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Sample records for age parity gestational

  1. The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: a meta-analysis

    PubMed Central

    2013-01-01

    Background Previous studies have reported on adverse neonatal outcomes associated with parity and maternal age. Many of these studies have relied on cross-sectional data, from which drawing causal inference is complex. We explore the associations between parity/maternal age and adverse neonatal outcomes using data from cohort studies conducted in low- and middle-income countries (LMIC). Methods Data from 14 cohort studies were included. Parity (nulliparous, parity 1-2, parity ≥3) and maternal age (<18 years, 18-<35 years, ≥35 years) categories were matched with each other to create exposure categories, with those who are parity 1-2 and age 18-<35 years as the reference. Outcomes included small-for-gestational-age (SGA), preterm, neonatal and infant mortality. Adjusted odds ratios (aOR) were calculated per study and meta-analyzed. Results Nulliparous, age <18 year women, compared with women who were parity 1-2 and age 18-<35 years had the highest odds of SGA (pooled adjusted OR: 1.80), preterm (pooled aOR: 1.52), neonatal mortality (pooled aOR: 2.07), and infant mortality (pooled aOR: 1.49). Increased odds were also noted for SGA and neonatal mortality for nulliparous/age 18-<35 years, preterm, neonatal, and infant mortality for parity ≥3/age 18-<35 years, and preterm and neonatal mortality for parity ≥3/≥35 years. Conclusions Nulliparous women <18 years of age have the highest odds of adverse neonatal outcomes. Family planning has traditionally been the least successful in addressing young age as a risk factor; a renewed focus must be placed on finding effective interventions that delay age at first birth. Higher odds of adverse outcomes are also seen among parity ≥3 / age ≥35 mothers, suggesting that reproductive health interventions need to address the entirety of a woman’s reproductive period. Funding Funding was provided by the Bill & Melinda Gates Foundation (810-2054) by a grant to the US Fund for UNICEF to support the activities of the Child

  2. Small for gestational age (SGA)

    MedlinePlus

    ... medlineplus.gov/ency/article/002302.htm Small for gestational age (SGA) To use the sharing features on this page, please enable JavaScript. Small for gestational age means that a fetus or an infant is ...

  3. Large for gestational age (LGA)

    MedlinePlus

    ... medlineplus.gov/ency/article/002248.htm Large for gestational age (LGA) To use the sharing features on this page, please enable JavaScript. Large for gestational age means that a fetus or infant is larger ...

  4. Outcomes of Small for Gestational Age Infants < 27 Weeks’ Gestation

    PubMed Central

    De Jesus, Lilia C.; Pappas, Athina; Shankaran, Seetha; Li, Lei; Das, Abhik; Bell, Edward F.; Stoll, Barbara J.; Laptook, Abbot R.; Walsh, Michele C.; Hale, Ellen C.; Newman, Nancy S.; Bara, Rebecca; Higgins, Rosemary D.

    2014-01-01

    Objective To determine whether small for gestational age (SGA) infants <27 weeks gestation is associated with mortality, morbidity, growth and neurodevelopmental impairment at 18–22 months’ corrected age (CA). Study design This was a retrospective cohort study from National Institute of Child Health and Human Development Neonatal Research Network’s Generic Database and Follow-up Studies. Infants born at <27 weeks’ gestation from January 2006 to July 2008 were included. SGA was defined as birth weight <10th percentile for gestational age by the Olsen growth curves. Infants with birth weight ≥10th percentile for gestational age were classified as non-SGA. Maternal and infant characteristics, neonatal outcomes and neurodevelopmental data were compared between the groups. Neurodevelopmental impairment was defined as any of the following: cognitive score <70 on BSID III, moderate or severe cerebral palsy, bilateral hearing loss (+/− amplification) or blindness (vision <20/200). Logistic regression analysis evaluated the association between SGA status and death or neurodevelopmental impairment. Results There were 385 SGA and 2586 non-SGA infants. Compared with the non-SGA group, mothers of SGA infants were more likely to have higher level of education, prenatal care, cesarean delivery, pregnancy-induced hypertension and antenatal corticosteroid exposure. SGA infants were more likely to have postnatal growth failure, a higher mortality and to have received prolonged mechanical ventilation and postnatal steroids. SGA status was associated with higher odds of death or neurodevelopmental impairment [OR 3.91 (95% CI: 2.91–5.25), P<0.001]. Conclusion SGA status among infants <27 weeks’ gestation was associated with an increased risk for postnatal steroid use, mortality, growth failure and neurodevelopmental impairment at 18–22 months’ CA. PMID:23415614

  5. Predicting gestational age using neonatal metabolic markers

    PubMed Central

    Ryckman, Kelli K.; Berberich, Stanton L.; Dagle, John M.

    2016-01-01

    Background Accurate gestational age estimation is extremely important for clinical care decisions of the newborn as well as for perinatal health research. Although prenatal ultrasound dating is one of the most accurate methods for estimating gestational age, it is not feasible in all settings. Identifying novel and accurate methods for gestational age estimation at birth is important, particularly for surveillance of preterm birth rates in areas without routine ultrasound dating. Objective We hypothesized that metabolic and endocrine markers captured by routine newborn screening could improve gestational age estimation in the absence of prenatal ultrasound technology. Study Design This is a retrospective analysis of 230,013 newborn metabolic screening records collected by the Iowa Newborn Screening Program between 2004 and 2009. The data were randomly split into a model-building dataset (n = 153,342) and a model-testing dataset (n = 76,671). We performed multiple linear regression modeling with gestational age, in weeks, as the outcome measure. We examined 44 metabolites, including biomarkers of amino acid and fatty acid metabolism, thyroid-stimulating hormone, and 17-hydroxyprogesterone. The coefficient of determination (R2) and the root-mean-square error were used to evaluate models in the model-building dataset that were then tested in the model-testing dataset. Results The newborn metabolic regression model consisted of 88 parameters, including the intercept, 37 metabolite measures, 29 squared metabolite measures, and 21 cubed metabolite measures. This model explained 52.8% of the variation in gestational age in the model-testing dataset. Gestational age was predicted within 1 week for 78% of the individuals and within 2 weeks of gestation for 95% of the individuals. This model yielded an area under the curve of 0.899 (95% confidence interval 0.895−0.903) in differentiating those born preterm (<37 weeks) from those born term (≥37 weeks). In the subset of

  6. Who develops carpal tunnel syndrome during pregnancy: An analysis of obesity, gestational weight gain, and parity

    PubMed Central

    Smith, Bryan; Wright, Sean; Weiner, Mark; Wright, Kevin; Rubin, David

    2014-01-01

    Purpose To examine the prevalence, onset, and risk factors of carpal tunnel syndrome during pregnancy. Methods Maternal electronic medical records were linked to birth certificate records using social security number. The outcome of carpal tunnel syndrome during pregnancy was defined as ICD9 code 354.0 given at a prenatal visit. Chi-square, t-test, and adjusted logistic regression were performed. Results We analyzed 17,623 prenatal visits from the Hospital of the University of Pennsylvania from 1/2003–12/2007. Mean maternal age was 26.4 (6.5) years, with 21% white, 69% black, and 46% overweight or obese. Ninety-one (2.8%) mothers participated in 765 prenatal visits given a carpal tunnel syndrome diagnosis code. Compared to mothers without carpal tunnel syndrome, mothers with carpal tunnel syndrome were older (29.72 (5.42) versus 26.04 (6.37) years, p = 0.005), gained more weight during pregnancy (40.65 (10.13) pounds versus 34.2 (9.41) pounds, p = 0.04), and more likely to have college education (69.9% versus 44.5%, p = 0.03). Average onset (SD) of carpal tunnel syndrome was 18.1 (8.4) weeks’ gestation. Conclusion Mothers with carpal tunnel syndrome had high rates of overweight, obesity, and excessive gestational weight gain. Diagnosis of carpal tunnel syndrome was rare but often occurred in the first and second trimesters, earlier than the frequently reported third trimester onset seen in literature. When looking at predictors of carpal tunnel syndrome, obese prepregnancy body mass index (BMI ≥ 30 kg/m2) and excessive gestational weight gain, greater than two previous live births, higher level of maternal education and more prenatal care (>10 visits) were associated with increased risk of carpal tunnel syndrome. Higher maternal age was not associated with carpal tunnel syndrome diagnosis after adjusting for weight and parity, suggesting mediation by these covariates.

  7. Postnatal overestimation of gestational age in preterm infants.

    PubMed

    Shukla, H; Atakent, Y S; Ferrara, A; Topsis, J; Antoine, C

    1987-10-01

    In a study involving 25 preterm infants, obstetric clinical age (standard gestational age) was determined by history, physical examination, and ultrasonographic evaluation. Postnatally, these infants were then evaluated using the Dubowitz Scoring System (DSS) for gestational age assessment. The DSS, as administered by us, significantly overestimated gestational age compared with the standard gestational age (mean +/- 1 SD: 34.2 +/- 2.9 vs 32.5 +/- 3.9 weeks, respectively) in preterm infants. To illustrate, the gestational ages of 13 newborns (52%) in the total study group were each overestimated by more than two weeks. This percentage increased to 75% among the 16 infants whose gestational ages were less than 34 weeks (by standard gestational age). When the standard gestational age was underestimated by the DSS, this difference never exceeded two weeks. These findings suggest that the present system of postnatal assessment of gestational age in preterm infants needs further investigation. PMID:3307384

  8. Relationship between Body Weight of Primiparous Sows during Late Gestation and Subsequent Reproductive Efficiency over Six Parities

    PubMed Central

    Kim, Jin Soo; Yang, Xiaojian; Baidoo, Samuel Kofi

    2016-01-01

    The present study investigated the impact of parity 1 gilt body weight during late gestation (d 109) on subsequent reproductive performance of sows and performance of suckling pigs. A total of 2,404 farrowing records over 6 parities were divided into six groups on the basis of body weight (190, 200, 210, 220, 230, and 240 kg) at d 109 of gestation of 585 gilts. Significant effects (p< 0.05) of body weight on sow retention rate was noticed, with the 210 kg group having the lowest culling rate and highest total number of piglets born alive over the 6 parities. With increase of body weight, a linear increase (p<0.05) in losses of body weight and backfat during the lactation period of parity 1 and a linear decrease (p<0.05) in backfat loss for parities 4 and 6 were found. Compared with light sows, heavy sows had higher (p<0.05) litter weight at birth for parities 1 and 2 and at weaning in parity 1. Sow weaning-to-estrus interval of sows was not influenced (p>0.05) by body weight. In conclusion, maintaining optimal body weight during gestation would be beneficial to sows and suckling piglets. PMID:26954198

  9. Relationship between Body Weight of Primiparous Sows during Late Gestation and Subsequent Reproductive Efficiency over Six Parities.

    PubMed

    Kim, Jin Soo; Yang, Xiaojian; Baidoo, Samuel Kofi

    2016-06-01

    The present study investigated the impact of parity 1 gilt body weight during late gestation (d 109) on subsequent reproductive performance of sows and performance of suckling pigs. A total of 2,404 farrowing records over 6 parities were divided into six groups on the basis of body weight (190, 200, 210, 220, 230, and 240 kg) at d 109 of gestation of 585 gilts. Significant effects (p< 0.05) of body weight on sow retention rate was noticed, with the 210 kg group having the lowest culling rate and highest total number of piglets born alive over the 6 parities. With increase of body weight, a linear increase (p<0.05) in losses of body weight and backfat during the lactation period of parity 1 and a linear decrease (p<0.05) in backfat loss for parities 4 and 6 were found. Compared with light sows, heavy sows had higher (p<0.05) litter weight at birth for parities 1 and 2 and at weaning in parity 1. Sow weaning-to-estrus interval of sows was not influenced (p>0.05) by body weight. In conclusion, maintaining optimal body weight during gestation would be beneficial to sows and suckling piglets. PMID:26954198

  10. Trimester-Specific Gestational Weight Gain and Infant Size for Gestational Age

    PubMed Central

    Sridhar, Sneha B.; Xu, Fei; Hedderson, Monique M.

    2016-01-01

    Gestational weight gain is known to influence fetal growth. However, it is unclear whether the associations between gestational weight gain and fetal growth vary by trimester. In a diverse cohort of 8,977 women who delivered a singleton between 2011 and 2013, we evaluated the associations between trimester-specific gestational weight gain and infant size for gestational age. Gestational weight gain was categorized per the 2009 Institute of Medicine (IOM) recommendations; meeting the recommendations was the referent. Large for gestational age and small for gestational age were defined as birthweight > 90th percentile or <10th percentile, respectively, based on a national reference standard birthweight distribution. Logistic regression models estimated the odds of having a large or small for gestational age versus an appropriate for gestational age infant. Only gestational weight gain exceeding the IOM recommendations in the 2nd and 3rd trimesters independently increased the odds of delivering a large for gestational age infant (Odds Ratio (95% Confidence Interval): 1st: 1.17 [0.94, 1.44], 2nd: 1.47 [1.13, 1.92], 3rd: 1.70 [1.30, 2.22]). Gestational weight gain below the IOM recommendations increased the likelihood of having a small for gestational age infant in the 2nd trimester only (1.76 [1.23, 2.52]). There was effect modification, and gestational weight gain below the IOM recommendations increased the likelihood of having a small for gestational age infant in the 2nd trimester and only among women with a pre-pregnancy body mass index from 18.5–24.9 kg/m2 (2.06 [1.35, 3.15]). These findings indicate that gestational weight gain during the 2nd and 3rd trimesters is more strongly associated with infant growth. Interventions to achieve appropriate gestational weight gain may optimize infant size at birth. PMID:27442137

  11. The abortion debate: measuring gestational age.

    PubMed

    Santee, B; Henshaw, S K

    1992-01-01

    Abortion statistics are flawed by the lack of consistency in reporting gestational age. Several methods are generally used, and the number of abortions occurring before 12 weeks changes considerably depending upon the method used to determine gestational age. Pregnancy can be measured from the beginning of last menstruation or from fertilization, which is 14 days after the 1st day of the last menstrual period. Neither method accurately records pregnancy as determined by specialists in embryology and fetal development. Pregnancy actually begins with implantation, which begins 6-7 days after fertilization and ends 10-14 days later. Completion of fertilization and implantation occurs as much as 28 days after the 1st day of the last menstrual period. A report of an 8-week pregnancy is actually 6 weeks from fertilization and 4-5 weeks from implantation. The Centers for Disease Control and other abortion data collecting agencies use the 1st day of the last menstrual period. Statistics generally show that 50% of abortions occur before 8 weeks of gestation and 90% by 12 weeks. When gestation is considered at fertilization, 78% of abortions occur under 9 weeks, while 52% of abortions under 9 weeks are performed with data beginning at the 1st day of the last menstrual period. For abortions occurring under 12 weeks, 95% beginning at fertilization and 90% occur at the 1st day of the last menstrual period. 2/1000 vs. 5/1000 abortions occur under 20 weeks for data beginning at fertilization vs. at the onset of the last period. It is important to report abortion data accurately and to specify the method used to determine the gestational time period. PMID:1526273

  12. Combined effects of maternal age and parity on successful initiation of exclusive breastfeeding.

    PubMed

    Kitano, Naomi; Nomura, Kyoko; Kido, Michiko; Murakami, Keiko; Ohkubo, Takayoshi; Ueno, Masami; Sugimoto, Mitsuhiro

    2016-06-01

    Maternal age at first childbirth has increased in most developed countries in the past 20 years. The purpose of this study is to investigate effects of maternal age at delivery and parity on successful initiation of exclusive breastfeeding (EBF). This retrospective study investigated 1193 singleton dyads with vaginal-delivered at 37-42 gestational weeks during January and December in 2011 at one large "Baby-Friendly" certified hospital in Japan. A multivariate logistic regression model was used to evaluate individual and combined effects of maternal age and parity on successful initiation of EBF after adjusted for pre-pregnancy body mass index, gestational weight gain, pregnancy complications, mothers' underlying illness, smoking and alcohol drinking habits, gestational week at delivery, child's sex and nurturing support from grandparents. Success rates of EBF at one month after child delivery was 69.4% in primiparous aged ≥ 35 (group A: n = 284), 73.5% in multiparous aged ≥ 35 (group B: n = 268), 74.3% in primiparous aged < 35 (group C: n = 432), and 82.3% in multiparous aged < 35 (group D: n = 209). Older maternal age and primiparous became independently associated with EBF initiation. The combined effect for successful initiation of EBF was the lowest in group A referent to group D both at discharge and at one month (odds ratio (OR) 5.9, 95% confidence interval (CI): 3.0-11.9, and OR 2.2, 95% CI: 1.4-3.4, respectively). Primiparous mothers in late child-bearing aged 35 years or older are at the greatest risk of EBF initiation. PMID:26844198

  13. Combined effects of maternal age and parity on successful initiation of exclusive breastfeeding

    PubMed Central

    Kitano, Naomi; Nomura, Kyoko; Kido, Michiko; Murakami, Keiko; Ohkubo, Takayoshi; Ueno, Masami; Sugimoto, Mitsuhiro

    2015-01-01

    Maternal age at first childbirth has increased in most developed countries in the past 20 years. The purpose of this study is to investigate effects of maternal age at delivery and parity on successful initiation of exclusive breastfeeding (EBF). This retrospective study investigated 1193 singleton dyads with vaginal-delivered at 37–42 gestational weeks during January and December in 2011 at one large “Baby-Friendly” certified hospital in Japan. A multivariate logistic regression model was used to evaluate individual and combined effects of maternal age and parity on successful initiation of EBF after adjusted for pre-pregnancy body mass index, gestational weight gain, pregnancy complications, mothers' underlying illness, smoking and alcohol drinking habits, gestational week at delivery, child's sex and nurturing support from grandparents. Success rates of EBF at one month after child delivery was 69.4% in primiparous aged ≥ 35 (group A: n = 284), 73.5% in multiparous aged ≥ 35 (group B: n = 268), 74.3% in primiparous aged < 35 (group C: n = 432), and 82.3% in multiparous aged < 35 (group D: n = 209). Older maternal age and primiparous became independently associated with EBF initiation. The combined effect for successful initiation of EBF was the lowest in group A referent to group D both at discharge and at one month (odds ratio (OR) 5.9, 95% confidence interval (CI): 3.0–11.9, and OR 2.2, 95% CI: 1.4–3.4, respectively). Primiparous mothers in late child-bearing aged 35 years or older are at the greatest risk of EBF initiation. PMID:26844198

  14. Neurological outcome in preterm small for gestational age infants compared to appropriate for gestational age preterm at the age of 18 months: a prospective study.

    PubMed

    Karagianni, Paraskevi; Kyriakidou, Maria; Mitsiakos, Georgios; Chatzioanidis, Helias; Koumbaras, Emmanouel; Evangeliou, Athanasios; Nikolaides, Nikolaos

    2010-02-01

    The aim of this study was to investigate the neurological outcome of premature small for gestational age infants at the corrected age of 18 months by the Hammersmith Infant Neurological Examination. A prospective trial was conducted comparing 41 preterm infants being small for gestational age with 41 appropriate for gestational age infants. Birth weight was significantly lower in small for gestational age infants compared with appropriate for gestational age infants (1724.6 +/- 433 versus 1221 +/- 328 g). There were no significant differences regarding the median gestational age and Apgar scores. Median global scores differ significantly between both groups: 75 (47-78) versus 76 (72-78) for the small for gestational age and appropriate for gestational age infants, respectively. Both groups had optimal scores. In conclusion, although the small for gestational age group scored lower in the Hammersmith Infant Neurological Examination, median global score in both groups was within optimal range. PMID:19372094

  15. Temperament of Small-for-Gestational-Age and Appropriate- for-Gestational-Age Infants across the First Year of Life.

    ERIC Educational Resources Information Center

    Halpern, Leslie F.; Coll, Cynthia T. Garcia

    2000-01-01

    Temperament development was studied in 39 full-term small-for-gestational-age infants and 30 full-term appropriate-for-gestational-age infants. Temperament was measured at 4, 8, and 12 months of age using a behavioral assessment procedure and questionnaire ratings. Findings indicated that restricted fetal growth negatively affects infant…

  16. Pregnancy among the Hmong: Birthweight, Age, and Parity.

    ERIC Educational Resources Information Center

    Helsel, Deborah; And Others

    1992-01-01

    Reproductive factors for Hmong immigrants (mothers of 1,937 children) were compared with those of 3,776 white, non-Hispanic women. Despite a high proportion of births at high parity and advanced maternal age, Hmong women gave birth to very low birth weight babies at about the same rate as white women. (SLD)

  17. Lean body mass in small for gestational age and appropriate for gestational age infants

    SciTech Connect

    Petersen, S.; Gotfredsen, A.; Knudsen, F.U.

    1988-11-01

    Dual photon absorptiometry using /sup 153/Gd in a whole-body scanner was used to measure lean body mass (LBM) in 51 newborn infants. LBM% decreased exponentially with increasing gestational age in both small for gestational age (SGA) and appropriate for gestational age (AGA) infants. In preterm SGA and AGA infants LBM was 104% and 103%, respectively, indicating that no fat was detectable. In term SGA infants LBM was 98%, which corresponded to 48 gm fat on average, and in term AGA infants LBM was 87%, which corresponded to 452 gm fat on average. The LBM%, ponderal index, and skinfold thickness were significantly different between AGA and SGA infants. Infants with clinical signs of intrauterine wastage had significantly higher LBM% than did infants without signs of weight loss. Our results on LBM% by dual photon absorptiometry agree with earlier dissection data; the clinically applicable methods of (1) height combined with weight (i.e., ponderal index), (2) skinfold thickness, and (3) scoring by clinical observations are useful for the estimation of lack of fat as an indicator of intrauterine growth retardation.

  18. Weight Gain in Pregnancy, Maternal Age and Gestational Age in Relation to Fetal Macrosomia

    PubMed Central

    Li, Yi; Liu, Qi-Fei; Zhang, Dan; Shen, Ying; Ye, Kui; Lai, Han-Lin; Wang, Hai-Qing; Hu, Chuan-Lai; Zhao, Qi-Hong

    2015-01-01

    To investigate the possible risk factors related to macrosomia. Pregnant women and their newborns (n = 1041) were recruited from a cohort study in Maternal and Child Care Center of Hefei from January 2011 to July 2012. Questionnaires were applied to collect the demographic data besides the medical records. Detailed health records of the entire pregnancy were obtained using retrospective study. Meanwhile the data of neonatal outcomes was prospectively tracked. Associations between exposure risk factors and macrosomia were analyzed using Pearson's chi squared test. Logistic regression models were used to assess the independent association between these potential predictors and macrosomia. The incidence of macrosomia of this cohort was 11.24% of which male: female = 2.55:1. Male incidence (8.07%) of macrosomia was higher than female (3.17%), p < 0.001. Body mass index (BMI) before pregnancy (pre-BMI), maternal height, parity were not independently associated with macrosomia; multiple logistic regression analysis indicated that macrosomia was mainly independently associated with weight gain in pregnancy (OR=1.14, 95% CI [1.10-1.19]), maternal age (OR = 1.09, 95% CI [1.03-1.15]) and gestational age (OR = 1.62, 95% CI [1.31-1.99]), respectively. Our findings indicate that weight gain in pregnancy, maternal age and gestational age should be considered as independent risk factors for macrosomia. PMID:25954731

  19. Estimation of gestational age from gall-bladder length.

    PubMed

    Udaykumar, K; Udaykumar, Padmaja; Nagesh, K R

    2016-01-01

    Establishing a precise duration of gestation is vital in situations such as infanticide and criminal abortions. The present study attempted to estimate the gestational age of the foetus from gall-bladder length. Foetuses of various gestational age groups were dissected, and the length of the gall bladder was measured. The results were analysed, and a substantial degree of correlation was statistically confirmed. This novel method is helpful when the foetus is fragmented, putrefied or eviscerated, where this method can be used as an additional parameter to improve the accuracy of foetal age estimation. PMID:25990829

  20. Recent Declines in Induction of Labor by Gestational Age

    MedlinePlus

    ... rates at 38 weeks of gestation declined for all maternal age groups under 40. Trends in induction ... 38 weeks declined in nearly three-quarters of all states. The largest declines in labor induction for ...

  1. Risk of Autism Spectrum Disorders in Low Birth Weight and Small for Gestational Age Infants

    PubMed Central

    Lampi, Katja M.; Lehtonen, Liisa; Tran, Phuong Lien; Suominen, Auli; Lehti, Venla; Banerjee, P. Nina; Gissler, Mika; Brown, Alan S.; Sourander, Andre

    2012-01-01

    Objective To examine the relationship between birth weight, gestational age, small for gestational age (SGA), and three most common autism spectrum disorder (ASD) subtypes. Study design In this population-based case-control study conducted in Finland, 4713 cases born between 1987 and 2005 with ICD-diagnoses of childhood autism, Asperger syndrome or PDD, were ascertained from the Finnish Hospital Discharge Register. Four controls, individually matched on sex, date of birth, and place of birth, were selected from the Finnish Medical Birth Register for each case. Conditional logistic regression models were used to assess whether birth weight and gestational age information predicted ASD after controlling for maternal age, parity, smoking during pregnancy and psychiatric history, as well as for infant’s major congenital anomalies. Results Very low (<1500g) and moderately low (<2500g) birth weight, very low gestational age (less than 32 weeks), and SGA increased risk of childhood autism (adjusted OR 3.05, 95% CI 1.4–6.5; 1.57, 1.1–2.3; 2.51, 1.3–5.0 and 1.72, 1.1–2.6, respectively). Very low and moderately low birth weight, very low gestational age, and SGA were also associated with increase in PDD risk (OR 3.44, 95% CI 1.9–6.3; 1.81, 1.4–2.4; 2.46, 1.4–2.3 and 2.24, 1.7–3.0, respectively). No associations were found between the perinatal characteristics and Asperger syndrome. The increased risks persisted after controlling for selected potential confounders. Conclusions The finding that low birth weight, prematurity and SGA were related to childhood autism and PDD but not to Asperger syndrome suggests that prenatal factors related to these exposures may differ for these ASD subtypes, which may have preventive implications. PMID:22677565

  2. Postnatal Foot Length to Determine Gestational Age: A Pilot Study.

    PubMed

    Wyk, Lizelle Van; Smith, Johan

    2016-04-01

    Gestational age is a critical factor in the management, decision-making, prognostication and follow-up of newborn infants. It is also essential for research and epidemiology. In the absence of an early assessment of fetal gestation by abdominal ultrasound, many neonatal units in developing countries determine gestational age by neonatal scores and last menstrual period-both of which are highly inaccurate. The aim of this pilot study was to determine whether postnatal foot length measurement could accurately determine gestational age in a specified South African hospitalized neonatal population. Foot length was measured with a plastic Verniere's caliper. Foot length was shown to correlate well with gestational age (r = 0.919,p < 0.001). Intra-observer and inter-observer variability of foot length measurements was low. Foot length can therefore be used with high accuracy to determine the gestational age in a population where there is poor access to or utilization of antenatal sonar. PMID:26758249

  3. Treatment-Associated Anxiety among Pregnant Women and their Partners: What is the Influence of Sex, Parity, Age and Education?

    PubMed Central

    Kannenberg, K.; Weichert, J.; Rody, A.; Banz-Jansen, C.

    2016-01-01

    Background: Anxiety during pregnancy can influence outcomes negatively. The aim of this study was to assess the fears of expectant parents in the setting of antenatal and obstetric care according to their sex, age, parity and education. Methods: 259 pregnant women and 183 partners, who had presented for antenatal investigation, routine antenatal care or for delivery in the UKSH womenʼs hospital, Lübeck campus, completed a self-assessment questionnaire of fears and the German version of the STAI (Laux et al.). ANOVA and t-tests were used for significance testing. Results: Pregnant women had higher levels of trait anxiety and state anxiety than their partners. Level of education had a significant, inverse effect on trait anxiety. Age had no influence. Fears for the childʼs health ranked highest among pregnancy-specific fears. Expectant fathers had the same level of anxiety for the birth irrespective of parity; for women fear of the birth decreased with increasing parity. Anxiety only increased significantly for expectant fathers from the 20th week of gestation onwards. Conclusions: Pregnant women and their partners have different levels of anxiety dependant on their age, education, parity and the stage of pregnancy. These findings could contribute towards improving support of couples during pregnancy. The fears of expectant fathers require particular attention.

  4. Effect of dams' parity and age on daughters' milk yield in Norwegian Red cows.

    PubMed

    Storli, K S; Heringstad, B; Salte, R

    2014-10-01

    The effect of age and parity of dams on their daughters' milk yield is not well known. Lactation data from 276,000 cows were extracted from the Norwegian Dairy Herd Recording System and analyzed using a linear animal model to estimate effects of parity and age within parity of dam. The 305-d milk yield of daughters decreased as parity of dam increased. Daughters of first-parity dams produced 149 kg more milk than did daughters of seventh-parity dams. We also observed an effect of age of dam within parity on 305-d milk yield of daughters in first lactation. Dams that were young at first calving gave birth to daughters with a higher milk yield compared with older dams within the same parity. The effect of age within parity of dam was highest for second-parity dams. Extensive use of heifers would have a systematic effect, and age and parity of dam should be included in the model when planning a future strategy. PMID:25087031

  5. Fetal Habituation Performance: Gestational Age and Sex Effects

    ERIC Educational Resources Information Center

    McCorry, Noleen K.; Hepper, Peter G.

    2007-01-01

    Habituation is the decrement in response to repeated stimulation. Fetal habituation performance may reflect the functioning of the central nervous system (CNS) prenatally. However, basic characteristics of the prenatal habituation phenomena remain unclear, such as the relationship with gestational age (GA) and fetal sex. The current study…

  6. How to feed small for gestational age newborns

    PubMed Central

    2013-01-01

    Feeding small for gestational age (SGA) newborns is extremely challenging and the neonatologist should be brave and cautious at the same time. Although these babies have a high risk of milk intolerance and necrotising enterocolitis, enteral feeding guidelines are not well established and practice varies widely among different neonatal units. Currently available studies on this topic include extremely and very low birth weight neonates, but are not focused specifically on small for gestational age infants. This review analyzes papers focused on feeding interventions in order to provide the best available evidences about the optimum timing for introduction of enteral feeding, how fast feed volume can be advanced, which milk and which feeding method is more appropriate in SGA infants. PMID:23663313

  7. Global Prevalence of Small for Gestational Age Births.

    PubMed

    Black, Robert E

    2015-01-01

    Fetal growth restriction is found both in babies who are preterm or full-term, and in either case has important adverse effects on subsequent survival, health, growth and development. Fetal growth restriction is usually assessed by comparing the weight of the newborn with the expected weight for the child's gestational age using less than the 10th centile of a reference population for fetal growth as the threshold for being called small for gestational age (SGA). We estimate that in 2010 32.4 million babies were born SGA in low- and middle-income countries, constituting 27% of all live births. The estimated prevalence of SGA is highest in South Asia and in Sahelian countries of Africa. India has the world's largest number of SGA births, 12.8 million in 2010, due to the large number of births and the high proportion, 46.9%, of births that are SGA. The prevalence of SGA births is approximately double the prevalence of low-birthweight births (using the common indicator of <2,500 g birthweight) globally and in the world's regions. Thus, given the adverse effects of being born SGA, even weighing 2,500 g or more, it is important that maternal, neonatal and child health programs seek and use information on gestational age as well as birthweight to appropriately assess the newborn's risks and direct care. PMID:26111558

  8. Predictors of Birth Weight and Gestational Age Among Adolescents

    PubMed Central

    Harville, Emily W.; Madkour, Aubrey Spriggs; Xie, Yiqiong

    2012-01-01

    Although pregnant adolescents are at high risk of poor birth outcomes, the majority of adolescents go on to have full-term, healthy babies. Data from the National Longitudinal Study of Adolescent Health, a longitudinal study of a nationally representative sample of adolescents in grades 7–12 in the United States who were surveyed from 1994–1995 through 2008, were used to examine the epidemiology of preterm birth and low birth weight within this population. Outcomes of pregnancies were reported by participants in the fourth wave of data collection (when participants were 24–32 years of age); data were compared between female participants who reported a first singleton livebirth at less than 20 years of age (n = 1,101) and those who were 20 years of age or older (n = 2,846). Multivariable modeling was used to model outcomes; predictors included demographic characteristics and maternal health and behavior. Among black adolescents, low parental educational levels and older age at pregnancy were associated with higher birth weight, whereas low parental educational levels and being on birth control when one got pregnant were associated with higher gestational age. In nonblack adolescents, lower body mass index was associated with lower birth weight, whereas being unmarried was associated with lower gestational age. Predictors of birth outcomes may differ by age group and social context. PMID:23035139

  9. The prevalence of gestational diabetes mellitus recurrence--effect of ethnicity and parity: a metaanalysis.

    PubMed

    Schwartz, Naama; Nachum, Zohar; Green, Manfred S

    2015-09-01

    Reports on the gestational diabetes mellitus (GDM) recurrence rate have been highly variable. Our objectives were to examine the possible causes of GDM recurrence rate variability and to obtain pooled estimates in subgroups. We have carried out a systematic review and metaanalysis based on the Metaanalysis Of Observational Studies in Epidemiology statement. We identified papers published from 1973 to September 2014. We identified papers using Medline (PubMed and Ovid), ClinicalTrials.gov and Google Scholar databases, and published references. We included only English-language, population-based studies that reported specified GDM criteria and GDM recurrence rate. A total of 18 eligible studies with 19,053 participants were identified. We used the Cochrane's Q test of heterogeneity to choose the model for estimating the pooled GDM recurrence rate. Metaregression was also used to explore the possible causes of variability between studies. The pooled GDM recurrence rate was 48% (95% confidence interval, 41-54%). A significant association between ethnicity and GDM recurrence rate was found (P = .02). Non-Hispanic whites had lower recurrence rate compared with other ethnicities (39% and 56%, respectively). Primiparous women had a lower recurrence rate compared with multiparous women (40% and 73%, respectively; P < .0001) No evidence for association between family history of diabetes and GDM recurrence was found. The overall GDM recurrence rate is high. Non-Hispanic whites and primiparous women have substantially lower GDM recurrence rates, which contributes to the variability between studies. Because no association between family history of diabetes and GDM recurrence was found, the large differences between ethnic groups may have also resulted from nongenetic factors. Thus, intervention programs could reduce the GDM recurrence rates. PMID:25757637

  10. Vitamin A status in pregnant women in Iran in 2001 and its relationship with province and gestational age

    PubMed Central

    Olang, Beheshteh; Abdollahi, Zahra; Neshati, Roshanak; Ali, Mohamed Atiya; Naghavi, Mohsen; Yngve, Agneta

    2014-01-01

    Background Vitamin A deficiency is considered as one of the public health problems among pregnant women worldwide. Population representative data on vitamin A status in pregnancy have not previously been published from Iran. Objectives The aim of this study was to publish data on vitamin A status in pregnant women in all the provinces of Iran in 2001, including urban and rural areas, and to describe the association of vitamin A status with maternal age, gestational age, and parity. Design This descriptive cross-sectional study was conducted on 3,270 healthy pregnant women from the entire country, 2,631 with gestational age ≤36 weeks, and 639 with gestational age >36 weeks. Vitamin A status was determined in serum using high-performance liquid chromatography. Result Retinol levels corresponding to deficiency were detected in 6.6% (<0.36 µmol/L) and 18% had insufficient vitamin A levels (≥0.36–<0.7 µmol/L). Suboptimal level of serum retinol was observed in 55.3% of the pregnant women (0.7–1.4 µmol/L). Only about 20% of the women had optimal values (>1.4 µmol/L). The level of serum retinol was lower in older pregnant women (p=0.008), and at higher gestational age (p=0.009). High vitamin A levels were observed in pregnant women in the central areas of Iran and the lowest values in those in the southern areas of Iran. Conclusions The vitamin A status was good in 2001 but should be closely monitored also in the future. About 25% of pregnant women had a vitamin A status diagnosed as insufficient or deficient (<0.7 µmol/L). The mean serum retinol decreased as the gestational age increased. The clinical significance of this finding should be further investigated, followed by a careful risk group approach to supplementation during pregnancy. PMID:25317119

  11. Estimation of fetal gestational age from ultrasound images

    NASA Astrophysics Data System (ADS)

    Salari, Valiollah

    1992-06-01

    Estimation of fetal gestational age, weight, and determination of fetal growth from the measurements of certain parameters of fetal head, abdomen, and femur have been well established in prenatal sonography. The measurements are made from the two dimensional, B- mode, ultrasound images of the fetus. The most common parameters measured are, biparietal diameter, occipital frontal diameter, head circumference, femur diaphysis length, and abdominal circumference. Since the fetal head has an elliptical shape and the femur has a linear shape, fitting the ellipse on the image of the fetal head, a line on the image of the femur are the tasks of image processing which are discussed in this paper.

