Relation of maternal birthweight with early pregnancy obesity, gestational diabetes, and offspring macrosomia

This study aimed to investigate how maternal birthweight is related to early pregnancy obesity, gestational diabetes mellitus (GDM), and offspring birthweight. Females born term and singleton in Sweden between 1973 and 1995 (N = 305,893) were studied at their first pregnancy. Information regarding their birthweight, early pregnancy body mass index, and pregnancy complications was retrieved from the Swedish Medical Birth Register, as were data on their mothers and offspring. High maternal birthweights (2–3 standard deviation scores (SDS) and >3 SDS) were associated with greater odds of early pregnancy obesity, odds ratio (OR) 1.52 (95% confidence interval (CI) 1.42–1.63) and OR 2.06 (CI 1.71–2.49), respectively. A low maternal birthweight (<2 SDS) was associated with greater odds of GDM (OR 2.49, CI 2.00–3.12). No association was found between high maternal birthweight and GDM. A maternal birthweight 2–3 SDS was associated with offspring birthweight 2–3 SDS (OR 3.83, CI 3.44–4.26), and >3 SDS (OR 3.55, CI 2.54–4.97). Corresponding ORs for a maternal birthweight >3 SDS were 5.38 (CI 4.12–7.01) and 6.98 (CI 3.57–13.65), respectively. In conclusion, a high maternal birthweight was positively associated with early pregnancy obesity and offspring macrosomia. A low, but not a high maternal birthweight, was associated with GDM.

Longitudinal associations of behavioral problems and text reading skills in school-aged children born term and preterm

We assessed the contribution of total behavioral problems at 6 years to text reading skills at 8 years in children born term and preterm. Birth group moderated associations among total behavioral problems and reading skills; total behavioral problems predicted reading skills in the term but not preterm group.

Dynamic FDG PET Imaging to Probe for Cardiac Metabolic Remodeling in Adults Born Premature

Individuals born very premature have an increased cardiometabolic and heart failure risk. While the structural differences of the preterm heart are now well-described, metabolic insights into the physiologic mechanisms underpinning this risk are needed. Here, we used dynamic fluorodeoxyglucose (FDG) positron emission tomography/magnetic resonance imaging (PET-MRI) in young adults born term and preterm during normoxic (N = 28 preterm; 18 term) and hypoxic exposure (12% O2; N = 26 preterm; 17 term) to measure the myocardial metabolic rate of glucose (MMRglc) in young adults born term (N = 18) and preterm (N = 32), hypothesizing that young adults born preterm would have higher rates of MMRglc under normoxic conditions and a reduced ability to augment glucose metabolism under hypoxic conditions. MMRglc was calculated from the myocardial and blood pool time-activity curves by fitting the measured activities to the 3-compartment model of FDG kinetics. MMRglc was similar at rest between term and preterm subjects, and decreased during hypoxia exposure in both groups (p = 0.02 for MMRglc hypoxia effect). There were no differences observed between groups in the metabolic response to hypoxia, either globally (serum glucose and lactate measures) or within the myocardium. Thus, we did not find evidence of altered myocardial metabolism in the otherwise healthy preterm-born adult. However, whether subtle changes in myocardial metabolism may preceed or predict heart failure in this population remains to be determined.

Arthrogryposis Multiplex Congenita: A Rare Case Report

Arthrogryposis Multiplex Congenita is a descriptive term with various etiologies and complex clinical features including multiple joint contractures of various limb joints. It is associated with malformations, malfunctions and neurologic deficiencies. We report the case of a new born term female child admitted at Rural Medical College, Ahmednagar (Maharashtra) with positive family history and evident clinical features of arthrogryposis multiplex congenita. Multidisciplinary management was instituted. This case is presented for its rarity.

Human Milk Sampling Protocols Affect Estimation of Infant Lipid Intake

ABSTRACT Background Human milk (HM) lipid content is highly variable, and infants consume different volumes of milk. This makes precise sampling and calculation of the infant lipid intake problematic. Objectives In order to describe inaccuracies of estimates of lipid content introduced by various sampling protocols, we compared the true infant lipid intake with estimated intakes using different milk sampling protocols. Methods Monthly milk samples (n = 1026) from months 1 to 6 of lactation were collected from 20 healthy, exclusively breastfeeding women. Infant lipid intake was measured by 24-hour test-weighing at month 3. Total lipid content was measured by creamatocrit. Concentrations and infant lipid intakes were calculated using 11 sampling protocols, using either the true milk intake or an average of 800 mL/d. These estimates were compared with the true infant lipid intake using repeated-measures ANOVA and linear mixed modeling with multiple comparisons. Results The mean maternal age was 32.0 years (SD ± 3.10), and infants were born term (40.1 ± 1.1 weeks) with a mean birth weight of 3.87 kg (SD ± 0.39). The mean true infant lipid intake was 28.6 g/d (SD ± 9.8). The mean estimated lipid intake using 1 morning pre-feed sample underestimated intake by &gt;8.0 g/d. Estimates of infant lipid intake using other sampling protocols and an assumed intake volume of 800 mL/d also resulted in a wide range of differences (0.8–18.1 g/d) from the true intake. Use of 6 daily pre- and post-feed milk samples had a mean difference of only 0.1 g/d (95% CI, −2.9 to 2.7) from the true intake. Conclusions A sampling protocol with 6 pre- and post-feed samples provides the most accurate estimate of lipid intake if it is not possible to perform 24-hour test weights. The potential inaccuracies of sampling protocols should be taken into consideration in the interpretation and translation of infant lipid intake results.

97 Electrocardiographic features at rest and during exercise in young adults born preterm below 30 weeks of gestation

Introduction/Background Preterm birth has adverse consequences on the cardiovascular system. Whether premature birth is associated with conduction and repolarisation abnormalities past childhood and into adulthood still needs to be demonstrated. An exercise test could reveal such abnormalities. Objectives We aimed to assess electrocardiographic changes, particularly corrected QT (QTc) prolongation, in a cohort of young adults born preterm, at rest and during exercise. Design/Methods We analysed the ECG of young adults (23.9±3.1 years) born term (≥37 weeks, n=53) and preterm (&lt;30 weeks, n=49) at rest, peak exercise and 3 minutes into recovery during an exercise test on a cycle ergometer. We measured PR, QRS and QT intervals, calculated the QTc, and determined blood calcium, magnesium, potassium and fasting glucose. Results Mean gestational age was 39.7±1.1 and 27.3±1.3 weeks for the term and the preterm groups, respectively. Apart from an increased heart rate at rest in individuals born preterm, no significant difference was found between both groups for any other ECG parameters at rest (Table 1). None of the participants had a severely prolonged QTc (&gt;500ms) at rest; exercise revealed severely prolonged QTc in two participants including one in the preterm group. The use of QT-prolonging medications did not influence ECG parameters in either groups. Conclusion We observed no significant difference in electrocardiographic measurements between young adults born preterm and term. Current results do not support avoidance of QT-prolonging medications in individuals born preterm.