Retinopathy of prematurity: Postnatal weight gain and risk factors profile; a hospital-based study from a tertiary care center

Background: Premature infants often develop blindness in one or both eyes due to disparity in retinal growth. This condition is termed as retinopathy of prematurity (ROP). Aim: The aim of the study is to study the postnatal weight gain pattern of preterm infants (Age < 32 weeks) and risk factors of ROP in a tertiary care center and to validate the lower birth weight and gestational age (GA) for ROP. Methods: Hospital-based study on 110 preterm neonates admitted in the neonatal intensive care unit (NICU) who fulfilled the criteria for ROP screening. On screening, 55 neonates were identified to have ROP and 55 neonates identified to have no ROP. The profiles of ROP and risk factors were documented according to the International Classification for ROP recommendations. The data were analyzed for GA, birth weight, and risk factors predisposing to ROP. Results: A total of 110 preterm neonates were screened, out of which, 55 had ROP. The mean GA (P = 0.002), Apnea (P = 0.001), ventilation (P = 0.001), and surfactant (P = 0.001) were observed a significant difference. Further, a significant difference in weight gain pattern in the two groups (P < 0.05) was also observed. The group without ROP had a better weight gain pattern than the group with ROP. Conclusion: Our study revealed prematurity, low birth weight, and birth weight increasing patterns were found to be strong predictors of ROP. GA, apnea, ventilation, and surfactant were found to be statistically significant factors associated with ROP.

Retrospective longitudinal analysis of the effects of postnatal weight gain on the timing and tempo of puberty and menarche in a cohort of Italian girls

Objectiveover the last few decades there has been a progressive decline in the average age of onset of pubertal development stages in both sexes. The increase in the prevalence of childhood obesity seems to play an important role in this phenomenon.Designwe undertook a retrospective, longitudinal evaluation of the average age of thelarche and menarche to evaluate the relationship between BMI and weight change during the first years of life and the timing and tempo of puberty.Methodswe evaluated data for 577 Italian girls born between 1995 and 2003. We collected the main auxological and clinical parameters, including age at B2 and at menarche, BMI SDS at B2 and menarche, gestational age and birth weight and Z-score change from birth weight (BW) to BMI at B2 and menarche.Resultsthe mean age of B2 was 10.06 ± 1.03 years and the mean age of menarche was 12.08 ± 1.02 years. Age at B2 and menarche were inversely correlated with BMI SDS (p < 0.0001). Both age at menarche and at thelarche have an inverse relationship with the Z-score change from birth weight and BMI at menarche and thelarche respectively (p < 0.0001).Conclusionsour data confirm a significant relationship between BMI and age of B2 and menarche. We observed a clear relationship among weight change during the first years of life, age at thelarche and menarche and the duration of puberty, demonstrating the importance of weight and weight gain in determining the timing and tempo of pubertal changes and growth.

Effect of intestinal microecology on postnatal weight gain in very preterm infants in intensive care units

Objective To study the effect of intestinal microecology on postnatal weight gain of very preterm infants in neonatal intensive care unit (NICU). Methods Very preterm infants who met the inclusion criteria were enrolled. The subjects were divided into the extrauterine growth retardation (EUGR) group(defined as a body weight less than the 10th percentile of the corresponding gestational age or a weight loss between birth and a given time of > 2SD were considered EUGR) and normal growth group, and the growth was evaluated at 2 and 4 weeks after birth. Meanwhile, the stool samples were taken to perform16S ribosomal RNA (rRNA) high -throughput 16S rRNA sequencing of the intestinal microflora was performed on stool samples. Results A total of 22 infants were included. There was no significant difference in the alpha diversity indexes indices between the two groups at 2 weeks or 4 weeks after birth. The beta diversity analysis showed that the two groups had similar principal components of the intestinal microflora were similar between the two groups. Linear discriminant analysis (LDA) effect size (LEfSe) showed that 2 weeks after birth, the bacteria with an absolute LDA score (log10) higher than 4 included Streptococcaceae, Streptococcus, Bacteroidetes, Bacteroidales and Stenotrophomonas in the EUGR group and Enterococcaceae and Enterococcus in the control group. At the 4th week after birth, the bacteria with an absolute LDA score (log10) higher than 3 in the EUGR group includedwere Clostriaceae, Eubacteriaceae and Eubacterium. TheBy comparing the composition of the microbial community composition comparison showed, significant differences were found in the principal components of Enterococcus and Streptococcus on the family and genus levels at 2 weeks after birth. No Bifidobacterium was found in either group at 4 weeks after birth. Conclusion Intestinal microecology is different between infants with EUGR and those with normal growth. The diversity and richness of the intestinal microflora in preterm infants at the NICU are significantly insufficient and change dynamically with time, and the establishment of intestinal homeostasis is obviously delayed.

Birthweight And Postnatal Growth As Predictors of Elevated Blood Pressure In Adolescents of Low Socioeconomic Condition: A Cohort Study In Northeast Brazil

Objective: To evaluate low birthweight and rapid postnatal weight gain as predictors of elevated blood pressure in adolescence in a population of low socioeconomic status.Methods: A cohort study was carried out with 208 adolescents, 78 born with low weight and 130 born with appropriate weight. The infants were followed up during the first six postnatal months and reassessed at 8 and 18 years of age. The main exposure variables were birth weight and weight gain in the first six postnatal months. Rapid weight gain was defined when above 0.67 z score. The investigated co-variables were: sex, maternal height and family income at birth, breastfeeding duration from birth to six months, nutritional status at eight years old, socioeconomic conditions, nutritional status, fat mass index and physical activity level at 18 years. The outcome variable was the occurrence of elevated blood pressure at 18 years old.Results: The proportion of adolescents with elevated blood pressure was 37.5%. The multivariable logistic regression analysis showed the variables independently associated with a higher chance of elevated blood pressure in adolescence were rapid postnatal weight gain (OR=2.74; 95% CI 1.22-6.14; p=0.014), male sex (OR=4.15; 95% CI 1.66-40 10.38; p=0.002) and being physically active (OR=2.70; 95% CI 1.08-6.74; p=0.034).Conclusions: The occurrence of rapid weight gain in the first six postnatal months was a predictor for elevated blood pressure in adolescence. This result highlights the influence of factors related to development in early childhood on health problems in the future.

Sex differences in postnatal weight gain trajectories of extremely preterm newborns

Objective Both postnatal growth and sex play a crucial role in long-term outcomes of extremely preterm newborns (EPNs), but the relationship between sex and postnatal growth is not clear. This study aims to assess sex differences in weight trajectories. Study design Weight data in the first 200 days of life from 4327 EPNs were used for generalized additive mixed modeling. We considered gestational age and sex as fixed-effects, and included random intercepts and random slopes for postnatal age. We assessed interactions between fixed-effects and postnatal age. Results Male EPNs had higher predicted weight trajectories than females. Weight z-score trajectories decreased in both sexes before term-equivalent age comparably, but females showed faster increases afterward. Although weight gain velocity was comparable between both sexes, weight gain velocity in male EPNs was lower compared to the corresponding reference values from the 2013 Fenton growth charts, which explained slower z-score rises. Conclusion Sex disparity exists in postnatal weight gain trajectories of EPNs after reaching the term-equivalent age.