  12. Latin American Consensus: Children Born Small for Gestational Age

    PubMed Central

    2011-01-01

    Background Children born small for gestational age (SGA) experience higher rates of morbidity and mortality than those born appropriate for gestational age. In Latin America, identification and optimal management of children born SGA is a critical issue. Leading experts in pediatric endocrinology throughout Latin America established working groups in order to discuss key challenges regarding the evaluation and management of children born SGA and ultimately develop a consensus statement. Discussion SGA is defined as a birth weight and/or birth length greater than 2 standard deviations (SD) below the population reference mean for gestational age. SGA refers to body size and implies length-weight reference data in a geographical population whose ethnicity is known and specific to this group. Ideally, each country/region within Latin America should establish its own standards and make relevant updates. SGA children should be evaluated with standardized measures by trained personnel every 3 months during year 1 and every 6 months during year 2. Those without catch-up growth within the first 6 months of life need further evaluation, as do children whose weight is ≤ -2 SD at age 2 years. Growth hormone treatment can begin in SGA children > 2 years with short stature (< -2.0 SD) and a growth velocity < 25th percentile for their age, and should continue until final height (a growth velocity below 2 cm/year or a bone age of > 14 years for girls and > 16 years for boys) is reached. Blood glucose, thyroid function, HbA1c, and insulin-like growth factor-1 (IGF-1) should be monitored once a year. Monitoring insulin changes from baseline and surrogates of insulin sensitivity is essential. Reduced fetal growth followed by excessive postnatal catch-up in height, and particularly in weight, should be closely monitored. In both sexes, gonadal function should be monitored especially during puberty. Summary Children born SGA should be carefully followed by a multidisciplinary group

  13. Transabdominal and transrectal ultrasonography of fetuses in Württemberg ewes: Correlation with gestational age.

    PubMed

    Petrujkić, Branko T; Cojkić, Aleksandar; Petrujkić, Katarina; Jeremić, Ivan; Mašulović, Dragan; Dimitrijević, Vladimir; Savić, Mila; Pešić, Miodrag; Beier, Ross C

    2016-02-01

    It is useful to determine the gestational age in sheep to provide essential information for effective flock management practices. The aims of this study were to evaluate the efficacy and practical aspects for using two ultrasound techniques, transabdominal and transrectal, in determining the gestational age in Württemberg ewes. Monitoring of embryo and fetus developmental stages during the ewes' gestation was carried out with real time ultrasound using a transabdominal convex probe, frequency 3.5 MHz, and a transrectal linear probe, frequency 7.5 MHz. The size of the embryonic vesicle during the period from the 23rd to the 38th day of gestation can be used as a confirmational indicator of gestational age when the transrectal probe is used. The occipital nasal diameter correlated with the gestational age with both transabdominal (P < 0.05) and transrectal probes (P < 0.01) from the 46th to the 63rd day of gestation. The biparietal diameter of the fetal head measured by transabdominal probe during the period from the 46th to the 63rd day of gestation correlates with gestation age (P < 0.05). The diameter of the fetal eye orbit monitored by transrectal probe from the 46th to the 63rd day of gestation also correlated well with gestational age (P < 0.05). PMID:26223772

  14. Gestational age at delivery and neonatal outcome in uncomplicated twin pregnancies: what is the optimal gestational age for delivery according to chorionicity?

    PubMed Central

    Lee, Hye-Jung; Kim, Soo Hyun; Chang, Kylie Hae-Jin; Sung, Ji-Hee; Oh, Soo-young; Roh, Cheong-Rae; Kim, Jong-Hwa

    2016-01-01

    Objective To investigate the neonatal outcome according to the gestational age at delivery and to determine the optimal timing for delivery in uncomplicated monochorionic and dichorionic twin pregnancies. Methods This is a retrospective cohort study of women with uncomplicated twin pregnancies delivered at or beyond 35 weeks of gestation from 1995 to 2013. The primary outcome was neonatal composite morbidity, which was defined as when either one or both twins have one or more of the followings: fetal death after 35 weeks gestation, admission to neonatal intensive care unit, mechanical ventilator requirement, respiratory distress syndrome and neonatal death. To determine the optimal gestational age for delivery according to chorionicity, we compared the neonatal composite morbidity rate between women who delivered and women who remained undelivered at each gestational week in both monochorionic and dichorionic twin pregnancies. Results A total of 697 twin pregnancies were included (171 monochorionic and 526 dichorionic twins). The neonatal composite morbidity rate significantly decreased with advancing gestational age at delivery and its nadir was observed at 38 and ≥39 weeks of gestation in monochorionic and dichorionic twins, respectively. However, the composite morbidity rate did not differ between women who delivered and women who remained undelivered ≥36 and ≥37 weeks in monochorionic and dichorionic twins, respectively. Conclusion Our data suggest that the optimal gestational age for delivery was at ≥36 and ≥37 weeks in uncomplicated monochorionic and dichorionic twin pregnancies, respectively. PMID:26866030

  15. Risk factors for small for gestational age infants.

    PubMed

    McCowan, Lesley; Horgan, Richard P

    2009-12-01

    There are many established risk factors for babies who are small for gestational age (SGA) by population birth weight centiles (usually defined as <10th centile). The confirmed maternal risk factors include short stature, low weight, Indian or Asian ethnicity, nulliparity, mother born SGA, cigarette smoking and cocaine use. Maternal medical history of: chronic hypertension, renal disease, anti-phospholipid syndrome and malaria are associated with increased SGA. Risk factors developing in pregnancy include heavy bleeding in early pregnancy, placental abruption, pre-eclampsia and gestational hypertension. A short or very long inter-pregnancy interval, previous SGA infant or previous stillbirth are also risk factors. Paternal factors including changed paternity, short stature and father born SGA also contribute. Factors associated with reduced risk of SGA or increased birth weight include high maternal milk consumption and high intakes of green leafy vegetables and fruit. Future studies need to investigate risk factors for babies SGA by customised centiles as these babies have greater morbidity and mortality than babies defined as SGA by population centiles. PMID:19604726

  16. Gestational age assessment by nurses in a developing country using the Ballard method, external criteria only.

    PubMed

    Verhoeff, F H; Milligan, P; Brabin, B J; Mlanga, S; Nakoma, V

    1997-12-01

    The aim of this study was to evaluate postnatal examination of the newborn by nurses in a developing country, using a modified Ballard method, scoring for the six external criteria only (Ballard-ext). Applicability of gestational age estimates with the Ballard-ext. was assessed by calculating its agreement with gestational age derived from the last menstrual period (LMP), fundal height and the Dubowitz method. The smallest difference in gestational age and the most narrow limits of agreement were found between the Ballard-ext. and the Dubowitz method. No reliable gestational age could be obtained from LMP or fundal height. At low gestational ages, Ballard-ext. tended to give lower gestational ages compared with the Dubowitz method. At an average gestational age of more than 251 days, Ballard-ext. gave higher values compared with Dubowitz. Both Ballard-ext. and the Dubowitz method identified 48% of low birthweight babies as growth-retarded (gestational age > or = 37 weeks). No significant difference in gestational age assessment of newborns between nurses was observed. The Ballard method, scoring for external criteria alone, compared favourably with the Dubowitz method. The test is simple to perform and can be reliably used routinely by nurses. PMID:9578793

  17. Parity-related mortality: shape of association among middle-aged and elderly men and women.

    PubMed

    Jaffe, Dena H; Neumark, Yehuda D; Eisenbach, Zvi; Manor, Orly

    2009-01-01

    Parity is associated with mortality among middle-aged women, while substantially less is known about this relationship for men and the elderly. Using the census-based Israel Longitudinal Mortality Study (ILMS) II (1995-2004) we sought to examine the parity-mortality relationship among men and women, middle-aged and elderly. In our study cohort of 71,733 married men and 62,822 married women ages 45-89 years at baseline, 19,437 deaths were reported. Mortality differentials by parity were assessed using Cox proportional hazard regression models adjusted stepwise for age, origin, education and number of rooms. Analyzes were carried out for middle-aged (45-64 years) and elderly (65-89 years) men and women separately. We observed a non-linear relationship between parity and mortality for all individuals even after adjustment for demographic and socio-economic variables. In fully adjusted models, for example, nulliparous middle-aged women experienced the highest mortality risks (hazard ratios [HR] = 1.57, 95% confidence intervals [CI] 1.24, 1.98) followed by those with one child (HR = 1.29, 95% CI 1.10, 1.51). These results were attenuated somewhat for nulliparous older women (HR = 1.25, 95% CI 1.11, 1.41). The detrimental effects of low and high parity on mortality among both men and women suggest a non pregnancy-related pathway that is likely mediated by biological and psychosocial factors and other lifestyle characteristics that have long-term consequences into older ages. Further research is warranted to examine the effects of parity by specific cause of death. PMID:19145406

  18. Auditory brainstem response in neonates: influence of gender and weight/gestational age ratio

    PubMed Central

    Angrisani, Rosanna M. Giaffredo; Bautzer, Ana Paula D.; Matas, Carla Gentile; de Azevedo, Marisa Frasson

    2013-01-01

    OBJECTIVE: To investigate the influence of gender and weight/gestational age ratio on the Auditory Brainstem Response (ABR) in preterm (PT) and term (T) newborns. METHODS: 176 newborns were evaluated by ABR; 88 were preterm infants - 44 females (22 small and 22 appropriate for gestational age) and 44 males (22 small and 22 appropriate for gestational age). The preterm infants were compared to 88 term infants - 44 females (22 small and 22 appropriate for gestational age) and 44 males (22 small and 22 appropriate for gestational age). All newborns had bilateral presence of transient otoacoustic emissions and type A tympanometry. RESULTS: No interaural differences were found. ABR response did not differentiate newborns regarding weight/gestational age in males and females. Term newborn females showed statistically shorter absolute latencies (except on wave I) than males. This finding did not occur in preterm infants, who had longer latencies than term newborns, regardless of gender. CONCLUSIONS: Gender and gestational age influence term infants' ABR, with lower responses in females. The weight/gestational age ratio did not influence ABR response in either groups. PMID:24473955

  19. Thyroid hormones according to gestational age in pregnant Spanish women

    PubMed Central

    2009-01-01

    Background Thyroid function changes during pregnancy and maternal thyroid dysfunction have been associated with adverse outcomes. Our aim was to evaluate thyroid hormones levels in pregnant women resident in Aragon, Spain. Findings Samples for 1198 pregnant women with no apparent thyroid disorders were analyzed, using paramagnetic microparticle and chemiluminescent detection technologies, in order to determine levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), thyroid peroxidase antibodies (TPO-Ab), and thyroglobulin antibodies (Tg-Ab). Of the women in our sample, 85.22% had normal values for TPO-Ab and Tg-Ab and 14.77% had results revealing the presence of autoimmune diseases of the thyroid. The thyroid hormone reference values obtained according to gestational age (in brackets) were as follows: for free T3, values were 3.38 ± 0.52 pg/mL (<11 weeks), 3.45 ± 0.54 pg/mL (11-20 weeks), 3.32 ± 0.43 pg/mL (21-30 weeks), 3.21 ± 0.53 pg/mL (31-36 weeks), and 3.23 ± 0.41 pg/mL (>36 weeks); for free T4, values were 1.10 ± 0.14 ng/dL (<10 weeks), 1.04 ± 0.14 ng/dL (11-20 weeks), 0.93 ± 0.12 ng/dL (21-30 weeks), 0.90 ± 0.13 ng/dL (31-36 weeks), and 0.80 ± 0.21 ng/dL (>36 weeks); and for TSH, values were (μIU/mL): 1.12 ± 0.69 (<10 weeks), 1.05 ± 0.67 (11-20 weeks), 1.19 ± 0.60 (21-30 weeks), 1.38 ± 0.76 (31-36 weeks), and 1.46 ± 0.72 (>36 weeks). Conclusion Pregnant women with normal antibody values according to gestational age had values for FT4 and TSH, but not for FT3, that differed to a statistically significant degree. The values we describe can be used as reference values for the Aragon region of Spain. PMID:19939287

  20. Effects of Maternal Education, Age, and Parity of Fatal Infant Accidents.

    ERIC Educational Resources Information Center

    Wicklund, Kristine; And Others

    1984-01-01

    Analysis of computerized linked birth and death record information found that maternal age and education are inversely related to infant mortality, while mother's parity is directly related. Accident mortality rate differentials by educational level were more evident for certain categories of accident (suffocation, death by fire). (Author/GC)

  1. Gestational age-specific associations between infantile acute bronchiolitis and asthma after age five

    PubMed Central

    Strickland, Matthew J.; Marsh, Caitlin A.; Darrow, Lyndsey A.

    2014-01-01

    Background Infantile acute bronchiolitis is a risk factor for the development of pediatric asthma. The associations might differ according to gestational age. Methods Datasets of emergency department (ED) visits (Jan 2002 to June 2010) and live birth records (Jan 2002 to Dec 2004) from the state of Georgia were linked for all children who survived one year. Exposure was an ED visit for acute bronchiolitis during infancy (AB), and the outcome was an ED visit for asthma after age five years. The risk of asthma among children with AB (n = 11,564) was compared with the risk of asthma among children who did not have an ED visit for AB but who utilized the ED for another reason during infancy (n = 131,694). Associations were estimated using log-binomial regression models that controlled for several plausible confounders. Effect measure modification of the risk ratio by gestational age was investigated. Results Crude asthma risks (per 100 children) through June 2010 were 4.5 for children with AB and 2.3 for children without AB. The adjusted risk ratio for the overall association was 1.89 (95% confidence interval (CI) 1.73, 2.108). We did not observe effect modification of the risk ratio by gestational age. Conclusion A positive association was observed between ED visits for AB and subsequent asthma ED visits after age five; associations did not vary meaningfully by gestational age. Sensitivity analyses did not suggest large biases due to differences in ED utilization across socio-demographic groups or loss to follow-up from residential migration. PMID:25256755

  2. Joint Bayesian analysis of birthweight and censored gestational age using finite mixture models

    PubMed Central

    Schwartz, Scott L.; Gelfand, Alan E.; Miranda, Marie L.

    2016-01-01

    Birthweight and gestational age are closely related and represent important indicators of a healthy pregnancy. Customary modeling for birthweight is conditional on gestational age. However, joint modeling directly addresses the relationship between gestational age and birthweight, and provides increased flexibility and interpretation as well as a strategy to avoid using gestational age as an intermediate variable. Previous proposals have utilized finite mixtures of bivariate regression models to incorporate well-established risk factors into analysis (e.g. sex and birth order of the baby, maternal age, race, and tobacco use) while examining the non-Gaussian shape of the joint birthweight and gestational age distribution. We build on this approach by demonstrating the inferential (prognostic) benefits of joint modeling (e.g. investigation of `age inappropriate' outcomes like small for gestational age) and hence re-emphasize the importance of capturing the non-Gaussian distributional shapes. We additionally extend current models through a latent specification which admits interval-censored gestational age. We work within a Bayesian framework which enables inference beyond customary parameter estimation and prediction as well as exact uncertainty assessment. The model is applied to a portion of the 2003–2006 North Carolina Detailed Birth Record data (n=336129) available through the Children's Environmental Health Initiative and is fitted using the Bayesian methodology and Markov chain Monte Carlo approaches. PMID:20575047

  3. Presumed and definite bacteremia in extremely low gestational age newborns

    PubMed Central

    Patel, Sonal; Dammann, Olaf; Martin, Camilia R.; Allred, Elizabeth N.; Leviton, Alan

    2010-01-01

    Aim To explore risk patterns for presumed and definite, early and late neonatal bacteremia. Methods We studied 1106 ELGANs who survived until postnatal day 28. We defined early definite bacteremia as a positive bacterial culture in the first week and definite late bacteremia as a positive bacterial culture in week 2, 3 or 4. Bacteremia was presumed if antibiotics were given for more than 72 hours despite negative blood cultures. Results Risk patterns did not differ much for presumed and definite bacteremia in the first postnatal month. While maternal and pregnancy characteristics were associated with early bacteremia, neonatal co-morbidities, especially NEC, were the main antecedents/correlates of late bacteremia. All four categories of bacteremia were associated with younger gestational age and lower birth weight. Infants with presumed and definite bacteremia had similar distributions of days of ventilation and oxygenation. Conclusion Definite and presumed late bacteremia have rather similar risk patterns, while those of early and late bacteremia differ appreciably. PMID:20712830

  4. Stimulus requirements for pregnancy initiation in the golden hamster (Mesocricetus auratus) change with age and parity.

    PubMed

    Huck, U W; Lisk, R D; Guyton, C L

    1988-11-01

    Hamsters were mated repeatedly at 60, 180, 300 and 420 days of age or once during their lifetime at one of these ages. Copulatory stimulation was varied both for number of ejaculations (2 versus 14) and amount of vaginocervical stimulation (5 versus 50-60 intromissions). Two ejaculations provided sufficient spermatozoa to maximize litter size for all age and parity classes tested. Differences in fecundity depended on the amount of vaginocervical stimulation received. Higher levels of vaginocervical stimulation increased littering success at 300 and 420 days for nulliparous females and at 180, 300 and 420 days for multiparous females. Females which did not deliver litters did not show a cessation of oestrous cycles which characteristically follows the induction of a luteal phase. The decreased fecundity observed with increasing age or parity therefore resulted from a change in sensitivity to the stimulus conditions necessary to activate the neuroendocrine arc for establishment of pregnancy. PMID:3199363

  5. Adiposity in children born small for gestational age.

    PubMed

    Tappy, L

    2006-12-01

    Epidemiological studies indicate that children born small for gestational age (SGA) have an increased risk of metabolic and cardiovascular disorders as adults. This suggests that foetal undernutrition leads to permanent metabolic alterations, which predispose to metabolic abnormalities upon exposure to environmental factors such as low physical activity and/or high-energy intake in later life (thrifty phenotype hypothesis). However, this relationship is not restricted to foetal undernutrition or intrauterine growth retardation, but is also found for children born premature, or for high birth weight children. Furthermore, early post-natal nutrition, and more specifically catch-up growth, appear to modulate cardiovascular risk as well. Intrauterine growth retardation can be induced in animal models by energy/protein restriction, or ligation of uterine arteries. In such models, altered glucose homeostasis, including low beta-cell mass, low insulin secretion and insulin resistance is observed after a few weeks of age. In humans, several studies have confirmed that children born SGA have insulin resistance as adolescents and young adults. Alterations of glucose homeostasis and increased lipid oxidation can indeed be observed already in non-diabetic children born SGA at early pubertal stages. These children also have alterations of stature and changes in body composition (increased fat mass), which may contribute to the pathogenesis of insulin resistance. Permanent metabolic changes induced by foetal/early neonatal nutrition (metabolic inprinting) may involve modulation of gene expression through DNA methylation, or alterations of organ structure. It is also possible that events occurring during foetal/neonatal development lead to long-lasting alterations of the hypothalamo-pituitary-adrenal axis or the hypothalamo-pituitary-insulin-like growth factor-1 axis. PMID:17133233

  6. Parity and Risk of Coronary Heart Disease in Middle-aged and Older Chinese Women

    PubMed Central

    Shen, Lijun; Wu, Jing; Xu, Guiqiang; Song, Lulu; Yang, Siyi; Yuan, Jing; Liang, Yuan; Wang, Youjie

    2015-01-01

    Pregnancy leads to physiological changes in lipid, glucose levels, and weight, which may increase the risk of coronary heart disease (CHD) in later life. The purpose of this study was to examine whether parity is associated with CHD in middle-aged and older Chinese women. A total of 20,207 women aged 37 to 94 years from Dongfeng-Tongji Cohort who completed the questionnaire, were medically examined and provided blood samples, were included in our analysis. CHD cases were determined by self-report of physician diagnosis through face-to-face interviews. Logistic regression models were used to estimate the association between parity and CHD. The rate of CHD was 15.8%. Parity had a positive association with CHD without adjustment of covariates. After controlling for the potential confounders, increasing risk of coronary heart disease was observed in women who had two (OR, 1.65; 95% CI, 1.41–1.93), three (OR, 1.76; 95% CI, 1.44–2.16), and four or more live births (OR, 1.71; 95% CI, 1.33–2.20) compared with women with just one live birth. High parity was significantly associated with increasing risk of CHD in Chinese women. This suggests that multiparity may be a risk factor for CHD among Chinese women. PMID:26607032

  7. Denial of Abortion Because of Provider Gestational Age Limits in the United States

    PubMed Central

    Weitz, Tracy A.; Jones, Rachel K.; Barar, Rana E.; Foster, Diana Greene

    2014-01-01

    Objectives. We examined the factors influencing delay in seeking abortion and the outcomes for women denied abortion care because of gestational age limits at abortion facilities. Methods. We compared women who presented for abortion care who were under the facilities’ gestational age limits and received an abortion (n = 452) with those who were just over the gestational age limits and were denied an abortion (n = 231) at 30 US facilities. We described reasons for delay in seeking services. We examined the determinants of obtaining an abortion elsewhere after being denied one because of facility gestational age limits. We then estimated the national incidence of being denied an abortion because of facility gestational age limits. Results. Adolescents and women who did not recognize their pregnancies early were most likely to delay seeking care. The most common reason for delay was having to raise money for travel and procedure costs. We estimated that each year more than 4000 US women are denied an abortion because of facility gestational limits and must carry unwanted pregnancies to term. Conclusions. Many state laws restrict abortions based on gestational age, and new laws are lowering limits further. The incidence of being denied abortion will likely increase, disproportionately affecting young and poor women. PMID:23948000

  8. Gestational age assessment in malaria pregnancy cohorts: a prospective ultrasound demonstration project in Malawi

    PubMed Central

    2013-01-01

    Background Malaria during pregnancy is associated with an increased risk for low birth weight (<2500 grams). Distinguishing infants that are born premature (< 37 weeks) from those that are growth-restricted (less than the 10th percentile at birth) requires accurate assessment of gestational age. Where ultrasound is accessible, sonographic confirmation of gestational age is more accurate than menstrual dating. The goal was to pilot the feasibility and utility of adding ultrasound to an observational pregnancy malaria cohort. Methods In July 2009, research staff (three mid-level clinical providers, one nurse) from The Blantyre Malaria Project underwent an intensive one-week ultrasound training to perform foetal biometry. Following an additional four months of practice and remote image review, subjects from an ongoing cohort were recruited for ultrasound to determine gestational age. Gestational age at delivery established by ultrasound was compared with postnatal gestational age assessment (Ballard examination). Results One hundred and seventy-eight women were enrolled. The majority of images were of good quality (94.3%, 509/540) although a learning curve was apparent with 17.5% (24/135) images of unacceptable quality in the first 25% of scans. Ultrasound was used to date 13% of the pregnancies when menstrual dates were unknown and changed the estimated gestational age for an additional 25%. There was poor agreement between the gestational age at delivery as established by the ultrasound protocol compared to that determined by the Ballard examination (bias 0.8 weeks, limits of agreement -3.5 weeks to 5.1 weeks). The distribution of gestational ages by Ballard suggested a clustering of gestational age around the mean with 87% of the values falling between 39 and 41 weeks. The distribution of gestational age by ultrasound confirmed menstrual dates was more typical. Using ultrasound confirmed dates as the gold standard, 78.5% of preterm infants were misclassified as

  9. Risk of Developmental Delay Increases Exponentially as Gestational Age of Preterm Infants Decreases: A Cohort Study at Age 4 Years

    ERIC Educational Resources Information Center

    Kerstjens, Jorien M.; de Winter, Andrea F.; Bocca-TJeertes, Inger F.; Bos, Arend F.; Reijneveld, Sijmen A.

    2012-01-01

    Aim: The aim of the study was to assess the influence of decreasing gestational age on the risk of developmental delay in various domains at age 4 years among children born at a wide range of gestational ages. Method: In a community-based cohort, the parents of 1439 preterm-born children (24 0/7 to 35 6/7wks) and 544 term-born children (38 0/7 to…

  10. Birthweight percentiles for twin birth neonates by gestational age in China.

    PubMed

    Zhang, Bin; Cao, Zhongqiang; Zhang, Yiming; Yao, Cong; Xiong, Chao; Zhang, Yaqi; Wang, Youjie; Zhou, Aifen

    2016-01-01

    Localized birthweight references for gestational ages serve as an essential tool in accurate evaluation of atypical birth outcomes. Such references for twin births are currently not available in China. The aim of this study was to construct up-to-data sex specific birth weight references by gestational ages for twin births in China. We conducted a population-based analysis on the data of 22,507 eligible living twin infants with births dated between 8/01/2006 and 8/31/2015 from all 95 hospitals within the Wuhan area. Gestational ages in complete weeks were determined using a combination of last-menstrual-period based (LMP) estimation and ultrasound examination. Smoothed percentile curves were created by the Lambda Mu Sigma (LMS) method. Reference of the 3(rd), 10(th), 25(th), 50(th), 75(th), 90(th), 97(th) percentiles birth weight by sex and gestational age were made using 11,861 male and 10,646 female twin newborns with gestational age 26-42 weeks. Separate birthweight percentiles curves for male and female twins were constructed. In summary, our study firstly presents percentile curves of birthweight by gestational age for Chinese twin neonates. Further research is required for the validation and implementation of twin birthweight curves into clinical practice. PMID:27506479

  11. Accuracy of prediction of canine litter size and gestational age with ultrasound.

    PubMed

    Lenard, Z M; Hopper, B J; Lester, N V; Richardson, J L; Robertson, I D

    2007-06-01

    Different sonographic criteria have been developed to estimate canine fetal age, including fetal mensuration and assessment of fetal organ development. This retrospective study assessed the accuracy of gestational age and litter size predictions in 76 bitches using one of two techniques. The first method used the differential features of fetal organ development that occur in early and mid pregnancy, based on published tables for beagles. The second method used biparietal head and trunk diameters to predict gestational age based on tables published for late gestational Labrador Retrievers. The accuracy of the two methods was compared and the effect of maternal body weight and litter size evaluated. Litter size and maternal body weight did not affect the accuracy of gestational age prediction. Using a combination of both methods, the overall accuracy of predicting parturition date within 65 +/- 1 day and +/- 2 days was 70.8% and 86.1%, respectively. The correct litter size was predicted in 65% of cases, and in 89.5% of cases for +/- 1 pup. Pearson's correlation between actual litter size and predicted litter size was high (R = 0.957, P < 0.001). The organ development method of predicting gestational age was more accurate than late gestational fetal mensuration (P = 0.019). The optimum time for sonographic estimation of fetal age and litter size is early and mid pregnancy. PMID:17547634

  12. Predictors of Size for Gestational Age in St. Louis City and County

    PubMed Central

    2014-01-01

    Objective. To identify social, behavioral, and physiological risk factors associated with small for gestational age (SGA) by gestational age category in St. Louis City and County. Methods. A retrospective cohort study was conducted using birth certificate and fetal death records from 2000 to 2009 (n = 142,017). Adjusted associations of risk factors with SGA were explored using bivariate logistic regression. Four separate multivariable logistic regression analyses, stratified by gestational age, were conducted to estimate adjusted odds ratios. Results. Preeclampsia and inadequate weight gain contributed significantly to increased odds for SGA across all gestational age categories. The point estimates ranged from a 3.41 increased odds among women with preeclampsia and 1.76 for women with inadequate weight gain at 24–28 weeks' gestational age to 2.19 and 2.11 for full-term infants, respectively. Among full-term infants, smoking (aOR = 2.08), chronic hypertension (aOR = 1.46), and inadequate prenatal care (aOR = 1.25) had the next most robust and significant impact on SGA. Conclusion. Preeclampsia and inadequate weight gain are significant risk factors for SGA, regardless of gestational age. Education on the importance of nutrition and adequate weight gain during pregnancy is vital. In this community, disparities in SGA and smoking rates are important considerations for interventions designed to improve birth outcomes. PMID:25105127

  13. Birthweight percentiles for twin birth neonates by gestational age in China

    PubMed Central

    Zhang, Bin; Cao, Zhongqiang; Zhang, Yiming; Yao, Cong; Xiong, Chao; Zhang, Yaqi; Wang, Youjie; Zhou, Aifen

    2016-01-01

    Localized birthweight references for gestational ages serve as an essential tool in accurate evaluation of atypical birth outcomes. Such references for twin births are currently not available in China. The aim of this study was to construct up-to-data sex specific birth weight references by gestational ages for twin births in China. We conducted a population-based analysis on the data of 22,507 eligible living twin infants with births dated between 8/01/2006 and 8/31/2015 from all 95 hospitals within the Wuhan area. Gestational ages in complete weeks were determined using a combination of last-menstrual-period based (LMP) estimation and ultrasound examination. Smoothed percentile curves were created by the Lambda Mu Sigma (LMS) method. Reference of the 3rd, 10th, 25th, 50th, 75th, 90th, 97th percentiles birth weight by sex and gestational age were made using 11,861 male and 10,646 female twin newborns with gestational age 26–42 weeks. Separate birthweight percentiles curves for male and female twins were constructed. In summary, our study firstly presents percentile curves of birthweight by gestational age for Chinese twin neonates. Further research is required for the validation and implementation of twin birthweight curves into clinical practice. PMID:27506479

  14. Primary Prevention of Gestational Diabetes Mellitus and Large-for-Gestational-Age Newborns by Lifestyle Counseling: A Cluster-Randomized Controlled Trial

    PubMed Central

    Luoto, Riitta; Kinnunen, Tarja I.; Aittasalo, Minna; Kolu, Päivi; Raitanen, Jani; Ojala, Katriina; Mansikkamäki, Kirsi; Lamberg, Satu; Vasankari, Tommi; Komulainen, Tanja; Tulokas, Sirkku

    2011-01-01

    Background Our objective was to examine whether gestational diabetes mellitus (GDM) or newborns' high birthweight can be prevented by lifestyle counseling in pregnant women at high risk of GDM. Method and Findings We conducted a cluster-randomized trial, the NELLI study, in 14 municipalities in Finland, where 2,271 women were screened by oral glucose tolerance test (OGTT) at 8–12 wk gestation. Euglycemic (n = 399) women with at least one GDM risk factor (body mass index [BMI] ≥25 kg/m2, glucose intolerance or newborn's macrosomia (≥4,500 g) in any earlier pregnancy, family history of diabetes, age ≥40 y) were included. The intervention included individual intensified counseling on physical activity and diet and weight gain at five antenatal visits. Primary outcomes were incidence of GDM as assessed by OGTT (maternal outcome) and newborns' birthweight adjusted for gestational age (neonatal outcome). Secondary outcomes were maternal weight gain and the need for insulin treatment during pregnancy. Adherence to the intervention was evaluated on the basis of changes in physical activity (weekly metabolic equivalent task (MET) minutes) and diet (intake of total fat, saturated and polyunsaturated fatty acids, saccharose, and fiber). Multilevel analyses took into account cluster, maternity clinic, and nurse level influences in addition to age, education, parity, and prepregnancy BMI. 15.8% (34/216) of women in the intervention group and 12.4% (22/179) in the usual care group developed GDM (absolute effect size 1.36, 95% confidence interval [CI] 0.71–2.62, p = 0.36). Neonatal birthweight was lower in the intervention than in the usual care group (absolute effect size −133 g, 95% CI −231 to −35, p = 0.008) as was proportion of large-for-gestational-age (LGA) newborns (26/216, 12.1% versus 34/179, 19.7%, p = 0.042). Women in the intervention group increased their intake of dietary fiber (adjusted coefficient 1.83, 95% CI 0.30–3.25, p = 0

  15. Neuropsychological Impairment in School-Aged Children Born to Mothers With Gestational Diabetes.

    PubMed

    Bolaños, Lourdes; Matute, Esmeralda; Ramírez-Dueñas, María de Lourdes; Zarabozo, Daniel

    2015-10-01

    The aim of this study was to determine whether school-aged children born to mothers with gestational diabetes show delays in their neuropsychological development. Several key neuropsychological characteristics of 32 children aged 7 to 9 years born to mothers with gestational diabetes were examined by comparing their performance on cognitive tasks to that of 28 children aged 8 to 10 years whose mothers had glucose levels within normal limits during pregnancy. The gestational diabetes group showed low performance on graphic, spatial, and bimanual skills and a higher presence of soft neurologic signs. Lower scores for general intellectual level and the working memory index were also evident. Our results suggest that gestational diabetes is associated with mild cognitive impairment. PMID:25814475

  16. Determining gestational age based on information from the Birth in Brazil study.

    PubMed

    Pereira, Ana Paula Esteves; Leal, Maria do Carmo; da Gama, Silvana Granado Nogueira; Domingues, Rosa Maria Soares Madeira; Schilithz, Arthur Orlando Corrêa; Bastos, Maria Helena

    2014-08-01

    This study aimed at assessing the validity of different measures for estimating gestational age and to propose the creation of an algorithm for gestational age at birth estimates for the Birth in Brazil survey--a study conducted in 2011-2012 with 23,940 postpartum women. We used early ultrasound imaging, performed between 7-20 weeks of gestation, as the reference method. All analyses were performed stratifying by payment of maternity care (public or private). When compared to early ultrasound imaging, we found a substantial intraclass correlation coefficient of ultrasound-based gestational age at admission measure (0.95 and 0.94) and of gestational age reported by postpartum women at interview measure (0.90 and 0.88) for the public and private payment of maternity care, respectively. Last menstrual period-based measures had lower intraclass correlation coefficients than the first two measures evaluated. This study suggests caution when using the last menstrual period as the first measure for estimating gestational age in Brazil, strengthening the use of information obtained from early ultrasound imaging results. PMID:25167191

  17. Perinatal mortality in relation to birthweight and gestational age: a registry-based comparison of Northern Norway and Murmansk County, Russia.

