXN) downregulated in the larger birth weight neonatesv. controls. Multivariate modeling revealed that the estimated adjusted birth weight group difference exceeded one standard deviation of the expression level for eight of the 10 genes. Between 25 and 50% of variation in expression level was explained by multivariate modeling for eight of the 10 genes. Gene expression related to glycemic control, appetite/energy balance, obesity and inflammation were altered in tissue from babies with elevated birth weight, and these genes may provide important information regarding fetal programming in macrosomic babies.

Birth weight and blood pressure in first-grade elementary school students: A preliminary study

Background Fetal programming theory reveals that low birthweight is associated with higher risks of hypertension and cardio-vascular diseases in the adulthood.Objective To study the difference in blood pressure among first-grade students of different birth weight groups.Methods A cross-sectional study was performed. Blood pressureof 214 healthy first-grade elementary school students (102 malesand 112 females) in Bunaken Subdistrict, Manado, Indonesia, wasmeasured using a standard sphygmomanometer with appropriatecuff for arm size. Two readings were taken. Parents were asked tocomplete a questionnaire concerning the information on birth weightand length and confirmed by retrieving the record on a growthchart and/or a maternal-child health book. The subjects were di-vided into 6 groups according to their birth weight. The differencesin blood pressure values between birth weight groups were exam-ined by ANOVA.Results Systolic blood pressures were significantly higher in the<2500 g birth weight group (100.73+9.99 mmHg vs. 93.70+8.29mmHg) and in the 2500-<3000 g birth weight group compared tothose of the 3500-<4000 g one (99.56+9.14 mmHg vs. 93.70+8.29mmHg) with a P of 0.048 and 0.014, respectively. There was nodifference between diastolic blood pressure and birth weight.Conclusion Our study showed that the lower birth weight grouptends to have a higher systolic blood pressure than that of childrenwith normal birth weight

Pattern of newborn babies delivered by cesarean section

Background The birth rate in Indonesia is still high and abnormallabor constitutes 15% of all deliveries which needs cesarean sec-tion as a solution for complicated cases.Objectives To find the general physical condition of babies bornafter cesarean section as well as the characteristics of motherswho underwent cesarean section.Methods A retrospective study on newborn babies delivered bycesarean section conducted in Subdivision of Neonatology, Medi-cal School, University of North Sumatera-Pirngadi Hospital Medan,in period of 2 years (1991-1992).Results There were 8762 babies born during the study period,1484 babies (16.93%) delivered by cesarean section due to pla-centa previa (26.2%), prolonged labor (15.8%), cephalopelvic dis-proportion (10.3%), neglected labor (9.9%), eclampsia/preeclamp-sia (8.1%), fetal distress (7.5%), previous section (6.6%), breechpresentation (5.7%), solutio placenta (4.0%), and others (5.9%). Itwas shown that mothers undergoing caesarean section was mainly20-30 years old (66.4%), multigravida (47.8%), term gestationalage (79.4%), and minimal antenatal care (61.3%). There were 1224(82.5%) babies with birth weight >2500 grams and 894 (60.2%)suffered from asphyxia.Conclusions The evidence of asphyxia by cesarean section andlow birth weight group was significantly different from those nor-mally delivered (p<0.001). The mortality rate was 11.5% due tostill birth 29.2%, RDS 18.3%, sepsis 15.5%, pneumonia 12.3%,and gastroenteritis 11.5%

Clinical profile of newborns undergoing physical therapy in a neonatal intensive care unit

Introduction: In neonatal therapy units, physical therapy is directed toward integral baby care. Objective: To describe the profile of newborns (NBs) hospitalized in a Neonatal Intensive Care Unit (NICU). Methods: Retrospective documentary study with data collection from medical records from July 2011 to July 2013. The sample consisted of NBs who performed motor and respiratory therapy. Data were grouped into five categories according to birth weight (≤ 1000g, 1001-1500g, 1501-2000g, 2001-2500g, ≥ 2501g). Results: total of 1,884 newborns were admitted to the NICU within the stipulated period, 168 (13.9%) underwent physical therapy. Of the 168 NBs who underwent physical therapy, 137 were born in the hospital (81.5%) and 31 were transferred there (18.5%); 17 of these babies died during the neonatal hospital stay (10.1%). All newborns of the extremely low birth weight group (≤ 1000g) required mechanical ventilation, 72.7% non-invasive ventilation and 16.6% high-frequency oscillatory ventilation. The occurrence of pneumothorax in the extremely low birth weight group was 13.8% and 16% in the group with birth weight 1001-1500g. Conclusion: Infants with low birth weight (<2500g) constituted the profile of NBs who underwent physical therapy, which was directly related to higher incidence of death and pneumothorax, as well as increased use of mechanical and non-invasive ventilation.