    PubMed

    Anda, Erik Eik; Nieboer, Evert; Wilsgaard, Tom; Kovalenko, Anton Alexandrovich; Odland, Jon Øyvind

    2011-05-01

    The objective was to explore how perinatal mortality relates to birthweight, gestational age and optimal perinatal survival weight for two Arctic populations employing an existing and a newly established birth registry. A medical birth registry for all births in Murmansk County of North-West Russia became operational on 1st January 2006. Its primary function is to provide useful information for health care officials pertinent to improving perinatal care. The cohort studied consisted of 17,302 births in 2006-07 (Murmansk County) and 16,006 in 2004-06 (Northern Norway). Birthweight probability density functions were analysed, and logistic regression models were employed to calculate gestational-age-specific mortality ratios. The perinatal mortality rate was 10.7/1000 in Murmansk County and 5.7/1000 in Northern Norway. Murmansk County had a higher proportion of preterm deliveries (8.7%) compared to Northern Norway (6.6%). The odds ratio (OR) of risk of mortality (Northern Norway as the reference group) was higher for all gestational ages in Murmansk County, but the largest risk difference occurred among term deliveries (OR 2.45, 95% confidence interval 1.45, 4.14) which hardly changed on adjustment for maternal age, parity and gestation. Proportionately, more babies were born near (± 500 g) the optimal perinatal survival weight in Murmansk County (67.2%) than in Northern Norway (47.6%). The observed perinatal mortality was higher in Murmansk County at all birthweight strata and at gestational ages between weeks 25 and 42, but the adjusted risk difference was most significant for term deliveries. PMID:21470261

  18. Gestational Age and Neonatal Brain Microstructure in Term Born Infants: A Birth Cohort Study

    PubMed Central

    Broekman, Birit F. P.; Wang, Changqing; Li, Yue; Rifkin-Graboi, Anne; Saw, Seang Mei; Chong, Yap-Seng; Kwek, Kenneth; Gluckman, Peter D.; Fortier, Marielle V.; Meaney, Michael J.; Qiu, Anqi

    2014-01-01

    Objective Understanding healthy brain development in utero is crucial in order to detect abnormal developmental trajectories due to developmental disorders. However, in most studies neuroimaging was done after a significant postnatal period, and in those studies that performed neuroimaging on fetuses, the quality of data has been affected due to complications of scanning during pregnancy. To understand healthy brain development between 37–41 weeks of gestational age, our study assessed the in utero growth of the brain in healthy term born babies with DTI scanning soon after birth. Methods A cohort of 93 infants recruited from maternity hospitals in Singapore underwent diffusion tensor imaging between 5 to 17 days after birth. We did a cross-sectional examination of white matter microstructure of the brain among healthy term infants as a function of gestational age via voxel-based analysis on fractional anisotropy. Results Greater gestational age at birth in term infants was associated with larger fractional anisotropy values in early developing brain regions, when corrected for age at scan. Specifically, it was associated with a cluster located at the corpus callosum (corrected p<0.001), as well as another cluster spanning areas of the anterior corona radiata, anterior limb of internal capsule, and external capsule (corrected p<0.001). Conclusions Our findings show variation in brain maturation associated with gestational age amongst ‘term’ infants, with increased brain maturation when born with a relatively higher gestational age in comparison to those infants born with a relatively younger gestational age. Future studies should explore if these differences in brain maturation between 37 and 41 weeks of gestational age will persist over time due to development outside the womb. PMID:25535959

  19. Does passive smoking in early pregnancy increase the risk of small-for-gestational-age infants?

    PubMed Central

    Dejin-Karlsson, E; Hanson, B S; Ostergren, P O; Sjöberg, N O; Marsal, K

    1998-01-01

    OBJECTIVES: This study tested the hypothesis that women who deliver small-for-gestational-age infants are more often exposed to passive smoking at home or at work. METHODS: Among a 1-year cohort of nulliparous women in the city of Malmö, Sweden 872 (87.7%) women completed a questionnaire during their first prenatal visit. The study was carried out among women whose pregnancies resulted in a singleton live birth (n = 826), 6.7% of infants were classified as small for their gestational age. RESULTS: Passive smoking in early pregnancy was shown to double a woman's risk of delivering a small-for-gestational-age infant, independent of potential confounding factors such as age, height, weight, nationality, educational level, and the mother's own active smoking (odds ratio [OR] = 2.7). A stratified analysis indicated interactional effects of maternal smoking and passive smoking on relative small-for-gestational-age risk. CONCLUSIONS: Based on an attributable risk estimate, a considerable reduction in the incidence of small-for-gestational-age births could be reached if pregnant women were not exposed to passive smoking. PMID:9772856

  20. Gestational age and newborn size according to parental social mobility: an intergenerational cohort study

    PubMed Central

    Gigante, Denise P; Horta, Bernardo L; Matijasevich, Alicia; Loret de Mola, Christian; Barros, Aluisio J D; Santos, Ina S; Barros, Fernando C; Victora, Cesar G

    2015-01-01

    Background We examined the associations between socioeconomic trajectories from birth to adulthood and gestational age and birth size in the next generation, using linked data from two population-based birth cohorts carried out in a Brazilian city. By comparing socioeconomic trajectories of mothers and fathers, we attempted to identify-specific effects of maternal and paternal socioeconomic trajectory on offspring birth weight, birth length, head circumference and gestational age at birth. Methods 2 population-based birth cohort studies were carried out in 1982 and 2004 in Pelotas (Brazil); 156 mothers and 110 fathers from the earlier cohort had children in 2004. Gestational age and birth length, weight and head circumference were measured. Analyses were carried out separately for mothers and fathers. Mediation analyses assessed the role of birth weight and adult body mass index (BMI). Results Among mothers, but not for fathers, childhood poverty was strongly associated with smaller size in the next generation (about 400 g in weight and 1.5 cm in height) and shorter gestations (about 2 weeks). Adult poverty did not play a role. For mothers, the associations with gestational age, birth length and weight—but not with head circumference—persisted after adjusting for maternal birth weight and for the height and weight of the grandmother. Maternal birth weight did not mediate the observed associations, but high maternal BMI in adulthood was partly responsible for the association with gestational age. Conclusions Strong effects of early poverty on gestational age and birth size in the next generation were observed among mothers, but not among fathers. These findings suggest a specific maternal effect of socioeconomic trajectory, and in particular of early poverty on offspring size and duration of pregnancy. PMID:26109560

  1. Fetal kidney length as a useful adjunct parameter for better determination of gestational age

    PubMed Central

    Ugur, Mete G.; Mustafa, Aynur; Ozcan, Huseyin C.; Tepe, Neslihan B.; Kurt, Huseyin; Akcil, Emre; Gunduz, Reyhan

    2016-01-01

    Objectives: To determine the validity of fetal kidney length and amniotic fluid index (AFI) in labor dating. Methods: This prospective study included 180 pregnant women followed up in the outpatient clinic at the Department of Obstetrics and Gynecology, Gaziantep University, Turkey, between January 2014 and January 2015. The gestational age (GA) was estimated by early fetal ultrasound measures and last menstrual period. Routine fetal biometric parameters, fetal kidney length, and amniotic fluid index were measured. We studied the correlation between fetal kidney length, amniotic fluid index, and gestational age. Result: The mean gestational age depending on last menstrual period and early ultrasound was 31.98±4.29 (24-39 weeks). The mean kidney length was 35.66±6.61 (19-49 mm). There was a significant correlation between gestational age and fetal kidney length (r=0.947, p=0.001). However, there was a moderate negative correlation between GA and AFI. Adding fetal kidney length to the routine biometrics improved the effectiveness of the model used to estimate GA (R2=0.965 to R2=0.987). Conclusion: Gestational age can be better predicted by adding fetal kidney length to other routine parameters. PMID:27146616

  2. Low-Dose Aspirin in Early Gestation for Prevention of Preeclampsia and Small-for-Gestational-Age Neonates: Meta-analysis of Large Randomized Trials.

    PubMed

    Roberge, Stéphanie; Sibai, Baha; McCaw-Binns, Affette; Bujold, Emmanuel

    2016-07-01

    Objectives Meta-analyses of small to moderate size randomized controlled trials (RCTs) suggested that aspirin started before 17 weeks' gestation reduces the risk of preeclampsia and small-for-gestational-age (SGA) neonates. We evaluated data from large randomized trials originally excluded from meta-analyses. Methods We performed meta-analyses of RCTs including more than 350 participants that compared aspirin to placebo during pregnancy. Corresponding authors were contacted to obtain data according to gestational age. Outcomes included preeclampsia, severe preeclampsia, and SGA. Relative risks (RRs) with their 95% confidence intervals (CIs) were calculated. Results Data for women recruited before 17 weeks' gestation were obtained for three (50%) of the six eligible trials for a total of 11,949 participants including 3,293 recruited before 17 weeks' gestation with available data. We observed no impact of low-dose aspirin (60 mg) started before 17 weeks' gestation on the risk of preeclampsia (RR: 0.93; 95% CI: 0.75-1.15), severe preeclampsia (RR: 0.96; 95% CI: 0.71-1.28), or SGA (RR: 0.84; 95% CI: 0.56-1.26) and it was not statistically different than when started at or after 17 weeks' gestation. Conclusion Data from large randomized trials do not support greater benefits of low-dose aspirin (at 60 mg daily) when started before 17 weeks' gestation for the prevention of preeclampsia or SGA. PMID:26906184

  3. The Evaluation of the Effects of Paternal and Maternal Silent Coeliac Disease on Birthweight and Gestational Age in Newborns

    PubMed Central

    Kahveci, H; Turan, MI; Cayir, A; Laloglu, F; Ertekin, V; Orbak, Z

    2014-01-01

    ABSTRACT Objective: Coeliac disease is a chronic disease and is common all over the world. It has many other associated systemic side effects. This study investigated the effect of paternal and maternal silent coeliac disease on birthweight and gestational age in newborns. Methods: The study group consisted of 81 newborns who were hospitalized for prematurity or term-intrauterine growth retardation. The parents of premature and/or small for gestational age babies born with coeliac disease-specific antigens were investigated. Results: The differences were not statistically significant in fathers' tissue transglutaminase levels between premature appropriate gestational age, premature small gestational age and term small gestational age infants (p > 0.05), but statistically significant in mothers (p < 0.05). Conclusions: Silent coeliac disease may occur in parents, especially in mothers of preterm and small for gestational age infants, even in the absence of apparent clinical indications. PMID:25781285

  4. Effects of Gestational Age, Birth Weight, and Hypoxemia on Pharmacokinetics of Amikacin in Serum of Infants

    PubMed Central

    Myers, Martin G.; Roberts, Robert J.; Mirhij, Najwa J.

    1977-01-01

    The serum pharmacokinetics of amikacin were studied in 36 infants treated for suspected bacterial infection. A prolonged serum half-life was associated with the related variables of birth at an early gestational age, low birth weight, and hypoxemia. A postnatal age effect was not apparent when hypoxemic infants were excluded. PMID:879747

  5. Executive Functions of Six-Year-Old Boys with Normal Birth Weight and Gestational Age

    PubMed Central

    Phua, Desiree Yee-Ling; Rifkin-Graboi, Anne; Saw, Seang-Mei; Meaney, Michael J.; Qiu, Anqi

    2012-01-01

    Impaired fetal development, reflected by low birth weight or prematurity, predicts an increased risk for psychopathology, especially attention deficit hyperactivity disorder (ADHD). Such effects cut across the normal range of birth weight and gestation. Despite the strength of existing epidemiological data, cognitive pathways that link fetal development to mental health are largely unknown. In this study we examined the relation of birth weight (>2500 g) and gestational age (37–41 weeks) within the normal range with specific executive functions in 195 Singaporean six-year-old boys of Chinese ethnicity. Birth weight adjusted for gestational age was used as indicator of fetal growth while gestational age was indicative of fetal maturity. Linear regression revealed that increased fetal growth within the normal range is associated with an improved ability to learn rules during the intra/extra-dimensional shift task and to retain visual information for short period of time during the delayed matching to sample task. Moreover, faster and consistent reaction times during the stop-signal task were observed among boys born at term, but with higher gestational age. Hence, even among boys born at term with normal birth weight, variations in fetal growth and maturity showed distinct effects on specific executive functions. PMID:22558470

  6. Early-Onset Thrombocytopenia in Small-For-Gestational-Age Neonates: A Retrospective Cohort Study.

    PubMed

    Fustolo-Gunnink, S F; Vlug, R D; Smits-Wintjens, V E H J; Heckman, E J; Te Pas, A B; Fijnvandraat, K; Lopriore, E

    2016-01-01

    Thrombocytopenia is a common finding in small for gestational age (SGA) neonates and is thought to result from a unique pathophysiologic mechanism related to chronic intrauterine hypoxia. Our objective was to estimate the incidence and severity of early-onset thrombocytopenia in SGA neonates, and to identify risk factors for thrombocytopenia. We performed a retrospective cohort study of all consecutive SGA neonates admitted to our ward and a control group of appropriate for gestational age (AGA) neonates matched for gestational age at birth. Main outcome measures were incidence and severity of thrombocytopenia, hematological and clinical risk factors for thrombocytopenia, and bleeding. A total of 330 SGA and 330 AGA neonates were included, with a mean gestational age at birth of 32.9 ± 4 weeks. Thrombocytopenia (<150x109/L) was found in 53% (176/329) of SGA neonates and 20% (66/330) of AGA neonates (relative risk (RR) 2.7, 95% confidence interval (CI) [2.1, 3.4]). Severe thrombocytopenia (21-50x109/L) occurred in 25 neonates (8%) in the SGA and 2 neonates (1%) in the AGA group (RR 12.5, 95% CI [3.0, 52.5]). Platelet counts <20x109/L were not recorded. Within the SGA group, lower gestational age at birth (p = <0.01) and erythroblastosis (p<0.01) were independently associated with a decrease in platelet count. Platelet count was positively correlated with birth weight centiles. In conclusion, early-onset thrombocytopenia is present in over 50% of SGA neonates and occurs 2.7 times as often as in AGA neonates. Thrombocytopenia is seldom severe and is independently associated with lower gestational age at birth and erythroblastosis. PMID:27177157

  7. Executive Function Mediates Effects of Gestational Age on Functional Outcomes and Behavior in Preschoolers

    PubMed Central

    Loe, Irene M.; Feldman, Heidi M.; Huffman, Lynne C.

    2014-01-01

    Objective To investigate the role of executive function (EF) skills, measured by parent-rating and performance-based instruments, as mediators of the effects of gestational age on functional outcomes and behavior symptoms in preterm and full term preschoolers. Patients and methods Children born preterm (n=70; mean gestational age 29.6 weeks and mean birth weight 1365g) were compared to children born full term (n=79) on composite measures of EF (using the Behavior Rating Inventory of Executive Function and a performance-based EF battery), adaptive function, prereading skills, and behavior symptoms. For the entire sample, mediation analyses examined the effect of gestational age on outcomes with EF as mediator. Results Compared to children born full term, children born preterm had significantly higher parent-rated EF scores and lower performance-based EF scores, both indicating more problems; further, children born preterm had lower adaptive function and prereading scores and more problematic behavior. Gestational age contributed to adaptive function, prereading skills, and behavior symptoms for all children. EF acted as a mediator of gestational age for all three outcomes; different patterns emerged for parent-rated and performance-based EF evaluations. For adaptive function, both EF measures significantly mediated effects of gestational age; for prereading skills, only performance-based EF was significant; for behavior symptoms, only parent-rated EF was significant. Conclusions We propose standard assessment of EF, using both parent-rating and performance-based EF measures, in young preterm children and other children at risk of EF impairments. EF skills are measurable, mediate important functional outcomes, and may serve as intervention targets. PMID:24906034

  8. Early-Onset Thrombocytopenia in Small-For-Gestational-Age Neonates: A Retrospective Cohort Study

    PubMed Central

    Vlug, R. D.; Smits-Wintjens, V. E. H. J.; Heckman, E. J.; te Pas, A. B.; Fijnvandraat, K.; Lopriore, E.

    2016-01-01

    Thrombocytopenia is a common finding in small for gestational age (SGA) neonates and is thought to result from a unique pathophysiologic mechanism related to chronic intrauterine hypoxia. Our objective was to estimate the incidence and severity of early-onset thrombocytopenia in SGA neonates, and to identify risk factors for thrombocytopenia. We performed a retrospective cohort study of all consecutive SGA neonates admitted to our ward and a control group of appropriate for gestational age (AGA) neonates matched for gestational age at birth. Main outcome measures were incidence and severity of thrombocytopenia, hematological and clinical risk factors for thrombocytopenia, and bleeding. A total of 330 SGA and 330 AGA neonates were included, with a mean gestational age at birth of 32.9 ± 4 weeks. Thrombocytopenia (<150x109/L) was found in 53% (176/329) of SGA neonates and 20% (66/330) of AGA neonates (relative risk (RR) 2.7, 95% confidence interval (CI) [2.1, 3.4]). Severe thrombocytopenia (21-50x109/L) occurred in 25 neonates (8%) in the SGA and 2 neonates (1%) in the AGA group (RR 12.5, 95% CI [3.0, 52.5]). Platelet counts <20x109/L were not recorded. Within the SGA group, lower gestational age at birth (p = <0.01) and erythroblastosis (p<0.01) were independently associated with a decrease in platelet count. Platelet count was positively correlated with birth weight centiles. In conclusion, early-onset thrombocytopenia is present in over 50% of SGA neonates and occurs 2.7 times as often as in AGA neonates. Thrombocytopenia is seldom severe and is independently associated with lower gestational age at birth and erythroblastosis. PMID:27177157

  9. Cognitive outcome varies in adolescents born preterm, depending on gestational age, intrauterine growth and neonatal complications

    PubMed Central

    Lundequist, Aiko; Böhm, Birgitta; Lagercrantz, Hugo; Forssberg, Hans; Smedler, Ann-Charlotte

    2015-01-01

    Aim The aim of this study was to investigate long-term cognitive outcome in a cohort of 18-year-olds born preterm and previously assessed at the age of 5.5. Methods We tested 134 adolescents born preterm with a very low birthweight of <1500 g and 94 term-born controls with a comprehensive cognitive battery at 18 years of age. The cohort was subdivided into 73 extremely preterm, 42 very preterm and 19 moderately preterm infants with gestational ages of 23–27, 28–31 and 32–36 weeks, respectively. The moderately preterm group was dominated by adolescents born small for gestational age. Results Very preterm adolescents performed on a par with term-born controls. In contrast, extremely preterm adolescents displayed inferior results on all cognitive tests, more so if they had suffered neonatal complications. Moderately preterm adolescents scored lower than very preterm and full-term born adolescents, particularly on complex cognitive tasks. Conclusion Adolescents born at 28 weeks of gestation or later, with appropriate birthweight and no perinatal complications, functioned like term-born peers at 18 years of age. Extremely preterm birth per se posed a risk for long-term cognitive deficits, particularly executive deficits. Adolescents born moderately preterm but small for gestational age were at risk of general cognitive deficits. PMID:25394225

  10. Estimation of Gestational Age, Using Neonatal Anthropometry: A Cross-sectional Study in India

    PubMed Central

    Thawani, Rajat; Faridi, M.M.A.; Arora, Shilpa Khanna; Kumar, Rajeev

    2013-01-01

    Prematurity is a significant contributor to neonatal mortality in India. Conventionally, assessment of gestational age of newborns is based on New Ballard Technique, for which a paediatric specialist is needed. Anthropometry of the newborn, especially birthweight, has been used in the past to predict the gestational age of the neonate in peripheral health facilities where a trained paediatrician is often not available. We aimed to determine if neonatal anthropometric parameters, viz. birthweight, crown heel-length, head-circumference, mid-upper arm-circumference, lower segment-length, foot-length, umbilical nipple distance, calf-circumference, intermammary distance, and hand-length, can reliably predict the gestational age. The study also aimed to derive an equation for the same. We also assessed if these neonatal anthropometric parameters had a better prediction of gestational age when used in combination compared to individual parameters. We evaluated 1,000 newborns in a cross-sectional study conducted in Guru Teg Bahadur Hospital in Delhi. Detailed anthropometric estimation of the neonates was done within 48 hours after birth, using standard techniques. Gestational age was estimated using New Ballard Scoring. Out of 1,250 consecutive neonates, 1,000 were included in the study. Of them, 800 randomly-selected newborns were used in devising the model, and the remaining 200 newborns were used in validating the final model. Quadratic regression analysis using stepwise selection was used in building the predictive model. Birthweight (R=0.72), head-circumference (R=0.60), and mid-upper arm-circumference (R=0.67) were found highly correlated with gestation. The final equation to assess gestational age was as follows: Gestational age (weeks)=5.437×W–0.781×W2+2.815×HC–0.041×HC2+0.285×MUAC–22.745 where W=Weight, HC=Head-circumference and MUAC=Mid-upper arm-circumference; Adjusted R=0.76. On validation, the predictability of this equation is 46% (±1 week), 75

  11. Gene Expression in Placentas From Nondiabetic Women Giving Birth to Large for Gestational Age Infants.

    PubMed

    Ahlsson, F; Åkerud, H; Schijven, D; Olivier, J; Sundström-Poromaa, I

    2015-10-01

    Gestational diabetes, obesity, and excessive weight gain are known independent risk factors for the birth of a large for gestational age (LGA) infant. However, only 1 of the 10 infants born LGA is born by mothers with diabetes or obesity. Thus, the aim of the present study was to compare placental gene expression between healthy, nondiabetic mothers (n = 22) giving birth to LGA infants and body mass index-matched mothers (n = 24) giving birth to appropriate for gestational age infants. In the whole gene expression analysis, only 29 genes were found to be differently expressed in LGA placentas. Top upregulated genes included insulin-like growth factor binding protein 1, aminolevulinate δ synthase 2, and prolactin, whereas top downregulated genes comprised leptin, gametocyte-specific factor 1, and collagen type XVII α 1. Two enriched gene networks were identified, namely, (1) lipid metabolism, small molecule biochemistry, and organismal development and (2) cellular development, cellular growth, proliferation, and tumor morphology. PMID:25824011

  12. Effects of Gestational Age at Birth on Cognitive Performance: A Function of Cognitive Workload Demands

    PubMed Central

    Jaekel, Julia; Baumann, Nicole; Wolke, Dieter

    2013-01-01

    Objective Cognitive deficits have been inconsistently described for late or moderately preterm children but are consistently found in very preterm children. This study investigates the association between cognitive workload demands of tasks and cognitive performance in relation to gestational age at birth. Methods Data were collected as part of a prospective geographically defined whole-population study of neonatal at-risk children in Southern Bavaria. At 8;5 years, n = 1326 children (gestation range: 23–41 weeks) were assessed with the K-ABC and a Mathematics Test. Results Cognitive scores of preterm children decreased as cognitive workload demands of tasks increased. The relationship between gestation and task workload was curvilinear and more pronounced the higher the cognitive workload: GA2 (quadratic term) on low cognitive workload: R2 = .02, p<0.001; moderate cognitive workload: R2 = .09, p<0.001; and high cognitive workload tasks: R2 = .14, p<0.001. Specifically, disproportionally lower scores were found for very (<32 weeks gestation) and moderately (32–33 weeks gestation) preterm children the higher the cognitive workload of the tasks. Early biological factors such as gestation and neonatal complications explained more of the variance in high (12.5%) compared with moderate (8.1%) and low cognitive workload tasks (1.7%). Conclusions The cognitive workload model may help to explain variations of findings on the relationship of gestational age with cognitive performance in the literature. The findings have implications for routine cognitive follow-up, educational intervention, and basic research into neuro-plasticity and brain reorganization after preterm birth. PMID:23717694

  13. Labor patterns in twin gestations

    PubMed Central

    Leftwich, Heidi K.; Zaki, Mary N.; Wilkins, Isabelle; Hibbard, Judith U.

    2014-01-01

    Objective To compare labor progression in twin vs singleton gestations. Study Design Retrospective review of electronic database created by Consortium on Safe Labor, reflecting labor and delivery information from 12 clinical centers 2002-2008. Women with twin gestations, cephalic presentation of presenting twin, gestational age ≥34 weeks, with ≥2 cervical examinations were included. Exclusion criteria were fetal anomalies or demise. Singleton controls were selected by the same criteria. Categorical variables were analyzed by χ2; continuous by Student t test. Interval censored regression was used to determine distribution for time of cervical dilation in centimeters, or “traverse times,” and controlled for confounding factors. Repeated-measures analysis constructed mean labor curves by parity and number of fetuses. Results A total of 891 twin gestations were compared with 100,513 singleton controls. Twin gestations were more often older, white or African American, earlier gestational age, increased prepregnancy body mass index, and with lower birthweight. There was no difference in number of prior cesarean deliveries, induction, or augmentation, or epidural use. Median traverse times increased at every centimeter interval in nulliparous twins, in both unadjusted and adjusted analysis (P < .01). A similar pattern was noted for multiparas in both analyses. Labor curves demonstrated a delayed inflection point in the labor pattern for nulliparous and multiparous twin gestations. Conclusion Both nulliparous and multiparous women have slower progression of active phase labor with twins even when controlling for confounding factors. PMID:23871795

  14. Effects of age, parity, season of calving, and sire on milk yield of Carora cows in Venezuela.

    PubMed

    Morales, F; Blake, R W; Stanton, T L; Hahn, M V

    1989-08-01

    Age-parity-season of calving, mature equivalent factors were developed for the Carora breed of Venezuela from more than 13,000 244-d milk yield records from the Venezuelan milk recording program from 1975 to 1986. Age-parity-season interactions with parity-age were most important for young cows and seasonal effects most important for old cows. Multiplicative factors were verified as useful to adjust milk yields of Carora and Brown Swiss crossbred cows. Repeatabilities for mature equivalent adjusted milk were .47, .36, and .38 between pairs of repeated records through fourth lactation. Heritability of milk in first lactation by REML procedures was 12% based on 44 Carora sires with 14 effective daughters per sire. Small population size for Carora cattle hinders usefulness and cost effectiveness of progeny testing as the primary investment in genetic gain. Greater potential economy is likely from exploiting the dams of sires genetic pathway. PMID:2794175

  15. Induced abortion. Effects of marital status, age and parity on choice of pregnancy termination.

    PubMed

    Skjeldestad, F E; Borgan, J K; Daltveit, A K; Nymoen, E H

    1994-03-01

    Data from the Abortion File of the Central Bureau of Statistics in Norway for 1979-90 were used to examine the relative risks of induced abortion among groups varying by marital status, age, and parity for four 3-year time periods. Between January 1979 and December 1990, 639,551 births were registered and 174,590 pregnancies were terminated by abortion. The mean number of induced abortions in three-year periods increased from 12,800 to 14,600 (14%), and births increased from 50,700 to 58,800 (16%). The two prominent groups having abortions were unmarried women without children aged less than 30 years (40%) and married women with 2 or more children. Declines in abortion occurred among married women with two or more children, from 24% of all abortions in 1979-81 to 15% in 1988-90. Unmarried, pregnant women aged more than 20 years of age experienced a decline in abortion terminations. Unmarried teenage abortions remained stable. Pregnancy terminations increased primarily for married women aged 10-24 years without children. The lowest group with abortions comprised married childless women aged 25-29 years: the reference group. Unmarried women, regardless of age and parity, ended their pregnancies 40-50 times more often than the reference group. Registration of data affected the data by overestimation of abortions among single teenagers by 4% for all time periods. Although abortions increased among unmarried women aged over 20 years, there was still a decline in the proportion of pregnancies terminated by abortion among unmarried women aged over 20 years. Births among cohabiting or unmarried women increased more than the relative number of abortions among unmarried women. Cohabitation increased from 12% in 1977 to 30% in 1988. The suggestion was that the decreasing trend in abortion among pregnant unmarried women might be related to the changes in consensual unions. Data from the 1988 Norway Fertility Survey found that 40% of births were to childless married couples not

  16. Correlation between Umbilical Cord Diameter and Cross Sectional Area with Gestational Age and Foetal Anthropometric Parameters.

    PubMed

    Begum, K; Ahmed, M U; Rahman, M M; Hossain, M M; Begum, M; Sarkar, S K; Reza, M T; Hoshneara, M; Beg, A; Sultana, F; Begum, F; Akter, F A

    2016-04-01

    The objective of the study was to find out correlation between umbilical cord diameter, cross sectional area with gestational age and foetal anthropometric parameters. This cross sectional study was conducted among healthy women between the 24th and 40th completed weeks of a normal pregnancy in the Department of Radiology & Imaging, Mymensingh Medical College Hospital, Mymensingh during the study period, from July 2009 to June 2011. A total of 230 consecutive normal pregnancy patients were included in the study. The diameter & cross-sectional area of the umbilical cord were measured on a plane adjacent to the junction of the umbilical cord and the fetal abdomen, in cross-section, with maximum magnification of the image. The cord was manually circled, and it's cross sectional areas was automatically calculated by the ultrasonograph. The mean±SD age was 24.3±4.7 years with range from 19 to 36 years. The mean gestational age was 32.1±4.5 weeks and more than a half (56.4%) of the pregnant women were nulliparas. A positive significant (p<0.001) correlation were found between umbilical cord diameter with bi-parietal diameter (r=0.548); head circumference (r=0.411); abdominal circumference (r=0.444); femur length (r=0.366) and gestational age gestation age (r=0.643). Similarly, a significant (p<0.001) positive week correlation were found between umbilical cross sectional area with bi-parietal diameter (r=0.3303); head circumference (r=0.3202); abdominal circumference (r=0.2651); femur length (r=0.3307) and gestation age (r=0.4051). A positive significant better correlation was found with umbilical cord diameter than cross sectional area with foetal anthropometric parameters. PMID:27277346

  17. COMPARISON OF GESTATIONAL AGE AT DELIVERY BASED ON LAST MENSTRUAL PERIOD AND EARLY ULTRASOUND

    EPA Science Inventory

    Reported date of last menstrual period (LMP) is commonly used to estimate gestational age but may be unreliable if recall is inaccurate or time between menstruation and ovulation differs from the presumed 15-day interval. Early ultrasound is generally a more accurate method than ...

  18. Relation of polychlorinated biphenyls to birthweight and gestational age in the offspring of occupationally exposed mothers

    SciTech Connect

    Taylor, P.R.; Stelma, J.; Lawrence, C.E.

    1984-09-20

    A study was made of the relation between occupational exposure of women to high homolog polychlorinated biphenyls (PCB) and birthweight and gestational age among the live offspring of these workers. In 1982 interviews were conducted with 200 women who had held jobs with direct PCB exposure. A comparison was made with 205 women who had never held such a job. When all births occurring to mothers following exposure to PCBs were considered, the unadjusted mean birthweight in the direct exposure group was 96 grams less than the comparison group. No differences in gestational age were seen between groups. The birthweight difference was reduced to 41 grams following adjustment for potential confounding factors. In a parallel analysis using a continuous exposure variable estimate generated from an independently derived serum PCB prediction model, no effect of PCBs was noted on birthweight or gestational age using either crude or adjusted analyses. The authors conclude that no evidence for a biologically meaningful effect of high homolog PCBs on gestational age or birthweight exists.

  19. Antenatal blood pressure for prediction of pre-eclampsia, preterm birth, and small for gestational age babies: development and validation in two general population cohorts

    PubMed Central

    Silverwood, Richard J; de Stavola, Bianca L; Inskip, Hazel; Cooper, Cyrus; Godfrey, Keith M; Crozier, Sarah; Fraser, Abigail; Nelson, Scott M; Lawlor, Debbie A; Tilling, Kate

    2015-01-01

    Study question Can routine antenatal blood pressure measurements between 20 and 36 weeks’ gestation contribute to the prediction of pre-eclampsia and its associated adverse outcomes? Methods This study used repeated antenatal measurements of blood pressure from 12 996 women in the Avon Longitudinal Study of Parents and Children (ALSPAC) to develop prediction models and validated these in 3005 women from the Southampton Women’s Survey (SWS). A model based on maternal early pregnancy characteristics only (BMI, height, age, parity, smoking, existing and previous gestational hypertension and diabetes, and ethnicity) plus initial mean arterial pressure was compared with a model additionally including current mean arterial pressure, a model including the deviation of current mean arterial pressure from a stratified normogram, and a model including both at different gestational ages from 20-36 weeks. Study answer and limitations The addition of blood pressure measurements from 28 weeks onwards improved prediction models compared with use of early pregnancy risk factors alone, but they contributed little to the prediction of preterm birth or small for gestational age. Though multiple imputation of missing data was used to increase the sample size and minimise selection bias, the validation sample might have been slightly underpowered as the number of cases of pre-eclampsia was just below the recommended 100. Several risk factors were self reported, potentially introducing measurement error, but this reflects how information would be obtained in clinical practice. What this study adds The addition of routinely collected blood pressure measurements from 28 weeks onwards improves predictive models for pre-eclampsia based on blood pressure in early pregnancy and other characteristics, facilitating a reduction in scheduled antenatal care. Funding, competing interests, data sharing UK Wellcome Trust, US National Institutes of Health, and UK Medical Research Council. Other

  20. The relation of polychlorinated biphenyls to birth weight and gestational age in the offspring of occupationally exposed mothers

    SciTech Connect

    Taylor, P.R.; Stelma, J.M.; Lawrence, C.E. )

    1989-02-01

    The authors studied the relation of polychlorinated biphenyls (PCBs) to birth weight and gestational age among the live offspring of women occupationally exposed to PCBs during the manufacture of capacitors in Upstate New York. Interviews were conducted in 1982 with 200 women who had held jobs with direct exposure and 205 women who had never held a direct-exposure job in order to ascertain information on reproductive history and other factors influencing reproductive outcome. Exposure was assessed as high-homolog PCB (Aroclor 1254), a continuous exposure variable estimated from an independently derived prediction model. After adjustment for variables other than gestational age known to influence birth weight, a significant effect of high-homolog exposure is seen for birth weight. For gestational age, a small but significant decrease is also observed with an increase in estimated exposure. When gestational age is accounted for in addition to other variables related to birth weight, estimated serum PCB is no longer a significant predictor of birth weight. The authors conclude that these data indicate that there is a significant relation between increased estimated serum PCB level and decreased birth weight and gestational age, and that the decrease in birth weight is at least partially related to shortened gestational age. The magnitude of these effects was quite small compared with those of other known determinants of gestational age and birth weight, and the biologic importance of these effects is likely to be negligible except among already low birth weight or short gestation infants.

  1. Cell turnover in the "resting" human breast: influence of parity, contraceptive pill, age and laterality.

    PubMed Central

    Anderson, T. J.; Ferguson, D. J.; Raab, G. M.

    1982-01-01

    Morphological identification of cell multiplication (mitosis) and cell deletion (apoptosis) within the lobules of the "resting" human breast is used to assess the response of the breast parenchyma to the menstrual cycle. The responses are shown to have a biorhythm in phase with the menstrual cycle, with a 3-day separation of the mitotic and apoptotic peaks. The study fails to demonstrate significant differences in the responses between groups defined according to parity, contraceptive-pill use or presence of fibroadenoma. However, significant differences are found in the apoptotic response according to age and laterality. The results highlight the complexity of modulating influences on breast parenchymal turnover in the "resting" state, and prompt the investigation of other factors as well as steroid hormones and prolactin in the promotion of mitosis. The factors promoting apoptosis in the breast are still not clear. PMID:7126427

  2. A prospective study to compare serum human placental lactogen and menstrual dates for determining gestational age.

    PubMed

    Whittaker, P G; Lind, T; Lawson, J Y

    1987-01-01

    In a group of 575 healthy pregnant women with certain menstrual dates the estimation of the length of gestation from maternal serum human placental lactogen concentrations has been compared with gestational age calculated from the last menstrual period and ultrasonic measurements of the fetal biparietal diameter. In 412 of these patients labor started spontaneously, and the estimated dates of delivery determined by these three methods were also compared. In the range of 9 to 17 weeks of pregnancy, gestational age can be determined by human placental lactogen measurement to within 7 days (+/- 1 SD) which compares favorably with other methods. Regarding the prediction of the expected date of delivery, 88% were delivered within 2 weeks of the date predicted by last menstrual period, 82% within 2 weeks of the sonar date, and 80% by the date determined by human placental lactogen assessment. Prediction of delivery in a further group of 139 women with uncertain dates gave 73% within 2 weeks by sonar date and 69% within 2 weeks by human placental lactogen determination. We suggest human placental lactogen measurements should become part of routine antenatal care complementing rather than replacing the role of ultrasonic scanning. For those doctors and patients who wish to avoid more exposure to ultrasonic scanning than absolutely necessary, human placental lactogen estimates offer an alternative method for assessing the length of gestation. PMID:3541617

  3. Comparison of serum 25-hydroxy vitamin D levels between mothers with small for gestational age and appropriate for gestational age newborns in Kerman

    PubMed Central

    Mirzaei, Fatemeh; Amiri Moghadam, Tayebeh; Arasteh, Peyman

    2015-01-01

    Background: Vitamin D deficiency during pregnancy is associated with some adverse pregnancy outcomes but its relationship with fetal growth is unknown. Objective: We compared the 25-hydroxy vitamin D levels between mothers and their small for gestational age (SGA) newborns with mothers and their appropriate for gestational age (AGA) newborns. Materials and Methods: The study population included pregnant women that referred to Afzalipour Hospital in Kerman from 2012 to 2013. The case and control group consisted of 40 pregnant mothers with SGA and AGA newborns, respectively. The maternal and infants 25-hydroxy vitamin D levels were measured in the two groups. Results: 25-hydroxy vitamin D deficiency (<20 ng/ml) was statistically higher in women with SGA newborns in comparison to women with AGA newborns (p=0.003).Vitamin D deficiency was higher among the SGA newborns in comparison to AGA newborns (25% vs. 17.5%), although this finding was not statistically meaningful (p=0.379). The relationship of vitamin D deficiency levels between mothers and infants in both the SGA group and the AGA group was significant. Conclusion: Our study reveals a high prevalence of vitamin D deficiency in women with SGA infants in comparison to women with AGA children. In addition, maternal vitamin D deficiency is associated with its deficiency in newborns. PMID:26131008

  4. Small for gestational age as a predictor of behavioral and learning problems in twins.

    PubMed

    Rooney, Rosanna; Hay, David; Levy, Florence

    2003-02-01

    The study examines the effects of being born small for gestational age (SGA) on rates of behavioral problems in twins and siblings, utilising data from the Australian Twin Study of disruptive behavior disorders in twins and their siblings. Participants were 3944 twins and their siblings who were assessed at two intervals three years apart. At the first assessment (1991), they ranged between 4 and 12 years of age. Items assessing Attention Deficit/Hyperactivity Disorder were based on DSM-III-R criteria (Time 1) and DSM-IV criteria (Time 2). Other measures included history of speech and reading therapy, demographic information and obstetric and neonatal history. Results indicated that both male and female twins, who were extremely growth restricted (small for gestational age up to the third percentile-WGA3) showed more inattention, and poorer speech and reading scores. The effects were greater for males. Male twins who were small for gestation age, up to the 10th percentile, were more likely to have a DSM-IV diagnosis of Inattention. Implications of these results included WGA3 male twins being at a "triple disadvantage" for subsequent behavioral and learning problems, in that being male, being a twin and being small for gestational age are all significant factors. Recommendations are made for early intervention for low birthweight male twins. The study is consistent with recent follow-up studies of very-low-birthweight singletons, indicating male disadvantage in cognitive outcome. While there is some genetic component to SGA, it does constitute a potentially major contribution to common environmental effects that must be considered in twin-based genetic analyses. PMID:12626228

  5. Amplitude-integrated electroencephalographic activity and middle cerebral artery Doppler flow measurements in preterm small for gestational age infants.

    PubMed

    Kolsuz, Leyla Daban; Topcuoglu, Sevilay; Gursoy, Tugba; Karatekin, Güner; Ovali, H Fahri

    2015-03-01

    Amplitude-integrated encephalography (EEG) is frequently used in neonatal intensive care units to monitor brain functions. Its bedside application and easy interpretation are the most important features. Brain development of small for gestational age infants can be affected by intrauterine chronic hypoxia. The current study aimed to evaluate cerebral functions of small for gestational age infants by means of amplitude-integrated EEG. Thirty- to 34-week-old 22 small for gestational age and 27 appropriate for gestational age preterm infants were included in the study. The mode of delivery, gender, birth weight, and Apgar scores of the patients were recorded. Following middle cerebral artery mean velocity measurement with cranial Doppler at the 24th hour of birth, an amplitude-integrated EEG recording was performed on all infants, for a period of 4 to 24 hours. Small for gestational age infants had significantly higher middle cerebral artery mean velocity than appropriate for gestational age infants (21.09 ± 4.25 vs 17.8 ± 4.07; P = .029). The amplitude-integrated EEG recordings showed lower "lower border of quiet sleep" and total Burdjalov score in small for gestational age infants when compared with appropriate for gestational age infants (2.5 [1-3.25] µV vs 3 [2.75-4] µV; P = .04, 8 [6-10], 9 [9-11]; P = .04, respectively). Increased middle cerebral artery blood flow observed in small for gestational age infants might be a marker of chronic intrauterine hypoxia to which these infants were exposed. These infants demonstrated a more immature pattern of amplitude-integrated EEG. PMID:25296921

  6. Effect of gestational age and intrauterine nutrition on plasma transferrin and iron in the newborn.

    PubMed Central

    Scott, P H; Berger, H M; Kenward, C; Scott, P; Wharton, B A

    1975-01-01

    Plasma concentrations of transferrin and iron were measured in the cord blood of babies of varying gestational age and birthweight. Tranferrin and iron concentrations rose with gestational age; values in light-for-dates babies did not differ from those in babies of appropriate weight. In the last trimester of pregnancy plasma transferrin and iron concentrations in the fetus are affected by the maturity of the pregnancy but are independent of the nutritional status of the fetus. The low transferrin levels, particularly in preterm babies, may caution the use of iron especially by the parenteral route in the neonatal period, but we are wary of abandoning on this evidence alone the well tried clinical custom of giving oral iron to preterm babies who are not breast fed. PMID:1236569

  7. Evaluation of the normal fetal kidney length and its correlation with gestational age.

    PubMed

    Seilanian Toosi, Farrokh; Rezaie-Delui, Hossein

    2013-01-01

    A true estimation of gestational age (GA) plays an important role in quality maternity care and scheduling the labor date. This study aimed to evaluate the normal fetal kidney length (KL) and its correlation with GA. A cross-sectional study on 92 pregnant women between 8th and 10th week of gestation with normal singleton pregnancy underwent standard ultrasound fetal biometry and kidney length measurement. univariate and multivariate linear regression analysis was used to create a predictive equation to estimate GA on the KL and fetobiometry parameters. A significant correlation was found between GA and KL (r=0.83, P<0.002). The best GA predictor was obtained by combining head circumference, fetal biparietal diameter, femur length and KL with a standard error (SE) about 14.2 days. Our findings showed that KL measurements combination with other fetal biometric parameters could predict age of pregnancy with a better precision. PMID:23737313

  8. A matter of size: Part 2. Evaluating the large-for-gestational-age neonate.

    PubMed

    Lawrence, Elizabeth J

    2007-08-01

    Large for gestational age (LGA) is another designation used to assess and monitor growth throughout the pregnancy and after delivery. Large for gestational age is an abnormal growth descriptor that assists in anticipating neonatal needs pre-and postnatally. Careful monitoring for abnormal growth trends in the fetus is imperative prenatally. The relative size of a neonate affects many aspects of prenatal and postnatal surveillance. Nursing care is guided by the maternal history and the delivery room complications that may occur. Anticipating complications in the delivery room is vital to the survival of LGA neonates. Nursing care for LGA neonates requires knowledge based on these potential complications. A thorough physical assessment with appropriate glucose monitoring and parental education is required. Size matters when it comes to the health and welfare of all sizes of neonates. Anticipatory guidance with prenatal monitoring and education can improve outcomes in the neonate at risk for LGA complications at birth. PMID:17700192

  9. Measurements of body composition during late gestation and lactation in first and second parity sows and its relationship to piglet production and post-weaning reproductive performance

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The objective of this study was to characterize variation of multiple body condition traits in a white crossbred composite population of first- and second-parity sows and determine if these traits relate to litter production and reproductive parameters. As expected, parity 2 dams were heavier (P < 0...

  10. Metals exposure and risk of small-for-gestational age birth in a Canadian birth cohort: The MIREC study

    SciTech Connect

    Thomas, Shari; Arbuckle, Tye E.; Fisher, Mandy; Fraser, William D.; Ettinger, Adrienne; King, Will

    2015-07-15

    Background: Lead, mercury, cadmium and arsenic are some of the most common toxic metals to which Canadians are exposed. The effect of exposure to current low levels of toxic metals on fetal growth restriction is unknown. Objective: The aim of this study was to examine relationships between exposure to lead, mercury, cadmium and arsenic during pregnancy, and risk of small for gestational age (SGA) birth. Methods: Lead, mercury, cadmium and arsenic levels were measured in blood samples from the first and third trimesters in 1835 pregnant women from across Canada. Arsenic species in first trimester urine were also assessed. Relative risks and 95% confidence intervals were estimated using log binomial multivariate regression. Important covariates including maternal age, parity, pre-pregnancy BMI, and smoking, were considered in the analysis. An exploratory analysis was performed to examine potential effect modification of these relationships by single nucleotide polymorphisms (SNPs) in GSTP1 and GSTO1 genes. Results: No association was found between blood lead, cadmium or arsenic and risk for SGA. We observed an increased risk for SGA for the highest compared to the lowest tertile of exposure for mercury (>1.6 µg/L, RR=1.56.; 95% CI=1.04–2.58) and arsenobetaine (>2.25 µg/L, RR=1.65; 95% CI=1.10–2.47) after adjustment for the effects of parity and smoking. A statistically significant interaction was observed in the relationship between dimethylarsinic acid (DMA) levels in urinary arsenic and SGA between strata of GSTO1 A104A (p for interaction=0.02). A marginally significant interaction was observed in the relationship between blood lead and SGA between strata of GSTP1 A114V (p for interaction=0.06). Conclusions: These results suggest a small increase in risk for SGA in infants born to women exposed to mercury and arsenic. Given the conflicting evidence in the literature this warrants further investigation in other pregnant populations. - Highlights: • Metals

  11. Systemic inflammation in the extremely low gestational age newborn following maternal genitourinary infections

    PubMed Central

    Fichorova, Raina N.; Beatty, Noah; Sassi, Rita R. S.; Yamamoto, Hidemi S.; Allred, Elizabeth N.; Leviton, Alan

    2014-01-01

    Problem Gestational genitourinary infections are associated with life-long disabilities, but it is unknown if neonatal inflammation is involved. Method Mothers of 914 infants born before 28th gestation week reported cervical/vaginal infection (CVI), and/or urine/bladder/kidney infection (UTI), or neither. Inflammation proteins measured in baby’s blood on postnatal days 1, 7 and 14 were considered elevated if in the top quartile for gestational age. Logistic regression models adjusting for potential confounders assessed odds ratios. Results Compared to neither UTI/CVI, mothers with CVI were more likely to have infants with elevated CRP, SAA, MPO, IL-1β, IL-6, IL-6R, TNF-α, RANTES, ICAM-3, E-selectin and VEGF-R2 on day 1; those with UTI were more likely to have infants with elevated MPO, IL-6R, TNF-R1, TNF-R2, and RANTES on day 7. Placental anaerobes and genital micoplasma were more common in pregnancies with CVI. Conclusion Gestational UTI/CVI should be targeted for preventing systemic inflammation in the very preterm newborn. PMID:25164433

  12. Simple mathematical formulae for estimation of median values of fetal biometry at each gestational age

    PubMed Central

    Choi, Hwa Young; Kim, Jeong Ha; Park, Jee Yoon; Jung, Eun Young; No, Jae Hong; Oh, Kyung Joon

    2016-01-01

    Objective The aim of this study was to propose simple mathematical formulae to estimate median values of fetal biometry including biparietal diameter (BPD), abdominal circumference (AC) and femur length (FL) at each gestational age (GA) easily without looking up the previously established reference values. Methods Simple mathematical formulae to estimate median values of fetal biometric values at each gestational week were inferred. To validate these formulae, three different linear equations were derived from previously reported reference values of median BPD, AC and FL using regression analysis at each gestational week. Finally, calculated data through the inferred formula were compared to retrospectively collected data (observed data). Results The equation revealing the relationship between BPD and GA was: median BPD (cm)=GA (wk)/4. Using this simple mathematical formula, the absolute percentage error between observed data and calculated data ranged from 0.12% to 7.50%. The equation between AC and GA was: median AC (cm)=GA (wk)-5. Through this formula, the absolute percentage error was analyzed same as above and it ranged from 0.30% to 4.76%. Lastly the derived formula between FL and GA was: median FL (cm)=GA (wk)/5 and the absolute percentage error ranged from 4.52% to 16.75%. Conclusion The three simple formulae suggested in our study showed a significantly easy way to estimate the median values of fetal biometry at each gestational week with good reliability. PMID:27004198

  13. EFFECTS OF MATERNAL EXPOSURE TO PHTHALATES AND BISPHENOL A DURING PREGNANCY ON GESTATIONAL AGE

    PubMed Central

    Weinberger, Barry; Vetrano, Anna M.; Archer, Faith E.; Marcella, Stephen W.; Buckley, Brian; Wartenberg, Daniel; Robson, Mark G.; Klim, Jammie; Azhar, Sana; Cavin, Sarah; Wang, Lu; Rich, David Q.

    2014-01-01

    Objective Phthalates and bisphenol A (BPA) are ubiquitous environmental toxicants, present in high concentrations in numerous consumer products. We hypothesized that maternal exposure to phthalates and BPA in pregnancy is associated with shortened gestation. Methods Urinary phthalate and BPA metabolites from 72 pregnant women were measured at the last obstetric clinic visit prior to delivery. Using linear regression models, we estimated the change in gestational age associated with each interquartile range (IQR) increase in phthalate and BPA metabolite concentration. Results IQR increases in urinary mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and BPA concentrations were associated with 4.2 and 1.1 day decreases in gestation, respectively. When stratified by gender, these alterations were found only in male infants. Conclusions We conclude that MEHHP and BPA (free + glucuronide) are associated with reductions in gestation, with effects observed only in males. Our findings are consistent with the idea that these agents induce gender-specific alterations in signaling via PPAR-γ transcription factor, androgen precursors, and/or inflammatory mediators during the initiation of labor. PMID:23795657

  14. Estimation of gestational age and assessment of canine fetal maturation using radiology and ultrasonography: a review.

    PubMed

    Lopate, C

    2008-08-01

    Since the duration of pregnancy in the bitch is relatively short, it is critical that fetuses are fully mature prior to delivery for them to survive. For breeders to be able to prepare for normal whelpings and align medical care in case of emergency, an estimated due date is necessary. In cases where ovulation timing is lacking and there is a singleton fetus or oversize fetuses, it is necessary to ascertain gestational age prior to setting the date of Cesarean section. In high-risk pregnancies, where there is poor or no ovulation timing, determination of fetal maturation and gestational age will assist in determining if pregnancy has progressed long enough to allow delivery of viable puppies. In cases where bitches are receiving supplemental progesterone for pregnancy maintenance medications must be discontinued at an appropriate time to permit delivery of viable puppies. It also allows for estimation of the likelihood of fetal survival if the pregnancy is terminated due to failing bitch health, with subsequent surgical delivery of the fetuses. Use of breeding dates alone does not provide due dates with adequate accuracy. In cases where there has been inadequate or no breeding management or ovulation timing, estimation of due date can be performed at the time of pregnancy diagnosis, or closer to term. Radiography can be used to confirm pregnancy and facilitate determination of gestational age, beginning 45d after the LH surge. Ultrasonography can be used from 19 to 21d after the LH surge to term to confirm pregnancy and predict gestational age, and from 25 or 26d to term to assess fetal viability and fetal stress. PMID:18534674

  15. Strabismus at Age 2 Years in Children Born Before 28 Weeks' Gestation: Antecedents and Correlates.

    PubMed

    VanderVeen, Deborah K; Allred, Elizabeth N; Wallace, David K; Leviton, Alan

    2016-03-01

    Children born very preterm are at greater risk of ophthalmic morbidities, including strabismus, than children born at term. We evaluated perinatal factors associated with strabismus at age 2 years in a large population of infants delivered before 28 weeks' gestation. A total of 996 infants in the multicenter ELGAN (Extremely Low Gestational Age Newborn) study who had a retinal exam in infancy and a developmental assessment at 2 years corrected age are included. Their mothers were interviewed about the pregnancy, and both mother and newborn charts were reviewed. Certified examiners administered the Bayley Scales of Infant Development-II and performed an examination of ocular alignment. Time-oriented logistic regression risk models were created to evaluate the associations of characteristics and exposures with the development of strabismus. Overall, 14% (n = 141) of the children had strabismus at 2 years, and 80% of strabismic children had esotropia. Characteristics associated with strabismus were birth before 26 weeks' gestation, severe fetal growth restriction, and maternal history of aspirin ingestion. Associated postnatal factors included a SNAP-II (Score for Neonatal Acute Physiology) illness severity value ≥ 30, brain ventriculomegaly, type I retinopathy of prematurity, and ventilator-dependent severe bronchopulmonary dysplasia. Strabismus in very preterm populations is associated with a number of antenatal and postnatal antecedents as well as clinical and imaging correlates indicative of brain damage in these children. Routine ophthalmologic assessments in the early years can allow appropriate and timely interventions. PMID:26350726

  16. Prevalence of hypospadias in Italy according to severity, gestational age and birthweight: an epidemiological study

    PubMed Central

    Ghirri, Paolo; Scaramuzzo, Rosa T; Bertelloni, Silvano; Pardi, Daniela; Celandroni, Amerigo; Cocchi, Guido; Danieli, Roberto; De Santis, Luisa; Di Stefano, Maria C; Gerola, Orietta; Giuffrè, Mario; Gragnani, Giuseppe S; Magnani, Cinzia; Meossi, Cristiano; Merusi, Ilaria; Sabatino, Giuseppe; Tumini, Stefano; Corsello, Giovanni; Boldrini, Antonio

    2009-01-01

    Background Hypospadias is a congenital displacement of the urethral meatus in male newborns, being either an isolated defect at birth or a sign of sexual development disorders. The aim of this study was to assess the prevalence rate of hypospadias in different Districts of Italy, in order to make a comparison with other countries all over the world. Methods We reviewed all the newborns file records (years 2001–2004) in 15 Italian Hospitals. Results We found an overall hypospadias prevalence rate of 3.066 ± 0.99 per 1000 live births (82.48% mild hypospadias, 17.52% moderate-severe). In newborns Small for Gestational Age (birthweight < 10th percentile) of any gestational age the prevalence rate of hypospadias was 6.25 per 1000 live births. Performing multivariate logistic regression analysis for different degrees of hypospadias according to severity, being born SGA remained the only risk factor for moderate-severe hypospadias (p = 0.00898) but not for mild forms (p > 0.1). Conclusion In our sample the prevalence of hypospadias results as high as reported in previous European and American studies (3–4 per 1000 live births). Pathogenesis of isolated hypospadias is multifactorial (genetic, endocrine and environmental factors): however, the prevalence rate of hypospadias is higher in infants born small for gestational age than in newborns with normal birth weight. PMID:19558700

  17. Association Between Low Dairy Intake During Pregnancy and Risk of Small-for-Gestational-Age Infants.

    PubMed

    Olmedo-Requena, Rocío; Amezcua-Prieto, Carmen; Luna-Del-Castillo, Juan de Dios; Lewis-Mikhael, Anne-Mary; Mozas-Moreno, Juan; Bueno-Cavanillas, Aurora; Jiménez-Moleón, José Juan

    2016-06-01

    Background Inadequate maternal nutrition is regarded as one of the most important indicators of fetal growth. The aim of this study was to analyze the associated risk of having a small for gestational age (SGA) infant according to the mother's dairy intake during the first half of pregnancy. Methods A prospective cohort study was performed using 1175 healthy pregnant women selected from the catchment area of Virgen de las Nieves University Hospital, Granada (Spain). SGA was defined as neonates weighing less than the 10th percentile, adjusted for gestational age. Factors associated with SGA were analyzed using logistic regression models. Population attributable fractions of SGA according to dairy intake were estimated. Results Dairy intake among women who gave birth to SGA infants was 513.9, versus 590.3 g/day for women with appropriate size for gestational age infants (P = 0.003). An increased intake of dairy products by 100 g/day during the first half of pregnancy decreased the risk of having a SGA infant by 11.0 %, aOR = 0.89 (0.83, 0.96). A dose-response gradient between dairy intake and SGA was observed. Conclusions An inadequate intake of dairy products is associated with a higher risk of SGA. Our results suggest a possible causal relation between dairy intake during pregnancy and the weight of the newborn, although we cannot discard residual confounding. These results should be further supported by properly designed studies. PMID:26971269

  18. Gestational age

    MedlinePlus

    ... the first day of the woman's last menstrual cycle to the current date. A normal pregnancy can ... looking at the baby.Weight, length, head circumference , vital signs, reflexes, muscle tone, posture, and the condition ...

  19. Effect of age, gestation and lactation on faecal IgA and calprotectin concentrations in dogs.

    PubMed

    Grellet, Aurélien; Mila, Hanna; Heilmann, Romy M; Feugier, Alexandre; Gruetzner, Niels; Suchodolski, Jan S; Steiner, Jorg M; Chastant-Maillard, Sylvie

    2014-01-01

    Faecal calprotectin and IgA have been suggested as non-invasive markers of gut health. Faecal calprotectin is a marker of intestinal inflammation in adults, whereas IgA has been suggested as a marker of intestinal immunity. The purpose of the present study was to evaluate the effect of gestation, lactation and age on faecal concentrations of these biomarkers. Thirty puppies, nineteen pregnant or lactating bitches and eighty-nine healthy control adult dogs were included in the study. Faeces were collected from the fourth week of gestation until the eighth week of lactation in pregnant and lactating bitches, and between 4 and 9 weeks of age in puppies. Faeces from the eighty-nine healthy control adult dogs were also collected. Faecal calprotectin and IgA concentrations were measured. Faecal calprotectin concentrations in control dogs were significantly lower than faecal calprotectin concentrations in puppies between 4 and 6 weeks of age (P < 0·001) or between 7 and 9 weeks of age (P = 0·004). Puppies between 4 and 6 weeks of age had significantly higher faecal IgA concentrations compared with puppies between 7 and 9 weeks of age (P = 0·001). Bitches during their second month of lactation had significantly lower faecal IgA concentrations compared with their first month of lactation (P = 0·049). Faecal calprotectin and IgA have been suggested as non-invasive and easily measured biomarkers of gut health in adults. However, the present study underlines that faecal IgA and calprotectin concentrations vary markedly depending of physiologic factors such as gestation, lactation and age. These factors need to be considered when these faecal biomarkers are used for evaluation of intestinal immunity or inflammation. PMID:26101610

  20. [Sonographic diagnosis of pregnancy and determination of fetal number and gestational age in ewes].

    PubMed

    Schmid, D; Schiess, A; Tustain, G; Fleisch, A; Bollwein, H; Janett, F

    2016-02-01

    The aim of the present study was to evaluate accuracy of transabdominal ultrasonography for pregnancy diagnosis, determination of fetal number and estimation of gestational age in ewes. A total of 1068 ewes from 8 different flocks (Swiss White Alpine n = 379, Swiss Black-Brown Mountain n = 189, Oxford-type n = 164, Ostfriesian n = 154, Texel n = 104, Lacaune x Osfriesian crossbred n = 78) was investigated using an Ovi-Scan™ ultrasound scanner with a 3.5 MHz 170° mechanical axial probe (BCF Technology Ltd., BelIshill, Great Britain). Scanning was performed transabdominally at the right inguinal region in ewes restrained in standing position. Sonographic findings were compared with lambing data recorded by the farmers. Included in the analysis were all ewes that, at the time of examination, were not pregnant and those that were pregnant between 26 and 110 days with a known lambing date and number of lambs born (n = 882). The sensitivity of pregnancy diagnosis was 97.8% and the specificity 97.6% (overall accuracy 97.8%, n = 853). Sensitivity and specificity for discrimination between single and multiple pregnancies was 95.8% and 90.5% (overall accuracy 93.9%, n = 752), respectively, when multiples were defined as positive. Discrimination between twins and triplets reached a sensitivity of 86.0% and a specificity of 99.5% (overall accuracy 98.0%, n = 458) when triplets were defined as positive. Considering a gestation period of 150 days, the mean deviation of the estimated to the effective day of gestation at examination was 5.6 ± 5.0 days (n = 781). The correlation between estimated and true gestational age was very high (r=0.936, P<0.0001). In conclusion, a highly accurate and efficient diagnosis of pregnancy with reliable estimation of fetal number and age is possible using an Ovi-Scan™ ultrasound scanner by an experienced examiner. PMID:27145684

  1. Maternal Microbe-Specific Modulation of Inflammatory Response in Extremely Low-Gestational-Age Newborns

    PubMed Central

    Fichorova, Raina N.; Onderdonk, Andrew B.; Yamamoto, Hidemi; Delaney, Mary L.; DuBois, Andrea M.; Allred, Elizabeth; Leviton, Alan

    2011-01-01

    The fetal response to intrauterine inflammatory stimuli appears to contribute to the onset of preterm labor as well as fetal injury, especially affecting newborns of extremely low gestational age. To investigate the role of placental colonization by specific groups of microorganisms in the development of inflammatory responses present at birth, we analyzed 25 protein biomarkers in dry blood spots obtained from 527 newborns delivered by Caesarean section in the 23rd to 27th gestation weeks. Bacteria were detected in placentas and characterized by culture techniques. Odds ratios for having protein concentrations in the top quartile for gestation age for individual and groups of microorganisms were calculated. Mixed bacterial vaginosis (BV) organisms were associated with a proinflammatory pattern similar to those of infectious facultative anaerobes. Prevotella and Gardnerella species, anaerobic streptococci, peptostreptococci, and genital mycoplasmas each appeared to be associated with a different pattern of elevated blood levels of inflammation-related proteins. Lactobacillus was associated with low odds of an inflammatory response. This study provides evidence that microorganisms colonizing the placenta provoke distinctive newborn inflammatory responses and that Lactobacillus may suppress these responses. PMID:21264056

  2. Positive correlations of age and parity with plasma concentration of macrophage migration inhibitory factor in Japanese black cows.

    PubMed

    Koizumi, Motoya; Nahar, Asrafun; Yamabe, Ryusei; Kadokawa, Hiroya

    2016-06-17

    Plasma Macrophage migration inhibitory factor (MIF) concentration correlates positively with age, and negatively with self-rated health in women, and optimal MIF concentration may promote proper reproductive function. This study was conducted to evaluate the hypotheses that plasma MIF concentration changes with parturition or postpartum first ovulation, and that age in months and parity correlate with plasma MIF concentration in Japanese black cows. Western blotting utilizing an anti-MIF mouse monoclonal antibody of various tissues and plasma from females indicated that MIF expression was stronger in the anterior pituitary than in other tissues. We developed a competitive EIA utilizing the same anti-MIF mouse monoclonal antibody with sufficient sensitivity and reliable performance for measuring bovine plasma samples. We then measured MIF concentrations in bovine plasma collected from 4 weeks before parturition to 4 weeks after postpartum first ovulation. There was no significant difference in plasma MIF concentration pre- and post-parturition, or before and after the postpartum first ovulation. Plasma MIF concentrations were positively correlated (P < 0.01) with parity (r = 0.703), age in months on the day of parturition (r = 0.647), and age in months on the day of the postpartum first ovulation (r = 0.553) when we used almost all data, except for that from a third-parity cow with an abnormally high plasma MIF concentration. We therefore concluded that plasma MIF concentrations may increase with age in months and parity, but do not change either before and after parturition or before and after postpartum first ovulation in Japanese black cows. PMID:26853787

  3. Positive correlations of age and parity with plasma concentration of macrophage migration inhibitory factor in Japanese black cows

    PubMed Central

    KOIZUMI, Motoya; NAHAR, Asrafun; YAMABE, Ryusei; KADOKAWA, Hiroya

    2016-01-01

    Plasma Macrophage migration inhibitory factor (MIF) concentration correlates positively with age, and negatively with self-rated health in women, and optimal MIF concentration may promote proper reproductive function. This study was conducted to evaluate the hypotheses that plasma MIF concentration changes with parturition or postpartum first ovulation, and that age in months and parity correlate with plasma MIF concentration in Japanese black cows. Western blotting utilizing an anti-MIF mouse monoclonal antibody of various tissues and plasma from females indicated that MIF expression was stronger in the anterior pituitary than in other tissues. We developed a competitive EIA utilizing the same anti-MIF mouse monoclonal antibody with sufficient sensitivity and reliable performance for measuring bovine plasma samples. We then measured MIF concentrations in bovine plasma collected from 4 weeks before parturition to 4 weeks after postpartum first ovulation. There was no significant difference in plasma MIF concentration pre- and post-parturition, or before and after the postpartum first ovulation. Plasma MIF concentrations were positively correlated (P < 0.01) with parity (r = 0.703), age in months on the day of parturition (r = 0.647), and age in months on the day of the postpartum first ovulation (r = 0.553) when we used almost all data, except for that from a third-parity cow with an abnormally high plasma MIF concentration. We therefore concluded that plasma MIF concentrations may increase with age in months and parity, but do not change either before and after parturition or before and after postpartum first ovulation in Japanese black cows. PMID:26853787

  4. Mother's Genome or Maternally-Inherited Genes Acting in the Fetus Influence Gestational Age in Familial Preterm Birth

    PubMed Central

    Plunkett, Jevon; Feitosa, Mary F.; Trusgnich, Michelle; Wangler, Michael F.; Palomar, Lisanne; Kistka, Zachary A.-F.; DeFranco, Emily A.; Shen, Tammy T.; Stormo, Adrienne E.D.; Puttonen, Hilkka; Hallman, Mikko; Haataja, Ritva; Luukkonen, Aino; Fellman, Vineta; Peltonen, Leena; Palotie, Aarno; Daw, E. Warwick; An, Ping; Teramo, Kari; Borecki, Ingrid; Muglia, Louis J.

    2009-01-01

    Objective While multiple lines of evidence suggest the importance of genetic contributors to risk of preterm birth, the nature of the genetic component has not been identified. We perform segregation analyses to identify the best fitting genetic model for gestational age, a quantitative proxy for preterm birth. Methods Because either mother or infant can be considered the proband from a preterm delivery and there is evidence to suggest that genetic factors in either one or both may influence the trait, we performed segregation analysis for gestational age either attributed to the infant (infant's gestational age), or the mother (by averaging the gestational ages at which her children were delivered), using 96 multiplex preterm families. Results These data lend further support to a genetic component contributing to birth timing since sporadic (i.e. no familial resemblance) and nontransmission (i.e. environmental factors alone contribute to gestational age) models are strongly rejected. Analyses of gestational age attributed to the infant support a model in which mother's genome and/or maternally-inherited genes acting in the fetus are largely responsible for birth timing, with a smaller contribution from the paternally-inherited alleles in the fetal genome. Conclusion Our findings suggest that genetic influences on birth timing are important and likely complex. PMID:19521103

  5. Neurodevelopmental Outcomes of Extremely Low Gestational Age Neonates with Low Grade Periventricular-Intraventricular Hemorrhage

    PubMed Central

    Payne, Allison H.; Hintz, Susan R.; Hibbs, Anna Maria; Walsh, Michele C.; Vohr, Betty R.; Bann, Carla M.; Wilson-Costello, Deanne E.

    2014-01-01

    Objective To compare neurodevelopmental outcomes at 18–22 months corrected age for extremely low gestational age infants with low grade (Grade 1 or 2) periventricular-intraventricular hemorrhage to infants with either no hemorrhage or severe (Grade 3 or 4) hemorrhage on cranial ultrasound. Design Longitudinal observational study Setting Sixteen centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network Participants 1472 infants born at <27 weeks gestational age between 2006–2008 with ultrasound results within the first 28 days of life and surviving to 18–22 months with complete follow-up assessments were eligible. Main Exposure Low grade periventricular-intraventricular hemorrhage Outcome Measures Outcomes included cerebral palsy, gross motor functional limitation, Bayley III cognitive and language scores, and composite measures of neurodevelopmental impairment. Regression modeling evaluated the association of hemorrhage severity with adverse outcomes while controlling for potentially confounding variables and center differences. Results Low grade hemorrhage was not associated with significant differences in unadjusted or adjusted risk of any adverse neurodevelopmental outcome compared to infants without hemorrhage. Compared with low grade hemorrhage, severe hemorrhage was associated with decrease in adjusted continuous cognitive (−3.91, [95% Confidence Interval [CI]: −6.41, −1.42]) and language (−3.19 [−6.19, −0.19]) scores as well as increased odds of each adjusted categorical outcome except severe cognitive impairment (OR: 1.46 [0.74, 2.88]) and mild language impairment (OR: 1.35 [0.88, 2.06]). Conclusion At 18–22 months, the neurodevelopmental outcomes of extremely low gestational age infants with low grade periventricular-intraventricular hemorrhage are not significantly different from those without hemorrhage. PMID:23460139

  6. Estimation of gestational age in Egyptian native goats by ultrasonographic fetometry.

    PubMed

    Karen, Aly M; Fattouh, El-Sayed M; Abu-Zeid, Saber S

    2009-08-01

    The main aim of the present study was to estimate the gestational age of Egyptian goats by B-mode ultrasound measurement of embryonic or fetal parts throughout pregnancy. Trans-rectal (TR) ultrasonography (7 MHz) was carried out on 15 pregnant Egyptian does at Day 10 post mating on alternate days until Day 25 and then once at 3-5-day intervals until Day 50. Trans-abdominal (TA) ultrasonography (3.5-5 MHz) was carried out on the same animals from Days 25 to 130 at 3-5-day intervals. After imaging the embryo or the fetus, the following parameters were measured: length of the embryo or fetus (CRL), heart rate (FHR), biparital diameter (BPD), trunk diameter (TD), placentome size (PS), umbilical cord diameter (UCD) and femur length (FL). The average of days at which the embryonic vesicle was first determined by TR and TA ultrasonography was 16.98+/-1.97 and 27.87+/-3.48, respectively. The embryo proper with a beating heart was first determined by TR and TA ultrasonography at an average of 22.36+/-2.66 and 30.36+/-4.75 days, respectively. All the fetal measures were significantly (P<0.0001) correlated with the gestational age. With the exception of fetal heart rate (R(2)=0.551), all the measured fetal structures were highly correlated (R(2)> or =90) with the gestational age. In conclusion, the age of embryo or fetus in Egyptian does can be estimated by ultrasound measuring the crown rump length, biparital diameter, trunk diameter, placentome size, umbilical cord diameter and femur length. PMID:18805657

  7. Feto-maternal heart rate ratio in pregnant bitches: effect of gestational age and maternal size.

    PubMed

    Alonge, S; Mauri, M; Faustini, M; Luvoni, G C

    2016-10-01

    Few information is available on parameters that can be used to objectively assess the foetal health during canine pregnancy. To identify a reliable parameter for the evaluation of foetal well-being, the effect of pre-gestational maternal bodyweight and gestational age on foetal heart rate (FHR) and on feto-maternal heart rate ratio (FHR/MHR) was investigated. Seventeen client-owned pregnant bitches of different pre-gestational maternal bodyweight were examined by serial echo colour Doppler. Only data from 11 uncomplicated pregnancies were included in the statistical analysis. The relationship between FHR, and FHR/MHR, and independent variables was analysed by polynomial regression (p ≤ .05). The FHR and the FHR/MHR significantly fitted a multiple quadratic regression for all independent variables. They both increased from 35 to 20 days before parturition and then a decreasing pattern followed. Higher values of both parameters were observed in bitches of lowest and highest bodyweight. Patterns of FHR and FHR/MHR were similar, but the ratio better describes the effect of the independent variables on the data. Thus, the highest significance of FHR/MHR compared to FHR alone encourages the application of this ratio to evaluate foetal well-being. The equation derived by the regression analysis of FHR/MHR could be applied in clinical practice to obtain its expected values in healthy pregnancies. PMID:27440379

  8. The Effect of Gestational and Lactational Age on the Human Milk Metabolome

    PubMed Central

    Sundekilde, Ulrik K.; Downey, Eimear; O’Mahony, James A.; O’Shea, Carol-Anne; Ryan, C. Anthony; Kelly, Alan L.; Bertram, Hanne C.

    2016-01-01

    Human milk is the ideal nutrition source for healthy infants during the first six months of life and a detailed characterisation of the composition of milk from mothers that deliver prematurely (<37 weeks gestation), and of how human milk changes during lactation, would benefit our understanding of the nutritional requirements of premature infants. Individual milk samples from mothers delivering prematurely and at term were collected. The human milk metabolome, established by nuclear magnetic resonance (NMR) spectroscopy, was influenced by gestational and lactation age. Metabolite profiling identified that levels of valine, leucine, betaine, and creatinine were increased in colostrum from term mothers compared with mature milk, while those of glutamate, caprylate, and caprate were increased in mature term milk compared with colostrum. Levels of oligosaccharides, citrate, and creatinine were increased in pre-term colostrum, while those of caprylate, caprate, valine, leucine, glutamate, and pantothenate increased with time postpartum. There were differences between pre-term and full-term milk in the levels of carnitine, caprylate, caprate, pantothenate, urea, lactose, oligosaccharides, citrate, phosphocholine, choline, and formate. These findings suggest that the metabolome of pre-term milk changes within 5–7 weeks postpartum to resemble that of term milk, independent of time of gestation at pre-mature delivery. PMID:27213440

  9. The Effect of Gestational and Lactational Age on the Human Milk Metabolome.

    PubMed

    Sundekilde, Ulrik K; Downey, Eimear; O'Mahony, James A; O'Shea, Carol-Anne; Ryan, C Anthony; Kelly, Alan L; Bertram, Hanne C

    2016-01-01

    Human milk is the ideal nutrition source for healthy infants during the first six months of life and a detailed characterisation of the composition of milk from mothers that deliver prematurely (<37 weeks gestation), and of how human milk changes during lactation, would benefit our understanding of the nutritional requirements of premature infants. Individual milk samples from mothers delivering prematurely and at term were collected. The human milk metabolome, established by nuclear magnetic resonance (NMR) spectroscopy, was influenced by gestational and lactation age. Metabolite profiling identified that levels of valine, leucine, betaine, and creatinine were increased in colostrum from term mothers compared with mature milk, while those of glutamate, caprylate, and caprate were increased in mature term milk compared with colostrum. Levels of oligosaccharides, citrate, and creatinine were increased in pre-term colostrum, while those of caprylate, caprate, valine, leucine, glutamate, and pantothenate increased with time postpartum. There were differences between pre-term and full-term milk in the levels of carnitine, caprylate, caprate, pantothenate, urea, lactose, oligosaccharides, citrate, phosphocholine, choline, and formate. These findings suggest that the metabolome of pre-term milk changes within 5-7 weeks postpartum to resemble that of term milk, independent of time of gestation at pre-mature delivery. PMID:27213440

  10. Chorioamnionitis and Early Childhood Outcomes among Extremely Low-Gestational-Age Neonates

    PubMed Central

    Pappas, Athina; Kendrick, Douglas E.; Shankaran, Seetha; Stoll, Barbara J.; Bell, Edward F.; Laptook, Abbott R.; Walsh, Michele C.; Das, Abhik; Hale, Ellen C.; Newman, Nancy S.; Higgins, Rosemary D.

    2014-01-01

    Importance Chorioamnionitis is strongly linked to preterm birth and to neonatal infection. The association between histological and clinical chorioamnionitis and cognitive, behavioral and neurodevelopmental outcomes among extremely preterm neonates is less clear. We evaluated the impact of chorioamnionitis on 18-22 month neurodevelopmental outcomes in a contemporary cohort of extremely preterm neonates. Objective To compare the neonatal and neurodevelopmental outcomes of three groups of extremely-low-gestational-age infants with increasing exposure to perinatal inflammation: no chorioamnionitis, histological chorioamnionitis alone, or histological plus clinical chorioamnionitis. Design Longitudinal observational study. Setting Sixteen centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Participants 2390 extremely preterm infants born <27 weeks' gestational age between January 1, 2006 and December 31, 2008 with placental histopathology and 18-22 months' corrected age follow-up data were eligible. Main exposure Chorioamnionitis Main Outcome Measures Outcomes included cerebral palsy, gross motor functional limitation, behavioral scores (according to the Brief Infant-Toddler Social and Emotional Assessment), cognitive and language scores (according to the Bayley Scales of Infant Development, 3rd-Edition) and composite measures of death/neurodevelopmental impairment. Multivariable logistic and linear regression models were developed to assess the association between chorioamnionitis and outcomes while controlling for important variables known at birth. Results Neonates exposed to chorioamnionitis had a lower gestational age (GA) and had higher rates of early-onset sepsis and severe periventricular-intraventricular hemorrhage as compared with unexposed neonates. In multivariable models evaluating death and neurodevelopmental outcomes, inclusion of gestational age in the model diminished the association

  11. Etiological Subgroups of Small-for-Gestational-Age: Differential Neurodevelopmental Outcomes

    PubMed Central

    Li, Xiuhong; Eiden, Rina D.; Epstein, Leonard H.; Shenassa, Edmond D.; Xie, Chuanbo; Wen, Xiaozhong

    2016-01-01

    Objectives It remains unclear why substantial variations in neurodevelopmental outcomes exist within small-for-gestational-age (SGA) children. We prospectively compared 5-y neurodevelopmental outcomes across SGA etiological subgroups. Methods Children born SGA (N = 1050) from U.S. Early Childhood Longitudinal Study-Birth Cohort (2001–2007) was divided into etiological subgroups by each of 7 well-established prenatal risk factors. We fit linear regression models to compare 5-y reading, math, gross motor and fine motor scores across SGA subgroups, adjusting for socio-demographic confounders. Results Compared to singleton SGA subgroup, multiple-birth SGA subgroup had lower mean reading (adjusted mean difference, -4.08 [95% confidence interval, -6.10, -2.06]) and math (-2.22 [-3.61, -0.84]) scores. These disadvantages in reading and math existed only among multiple-birth SGA subgroup without ovulation stimulation (reading, -4.50 [-6.64, -2.36]; math, -2.91 [-4.37, -1.44]), but not among those with ovulation stimulation (reading, -2.33 [-6.24, 1.57]; math 0.63 [-1.86, 3.12]). Compared to singleton SGA subgroup without maternal smoking and inadequate gestational weight gain, singleton SGA subgroup with co-occurrence of maternal smoking and inadequate gestational weight gain (GWG) had lower mean reading (-4.81 [-8.50, -1.12]) and math (-2.95 [-5.51, -0.38]) scores. These differences were not mediated by Apgar score. Conclusions Multiple-birth SGA subgroups (vs. singleton SGA) or singleton SGA subgroup with co-occurrence of smoking and inadequate GWG (vs. singleton SGA subgroup without maternal smoking and inadequate gestational weight gain) have poorer cognitive development up to 5 y. PMID:27501456

  12. Universal Gestational Age Effects on Cognitive and Basic Mathematic Processing: 2 Cohorts in 2 Countries

    PubMed Central

    Wolke, Dieter; Strauss, Vicky Yu-Chun; Johnson, Samantha; Gilmore, Camilla; Marlow, Neil; Jaekel, Julia

    2015-01-01

    Objective To determine whether general cognitive ability, basic mathematic processing, and mathematic attainment are universally affected by gestation at birth, as well as whether mathematic attainment is more strongly associated with cohort-specific factors such as schooling than basic cognitive and mathematical abilities. Study design The Bavarian Longitudinal Study (BLS, 1289 children, 27-41 weeks gestational age [GA]) was used to estimate effects of GA on IQ, basic mathematic processing, and mathematic attainment. These estimations were used to predict IQ, mathematic processing, and mathematic attainment in the EPICure Study (171 children <26 weeks GA). Results For children born <34 weeks GA, each lower week decreased IQ and mathematic attainment scores by 2.34 (95% CI: −2.99, −1.70) and 2.76 (95% CI: −3.40, −2.11) points, respectively. There were no differences among children born 34-41 weeks GA. Similarly, for children born <36 weeks GA, mathematic processing scores decreased by 1.77 (95% CI: −2.20, −1.34) points with each lower GA week. The prediction function generated using BLS data accurately predicted the effect of GA on IQ and mathematic processing among EPICure children. However, these children had better attainment than predicted by BLS. Conclusions Prematurity has adverse effects on basic mathematic processing following birth at all gestations <36 weeks and on IQ and mathematic attainment <34 weeks GA. The ability to predict IQ and mathematic processing scores from one cohort to another among children cared for in different eras and countries suggests that universal neurodevelopmental factors may explain the effects of gestation at birth. In contrast, mathematic attainment may be improved by schooling. PMID:25842966

  13. Differences in late fetal death rates in association with determinants of small for gestational age fetuses: population based cohort study

    PubMed Central

    Cnattingius, Sven; Haglund, Bengt; Kramer, Michael S

    1998-01-01

    Objective: To examine differences in late fetal death rates in association with determinants of small for gestational age fetuses. Design: Population based cohort study. Subjects: 1 026 249 pregnancies without congenital malformations. Setting: Sweden 1983-92. Main outcome measure: Late fetal death rate. Results: Depending on underlying determinants late fetal death rates were greatly increased in extremely small for gestational age fetuses (range 16 to 45 per 1000) compared with non-small for gestational age fetuses (1.4 to 4.6). In extremely small for gestational age fetuses late fetal death rates were increased from 31 per 1000 in mothers aged less than 35 years to 45 per 1000 in older mothers, and from 22 per 1000 in women <155 cm in height to 33 per 1000 in women ⩾175 cm tall. Late fetal death rates were also higher in extremely small for gestational age fetuses in singleton compared with twin pregnancies and in non-hypertensive pregnancies compared with pregnancies complicated by severe pre-eclampsia or other hypertensive disorders. Slightly higher late fetal death rates were observed in nulliparous compared with parous women and in non-smokers compared with smokers. Conclusions: Although the risk of late fetal death is greatly increased in fetuses that are extremely small for gestational age the risk is strongly modified by underlying determinants—for example, there is a lower risk of late fetal death in a small for gestational age fetus if the mother is of short stature, has a twin pregnancy, or has hypertension. Key messages Small for gestational age fetuses are at increased risk of late fetal death regardless of the underlying determinants The effect of birthweight ratio on risk of late fetal death is modified by underlying determinants, except maternal age Regardless of birthweight ratio the rates of late fetal death are higher among women aged 35 years or older compared with younger women In pregnancies of extremely small for gestational age

  14. The Effect of Gestational Age at Birth on Post-Term Maturation of Heart Rate Variability

    PubMed Central

    Fyfe, Karinna L.; Yiallourou, Stephanie R.; Wong, Flora Y.; Odoi, Alexsandria; Walker, Adrian M.; Horne, Rosemary S.C.

    2015-01-01

    Study Objective: Preterm birth delays maturation of autonomic cardiovascular control, reflected in reduced heart rate variability (HRV) in preterm compared to term infants at term-equivalent age. It has been suggested that immature cardiovascular control contributes to the increased risk for the sudden infant death syndrome (SIDS) in preterm infants. However, the effects of prone sleeping, the major SIDS risk factor, and of gestational age (GA) at birth on HRV have not been assessed in preterm infants beyond term-equivalent age. Subjects and Methods: Very preterm (n = 21; mean GA 29.4 ± 0.3 weeks), preterm (n = 14; mean GA 33.5 ± 0.3 weeks), and term (n = 17; mean GA 40.1 ± 0.3 weeks) infants were recruited and underwent daytime polysomnography at 2–4 weeks, 2–3 months, and 5–6 months post-term corrected age (CA). Infants slept both supine and prone. HRV was assessed in the low frequency (LF) and high frequency (HF) ranges. Results: There was no effect of prone sleeping on HRV parameters in either preterm group. In term infants LF/HF was significantly elevated in the prone position in AS at 2–4 weeks (P < 0.05). HF HRV was significantly reduced (P < 0.05) and LF/HF increased (P < 0.05) in very preterm compared to both preterm and term infants at 2–3 months CA. Conclusion: Prone sleeping did not significantly impact on heart rate variability (HRV) in preterm infants. However, reduced maturation of high frequency HRV in very preterm infants resulted in significantly altered sympathovagal balance at 2–3 months corrected age, the age of peak sudden infant death syndrome (SIDS) risk. This may contribute to the increased risk of SIDS in infants born at earlier gestational age. Citation: Fyfe KL, Yiallourou SR, Wong FY, Odoi A, Walker AM, Horne RS. The effect of gestational age at birth on post-term maturation of heart rate variability. SLEEP 2015;38(10):1635–1644. PMID:25902805

  15. Learning-based prediction of gestational age from ultrasound images of the fetal brain.

    PubMed

    Namburete, Ana I L; Stebbing, Richard V; Kemp, Bryn; Yaqub, Mohammad; Papageorghiou, Aris T; Alison Noble, J

    2015-04-01

    We propose an automated framework for predicting gestational age (GA) and neurodevelopmental maturation of a fetus based on 3D ultrasound (US) brain image appearance. Our method capitalizes on age-related sonographic image patterns in conjunction with clinical measurements to develop, for the first time, a predictive age model which improves on the GA-prediction potential of US images. The framework benefits from a manifold surface representation of the fetal head which delineates the inner skull boundary and serves as a common coordinate system based on cranial position. This allows for fast and efficient sampling of anatomically-corresponding brain regions to achieve like-for-like structural comparison of different developmental stages. We develop bespoke features which capture neurosonographic patterns in 3D images, and using a regression forest classifier, we characterize structural brain development both spatially and temporally to capture the natural variation existing in a healthy population (N=447) over an age range of active brain maturation (18-34weeks). On a routine clinical dataset (N=187) our age prediction results strongly correlate with true GA (r=0.98,accurate within±6.10days), confirming the link between maturational progression and neurosonographic activity observable across gestation. Our model also outperforms current clinical methods by ±4.57 days in the third trimester-a period complicated by biological variations in the fetal population. Through feature selection, the model successfully identified the most age-discriminating anatomies over this age range as being the Sylvian fissure, cingulate, and callosal sulci. PMID:25624045

  16. Factors Associated With Treatment for Hypotension in Extremely Low Gestational Age Newborns During the First Postnatal Week

    PubMed Central

    Laughon, Matthew; Bose, Carl; Allred, Elizabeth; O'Shea, T. Michael; Van Marter, Linda J.; Bednarek, Francis; Leviton, Alan

    2009-01-01

    Objective The goals were to identify the blood pressures of extremely low gestational age newborns that prompt intervention, to identify other infant characteristics associated with receipt of therapies intended to increase blood pressure, and to assess the interinstitutional variability in the use of these therapies. Methods The cohort included 1507 extremely low gestational age newborns born at 23 weeks to 276/7 weeks of gestation, at 14 institutions, between March 2002 and August 2004; 1387 survived the first postnatal week. Blood pressures were measured as clinically indicated. Interventions were grouped as any treatment (ie, vasopressor and/or fluid boluses of >10 mL/kg) and vasopressor treatment, and logistic regression analyses were performed. Results At each gestational age, the lowest mean arterial pressures in treated and untreated infants tended to increase with advancing postnatal age. Infants who received any therapy tended to have lower mean arterial pressures than infants who did not, but uniform thresholds for treatment were not apparent. The proportion of infants receiving any treatment decreased with increasing gestational age from 93% at 23 weeks to 73% at 27 weeks. Treatment nearly always began during the first 24 hours of life. Lower gestational age, lower birth weight, male gender, and higher Score for Neonatal Acute Physiology–II values were associated with any treatment and vasopressor treatment. Institutions varied greatly in their tendency to offer any treatment and vasopressor treatment. Neither the lowest mean arterial pressure on the day of treatment nor other characteristics of the infants accounted for center differences in treatment. Conclusions Blood pressure in extremely premature infants not treated for hypotension increased directly with both increasing gestational age and postnatal age. The decision to provide treatment was associated more strongly with the center where care was provided than with infant attributes. PMID

  17. A method for estimating gestational age of fetal remains based on long bone lengths.

    PubMed

    Carneiro, Cristiana; Curate, Francisco; Cunha, Eugénia

    2016-09-01

    The estimation of gestational age (GA) in fetal human remains is important in forensic settings, particularly to assess fetal viability, in addition to often being the only biological profile parameter that can be assessed with some accuracy for non-adults. The length of long bone diaphysis is one of the most frequently used methods for fetal age estimation. The main objective of this study was to present a simple and objective method for estimating GA based on the measurements of the diaphysis of the femur, tibia, fibula, humerus, ulna, and radius. Conventional least squares regression equations (classical and inverse calibration approaches) and quick reference tables were generated. A supplementary objective was to compare the performance of the new formulae against previously published models. The sample comprised 257 fetuses (136 females and 121 males) with known GA (between 12 and 40 weeks) and was selected based on clinical and pathological information. All measurements were performed on radiographic images acquired in anonymous clinical autopsy records from spontaneous and therapeutic abortions in two Portuguese hospitals. The proposed technique is straightforward and reproducible. The models for the GA estimation are exceedingly accurate and unbiased. Comparisons between inverse and classical calibration show that both perform exceptionally well, with high accuracy and low bias. Also, the newly developed equations generally outperform earlier methods of GA estimation in forensic contexts. Quick reference tables for each long bone are now available. The obtained models for the estimation of gestational age are of great applicability in forensic contexts. PMID:27251047

  18. Weight for gestational age and metabolically healthy obesity in adults from the Haguenau cohort

    PubMed Central

    Matta, Joane; Carette, Claire; Levy Marchal, Claire; Bertrand, Julien; Pétéra, Mélanie; Zins, Marie; Pujos-Guillot, Estelle; Comte, Blandine; Czernichow, Sébastien

    2016-01-01

    Background An obesity subphenotype, named ‘metabolically healthy obese’ (MHO) has been recently defined to characterise a subgroup of obese individuals with less risk for cardiometabolic abnormalities. To date no data are available on participants born with small weight for gestational age (SGA) and the risk of metabolically unhealthy obesity (MUHO). Objective Assess the risk of MUHO in SGA versus appropriate for gestational age (AGA) adult participants. Methods 129 young obese individuals (body mass index ≥30 kg/m²) from data of an 8-year follow-up Haguenau cohort (France), were identified out of 1308 participants and were divided into 2 groups: SGA (n=72) and AGA (n=57). Metabolic characteristics were analysed and compared using unpaired t-test. The HOMA-IR index was determined for the population and divided into quartiles. Obese participants within the first 3 quartiles were considered as MHO and those in the fourth quartile as MUHO. Relative risks (RRs) and 95% CI for being MUHO in SGA versus AGA participants were computed. Results The SGA-obese group had a higher risk of MUHO versus the AGA-obese group: RR=1.27 (95% CI 1.10 to 1.6) independently of age and sex. Conclusions In case of obesity, SGA might confer a higher risk of MUHO compared with AGA. PMID:27580829

  19. Is Asymmetric Dimethylarginine Associated with Being Born Small and Large for Gestational Age?

    PubMed Central

    Chiavaroli, Valentina; Diesse, Laura; de Giorgis, Tommaso; Giannini, Cosimo; Marcovecchio, Maria Loredana; Chiarelli, Francesco

    2014-01-01

    Abstract Low and high birth weights have been linked to increased susceptibility to cardiovascular and metabolic alterations. However, the natural history of cardiometabolic disturbances in children born small (SGA) and large (LGA) for gestational age is still unclear and no reliable biomarker of cardiovascular risk has definitively been identified in these subjects. Interestingly, asymmetric dimethylarginine (ADMA), antagonist of nitric oxide (NO) production, has been recognized as novel cardiovascular marker able to identify subjects at higher risk of health disturbances. Despite the well-described role of ADMA as a predictor of degenerative disease in adults, its potential application in pediatrics, and specifically in SGA and LGA children, has not been explored as only few data in preterm infants and SGA newborns are available. Therefore, we investigated potential alterations in circulating ADMA and NO levels in SGA and LGA children compared with those born appropriate (AGA) for gestational age. Of note, ADMA was significantly higher in SGA and LGA children than AGA peers. Intriguingly, SGA and LGA categories as well as insulin resistance were independently related to ADMA. Our observations lead to the intriguing hypothesis that ADMA could be involved in the development of cardiometabolic alterations in SGA and LGA children already during the prepubertal age. Antioxid. Redox Signal. 20, 2317–2322. PMID:24350633

  20. Growth status of small for gestational age Indian children from two socioeconomic strata

    PubMed Central

    Khadilkar, Vaman V.; Mandlik, Rubina M.; Palande, Sonal A.; Pandit, Deepa S.; Chawla, Meghna; Nadar, Ruchi; Chiplonkar, Shashi A.; Kadam, Sandeep S.; Khadilkar, Anuradha A.

    2016-01-01

    Aims: To assess growth and factors associated with growth in children born small for gestational age (SGA) from two socioeconomic strata in comparison to age- and sex-matched healthy controls. Methods: Retrospective study conducted at two hospitals in Pune, 0.5–5 years, 618 children: 189-SGA from upper socioeconomic strata (USS), 217-SGA from lower socioeconomic strata (LSS), and 212 appropriate for gestational age healthy controls were randomly selected. Birth and maternal history, socioeconomic status, length/height, and weight of children were recorded. Anthropometric data were converted to Z scores (height for age Z-score [HAZ], weight for age Z-score [WAZ]) using WHO AnthroPlus software. Results: The HAZ and WAZ of the SGA group were significantly lower as compared to the controls and that of the LSS SGAs were lower than USS SGAs (P < 0.05). Thirty two percent children were stunted (HAZ <−2.0) in USS and 49% in LSS (P < 0.05). Twenty nine percent children in the USS SGA group were stunted at 2 years and 17% at 5 years. In the LSS SGA group, 54% children were stunted at 2 years and 46% at 5 years. Generalized linear model revealed normal vaginal delivery (β = 0.625) and mother's age (β =0.072) were positively associated and high SES (β = −0.830), absence of major illness (β = −1.01), higher birth weight (β = −1.34) were negatively associated for risk of stunting (P < 0.05). Conclusion: Children born SGA showed poor growth as compared to controls. Special attention to growth is necessary in children from LSS, very low birth weight babies, and those with major illnesses during early years of life. PMID:27366721

  1. Using fMRI to Investigate Memory in Young Children Born Small for Gestational Age

    PubMed Central

    de Bie, Henrica M. A.; de Ruiter, Michiel B.; Ouwendijk, Mieke; Oostrom, Kim J.; Wilke, Marko; Boersma, Maria

    2015-01-01

    Objectives Intrauterine growth restriction (IUGR) can lead to infants being born small for gestational age (SGA). SGA is associated with differences in brain anatomy and impaired cognition. We investigated learning and memory in children born SGA using neuropsychological testing and functional Magnetic Resonance Imaging (fMRI). Study Design 18 children born appropriate for gestational age (AGA) and 34 SGA born children (18 with and 16 without postnatal catch-up growth) participated in this study. All children were between 4 and 7 years old. Cognitive functioning was assessed by IQ and memory testing (Digit/Word Span and Location Learning). A newly developed fMRI picture encoding task was completed by all children in order to assess brain regions involved in memory processes. Results Neuropsychological testing demonstrated that SGA children had IQ’s within the normal range but lower than in AGA and poorer performances across measures of memory. Using fMRI, we observed memory related activity in posterior parahippocampal gyrus as well as the hippocampus proper. Additionally, activation was seen bilaterally in the prefrontal gyrus. Children born SGA showed less activation in the left parahippocampal region compared to AGA. Conclusions This is the first fMRI study demonstrating different brain activation patterns in 4-7 year old children born SGA, suggesting that intrauterine growth restriction continues to affect neural functioning in children later-on. PMID:26132815

  2. Global and Regional Differences in Brain Anatomy of Young Children Born Small for Gestational Age

    PubMed Central

    De Bie, Henrica M. A.; Oostrom, Kim J.; Boersma, Maria; Veltman, Dick J.; Barkhof, Frederik

    2011-01-01

    In children who are born small for gestational age (SGA), an adverse intrauterine environment has led to underdevelopment of both the body and the brain. The delay in body growth is (partially) restored during the first two years in a majority of these children. In addition to a negative influence on these physical parameters, decreased levels of intelligence and cognitive impairments have been described in children born SGA. In this study, we used magnetic resonance imaging to examine brain anatomy in 4- to 7-year-old SGA children with and without complete bodily catch-up growth and compared them to healthy children born appropriate for gestational age. Our findings demonstrate that these children strongly differ on brain organisation when compared with healthy controls relating to both global and regional anatomical differences. Children born SGA displayed reduced cerebral and cerebellar grey and white matter volumes, smaller volumes of subcortical structures and reduced cortical surface area. Regional differences in prefrontal cortical thickness suggest a different development of the cerebral cortex. SGA children with bodily catch-up growth constitute an intermediate between those children without catch-up growth and healthy controls. Therefore, bodily catch-up growth in children born SGA does not implicate full catch-up growth of the brain. PMID:21931650

  3. Long-Term Survival of Individuals Born Small and Large for Gestational Age

    PubMed Central

    Wennerström, E. Christina M.; Simonsen, Jacob; Melbye, Mads

    2015-01-01

    Background Little is known on long-term survival and causes of death among individuals born small or large for gestational age. This study investigates birth weight in relation to survival and causes of death over time. Methods A national cohort of 1.7 million live-born singletons in Denmark was followed during 1979–2011, using the Danish Civil Registration System, the Medical Birth Registry and the Cause of Death Registry. Cox proportional hazards were estimated for the impact of small (SGA) and large (LGA) gestation weight and mortality overall, by age group and birth cohort. Results Compared to normal weight children, SGA children were associated with increased risk of dying over time. Though most of the deaths occurred during the first year of life, the cumulative mortality risk was increased until 30 years of age. The hazard ratios [HR] for dying among SGA children ages <2 years were: 3.47 (95% CI, 3.30–3.64) and 1.06 (95% CI, 0.60–1.87) in 30 years and older. HR for dying among SGA adults (20–29 years) were: 1.20 (95% CI, 0.99–1.46) in years 1979–1982 and 1.61 (95% CI, 1.04–2.51) in years 1989–1994. The SGA born had increased risk of dying from infection, heart disease, respiratory disease, digestive disease, congenital malformation, perinatal conditions, and accidents, suicide, and homicide. Individuals born LGA were associated with decreased mortality risk, but with increased risk of dying from malignant neoplasm. Conclusions Survival has improved independently of birth weight the past 30 years. However, children born SGA remain at significantly increased risk of dying up till they turn 30 years of age. Individuals born LGA have lower mortality risk but only in the first two years of life. PMID:26390219

  4. Dynamics of lipoprotein level in blood plasma of pregnant women as a function of gestational age according to FTIR spectroscopy

    NASA Astrophysics Data System (ADS)

    Korolik, E. V.; Korolenko, E. A.; Tretinnikov, O. N.; Kozlyakova, O. V.; Korolik, A. K.; Kirkovskiy, V. V.

    2013-01-01

    Results of an IR spectroscopic investigation of films of blood plasma taken from women of reproductive age, pregnant women with positive and negative Rh factors, and Rh-immunized women were presented as a function of gestational age. It was found that the lipoprotein content in blood plasma of all groups of pregnant women increased during the early stages of pregnancy (17-23 weeks) irrespective of the Rh factor and attained its peak value by weeks 30-35. It was shown that the lipoprotein level in blood plasma as a function of gestational age was quantitatively the same for pregnant women with positive and negative Rh factors. It was established for the first time that this dependence for Rh-immunized women featured a considerable increase of lipoprotein content at gestational age 30-32 weeks and declined acutely by week 36.

  5. Gestational Age at Birth and 'Body-Mind' Health at 5 Years of Age: A Population Based Cohort Study.

    PubMed

    Cronin, Frances M; Segurado, Ricardo; McAuliffe, Fionnuala M; Kelleher, Cecily C; Tremblay, Richard E

    2016-01-01

    Numerous studies have identified the effects of prematurity on the neonate's physical health, however few studies have explored the effects of prematurity on both the physical and mental health of the child as they develop. Secondary analysis of data from the Millennium Cohort Study, a longitudinal study of infants (n = 18 818, born 2000-2002 in the United Kingdom) was performed. Effects of gestational age at birth on health outcomes at 5 years were measured using parental rating of their children's general health and severity of behavior problems. The association between parent's general health ratings and behavior problem ratings was low: 86% of those reporting serious behavior problems (5% of the sample, n = 764) rated their child as being in excellent, very good, or good health. Still, a gradient of increasing risk of poorer outcome with decreasing gestational age was observed for a composite health measure (poor/fair health and/or serious behavior problems), suggesting an association with prematurity for this composite assessment of health status. The greatest contribution to the childhood composite health measure at 5 years was for children born at 32-36 weeks gestation: population attributable fractions for having poor outcomes was 3.4% (Bonferroni-adjusted 95% confidence interval 1.1%-6.2%), compared to 1% (0.2-2.3) for birth at less than 32 weeks. Results suggest that preterm children, by school entry, are not only at high risk of physical health problems, but also of behavioral health problems. The recognition of, and response to comprehensive health and well-being outcomes related to prematurity are important in order to correctly plan and deliver adequate paediatric health services and policies. PMID:26975048

  6. Gestational Age at Birth and ‘Body-Mind’ Health at 5 Years of Age: A Population Based Cohort Study

    PubMed Central

    Segurado, Ricardo; McAuliffe, Fionnuala M.; Kelleher, Cecily C.

    2016-01-01

    Numerous studies have identified the effects of prematurity on the neonate’s physical health, however few studies have explored the effects of prematurity on both the physical and mental health of the child as they develop. Secondary analysis of data from the Millennium Cohort Study, a longitudinal study of infants (n = 18 818, born 2000–2002 in the United Kingdom) was performed. Effects of gestational age at birth on health outcomes at 5 years were measured using parental rating of their children’s general health and severity of behavior problems. The association between parent’s general health ratings and behavior problem ratings was low: 86% of those reporting serious behavior problems (5% of the sample, n = 764) rated their child as being in excellent, very good, or good health. Still, a gradient of increasing risk of poorer outcome with decreasing gestational age was observed for a composite health measure (poor/fair health and/or serious behavior problems), suggesting an association with prematurity for this composite assessment of health status. The greatest contribution to the childhood composite health measure at 5 years was for children born at 32–36 weeks gestation: population attributable fractions for having poor outcomes was 3.4% (Bonferroni-adjusted 95% confidence interval 1.1%–6.2%), compared to 1% (0.2–2.3) for birth at less than 32 weeks. Results suggest that preterm children, by school entry, are not only at high risk of physical health problems, but also of behavioral health problems. The recognition of, and response to comprehensive health and well-being outcomes related to prematurity are important in order to correctly plan and deliver adequate paediatric health services and policies. PMID:26975048

  7. Assessment of MRI-Based Automated Fetal Cerebral Cortical Folding Measures in Prediction of Gestational Age in the Third Trimester

    PubMed Central

    Wu, J.; Awate, S.P.; Licht, D.J.; Clouchoux, C.; du Plessis, A.J.; Avants, B.B.; Vossough, A.; Gee, J.C.; Limperopoulos, C.

    2016-01-01

    BACKGROUND AND PURPOSE Traditional methods of dating a pregnancy based on history or sonographic assessment have a large variation in the third trimester. We aimed to assess the ability of various quantitative measures of brain cortical folding on MR imaging in determining fetal gestational age in the third trimester. MATERIALS AND METHODS We evaluated 8 different quantitative cortical folding measures to predict gestational age in 33 healthy fetuses by using T2-weighted fetal MR imaging. We compared the accuracy of the prediction of gestational age by these cortical folding measureswiththeaccuracyofpredictionbybrainvolumemeasurementandbyapreviouslyreportedsemiquantitativevisualscaleofbrain maturity. Regression models were constructed, and measurement biases and variances were determined via a cross-validation procedure. RESULTS The cortical folding measures are accurate in the estimation and prediction of gestational age (mean of the absolute error, 0.43 ± 0.45 weeks) and perform better than (P = .024) brain volume (mean of the absolute error, 0.72 ± 0.61 weeks) or sonography measures (SDs approximately 1.5 weeks, as reported in literature). Prediction accuracy is comparable with that of the semiquantitative visual assessment score (mean, 0.57 ± 0.41 weeks). CONCLUSIONS Quantitative cortical folding measures such as global average curvedness can be an accurate and reliable estimator of gestational age and brain maturity for healthy fetuses in the third trimester and have the potential to be an indicator of brain-growth delays for at-risk fetuses and preterm neonates. PMID:26045578

  8. The effect of gestational age on symptom severity in children with autism spectrum disorder.

    PubMed

    Movsas, Tammy Z; Paneth, Nigel

    2012-11-01

    Between 2006 and 2010, two research-validated instruments, Social Communication Questionnaire (SCQ) and Social Responsiveness Scale (SRS) were filled out online by 4,188 mothers of Autism Spectrum Disorder (ASD) children, aged 4-21, as part of voluntary parental participation in a large web-based registry. Univariate and multivariate linear regression analysis (adjusted for child's sex, ability to verbalize, categorical IQ score, and fetal growth rate) demonstrated significantly higher SCQ and SRS scores for ASD children of both preterm (<37 weeks) and post-term (>42 weeks) gestational age (GA) compared to ASD children of normal GA, thus indicating that both preterm and post-term children manifest increased ASD symptomatology. Normal GA at birth appears to mitigate the severity of autistic social impairment in ASD children. PMID:22422339

  9. Maternal 75-g OGTT glucose levels as predictive factors for large-for-gestational age newborns in women with gestational diabetes mellitus.

    PubMed

    Brankica, Krstevska; Valentina, Velkoska Nakova; Slagjana, Simeonova Krstevska; Sasha, Jovanovska Mishevska

    2016-02-01

    Objective Our goal was to investigate which glucose measurement from the 75-g oral glucose tolerance test (OGTT) has more capability of predicting large for-gestational-age (LGA) newborns of mothers with gestational diabetes mellitus (GDM). Subjects and methods The study group consisted of 118 consecutively pregnant women with singleton pregnancy, patients of Outpatients Department of the Endocrinology, Diabetes, and Metabolic Disorders Clinic. All were prospectively screened for GDM between 24th and 28th week of pregnancy and followed to delivery. Outcome measures included: patients' ages, pre-pregnancy BMI, BMI before delivery, FPG, 1 and 2 hour OGTT glucose values, haemoglobin A1c at third trimester, gestational week of delivery, mode of delivery and baby birth weight. Results From 118 pregnancies, 78 (66.1%) women were with GDM, and 40 (33.9%) without GDM. There were statistically significant differences (30.7 versus 5.0%, p < 0.01) between LGA newborns from GDM and control group, respectively. Gestation week of delivery and fasting glucose levels were independent predictors for LGA (Beta = 0.58 and Beta = 0.37 respectively, p < 0.01). Areas under the receiver operator characteristic curve (AUC) were compared for the prediction of LGA (0.782 (0.685-0.861) for fasting, 0.719 (0.607-0.815) for 1-hour and 0.51 (0.392-0.626) for 2-hour OGTT plasma glucose levels). Conclusion Fasting and 1-hour plasma glucose levels from OGTT may predict LGA babies in GDM pregnancies. PMID:26909480

  10. Prevalence, Type, Distribution, and Severity of Cerebral Palsy in Relation to Gestational Age: A Meta-Analytic Review

    ERIC Educational Resources Information Center

    Himpens, E.; Van den Broeck, C.; Oostra, A.; Calders, P.; Vanhaesebrouck, P.

    2008-01-01

    The aim of this review is to determine the relationship between gestational age (GA) and prevalence, type, distribution, and severity of cerebral palsy (CP). Epidemiological studies with cohorts expressed by GA were assessed. A comprehensive meta-analysis and meta-regression was performed on four fetal age categories. Studies of children with CP…

  11. Asymmetric large-for-gestational-age infants of type 1 diabetic women: morbidity and abdominal growth.

    PubMed

    Bollepalli, Sureka; Dolan, Lawrence M; Miodovnik, Menachem; Feghali, Maisa; Khoury, Jane C

    2010-09-01

    We sought to examine neonatal morbidity in four groups of offspring (asymmetric large for gestational age [LGA], symmetric LGA, asymmetric non-LGA, symmetric non-LGA) exposed in utero to maternal type 1 diabetes, and the association between rate of fetal abdominal circumference growth and asymmetric LGA. We performed a secondary analysis of 302 singleton pregnancies. Neonatal morbidity (respiratory distress syndrome, polycythemia, hypoglycemia, hyperbilirubinemia, acidosis, and composite morbidity [any of the five]) was assessed. Serial ultrasound examinations after 20 weeks' gestation were available for 35 fetuses. Logistic regression and general linear mixed modeling were used for analysis. Asymmetric LGA infants had 3.5-, 2.2-, and 3.2-fold greater odds of hypoglycemia, hyperbilirubinemia, and composite morbidity, respectively, compared with symmetric non-LGA infants. The rate of growth of the abdominal circumference in asymmetric LGA infants (1.11 cm/wk) was greater than for both the symmetric LGA infants (0.87 cm/wk, P = 0.09) and the symmetric non-LGA infants (0.87 cm/wk, P = 0.03). Asymmetric LGA infants are at higher risk for morbidity than symmetric LGA and non-LGA infants. Intrauterine growth rate of the abdominal circumference may potentially be used as a marker to identify the asymmetric LGA and thereby aid in the identification of newborns at greatest risk for perinatal complications. PMID:20225174

  12. Gestational age at prior preterm birth does not affect cerclage efficacy

    PubMed Central

    Wing, Deborah A.; Szychowski, Jeff; Owen, John; Hankins, Gary; Iams, Jay D.; Sheffield, Jeanne S.; Perez-Delboy, Annette; Berghella, Vincenzo; Guzman, Edwin R.

    2010-01-01

    OBJECTIVE To evaluate effect of earliest prior spontaneous preterm birth (SPTB) gestational age (GA) on cervical length (CL), pregnancy duration, and ultrasound-indicated cerclage efficacy in a subsequent gestation. STUDY DESIGN Planned secondary analysis of the NICHD- trial of cerclage for CL < 25 mm. Women with at least one prior SPTB between 17-33 6/7 weeks underwent serial vaginal ultrasound screening between 16 and 23 6/7 weeks; CL at qualifying randomization evaluation was utilized. RESULTS We observed a significant correlation (p=0.0008) between prior SPTB GA and qualifying CL. In a linear regression model when controlling for CL and cerclage, neither prior SPTB GA nor the interaction between cerclage and prior birth GA was significant predictor of subsequent birth GA. CONCLUSION While there is an association between prior SPTB GA and CL in women with mid-trimester CL < 25 mm, there does not appear to be a disproportionate benefit of cerclage in women with earlier prior SPTB. PMID:20579957

  13. Percentile Distributions of Birth Weight according to Gestational Ages in Korea (2010-2012)

    PubMed Central

    2016-01-01

    The Pediatric Growth Chart (2007) is used as a standard reference to evaluate weight and height percentiles of Korean children and adolescents. Although several previous studies provided a useful reference range of newborn birth weight (BW) by gestational age (GA), the BW reference analyzed by sex and plurality is not currently available. Therefore, we aimed to establish a national reference range of neonatal BW percentiles considering GA, sex, and plurality of newborns in Korea. The raw data of all newborns (470,171 in 2010, 471,265 in 2011, and 484,550 in 2012) were analyzed. Using the Korean Statistical Information Service data (2010–2012), smoothed percentile curves (3rd–97th) by GA were created using the lambda-mu-sigma method after exclusion and the data were distinguished by all live births, singleton births, and multiple births. In the entire cohort, male newborns were heavier than female newborns and singletons were heavier than twins. As GA increased, the difference in BW between singleton and multiples increased. Compared to the previous data published 10 years ago in Korea, the BW of newborns 22–23 gestational weeks old was increased, whereas that of others was smaller. Other countries' data were also compared and showed differences in BW of both singleton and multiple newborns. We expect this updated data to be utilized as a reference to improve clinical assessments of newborn growth. PMID:27247504

  14. Percentile Distributions of Birth Weight according to Gestational Ages in Korea (2010-2012).

    PubMed

    Lee, Jin Kyoung; Jang, Hye Lim; Kang, Byung Ho; Lee, Kyung-Suk; Choi, Yong-Sung; Shim, Kye Shik; Lim, Jae Woo; Bae, Chong-Woo; Chung, Sung-Hoon

    2016-06-01

    The Pediatric Growth Chart (2007) is used as a standard reference to evaluate weight and height percentiles of Korean children and adolescents. Although several previous studies provided a useful reference range of newborn birth weight (BW) by gestational age (GA), the BW reference analyzed by sex and plurality is not currently available. Therefore, we aimed to establish a national reference range of neonatal BW percentiles considering GA, sex, and plurality of newborns in Korea. The raw data of all newborns (470,171 in 2010, 471,265 in 2011, and 484,550 in 2012) were analyzed. Using the Korean Statistical Information Service data (2010-2012), smoothed percentile curves (3(rd)-97(th)) by GA were created using the lambda-mu-sigma method after exclusion and the data were distinguished by all live births, singleton births, and multiple births. In the entire cohort, male newborns were heavier than female newborns and singletons were heavier than twins. As GA increased, the difference in BW between singleton and multiples increased. Compared to the previous data published 10 years ago in Korea, the BW of newborns 22-23 gestational weeks old was increased, whereas that of others was smaller. Other countries' data were also compared and showed differences in BW of both singleton and multiple newborns. We expect this updated data to be utilized as a reference to improve clinical assessments of newborn growth. PMID:27247504

  15. Antenatal Antecedents of Cognitive Impairment at 24 Months In Extremely Low Gestational Age Newborns

    PubMed Central

    O’Shea, Thomas M.; Kuban, Karl C. K.; Allred, Elizabeth N.; Hecht, Jonathan L.; Dammann, Olaf; Paneth, Nigel; McElrath, T. F.; Onderdonk, Andrew; Leviton, Alan

    2012-01-01

    BACKGROUND AND OBJECTIVES: Extremely low gestational age neonates are more likely than term infants to develop cognitive impairment. Few studies have addressed antenatal risk factors of this condition. We identified antenatal antecedents of cognitive impairment determined by the Mental Development Index (MDI) portion of the Bayley Scales of Infant Development, Second Edition (BSID-II), at 24 months corrected age. METHODS: We studied a multicenter cohort of 921 infants born before 28 weeks of gestation during 2002 to 2004 and assessed their placentas for histologic characteristics and microorganisms. The mother was interviewed and her medical record was reviewed. At 24 months adjusted age, children were assessed with BSID-II. Multinomial logistic models were used to estimate odds ratios. RESULTS: A total of 103 infants (11%) had an MDI <55, and 99 infants (11%) had an MDI between 55 and 69. No associations were identified between organisms recovered from the placenta and developmental delay. Factors most strongly associated with MDI <55 were thrombosis of fetal vessels (OR 3.1; 95% confidence interval [CI] 1.2, 7.7), maternal BMI >30 (OR 2.0; 95% CI 1.1, 3.5), maternal education ≤12 years (OR 3.4; 95% CI 1.9, 6.2), nonwhite race (OR 2.2; 95% CI 1.3, 3.8), birth weight z score < −2 (OR 2.8; 95% CI 1.1, 6.9), and male gender (OR 2.7; 95% CI 1.6, 4.5). CONCLUSIONS: Antenatal factors, including thrombosis of fetal vessels in the placenta, severe fetal growth restriction, and maternal obesity, convey information about the risk of cognitive impairment among extremely premature newborns. PMID:22331342

  16. Blood and urine 8-iso-PGF2α levels in babies of different gestational ages

    PubMed Central

    Li, Sitao; Hao, Hu; Zhou, Ping; Gao, Ping Ming; Xiao, Xin

    2014-01-01

    Objective: We measured cord blood and urine 8-iso-prostaglandin F2α (8-iso-PGF2α) levels in babies of different gestational ages to determine lipid peroxidation status. Methods: Babies at gestational ages of 28-43 weeks were divided into group A (28-32 weeks), group B (33-36 weeks), group C (37-41 weeks), and group D (42-43 weeks). 8-iso-PGF2α in umbilical cord blood (UCB) at birth and urine at 6 hours after birth was and tested by ELISA. Results: UCB and urine 8-iso-PGF2α levels in group C were 130.09 ± 31.73 pg/ml and 27.14 ± 6.73 pg/ml, respectively. UCB 8-iso-PGF2α levels in group A and B were 188.42 ± 59.34 pg/ml and 189.37 ± 68.46 pg/ml, and urine 8-iso-PGF2α were 32.14 ± 7.32 pg/ml and 30.46 ± 8.83 pg/ml, respectively. Blood and urine 8-iso-PGF2α levels in group D (post-term) were 252.01 ± 46.42 pg/ml and 44.00 ± 8.50 pg/ml. For all babies, UCB and urine iso-PGF2α levels were significantly correlated (r = 0.65, P < 0.01). Conclusions: We established blood and urine iso-PGF2α levels in normal full-term babies. Urine 8-iso-PGF2α levels may reflect the extent of lipid peroxidation in babies. In pre-term and post-term babies, there was evidence for increased lipid peroxidation. PMID:25664058

  17. Advanced Gestational Age Increases Serum Carbohydrate-Deficient Transferrin Levels in Abstinent Pregnant Women

    PubMed Central

    Bakhireva, Ludmila N.; Cano, Sandra; Rayburn, William F.; Savich, Renate D.; Leeman, Lawrence; Anton, Raymond F.; Savage, Daniel D.

    2012-01-01

    Aims: Carbohydrate-deficient transferrin (%CDT) is a well-established and highly specific biomarker for sustained heavy consumption of alcohol. However, in pregnant women, the specificity of this biomarker might be affected by advanced gestational age, even after accounting for increased transferrin concentrations in pregnancy. The goal of this prospective study was to assess the variability in %CDT during pregnancy among alcohol-abstaining patients. Methods: Patients were recruited during one of the first prenatal care visits and followed-up to term. Abstinence was confirmed by maternal self-report and by alcohol biomarkers. Biomarkers assessed in the mother included serum gamma-glutamyltranspeptidase, urine ethyl glucuronide and ethyl sulfate, and whole blood phosphatidylethanol (PEth). In addition, PEth was measured in a dry blood spot card obtained from a newborn. For %CDT analysis, serum samples were collected at baseline and at term and analyzed by an internationally validated high-performance liquid chromatography and spectrophotometric detection method. Results: At recruitment (mean gestational age 22.6 ± 7.3 weeks), the mean %CDT concentration was 1.49 ± 0.30%, while at term, it increased to 1.67 ± 0.28% (P = 0.001). Using a conventional cutoff concentration %CDT >1.7%, 22.9 and 45.7% of the sample would be classified as ‘positive’ for this biomarker at recruitment and at term, respectively (P = 0.011 ). Conclusion: These results suggest that a conventional cutoff of 1.7% might be too low for pregnant women and would generate false-positive results. We propose that %CDT >2.0% be used as a cutoff concentration indicative of alcohol exposure in pregnant women. The sensitivity of %CDT at this cutoff for heavy drinking during pregnancy needs to be assessed further. PMID:22878591

  18. Factors affecting vocabulary acquisition at age 2 in children born between 23 and 28 weeks' gestation.

    PubMed

    Marston, Louise; Peacock, Janet L; Calvert, Sandra A; Greenough, Anne; Marlow, Neil

    2007-08-01

    Language development is often slower in preterm children compared with their term peers. We investigated factors associated with vocabulary acquisition at 2 years in a cohort of children born at 28 weeks' gestation or less. For children entered into the United Kingdom Oscillation Study, language development was evaluated by using the MacArthur-Bates Communicative Development Inventories score, completed by parents as part of a developmental questionnaire. The effect of demographic, neonatal, socioeconomic factors, growth, and disability were investigated using multifactorial random effects modelling. Questionnaires were returned by 288 participants (148 males, 140 females). The mean number of words vocalized was 42 (SD 29). Multifactorial analysis showed only four factors were significantly associated with vocabulary acquisition. These were: (1) level of disability (mean words: no disability, 45; other disability, 38; severe disability, 30 [severe disability is defined as at least one extreme response in one of the following clinical domains: neuromotor, vision, hearing, communication, or other physical disabilities]; 95% confidence interval [CI] for the difference between no and severe disability 7- 23); (2) sex (39 males, 44 females; 95% CI 0.4-11); (3) length of hospital stay (lower quartile, 47; upper quartile, 38; 95% CI -12 to -4); and (4) weight SD score at 12 months (lower quartile, 39; upper quartile, 44; 95% CI 1-9). There was no significant association between gestational age and vocabulary after multifactorial analysis. There was no significant effect of any socioeconomic factor on vocabulary acquisition. We conclude that clinical factors, particularly indicators of severe morbidity, dominate the correlates of vocabulary acquisition at age 2 in children born very preterm. PMID:17635204

  19. Small for gestational age and exposure to particulate air pollution in the early-life environment of twins.

    PubMed

    Bijnens, Esmée M; Derom, Catherine; Gielen, Marij; Winckelmans, Ellen; Fierens, Frans; Vlietinck, Robert; Zeegers, Maurice P; Nawrot, Tim S

    2016-07-01

    Several studies in singletons have shown that maternal exposure to ambient air pollutants is associated with restricted fetal growth. About half of twins have low birth weight compared with six percent in singletons. So far, no studies have investigated maternal air pollution exposure in association with birth weight and small for gestational age in twins. We examined 4760 twins of the East Flanders Prospective Twins Survey (2002-2013), to study the association between in utero exposure to air pollution with birth weight and small for gestational age. Maternal particulate air pollution (PM10) and nitric dioxide (NO2) exposure was estimated using a spatial temporal interpolation method over various time windows during pregnancy. In the total group of twins, we observed that higher PM10 and NO2 exposure during the third trimester was significantly associated with a lower birth weight and higher risk of small for gestational age. However, the association was driven by moderate to late preterm twins (32-36 weeks of gestation). In these twins born between 32 and 36 weeks of gestation, birth weight decreased by 40.2g (95% CI: -69.0 to -11.3; p=0.006) and by 27.3g (95% CI: -52.9 to -1.7; p=0.04) in association for each 10µg/m³ increment in PM10 and NO2 concentration during the third trimester. The corresponding odds ratio for small for gestational age were 1.68 (95% CI: 1.27-2.33; p=0.0003) and 1.51 (95% CI: 1.18-1.95; p=0.001) for PM10 or NO2, respectively. No associations between air pollution and birth weight or small for gestational age were observed among term born twins. Finally, in all twins, we found that for each 10µg/m³ increase in PM10 during the last month of pregnancy the within-pair birth weight difference increased by 19.6g (95% CI: 3.7-35.4; p=0.02). Assuming causality, an achievement of a 10µg/m³ decrease of particulate air pollution may account for a reduction by 40% in small for gestational age, in twins born moderate to late preterm. PMID

  20. Bone Mineral Density in Gravida: Effect of Pregnancies and Breast-Feeding in Women of Differing Ages and Parity

    PubMed Central

    Mishukov, Yuri; Babchenko, Liana; Samueloff, Arnon; Zimran, Ari

    2014-01-01

    Changes of bone during pregnancy and during lactation evaluated by bone mineral density (BMD) may have implications for risk of osteoporosis and fractures. We studied BMD in women of differing ages, parity, and lactation histories immediately postpartum for BMD, T-scores, and Z-scores. Institutional Review Board approval was received. All women while still in hospital postpartum were asked to participate. BMD was performed by dual-energy X-ray absorptiometry (DXA) machine at femoral neck (FN) and lumbar spine (LS) by a single technician. Of 132 participants, 73 (55.3%) were ≤30 years; 27 (20.5%) were primiparous; 36 (27.3%) were grand multiparous; 35 (26.5%) never breast fed. Mean FN T-scores and Z-scores were higher than respective mean LS scores, but all means were within the normal limits. Mean LS T-scores and Z-scores were highest in the grand multiparas. There were only 2 (1.5%) outliers with low Z-scores. We conclude that, in a large cohort of Israeli women with BMD parameters assessed by DXA within two days postpartum, mean T-scores and Z-scores at both the LS and FN were within normal limits regardless of age (20–46 years), parity (1–13 viable births), and history of either no or prolonged months of lactation (up to 11.25 years). PMID:25506038

  1. Bone mineral density in gravida: effect of pregnancies and breast-feeding in women of differing ages and parity.

    PubMed

    Lebel, Ehud; Mishukov, Yuri; Babchenko, Liana; Samueloff, Arnon; Zimran, Ari; Elstein, Deborah

    2014-01-01

    Changes of bone during pregnancy and during lactation evaluated by bone mineral density (BMD) may have implications for risk of osteoporosis and fractures. We studied BMD in women of differing ages, parity, and lactation histories immediately postpartum for BMD, T-scores, and Z-scores. Institutional Review Board approval was received. All women while still in hospital postpartum were asked to participate. BMD was performed by dual-energy X-ray absorptiometry (DXA) machine at femoral neck (FN) and lumbar spine (LS) by a single technician. Of 132 participants, 73 (55.3%) were ≤30 years; 27 (20.5%) were primiparous; 36 (27.3%) were grand multiparous; 35 (26.5%) never breast fed. Mean FN T-scores and Z-scores were higher than respective mean LS scores, but all means were within the normal limits. Mean LS T-scores and Z-scores were highest in the grand multiparas. There were only 2 (1.5%) outliers with low Z-scores. We conclude that, in a large cohort of Israeli women with BMD parameters assessed by DXA within two days postpartum, mean T-scores and Z-scores at both the LS and FN were within normal limits regardless of age (20-46 years), parity (1-13 viable births), and history of either no or prolonged months of lactation (up to 11.25 years). PMID:25506038

  2. Efficacy and safety of growth hormone treatment for children born small for gestational age

    PubMed Central

    2014-01-01

    Recombinant growth hormone (GH) is an effective treatment for short children who are born small for gestational age (SGA). Short children born SGA who fail to demonstrate catch-up growth by 2-4 years of age are candidates for GH treatment initiated to achieve catch-up growth to a normal height in early childhood, maintain a normal height gain throughout childhood, and achieve an adult height within the normal target range. GH treatment at a dose of 35-70 µg/kg/day should be considered for those with very marked growth retardation, as these patients require rapid catch-up growth. Factors associated with response to GH treatment during the initial 2-3 years of therapy include age and height standard deviation scores at the start of therapy, midparental height, and GH dose. Adverse events due to GH treatment are no more common in the SGA population than in other conditions treated with GH. Early surveillance in growth clinics is strongly recommended for children born SGA who have not caught up. Although high dose of up to 0.067 mg/kg/day are relatively safe for short children with growth failure, clinicians need to remain aware of long-term mortality and morbidity after GH treatment. PMID:25324863

  3. Zinc supplementation and growth of infants born small for gestational age.

    PubMed

    Castillo-Durán, C; Rodríguez, A; Venegas, G; Alvarez, P; Icaza, G

    1995-08-01

    To analyze the effect of zinc supplementation on postnatal growth of infants born small for gestational age, we selected 68 infants at birth and followed them monthly for 6 months. They were randomly assigned to a supplemented group (group S, n = 35) receiving 3 mg of Zn (acetate) per day, or to a placebo (group P, n = 33), in a double-blind study. Weight increments in group S were significantly higher than those in group P at 2 months (p < 0.003); z scores showed catch-up growth only in group S. Length increments were also greater in group S than in group P, ending at 6 months were 64.9 +/- 1.8 versus 63.4 +/- 3.5 cm (mean +/- SD; p < 0.01); changes in z scores for 6 months were -1.28 to -0.66 in group S and -1.43 to -1.47 in group P (p < 0.001). Weight-for-length improved similarly in both groups (z score, -2.2 to +0.2). The increase in weight-for-age was higher in group S girls (p < 0.034), ending at 6 months with -0.13 +/- 0.59, versus -0.52 +/- 0.62 in group S boys, -1.15 +/- 0.49 in group P girls, and -1.05 +/- 0.80 in group P boys (+/- SD). More infants in group P received cow milk-based formula before 4 months because of inadequate weight increments. An additive effect on weight increase was observed between Zn supplementation (p < 0.02), exclusive breast-feeding after 4 months of age (p < 0.001), and gender (p < 0.02). Plasma and hair Zn values showed a downward trend, less marked in group S than in group P. We conclude that Chilean infants born small for gestational age have better weight and linear growth during the first 6 months of life if they receive Zn supplementation. PMID:7636643

  4. Whole-body protein turnover in preterm appropriate for gestational age and small for gestational age infants: comparison of [15N]glycine and [1-(13)C]leucine administered simultaneously.

    PubMed

    Van Goudoever, J B; Sulkers, E J; Halliday, D; Degenhart, H J; Carnielli, V P; Wattimena, J L; Sauer, P J

    1995-04-01

    Measurements of whole-body protein turnover in preterm infants have been made using different stable isotope methods. Large variation in results has been found, which could be due to different clinical conditions and/or the use of different tracers. We studied 14 appropriate for gestational age and nine small for gestational age orally fed preterm infants using [15N]glycine and [1-(13)C]leucine simultaneously, which allowed us to make a comparison of commonly used methods to calculate whole-body protein turnover. Whole-body protein turnover was calculated from 15N enrichment in urinary ammonia and urea after [15N]-glycine administration and from the 13C enrichment in expired CO2 after administration of [1-(13)C]leucine. Enrichment of alpha-ketoisocaproic acid after [1-(13)C]leucine constant infusion was measured as a direct parameter of whole-body protein turnover. Group means for whole-body protein turnover using [15N]glycine or [1-(13)C]leucine ranged from 10 to 14 g.kg-1.d-1, except when using the end product method that assumes a correlation between leucine oxidation and total nitrogen excretion. We found very low 15N enrichment of urinary urea in the majority of small for gestational age infants. These infants also had a lower nitrogen excretion in urine and oxidized less leucine. Nitrogen balance was higher in small for gestational age infants (416 +/- 25 mg.kg-1.d-1) compared with appropriate for gestational age infants (374 +/- 41 mg.kg-1.d-1, p = 0.003). [15N]Glycine does not seem to exchange its label with the body nitrogen pool to a significant degree and is therefore not always suitable as a carrier for 15N in protein turnover studies in premature infants. PMID:7596675

  5. Nutritional requirements and feeding recommendations for small for gestational age infants.

    PubMed

    Tudehope, David; Vento, Maximo; Bhutta, Zulfiqar; Pachi, Paulo

    2013-03-01

    We define the small for gestational age (SGA) infant as an infant born ≥ 35 weeks' gestation and <10th percentile on the Fenton Growth Chart. Policy statements from many organizations recommend mother's own milk for SGA infants because it meets most of their nutritional requirements and provides short- and long-term benefits. Several distinct patterns of intrauterine growth restriction are identified among the heterogeneous grouping of SGA infants; each varies with regard to neonatal morbidities, requirements for neonatal management, postnatal growth velocities, neurodevelopmental progress, and adult health outcomes. There is much we do not know about nutritional management of the SGA infant. We need to identify and define: infants who have "true" growth restriction and are at high risk for adverse metabolic outcomes in later life; optimal growth velocity and "catch-up" growth rates that are conducive with life-long health and well being; global approaches to management of hypoglycemia; and an optimal model for postdischarge care. Large, rigorously conducted trials are required to determine whether aggressive feeding of SGA infants results in improved nutritional rehabilitation, growth, and neurodevelopmental outcomes. Before birth, maternal supplementation with specific nutrients reduces the rate and severity of growth restriction and may prevent nutrient deficiency states if infants are born SGA. After birth, the generally accepted goal is to provide enough nutrients to achieve postnatal growth similar to that of a normal fetus. In addition, we recommend SGA infants be allowed to "room in" with their mothers to promote breastfeeding, mother-infant attachment, and skin-to-skin contact to assist with thermoregulation. PMID:23445853

  6. COMPARISON OF GESTATIONAL AGE AT BIRTH BASED ON LAST MENSTRUAL PERIOD AND ULTRASOUND DURING THE FIRST TRIMESTER

    EPA Science Inventory

    Reported last menstrual period (LMP) is commonly used to estimate gestational age (GA) but may be unreliable. Ultrasound in the first trimester is generally considered a highly accurate method of pregnancy dating. The authors compared first trimester report of LMP and first trime...

  7. Age at calving in heifers and level of milk production during gestation in cows are associated with the birth size of Holstein calves.

    PubMed

    Kamal, M M; Van Eetvelde, M; Depreester, E; Hostens, M; Vandaele, L; Opsomer, G

    2014-09-01

    The objective of the present study was to evaluate environmental and dam factors associated with birth size of Holstein calves. Data of 1,594 births from dairy herds in Belgium and Germany were analyzed in a retrospective cross-sectional study. Immediately after birth, the birth weight of the calves was measured. On the next day, the heart girth (HG), withers height, and diagonal length of the dams and calves were measured. Parity, body condition score, gestation length (GL), and age at calving were recorded for all dams. For the cows, days open, lactation length, length of the dry period, and calving interval were also calculated. The magnitude and shape of the lactation that took place during gestation was quantified using the MilkBot model based on monthly milk weights. Using the same procedure, cumulative milk production from conception to drying off (MGEST) was calculated. After descriptive analyses, mixed models were used to identify factors that are significantly associated with the birth weight (most consistent measure of size at birth) of the calves born to both heifers and cows. Of the variables offered to the offspring birth weight model in heifers (n=540), calf sex, season of calving, GL, HG, withers height, diagonal length, and age at calving were significant. The mean birth weight of the calves born to heifers was estimated to be 41.3±1.01kg. In comparison to calves born to old (25.5 to 37.3mo; n=99) heifers, the birth weight was estimated to be 2.75, 3.29, and 2.35kg heavier when the calves were born to very young (20.3 to <22mo; n=98), young (22 to <23.5mo; n=145), and standard aged (23.5 to <25.5mo; n=198) heifers, respectively. Of the variables offered to the offspring birth weight model in cows (n=1,054), calf sex, season of calving, GL, parity, dry period, and MGEST were significant. The mean birth weight of the calves born to cows was estimated to be 44.1±0.99kg. For cows having an identical HG, the birth weight of the calves was estimated to

  8. Effects of gestational length, gender, postnatal age, and birth order on visual contrast sensitivity in infants

    PubMed Central

    Dobkins, Karen R.; Bosworth, Rain G.; McCleery, Joseph P.

    2010-01-01

    To investigate effects of visual experience versus preprogrammed mechanisms on visual development, we used multiple regression analysis to determine the extent to which a variety of variables (that differ in the extent to which they are tied to visual experience) predict luminance and chromatic (red/green) contrast sensitivity (CS), which are mediated by the magnocellular (M) and parvocellular (P) subcortical pathways, respectively. Our variables included gestational length (GL), birth weight (BW), gender, postnatal age (PNA), and birth order (BO). Two-month-olds (n = 60) and 6-month-olds (n = 122) were tested. Results revealed that (1) at 2 months, infants with longer GL have higher luminance CS; (2) at both ages, CS significantly increases over a ~21-day range of PNA, but this effect is stronger in 2- than 6-month-olds and stronger for chromatic than luminance CS; (3) at 2 months, boys have higher luminance CS than girls; and (4) at 2 months, firstborn infants have higher CS, while at 6 months, non-firstborn infants have higher CS. The results for PNA/GL are consistent with the possibility that P pathway development is more influenced by variables tied to visual experience (PNA), while M pathway development is more influenced by variables unrelated to visual experience (GL). Other variables, including prenatal environment, are also discussed. PMID:19810800

  9. Assessing the Causal Relationship of Maternal Height on Birth Size and Gestational Age at Birth: A Mendelian Randomization Analysis

    PubMed Central

    Zhang, Ge; Bacelis, Jonas; Lengyel, Candice; Teramo, Kari; Hallman, Mikko; Helgeland, Øyvind; Johansson, Stefan; Myhre, Ronny; Sengpiel, Verena; Njølstad, Pål Rasmus; Jacobsson, Bo; Muglia, Louis

    2015-01-01

    Background Observational epidemiological studies indicate that maternal height is associated with gestational age at birth and fetal growth measures (i.e., shorter mothers deliver infants at earlier gestational ages with lower birth weight and birth length). Different mechanisms have been postulated to explain these associations. This study aimed to investigate the casual relationships behind the strong association of maternal height with fetal growth measures (i.e., birth length and birth weight) and gestational age by a Mendelian randomization approach. Methods and Findings We conducted a Mendelian randomization analysis using phenotype and genome-wide single nucleotide polymorphism (SNP) data of 3,485 mother/infant pairs from birth cohorts collected from three Nordic countries (Finland, Denmark, and Norway). We constructed a genetic score based on 697 SNPs known to be associated with adult height to index maternal height. To avoid confounding due to genetic sharing between mother and infant, we inferred parental transmission of the height-associated SNPs and utilized the haplotype genetic score derived from nontransmitted alleles as a valid genetic instrument for maternal height. In observational analysis, maternal height was significantly associated with birth length (p = 6.31 × 10−9), birth weight (p = 2.19 × 10−15), and gestational age (p = 1.51 × 10−7). Our parental-specific haplotype score association analysis revealed that birth length and birth weight were significantly associated with the maternal transmitted haplotype score as well as the paternal transmitted haplotype score. Their association with the maternal nontransmitted haplotype score was far less significant, indicating a major fetal genetic influence on these fetal growth measures. In contrast, gestational age was significantly associated with the nontransmitted haplotype score (p = 0.0424) and demonstrated a significant (p = 0.0234) causal effect of every 1 cm increase in maternal

  10. Estimating Gestational Age in Late Presenters to Antenatal Care in a Resource-Limited Setting on the Thai-Myanmar Border

    PubMed Central

    Moore, Kerryn A.; Simpson, Julie A.; Thomas, Kyla H.; Rijken, Marcus J.; White, Lisa J.; Lu Moo Dwell, Saw; Paw, Moo Kho; Wiladphaingern, Jacher; Pukrittayakamee, Sasithon; Nosten, François; Fowkes, Freya J. I.; McGready, Rose

    2015-01-01

    Estimating gestational age in resource-limited settings is prone to considerable inaccuracy because crown-rump length measured by ultrasound before 14 weeks gestation, the recommended method for estimating gestational age, is often unavailable. Judgements regarding provision of appropriate obstetric and neonatal care are dependent on accurate estimation of gestational age. We determined the accuracy of the Dubowitz Gestational Age Assessment, a population-specific symphysis-fundal height formula, and ultrasound biometry performed between 16 and 40 weeks gestation in estimating gestational age using pre-existing data from antenatal clinics of the Shoklo Malaria Research Unit on the Thai-Myanmar border, where malaria is endemic. Two cohorts of women who gave birth to live singletons were analysed: 1) 250 women who attended antenatal care between July 2001 and May 2006 and had both ultrasound crown-rump length (reference) and a Dubowitz Gestational Age Assessment; 2) 975 women attending antenatal care between April 2007 and October 2010 who had ultrasound crown-rump length, symphysis-fundal measurements, and an additional study ultrasound (biparietal diameter and head circumference) randomly scheduled between 16 and 40 weeks gestation. Mean difference in estimated newborn gestational age between methods and 95% limits of agreement (LOA) were determined from linear mixed-effects models. The Dubowitz method and the symphysis-fundal height formula performed well in term newborns, but overestimated gestational age of preterms by 2.57 weeks (95% LOA: 0.49, 4.65) and 3.94 weeks (95% LOA: 2.50, 5.38), respectively. Biparietal diameter overestimated gestational age by 0.83 weeks (95% LOA: -0.93, 2.58). Head circumference underestimated gestational age by 0.39 weeks (95% LOA: -2.60, 1.82), especially if measured after 24 weeks gestation. The results of this study can be used to quantify biases associated with alternative methods for estimating gestational age in the absence of

  11. Longitudinal analysis of DNA methylation associated with birth weight and gestational age

    PubMed Central

    Simpkin, Andrew J.; Suderman, Matthew; Gaunt, Tom R.; Lyttleton, Oliver; McArdle, Wendy L.; Ring, Susan M.; Tilling, Kate; Davey Smith, George; Relton, Caroline L.

    2015-01-01

    Gestational age (GA) and birth weight have been implicated in the determination of long-term health. It has been hypothesized that changes in DNA methylation may mediate these long-term effects. We obtained DNA methylation profiles from cord blood and peripheral blood at ages 7 and 17 in the same children from the Avon Longitudinal Study of Parents and Children. Repeated-measures data were used to investigate changes in birth-related methylation during childhood and adolescence. Ten developmental phenotypes (e.g. height) were analysed to identify possible mediation of health effects by DNA methylation. In cord blood, methylation at 224 CpG sites was found to be associated with GA and 23 CpG sites with birth weight. Methylation changed in the majority of these sites over time, but neither birth characteristic was strongly associated with methylation at age 7 or 17 (using a conservative correction for multiple testing of P < 1.03 × 10–7), suggesting resolution of differential methylation by early childhood. Associations were observed between birth weight-associated CpG sites and phenotypic characteristics in childhood. One strong association involved birth weight, methylation of a CpG site proximal to the NFIX locus and bone mineral density at age 17. Analysis of serial methylation from birth to adolescence provided evidence for a lack of persistence of methylation differences beyond early childhood. Sites associated with birth weight were linked to developmental genes and have methylation levels which are associated with developmental phenotypes. Replication and interrogation of causal relationships are needed to substantiate whether methylation differences at birth influence the association between birth weight and development. PMID:25869828

  12. The association of cerebral palsy and death with small-for-gestational age birth weight in preterm neonates by individualized and population-based percentiles

    PubMed Central

    Grobman, William A.; Lai, Yinglei; Rouse, Dwight J.; Spong, Catherine Y.; Varner, Michael W.; Mercer, Brian M.; Leveno, Kenneth J.; Iams, Jay D.; Wapner, Ronald J.; Sorokin, Yoram; Thorp, John M.; Ramin, Susan M.; Malone, Fergal D.; O'sullivan, Mary J.; Hankins, Gary D. V.; Caritis, Steve N.

    2013-01-01

    OBJECTIVE To determine whether an individualized growth standard (IS) improves identification of preterm small-for-gestational-age (SGA) neonates at risk of developing moderate/severe cerebral palsy (CP) or death. STUDY DESIGN Secondary analysis of data from a randomized trial of MgSO4 for prevention of CP or death among anticipated preterm births. Singleton non-anomalous liveborns delivered before 34 weeks’ were classified as SGA (< 10th % for their GA) by a population standard (PS) or an IS (incorporating maternal age, height, weight, parity, race/ethnicity, and neonatal gender). The primary outcome was prediction of moderate or severe CP or death by age 2. RESULTS Of 1588 eligible newborns, 143 (9.4%) experienced CP (N=33) or death (N=110). Forty-four (2.8%) were SGA by the PS and 364 (22.9%) by the IS. All PS-SGA newborns also were identified as IS-SGA. SGA newborns by either standard had a similarly increased risk of CP or death (PS: RR 2.4, 95% CI 1.3–4.3 vs. IS: RR 1.8, 95% CI 1.3–2.5, respectively). The similarity of RRs remained after stratification by MgSO4 treatment group. The IS was more sensitive (36% vs. 6%, p <.001), but less specific (78% vs. 98%, p <.001) for CP or death. ROC curve analysis revealed a statistically lower AUC for the PS, although the ability of either method to predict which neonates would subsequently develop CP or death was poor (PS: 0.55, 95% CI 0.49–0.60 vs. IS: 0.59, 95% CI 0.54–0.64, p<.001). CONCLUSION An individualized SGA growth standard does not improve the association with, or prediction of, CP or death by age 2. PMID:23770470

  13. Maternal-Fetal Disposition of Glyburide in Pregnant Mice Is Dependent on Gestational Age

    PubMed Central

    Shuster, Diana L.; Risler, Linda J.; Liang, Chao-Kang J.; Rice, Kenneth M.; Shen, Danny D.; Hebert, Mary F.; Thummel, Kenneth E.

    2014-01-01

    Gestational diabetes mellitus is a major complication of human pregnancy. The oral clearance (CL) of glyburide, an oral antidiabetic drug, increases 2-fold in pregnant women during late gestation versus nonpregnant controls. In this study, we examined gestational age–dependent changes in maternal-fetal pharmacokinetics (PK) of glyburide and metabolites in a pregnant mouse model. Nonpregnant and pregnant FVB mice were given glyburide by retro-orbital injection. Maternal plasma was collected over 240 minutes on gestation days (gd) 0, 7.5, 10, 15, and 19; fetuses were collected on gd 15 and 19. Glyburide and metabolites were quantified using high-performance liquid chromatography–mass spectrometry, and PK analyses were performed using a pooled data bootstrap approach. Maternal CL of glyburide increased approximately 2-fold on gd 10, 15, and 19 compared with nonpregnant controls. Intrinsic CL of glyburide in maternal liver microsomes also increased as gestation progressed. Maternal metabolite/glyburide area under the curve ratios were generally unchanged or slightly decreased throughout gestation. Total fetal exposure to glyburide was <5% of maternal plasma exposure, and was doubled on gd 19 versus gd 15. Fetal metabolite concentrations were below the limit of assay detection. This is the first evidence of gestational age–dependent changes in glyburide PK. Increased maternal glyburide clearance during gestation is attributable to increased hepatic metabolism. Metabolite elimination may also increase during pregnancy. In the mouse model, fetal exposure to glyburide is gestational age–dependent and low compared with maternal plasma exposure. These results indicate that maternal glyburide therapeutic strategies may require adjustments in a gestational age–dependent manner if these same changes occur in humans. PMID:24898265

  14. Preterm or Not – An Evaluation of Estimates of Gestational Age in a Cohort of Women from Rural Papua New Guinea

    PubMed Central

    Ome-Kaius, Maria; Mola, Glen; White, Lisa; Wangnapi, Regina A.; Rogerson, Stephen J.; Mueller, Ivo

    2015-01-01

    Background Knowledge of accurate gestational age is required for comprehensive pregnancy care and is an essential component of research evaluating causes of preterm birth. In industrialised countries gestational age is determined with the help of fetal biometry in early pregnancy. Lack of ultrasound and late presentation to antenatal clinic limits this practice in low-resource settings. Instead, clinical estimators of gestational age are used, but their accuracy remains a matter of debate. Methods In a cohort of 688 singleton pregnancies from rural Papua New Guinea, delivery gestational age was calculated from Ballard score, last menstrual period, symphysis-pubis fundal height at first visit and quickening as well as mid- and late pregnancy fetal biometry. Published models using sequential fundal height measurements and corrected last menstrual period to estimate gestational age were also tested. Novel linear models that combined clinical measurements for gestational age estimation were developed. Predictions were compared with the reference early pregnancy ultrasound (<25 gestational weeks) using correlation, regression and Bland-Altman analyses and ranked for their capability to predict preterm birth using the harmonic mean of recall and precision (F-measure). Results Average bias between reference ultrasound and clinical methods ranged from 0–11 days (95% confidence levels: 14–42 days). Preterm birth was best predicted by mid-pregnancy ultrasound (F-measure: 0.72), and neuromuscular Ballard score provided the least reliable preterm birth prediction (F-measure: 0.17). The best clinical methods to predict gestational age and preterm birth were last menstrual period and fundal height (F-measures 0.35). A linear model combining both measures improved prediction of preterm birth (F-measure: 0.58). Conclusions Estimation of gestational age without ultrasound is prone to significant error. In the absence of ultrasound facilities, last menstrual period and fundal

  15. Neonatal Mortality Risk Associated with Preterm Birth in East Africa, Adjusted by Weight for Gestational Age: Individual Participant Level Meta-Analysis

    PubMed Central

    Marchant, Tanya; Willey, Barbara; Katz, Joanne; Clarke, Siân; Kariuki, Simon; ter Kuile, Feiko; Lusingu, John; Ndyomugyenyi, Richard; Schmiegelow, Christentze; Watson-Jones, Deborah; Armstrong Schellenberg, Joanna

    2012-01-01

    Background Low birth weight and prematurity are amongst the strongest predictors of neonatal death. However, the extent to which they act independently is poorly understood. Our objective was to estimate the neonatal mortality risk associated with preterm birth when stratified by weight for gestational age in the high mortality setting of East Africa. Methods and Findings Members and collaborators of the Malaria and the MARCH Centers, at the London School of Hygiene & Tropical Medicine, were contacted and protocols reviewed for East African studies that measured (1) birth weight, (2) gestational age at birth using antenatal ultrasound or neonatal assessment, and (3) neonatal mortality. Ten datasets were identified and four met the inclusion criteria. The four datasets (from Uganda, Kenya, and two from Tanzania) contained 5,727 births recorded between 1999–2010. 4,843 births had complete outcome data and were included in an individual participant level meta-analysis. 99% of 445 low birth weight (<2,500 g) babies were either preterm (<37 weeks gestation) or small for gestational age (below tenth percentile of weight for gestational age). 52% of 87 neonatal deaths occurred in preterm or small for gestational age babies. Babies born <34 weeks gestation had the highest odds of death compared to term babies (odds ratio [OR] 58.7 [95% CI 28.4–121.4]), with little difference when stratified by weight for gestational age. Babies born 34–36 weeks gestation with appropriate weight for gestational age had just three times the likelihood of neonatal death compared to babies born term, (OR 3.2 [95% CI 1.0–10.7]), but the likelihood for babies born 34–36 weeks who were also small for gestational age was 20 times higher (OR 19.8 [95% CI 8.3–47.4]). Only 1% of babies were born moderately premature and small for gestational age, but this group suffered 8% of deaths. Individual level data on newborns are scarce in East Africa; potential biases arising due to the non

  16. Accurate assessment of early gestational age in normal and diabetic women by serum human placental lactogen concentration.

    PubMed

    Whittaker, P G; Aspillaga, M O; Lind, T

    1983-08-01

    Serum human placental lactogen (hPL) and human chorionic gonadotropin (hCG) were assayed and fetal crown-rump length (CRL) was determined by sonar in three groups of pregnant women--35 with uncomplicated pregnancies, 13 with insulin-dependent diabetes mellitus, and 21 who represented a general pregnancy population. Each patient had a regular cycle and recorded last menstrual period, ovulated spontaneously, and was delivered of a single live baby. Serum hPL concentrations within the range 0.01-0.80 microU/ml in patients in the first group gave estimates of gestation with an SD of 6.3 days which was the same as the SD derived from CRL measurements. When the hPL regression equation was applied to the diabetic mothers the difference between the gestational age estimated from hPL and that estimated from LMP had a mean value of - 0.9 days with an SD of 6.2 days; this difference was not significantly different from zero. The third group of patients had a mean difference between hPL and LMP derived gestational age of 0.7 days (+/- 6.7 SD). Serum hPL offers a method of estimating gestation sufficiently precise to be used as a practical alternative to sonar measurements of CRL. PMID:6135831

  17. Joint Effects of Structural Racism and Income Inequality on Small-for-Gestational-Age Birth

    PubMed Central

    Wallace, Maeve E.; Liu, Danping; Grantz, Katherine L.

    2015-01-01

    Objectives. We examined potential synergistic effects of racial and socioeconomic inequality associated with small-for-gestational-age (SGA) birth. Methods. Electronic medical records from singleton births to White and Black women in 10 US states and the District of Columbia (n = 121 758) were linked to state-level indicators of structural racism, including the ratios of Blacks to Whites who were employed, were incarcerated, and had a bachelor’s or higher degree. We used state-level Gini coefficients to assess income inequality. Generalized estimating equations models were used to quantify the adjusted odds of SGA birth associated with each indicator and the joint effects of structural racism and income inequality. Results. Structural racism indicators were associated with higher odds of SGA birth, and similar effects were observed for both races. The joint effects of racial and income inequality were significantly associated with SGA birth only when levels of both were high; in areas with high inequality levels, adjusted odds ratios ranged from 1.81 to 2.11 for the 3 structural racism indicators. Conclusions. High levels of racial inequality and socioeconomic inequality appear to increase the risk of SGA birth, particularly when they co-occur. PMID:26066964

  18. Neuropsychological deficits in young adults born small-for-gestational age (SGA) at term.

    PubMed

    Østgård, Heidi Furre; Skranes, Jon; Martinussen, Marit; Jacobsen, Geir W; Brubakk, Ann-Mari; Vik, Torstein; Pripp, Are H; Løhaugen, Gro C C

    2014-03-01

    Reduced IQ, learning difficulties and poor school performance have been reported in small-for-gestational-age (SGA) subjects. However, few studies include a comprehensive neuropsychological assessment. Our aim was to study neuropsychological functioning in young adults born SGA at term. A comprehensive neuropsychological test battery was administered to 58 SGA subjects (birth weight <10th centile) born at term, and 81 term non-SGA controls (birth weight ≥10th centile). The SGA group obtained significantly (p < .01) lower scores on the attention, executive and memory domains compared to non-SGA controls and showed higher risk of obtaining scores below -1.5 SD on the memory domain (odds ratio = 13.3, 95% confidence interval: 1.57, 112.47). At a subtest level, the SGA group obtained lower scores on most neuropsychological tests, with significant differences on 6 of 46 measures: the Trail Making Test 3 (letter sequencing), the Wechsler Memory Scale mental control and the auditory immediate memory scale, the Design Fluency, the Stroop 3 (inhibition) and the Visual Motor Integration (VMI) motor coordination subtest. Young adults born SGA score more poorly on neuropsychological tests compared with non-SGA controls. Differences were modest, with more significant differences in the memory domain. PMID:24559531

  19. Catch-up growth and catch-up fat in children born small for gestational age

    PubMed Central

    Cho, Won Kyoung

    2016-01-01

    Infants born small for gestational age (SGA) are at increased risk of perinatal morbidity, persistent short stature, and metabolic alterations in later life. Recent studies have focused on the association between birth weight (BW) and later body composition. Some reports suggest that fetal nutrition, as reflected by BW, may have an inverse programing effect on abdominal adiposity later in life. This inverse association between BW and abdominal adiposity in adults may contribute to insulin resistance. Rapid weight gain during infancy in SGA children seemed to be associated with increased fat mass rather than lean mass. Early catch-up growth after SGA birth rather than SGA itself has been noted as a cardiovascular risk factor in later life. Children who are born SGA also have a predisposition to accumulation of fat mass, particularly intra-abdominal fat. It is not yet clear whether this predisposition is due to low BW itself, rapid postnatal catch-up growth, or a combination of both. In this report, we review the published literature on central fat accumulation and metabolic consequences of being SGA, as well as the currently popular research area of SGA, including growth aspects. PMID:26893597

  20. Cesarean section, gestational age, and transient tachypnea of the newborn: timing is the key.

    PubMed

    Riskin, Arieh; Abend-Weinger, Marta; Riskin-Mashiah, Shlomit; Kugelman, Amir; Bader, David

    2005-10-01

    The purpose of this study was to identify risk factors and to characterize infants with transient tachypnea of the newborn (TTN). A total of 67 newborns with TTN, born at gestational age (GA)>or=35 weeks, were studied. Newborns delivered before and after each study case served as controls. Mean GA was lower and cesarean section (CS) rate was higher in the TTN group (38.2+/-2.3 versus 39.5+/-1.4 weeks, p<0.001; 50.7% versus 22.4%, p<0.001). GA<38 weeks was found to be associated with increased risk for TTN in infants delivered by elective CS. TTN was associated with significant morbidities and longer hospital stay (7.2+/-5.6 versus 2.9+/-1.4 days; p<0.001). Delivery by CS and younger GA are risk factors for TTN. Although TTN is a self-limited disease, it is associated with significant morbidities. Scheduling elective CS at GA of not less than 38 weeks may decrease the frequency of TTN. PMID:16215925

  1. Copy Number Variants in Short Children Born Small for Gestational Age

    PubMed Central

    Wit, Jan M.; van Duyvenvoorde, Hermine A.; van Klinken, Jan B.; Caliebe, Janina; Bosch, Cathy A.J.; Lui, Julian C.; Gijsbers, Antoinet C.J.; Bakker, Egbert; Breuning, Martijn H.; Oostdijk, Wilma; Losekoot, Monique; Baron, Jeffrey; Binder, Gerhard; Ranke, Michael B.; Ruivenkamp, Claudia A.L.

    2014-01-01

    Background/aims In addition to Genome-Wide Association studies (GWAS) height-associated genes may be uncovered by studying individuals with extreme short or tall stature. Methods Genome-wide analysis for copy number variants (CNVs), using Single Nucleotide Polymorphism (SNP) arrays, was performed in 49 index cases born small for gestational age (SGA) with persistent short stature. Segregation analysis was performed, and genes in CNVs were compared with information from GWAS, gene expression in rodents’ growth plates, and published information. Results CNVs were detected in 13 cases. In 5 children a known cause of short stature was found: UPD7, UPD14, a duplication of the SHOX enhancer region, an IGF1R deletion, and a 22q11.21 deletion. In the remaining 8 cases potential pathogenic CNVs were detected, either de novo (n=1), segregating (n=2), or not segregating with short stature (n=5). Bioinformatic analysis of the de novo and segregating CNVs suggested that HOXD4, AGPS, PDE11A, OSBPL6, PRKRA and PLEKHA3, and possibly DGKB and TNFRSF11B are potential candidate genes. A SERPINA7 or NRK defect may be associated with an X-linked form of short stature. Conclusion SNP arrays detected 5 known causes of short stature with prenatal onset and suggested several potential candidate genes. PMID:25300501

  2. What is the relationship between gestational age and docosahexaenoic acid (DHA) and arachidonic acid (ARA) levels?

    PubMed

    Baack, Michelle L; Puumala, Susan E; Messier, Stephen E; Pritchett, Deborah K; Harris, William S

    2015-09-01

    Long chain polyunsaturated fatty acids (LCPUFA) including docosahexaenoic acid (DHA) and arachidonic acid (ARA) are increasingly transferred from mother to fetus late in pregnancy. Infants born before this transfer is complete are at risk for deficiency. This study determines the relationship between gestational age (GA) and circulating LCPUFA levels to better understand the unique needs of premature infants born at various GAs. Whole blood was collected within the first 7 days of life from 60 preterm (≤34 weeks GA) and 30 term infants (≥38 weeks GA) and FA levels were analyzed. Since concurrent intravenous lipid emulsion can skew composition data, blood LCPUFA concentrations were also measured. Levels were compared among groups, and linear regression models were used to examine the association between FA composition and GA. Preterm infants had significantly lower DHA and ARA levels than term peers, and whether assessed as concentrations or compositions, both directly correlated with GA (p<0.0001). Moreover, FA comparisons suggest that premature infants have impaired synthesis of LCPUFAs from precursors and may require preformed DHA and ARA. This study confirms that essential FA status is strongly related to GA, and that those babies born the earliest are at the greatest risk of LCPUFA deficiency. PMID:26205427

  3. Effects of cadmium, calcium, age and parity on bone mineral, density and strength in female rats

    SciTech Connect

    Hammond, B.F.

    1985-06-01

    Weanling female rats were fed diets containing one of three levels of calcium and one of four levels of cadmium in the drinking water. Approximately 10 animals from each group were sacrificed after the first pregnancy and the remaining animals after the fourth pregnancy. Reproductive performance, plasma and bone Ca and P and bone density and strength were measured. After the first pregnancy, offspring of dams treated with 5 or 10 ppM Cd were smaller at birth than offspring of dams treated with 0 or 1 ppM Cd. Offspring of dams fed 5 or 10 ppM Cd or the 0.3% Ca diet had decreased weaning weight regardless of parity. Cadmium treatment had no effect on the plasma Ca or the Ca-P ratio. At Cd levels of 5 or 10 ppM the plasma P was increased. The 0.3% Ca diet depressed the plasma Ca and the 0.9% Ca diet elevated the plasma Ca and depressed the plasma P when compared to the 0.6% diet. Parity did not affect plasma Ca but, after four pregnancies, plasma P was decreased. Plasma Ca of mature dams was higher than that of adolescent dams but plasma P was unaffected. Bone mineral, density and strength were decreased by the 0.3% Ca diet especially when Cd levels reached 10 ppM. Increasing dietary Ca above normal increased femur Ca of dams fed 1 ppM Cd but did not increase the Ca of the femur of dams given higher levels of Cd. After the first pregnancy, femur Ca of mature dams was greater than that of adolescent dams. After the fourth pregnancy, femurs of mature dams were less strong than those of adolescent dams; however, the density was the same. Increasing dietary Ca above 0.6% lessened the detrimental effects of 5 ppM Cd ingestion on bone density. Mature dams were less affected by the 0.3% Ca 10 ppM Cd treatment than were adolescent dams. 60 refs., 3 figs., 26 tabs.

  4. Female parity, maternal kinship, infant age and sex influence natal attraction and infant handling in a wild colobine (Colobus vellerosus).

    PubMed

    Bădescu, Iulia; Sicotte, Pascale; Ting, Nelson; Wikberg, Eva C

    2015-04-01

    Primate females often inspect, touch and groom others' infants (natal attraction) and they may hold and carry these infants in a manner resembling maternal care (infant handling). While natal attraction and infant handling occur in most wild colobines, little is known about the factors influencing the expression of these behaviors. We examined the effects of female parity, kinship, and dominance rank, as well as infant age and sex in wild Colobus vellerosus at Boabeng-Fiema Monkey Sanctuary, Ghana. We collected data via focal sampling of females in 2008 and 2009 (N = 61) and of infants in 2010 (N = 12). Accounting for the individuals who interacted with our focal subjects, this study includes 74 females and 66 infants in 8 groups. We recorded female agonistic interactions ad libitum to determine dominance ranks. We used partial pedigree information and genotypes at 17 short tandem repeat loci to determine kinship. We knew female parity, infant age and sex from demographic records. Nulliparous females showed more natal attraction and infant handling than parous females, which may suggest that interactions with infants are more adaptive for nulliparous females because they learn mothering skills through these behaviors. Compared to non-kin, maternal kin were more likely to handle infants. Maternal kin may be permitted greater access to infants because mothers are most familiar with them. Handlers may incur inclusive fitness benefits from infant handling. Dominance rank did not affect female interactions with infants. The youngest infants received the most natal attraction and infant handling, and male infants were handled more than female infants. The potential benefits of learning to mother and inclusive fitness, in combination with the relatively low costs of natal attraction and infant handling, may explain the high rates of these behaviors in many colobines. PMID:25399677

  5. ASSOCIATIONS OF BLOOD PRESSURE CHANGE IN PREGNANCY WITH FETAL GROWTH AND GESTATIONAL AGE AT DELIVERY: FINDINGS FROM A PROSPECTIVE COHORT

    PubMed Central

    Macdonald-Wallis, Corrie; Tilling, Kate; Fraser, Abigail; Nelson, Scott M; Lawlor, Debbie A

    2014-01-01

    Hypertensive disorders of pregnancy are associated with intrauterine growth restriction and preterm birth. However, the associations of patterns of blood pressure change during pregnancy with these outcomes have not been studied in detail. We studied repeat antenatal blood pressure measurements of 9,697 women in the Avon Longitudinal Study of Parents and Children (median (interquartile range) 10 (9, 11) measurements per woman). Bivariate linear spline models were used to relate blood pressure changes to perinatal outcomes. Higher systolic, but not diastolic, blood pressure at baseline (8 weeks gestation) and a greater increase in systolic and diastolic blood pressure between 18 and 36 weeks gestation were associated with lower offspring birthweight and being smaller for gestational age in confounder-adjusted models. For example, the mean difference (95% CI) in birthweight per 1 mmHg/week greater increase in systolic blood pressure between 18-30 weeks was −71g (−134, −14) and between 30-36 weeks was −175g (−208, −145). A smaller decrease in systolic and diastolic blood pressure prior to 18 weeks and a greater increase between 18 and 36 weeks was associated with a shorter gestation (percentage difference in gestational duration per 1 mmHg/week greater increase in systolic blood pressure between 18-30 weeks: −0.60% (−1.01, −0.18) and 30-36 weeks: −1.01% (−1.36, −0.74)). Associations remained strong when restricting to normotensive women. We conclude that greater increases in blood pressure, from the 18-week nadir, are related to reduced fetal growth and shorter gestation even in women whose blood pressure does not cross the threshold for hypertensive disorders of pregnancy. PMID:24821945

  6. Gestational Weight Gain and Overweight in Children Aged 3–6 Years

    PubMed Central

    Guo, Lianhong; Liu, Jufen; Ye, Rongwei; Liu, Jianmeng; Zhuang, Zhixiong; Ren, Aiguo

    2015-01-01

    Objective To determine whether gestational weight gain (GWG) was associated with increased odds of childhood overweight after accounting for pre-pregnancy BMI. Methods In a prospective cohort study based on a premarital and perinatal health care system in China, data of 100 612 mother-child pairs were obtained. The main exposure was GWG as both a continuous and categorical variable. The outcome measure was overweight, defined by age- and sex-specific cutoff values for body mass index (BMI) in children aged 3–6 years. Results A 1-kg increase in maternal GWG was associated with an increase of 0.009 (95% confidence interval [CI]: 0.007–0.010, P < 0.001) in children’s mean BMI; in the subgroup of pre-pregnancy overweight/obese mothers, the increase in children’s BMI was 0.028 (95% CI, 0.017–0.039, P < 0.001). Excessive GWG played an important role in childhood overweight when adequate GWG was used as the reference, with an odds ratio (OR) of 1.21 (95% CI, 1.12–1.29). The risk was highest (OR 2.22; 95% CI, 1.79–2.76) in the children of mothers who were overweight/obese before pregnancy and gained excessive weight during pregnancy. Conclusions Greater maternal GWG was associated with greater offspring BMI, and the risk of overweight was doubled in children whose mothers were overweight/obese before pregnancy and gained excessive weight during pregnancy. As a result, maintenance of appropriate weight gain during pregnancy and prophylaxis of maternal overweight/obesity before pregnancy should be a strategy for preventing childhood overweight/obesity. PMID:26119288

  7. Younger gestational age is associated with worse neurodevelopmental outcomes after cardiac surgery in infancy

    PubMed Central

    Goff, Donna A.; Luan, Xianqun; Gerdes, Marsha; Bernbaum, Judy; D’Agostino, Jo Ann; Rychik, Jack; Wernovsky, Gil; Licht, Daniel J.; Nicolson, Susan C.; Clancy, Robert R.; Spray, Thomas L.; Gaynor, J. William

    2013-01-01

    Objective Evaluate the impact of near-term delivery on neurodevelopmental (ND) outcomes in children with congenital heart disease (CHD). Methods Secondary analysis of data from a study of genetic polymorphisms and ND outcomes after cardiac surgery in infants. The effect of gestational age (GA) as a continuous variable on ND outcomes was evaluated using general linear regression models. GA was also evaluated as a categorical variable to seek a threshold for better outcomes. ND domains tested at 4 years of age included cognition, language skills, attention, impulsivity, memory, executive function, social competence, visual-motor, and fine-motor skills. Results ND outcomes and GA were available for 378 infants. Median GA was 39 weeks (range, 28–42 weeks) with 351 born at 36 weeks or more (near-term/term). In univariate analysis of the near-term/term subgroup, older GA predicted better performance for cognition, visual-motor, and fine-motor skills. After covariate adjustment, older GA predicted better performance for fine-motor skills (P = .018). Performance for cognition, language, executive function, social skills, visual-motor, and fine-motor skills was better for those born at 39 to 40 weeks of GA or more versus those born at less than 39 weeks (all P<.05). Conclusions These findings are consistent with the hypothesis that delivery before 39 to 40 weeks of GA is associated with worse outcomes in patients with CHD. Early delivery of a child with CHD is often indicated because of maternal or fetal health issues. In the absence of these concerns, these data suggest that elective (or spontaneous) delivery at 39 to 40 weeks of GA is associated with better ND outcomes. PMID:22340027

  8. Two-hit model of brain damage in the very preterm newborn: small for gestational age and postnatal systemic inflammation

    PubMed Central

    Leviton, Alan; Fichorova, Raina N.; O’Shea, T. Michael; Kuban, Karl; Paneth, Nigel; Dammann, Olaf; Allred, Elizabeth N.

    2013-01-01

    Background We sought to disentangle the contributions of perinatal systemic inflammation and small for gestational age (SGA) to the occurrence of low Bayley Mental Development Indices (MDIs) at age 2 years. Method We measured the concentration of 25 inflammation-related proteins in blood obtained during the first 2 postnatal weeks from 805 infants who were born before the 28th week of gestation and who had MDI measurements at age 2 years and were able to walk independently. Results SGA newborns who did not have systemic inflammation (a concentration of an inflammation-related protein in the top quartile for gestational age on 2 days a week apart) were at greater risk of an MDI < 55, but not 55–69, than their peers who had neither SGA nor systemic inflammation. SGA infants who had elevated blood concentrations of IL-1beta, TNF-alpha, or IL-8 during the first two postnatal weeks were at even higher risk of an MDI < 55 than their SGA peers without systemic inflammation and of their non-SGA peers with systemic inflammation. Conclusion SGA appears to place very preterm newborns at increased risk of a very low MDI. Systemic inflammation adds considerably to the increased risk. PMID:23364171

  9. Effects of cadmium, calcium, age and parity on bone mineral, density and strength in female rats

    SciTech Connect

    Hammond, B.F.

    1985-01-01

    Weanling female rats were fed diets containing one of three levels of Ca (0.3, 0.6, or 0.9%) and one of four levels of Cd (0, 1, 5, or 10 ppm) in the drinking water. One half of each group was fed first as adolescents (55 days) and the other half as mature (110 days) females. Approximately 10 animals from each group were sacrificed after the first pregnancy and the remaining animals after the fourth pregnancy. Reproductive performance, plasma and bone Ca and P and bone density and strength were measured. After the first pregnancy, offspring of dams treated with 5 or 10 ppm Cd were smaller at birth than offspring of dams treated with 0 or 1 ppm Cd. After the fourth pregnancy, the decreased birth weight was evident only in offspring of dams treated with 10 ppm Cd. Offspring of dams fed 5 or 10 ppm Cd or the 0.3% Ca diet had decreased weaning weight regardless of parity. A 0.3% Ca diet superimposed upon a 5 or 10 ppm Cd intake decreased weaning weight of the male offspring after the first, but not the fourth, pregnancy with the offspring of adolescent dams affected more than those of mature dams. Offspring of dams fed the 0.9% Ca diet did not differ in weaning weight from the offspring of dams fed the 0.6% Ca diet. The 0.3% Ca diet depressed the plasma Ca and the 0.9% Ca diet elevated the plasma Ca and depressed the plasma P when compared to the 0.6% diet.

  10. Developmental Correlates of Head Circumference at Birth and Two Years in a Cohort of Extremely Low Gestational Age Newborns

    PubMed Central

    Kuban, Karl C. K.; Allred, Elizabeth N.; O’Shea, T. Michael; Paneth, Nigel; Westra, Sjirk; Miller, Cindy; Rosman, N. Paul; Leviton, Alan

    2009-01-01

    Objectives To evaluate the developmental correlates of microcephaly evident at birth and at 2 years in a cohort born at extremely low gestational age. Methods We assessed development and motor function at 2 years of 958 children born before the 28th week of gestation, comparing those who had microcephaly at birth or 2 years with children with normal head circumference while considering the contribution of neonatal cranial ultrasound lesions. Results A total of 11% of infants in our sample had microcephaly at 2 years. Microcephaly at 2 years, but not at birth, predicts severe motor and cognitive impairments at 2 years. A total of 71% of children with congenital microcephaly had a normal head circumference at 2 years and had neurodevelopmental outcomes comparable with those with normal head circumference at birth and 2 years. Among children with microcephaly at 2 years, more than half had a Mental Developmental Index <70, and nearly a third had cerebral palsy. The risks were increased if the child also had cerebral white matter damage on a cranial ultrasound scan obtained 2 years previously. Conclusion Among extremely low gestational age newborns, microcephaly at 2 years, but not at birth, is associated with motor and cognitive impairment at age 2. PMID:19555967

  11. Aortic Intima-Media Thickness and Aortic Diameter in Small for Gestational Age and Growth Restricted Fetuses

    PubMed Central

    Gomez-Roig, M. Dolores; Mazarico, Edurne; Valladares, Esther; Guirado, Laura; Fernandez-Arias, Mireia; Vela, Antonio

    2015-01-01

    Objective The objective of this study is to measure aortic intima-media thickness (aIMT) and aortic diameter (AD) in appropriate for gestational age (AGA) fetuses, small for gestational age (SGA) fetuses, and intrauterine growth restricted (IUGR) fetuses. Methods Case-control study performed between June 2011 and June 2012. Forty-nine AGA fetuses, 40 SGA fetuses, and 35 IUGR fetuses underwent concomitant measurement of aIMT and AD at a mean gestational age of 34.4 weeks. Results Median aIMT was higher in fetuses with IUGR (0.504 mm [95%CI: 0.477-0.530 mm]), than in SGA fetuses (0.466 mm [95% CI: 0.447–0.485 mm]), and AGA fetuses (0.471 mm [95% CI: 0.454-0.488 mm]) (p = 0.023). Mean AD was significantly lower in fetuses with IUGR (4.451 mm [95% CI: 4.258–4.655 mm]), than in AGA fetuses (4.74 mm [95% CI: 4.63-4.843 mm]) (p = 0.028). Conclusions Growth restricted fetuses have a thicker aortic wall than AGA and SGA fetuses, which possibly represents preclinical atherosclerosis and a predisposition to later cardiovascular disease. PMID:26017141

  12. Blood glucose levels within 7 days after birth in preterm infants according to gestational age

    PubMed Central

    Yoon, Ju Young; Choi, Chang Won; Yang, Sei Won; Kim, Beyong Il; Shin, Choong Ho

    2015-01-01

    Purpose This study investigated blood glucose levels in preterm babies according to gestational age (GA). Methods Subjects were 141 preterm infants with a GA<34 weeks. Data on blood glucose levels, GA, body weight, glucose infusion rate, and other contributing factors in the first 7 days after birth were analyzed. Hypoglycemia was defined as a blood glucose level of <40 mg/dL up to 24 hours after birth and as <50 mg/dL thereafter. Hyperglycemia was defined as a blood glucose level >180 mg/dL. Results During the 7 days after birth, hypo- and hyperglycemia occurred in 29 (29 of 141, 20.6%) and 42 (42 of 141, 29.8%) neonates, respectively. During the first 2 hours, 18 neonates (12.8%) exhibited hypoglycemia, and only 2 (2 of 141, 1.4%) developed hyperglycemia. From 6 to 24 hours, hypo- and hyperglycemia were observed in 0 and 9 (9 of 141, 6.4%) neonates, respectively. Infants small for their GA (SGA) were at risk for hypoglycemia both within 24 hours (odds ratio [OR], 2.718; P=0.045) and during days 2 to 7 (OR, 4.454; P=0.006), and hyperglycemia during days 2 to 7 (OR, 3.200; P=0.005). Low 1-minite Apgar score was risk factor for both hypo- and hyperglycemia during days 2 to 7 (OR, 0.756; P=0.035 for hypoglycemia and OR, 0.789; P=0.016 for hyperglycemia). Both hypo- and hyperglycemia within 24 hours were less common in those who started feeding (OR, 0.294; P=0.013 for hypoglycemia and OR, 0.162; P=0.011 for hyperglycemia). Conclusion Careful blood glucose level monitoring is required in preterm infants, especially SGA infants or those with low Apgar score. Early feeding could be beneficial for maintaining euglycemia. PMID:26817008

  13. Effect of age and endometrial degenerative changes on uterine blood flow during early gestation in mares.

    PubMed

    Ferreira, J C; Canesin, H S; Ignácio, F S; Rocha, N S; Pinto, C R; Meira, C

    2015-10-15

    The present experiment was divided into three studies to investigate the effect of age and endometrial degeneration on uterine blood flow of mares. In study 1, the influence of semen infusion and conception was evaluated using noninseminated (non-AI), inseminated nonpregnant (AI-NP), and inseminated pregnant (AI-P) mares (n = 7 mares/group). In study 2, the effect of age was investigated using young (≤6 years), adult (from 8 to 12 years), and old (≥15 years) pregnant mares (n = 7 mares/group). In study 3, uterine blood flow was also characterized in pregnant mares (n = 7 mares/group) with minimal, moderate, or severe endometrial degenerative changes (GI, GII, and GIII, respectively). Uterine vascular perfusion and pulsatility index from mesometrium attachment arteries were recorded daily from Day 0 (day of ovulation) to Day 12 and between Days 0 and 20 in nonpregnant and pregnant mares. Analysis according to the position of the embryo (uterine horn with embryo vs. opposite horn) was performed from Day 12 until Day 20. In study 1, increased uterine vascular perfusion and decreased pulsatility index were detected (P < 0.001) between Days 3 and 5 in non-AI and AI-P mares, whereas the uterine vascular perfusion of AI-NP mares did not change (P > 0.05) throughout the experiment. In study 2, the vascular perfusion of the uterine horn with embryo was higher (P < 0.001) than in the opposite uterine horn from Day 12 until Day 20 in both young and adult mares. With exception of Day 15, both uterine horns of old mares showed similar (P > 0.1) vascular perfusion from Day 12. In study 3, vascular perfusion of both uterine horns was lower (P < 0.001) in GIII mares than in GI and GII mares. After Day 15, the scores for uterine vascular perfusion were consistently greater (P < 0.001) in the uterine horn with embryo than in the opposite horn in GI mares. Results showed, for the first time, the reduced blood flow of the gravid uterus during early gestation in older mares and in

  14. Does induction of labor for constitutionally large-for-gestational-age fetuses identified in utero reduce maternal morbidity?

    PubMed Central

    2014-01-01

    Background The number of infants with a birth weight > 97th percentile for gestational age has increased over the years. Although some studies have examined the interest of inducing labor for fetuses with macrosomia suspected in utero, only a few have analyzed this suspected macrosomia according to estimated weight at each gestational age. Most studies have focused principally on neonatal rather than on maternal (and still less on perineal) outcomes. The principal aim of this study was to assess whether a policy of induction of labor for women with a constitutionally large-for-gestational-age fetus might reduce the occurrence of severe perineal tears; the secondary aims of this work were to assess whether this policy would reduce either recourse to cesarean delivery during labor or neonatal complications. Methods This historical cohort study (n = 3077) analyzed records from a French perinatal database. Women without diabetes and with a cephalic singleton term pregnancy were eligible for the study. We excluded medically indicated terminations of pregnancy and in utero fetal deaths. Among the pregnancies with fetuses suspected, before birth, of being large-for-gestational-age, we compared those for whom labor was induced from ≥ 37 weeks to ≤ 38 weeks+ 6 days (n = 199) to those with expectant obstetrical management (n = 2878). In this intention-to-treat analysis, results were expressed as crude and adjusted relative risks. Results The mean birth weight was 4012 g ± 421 g. The rate of perineal lesions did not differ between the two groups in either primiparas (aRR: 1.06; 95% CI: 0.86-1.31) or multiparas (aRR: 0.94; 95% CI: 0.84-1.05). Similarly, neither the cesarean rate (aRR: 1.11; 95% CI: 0.82-1.50) nor the risks of resuscitation in the delivery room or of death in the delivery room or in the immediate postpartum or of neonatal transfer to the NICU (aRR = 0.94; 95% CI: 0.59-1.50) differed between the two groups. Conclusions A

  15. Effect of parents occupational exposures on risk of stillbirth, preterm delivery, and small-for-gestational-age in infants

    SciTech Connect

    Savitz, D.A.; Whelan, E.A.; Kleckner, R.C. )

    1989-06-01

    Epidemiologic research on the effects of parental occupational exposures on fetal development has been limited. The National Natality and Fetal Mortality surveys obtained applicable data of probability samples of live births and fetal deaths which occurred in the US in 1980 among married women. Analyses were conducted for case groups of stillbirths (2,096 mothers, 3,170 fathers), preterm deliveries (<37 weeks completed gestation) (363 mothers, 552 fathers), and small-for gestational-age infants (218 mothers, 371 fathers) compared with controls. Occupational exposures were defined by industry of employment and by imputed exposures based on a job-exposure linkage system. For stillbirth, maternal work in the rubber, plastics, and synthetics industry and lead exposure and paternal employment in the textile industry had the largest odds ratios. Preterm birth was most strongly associated with maternal lead exposure, corroborating previous findings. Twofold increased risk of preterm delivery was found with paternal employment in the glass, clay, and stone; textile; and mining industries. Paternal exposures to x-rays and polyvinyl alcohol were associated with 1.5-fold increase in risk. The occupation of the mother was not associated with delivery of a small-for-gestational-age infant, in contrast to paternal employment in the art and textile industries. Several toxic agents were associated with risk elevation of 1.3 or greater for fathers, most notably benzene.

  16. Nutritional plane and selenium supply during gestation impact yield and nutrient composition of colostrum and milk in primiparous ewes

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Objectives were to investigate effects of nutritional plane and Se supply during gestation on yield and nutrient composition of colostrum and milk in first parity ewes. Rambouillet ewe lambs (n = 84, age = 240 +/- 17 d, BW = 52.1 +/- 6.2 kg), were allocated to 6 treatments in a 2 x 3 factorial array...

  17. Association of Gestational Age at Birth with Reasons for Subsequent Hospitalisation: 18 Years of Follow-Up in a Western Australian Population Study

    PubMed Central

    Slimings, Claudia; Einarsdóttir, Kristjana; Burgner, David

    2015-01-01

    Background Preterm infants are at a higher risk of hospitalisation following discharge from the hospital after birth. The reasons for rehospitalisation and the association with gestational age are not well understood. Methods This was a retrospective birth cohort study of all live, singleton infants born in Western Australia between 1st January 1980 and 31st December 2010, followed to 18 years of age. Risks of rehospitalisation following birth discharge by principal diagnoses were compared for gestational age categories (<32, 32–33, 34–36, 37–38 weeks) and term births (39–41weeks). Causes of hospitalisations at various gestational age categories were identified using ICD-based discharge diagnostic codes. Results Risk of rehospitalisation was inversely correlated with gestational age. Growth-related concerns were the main causes for rehospitalisation in the neonatal period (<1 month of age) for all gestational ages. Infection was the most common reason for hospitalisation from 29 days to 1 year of age, and up to 5 years of age. Injury-related hospitalisations increased in prevalence from 5 years to 18 years of age. Risk of rehospitalisation was higher for all preterm infants for most causes. Conclusions The highest risks of rehospitalisation were for infection related causes for most GA categories. Compared with full term born infants, those born at shorter GA remain vulnerable to subsequent hospitalisation for a variety of causes up until 18 years of age. PMID:26114969

  18. Is there any difference between high-risk infants with different birth weight and gestational age in neurodevelopmental characters?

    PubMed Central

    Kara, Özgün Kaya; Günel, Mintaze Kerem; Açıkel, Cengizhan; Yiğit, Şule; Arslan, Mutluay

    2015-01-01

    Aim: This study is aimed to investigate differences between cognitive, language and motor development of high-risk infants related to birth weight and gestational age. Material and Methods: One hundred sixty high-risk infants who were born 32 weeks, 1 500 gr and below included in this study. According to corrected age, 58 infants were 1 month, 72 were at 4 months, 82 were at 8 months and 65 were 12 months old. Infants were seperated two groups according to gestational age <30 weeks and 30–32 weeks and birth weight ≤1 000 gr and 1 001–1 500 gr. Infants motor development were assessed with Bayley-III Infant and Toddler Development Motor Scale (Bayley-III) and Neuro Sensory Motor Developmental Scale (NSMDA), cognitif and lanuage development were Bayley-III cognitive and Language scales. Assessments were applied by the same physiotherapist at 1 month, 4 months, 8 months and 12 months old infants in corrected age. Mann-Whitney U Test, 2 x 2 Chi-Square test ve Fisher’s exact tests were used to compare group data. Statistical significance was determined p<0.05. Results: Cognitive, motor and language developments were in normal ranges in all infants. There were no statistical differences in cognitive, language and motor development between groups (p>0.05). Conclusion: Results of this study showed that the motor, cognitive and language development were normal in all high risk infants and power gestational age and birth weight did not affect these parametes. PMID:26568690

  19. Factors Affecting Vocabulary Acquisition at Age 2 in Children Born between 23 and 28 Weeks' Gestation

    ERIC Educational Resources Information Center

    Marston, Louise; Peacock, Janet L.; Calvert, Sandra A.; Greenough, Anne; Marlow, Neil

    2007-01-01

    Language development is often slower in preterm children compared with their term peers. We investigated factors associated with vocabulary acquisition at 2 years in a cohort of children born at 28 weeks' gestation or less. For children entered into the United Kingdom Oscillation Study, language development was evaluated by using the…

  20. A cross-sectional study on the relationship of age, gestational age and HIV infection to bacterial vaginosis and genital mycoplasma infection

    PubMed Central

    Redelinghuys, Mathys J; Ehlers, Marthie M; Dreyer, Andries W; Lombaard, Hennie; Olorunju, Steve A S; Kock, Marleen M

    2015-01-01

    Objectives Pregnant women are especially at risk of developing complications when infected with reproductive tract infections (RTIs). The objective of this study was to determine the prevalence of bacterial vaginosis (BV) and genital mycoplasmas in pregnant women and investigate the associations between BV, genital mycoplasmas, HIV infection, age and gestational age. Design Cross-sectional study with descriptive and analytical components. Setting Antenatal clinic of a tertiary academic hospital in South Africa. Participants 220 pregnant women older than 18 were included in the study and provided self-collected vaginal swabs. Primary and secondary outcomes BV and genital mycoplasma colonisation and/or infection in women of differing age, gestational period and HIV status. Results The prevalence of BV was 17.7% (39/220) (95% CI 12.9 to 23.4), intermediate vaginal flora (IVF) 15% (33/220) (95% CI 10.56 to 20.42), and the overall prevalence of genital mycoplasmas was 84% (185/220) (95% CI 78.47 to 88.58). BV was significantly associated with HIV infection with an OR of 2.84 (95% CI 1.08 to 7.46 and p value=0.034). However, BV was inversely associated with gestational age with an OR of 0.08 (95% CI 0.01 to 0.42 and p value=0.003) for second trimester pregnancies and an OR of 0.03 (95% CI 0.01 to 0.17 and p value<0.001) for third trimester pregnancies using the first trimester as reference. IVF was significantly associated with HIV infection with an OR of 2.7 (95% CI 1.07 to 6.79 and p value=0.035) but not with age or gestational age. Genital mycoplasmas were not significantly associated with age, gestational age, HIV status, BV flora or IVF. Conclusions The high infection rate of genital mycoplasmas and the association of BV with HIV found in this study reiterate the importance of screening for these RTIs in high-risk groups such as pregnant women. PMID:26482771

  1. The effect of gestational age on expression of genes involved in uptake, trafficking and synthesis of fatty acids in the rat placenta.

    PubMed

    Rodríguez-Cruz, Maricela; González, Raúl Sánchez; Maldonado, Jorge; López-Alarcón, Mardia; Bernabe-García, Mariela

    2016-10-15

    Gestation triggers a tight coordination among maternal tissues to provide fatty acids (FA) to the fetus through placental transport; however, there is insufficient evidence regarding regulation of proteins involved in placental transport of FA according to gestational age. The aim of this study was to determine the role of gestational age on the expression of genes involved in FA uptake, trafficking and synthesis in the rat placenta to support fetal demands. Gene expression of encoding proteins for placental transport and synthesis of FA was measured in placenta. Also, FA composition was measured in placenta, fetuses and newborns. mRNA expression of lipoprotein lipase (lpl) and fatp-1 (for uptake) was 4.4- and 1.43-fold higher, respectively, during late gestation than at P14, but expression of p-fabp-pm decreased 0.37-fold at late pregnancy in comparison with P14. Only mRNA fabp-4 member for trafficking of FA was 2.95-fold higher at late gestation than at P14. mRNA of fasn and elovl-6 participating in saturated FA and enzymes for the polyunsaturated FA synthesis were downregulated during late gestation and their regulator srebf-1c increased at P16. This study suggests that gestational age has an effect on expression of some genes involved in uptake, trafficking and synthesis of FA in the rat placenta; mRNA expression of lpl and, fatp-1 for uptake and fabp-4 implicated in trafficking was expressed at high levels at late gestation. In addition, placenta expresses the mRNAs involved in FA synthesis; these genes were expressed at low levels at late gestation. Additionally, mRNAs of Srebf-1c transcriptional regulator of desaturases and elongases was highly expressed during late gestation. Finally, these changes in the rat placenta allowed the placenta to partially supply saturated and monounsaturated FA to the fetus. PMID:27317891

  2. Effects of Prepregnancy Body Mass Index and Gestational Weight Gain on Pregnancy Outcomes.

    PubMed

    Zhang, Cui Hong; Liu, Xiang Yu; Zhan, Yi Wei; Zhang, Long; Huang, Yan Jie; Zhou, Hong

    2015-09-01

    To investigate the single and joint effects of prepregnancy body mass index (BMI) and gestational weight gain (GWG) on pregnancy outcomes, electronic medical records of 14,196 women who delivered singleton live infant at a maternal and child health hospital in Beijing, China, in 2012 were reviewed. Logistic regression was used to assess the associations, adjusting for maternal age, height, education, parity, and offspring sex. Women of high prepregnancy BMI or excessive GWG had higher risks of gestational diabetes mellitus, hypertensive disorders in pregnancy, postpartum hemorrhage, caesarean delivery, macrosomia, and large for gestational age infant, while women of inadequate GWG had higher risks of preterm delivery, low birth weight, and small for gestational age infant. Findings suggest that antenatal care providers should help pregnant women control their GWG to normal. PMID:26058899

  3. Movin' on Up: Socioeconomic Mobility and the Risk of Delivering a Small-for-Gestational Age Infant.

    PubMed

    Slaughter-Acey, Jaime C; Holzman, Claudia; Calloway, Danuelle; Tian, Yan

    2016-03-01

    Objective Poor fetal growth is associated with increased rates of adverse health outcomes in children and adults. The social determinants of poor fetal growth are not well understood. Using multiple socioeconomic indicators measured at the individual level, this study examined changes in maternal socioeconomic position (SEP) from childhood to adulthood (socioeconomic mobility) in relation to poor fetal growth in offspring. Methods Data were from the Pregnancy Outcomes and Community Health Study (September 1998-June 2004) that enrolled women in mid-pregnancy from 52 clinics in five Michigan communities (2463 women: 1824 non-Hispanic White, 639 non-Hispanic Black). Fetal growth was defined by birthweight-for-gestational age percentiles; infants with birthweight-for-gestational age <10th percentile were referred to as small-for-gestational age (SGA). In logistic regression models, mothers whose SEP changed from childhood to adulthood were compared to two reference groups, the socioeconomic group they left and the group they joined. Results Approximately, 8.2 % of women (non-Hispanic White: 6.3 %, non-Hispanic Black: 13.9 %) delivered an SGA infant. Upward mobility was associated with decreased risk of delivering an SGA infant. Overall, the SGA adjusted-odds ratio was 0.34 [95 % confidence interval (CI) 0.17-0.69] for women who moved from lower to middle/upper versus static lower class, and 0.44 (CI 0.28-1.04) for women who moved from middle to upper versus static middle class. There were no significant differences in SGA risk when women were compared to the SEP group they joined. Conclusions Our findings support a link between mother's socioeconomic mobility and SGA offspring. Policies that allow for the redistribution or reinvestment of resources may reduce disparities in rates of SGA births. PMID:26541591

  4. Spontaneous uterine rupture after abdominal myomectomy at the gestational age of 20 weeks in pregnancy: A case report

    PubMed Central

    Pakniat, Hamideh; Soofizadeh, Nasrin; Khezri, Marzieh Beigom

    2016-01-01

    Background: Uterine rupture in pregnancy is rare and often could be life threatening and catastrophic. Myomectomy is one of very common surgeries in gynecology, performed as the vaginal, abdominal and laparoscopic surgeries. Pregnancies occured after abdominal and laparoscopic myomectomy are high risk for uterine rapture. Case: Patient was a 28 Years old female, pregnant woman at the 20 wks of gestational age with abdominal pain and a history of abdominal myomectomy 6 yrs ago. Uterus was ruptured and fetus in amniotic sac was found in abdominal cavity. Conclusion: Early diagnosis of uterine rupture after myomectomy can save patients from death. PMID:27525334

  5. Infants born large-for-gestational-age display slower growth in early infancy, but no epigenetic changes at birth

    PubMed Central

    Chiavaroli, Valentina; Cutfield, Wayne S.; Derraik, José G. B.; Pan, Zengxiang; Ngo, Sherry; Sheppard, Allan; Craigie, Susan; Stone, Peter; Sadler, Lynn; Ahlsson, Fredrik

    2015-01-01

    We evaluated the growth patterns of infants born large-for-gestational-age (LGA) from birth to age 1 year compared to those born appropriate-for-gestational-age (AGA). In addition, we investigated possible epigenetic changes associated with being born LGA. Seventy-one newborns were classified by birth weight as AGA (10th–90th percentile; n = 42) or LGA (>90th percentile; n = 29). Post-natal follow-up until age 1 year was performed with clinical assessments at 3, 6, and 12 months. Genome-wide DNA methylation was analysed on umbilical tissue in 19 AGA and 27 LGA infants. At birth, LGA infants had greater weight (p < 0.0001), length (p < 0.0001), ponderal index (p = 0.020), as well as greater head (p < 0.0001), chest (p = 0.044), and abdominal (p = 0.007) circumferences than AGA newborns. LGA infants were still larger at the age of 3 months, but by age 6 months there were no more differences between groups, due to higher length and weight increments in AGA infants between 0 and 6 months (p < 0.0001 and p = 0.002, respectively). Genome-wide analysis showed no epigenetic differences between LGA and AGA infants. Overall, LGA infants had slower growth in early infancy, being anthropometrically similar to AGA infants by 6 months of age. In addition, differences between AGA and LGA newborns were not associated with epigenetic changes. PMID:26419812

  6. Circulating GLP-1 in infants born small-for-gestational-age: breast-feeding versus formula-feeding.

    PubMed

    Díaz, M; Bassols, J; Sebastiani, G; López-Bermejo, A; Ibáñez, L; de Zegher, F

    2015-10-01

    Prenatal growth restraint associates with the risk for later diabetes, particularly if such restraint is followed by postnatal formula-feeding (FOF) rather than breast-feeding (BRF). Circulating incretins can influence the neonatal programming of hypothalamic setpoints for appetite and energy expenditure, and are thus candidate mediators of the long-term effects exerted by early nutrition. We have tested this concept by measuring (at birth and at age 4 months) the circulating concentrations of glucagon-like peptide-1 (GLP-1) in BRF infants born appropriate-for-gestational-age (AGA; n=63) and in small-for-gestational-age (SGA) infants receiving either BRF (n=28) or FOF (n=26). At birth, concentrations of GLP-1 were similar in AGA and SGA infants. At 4 months, pre-feeding GLP-1 concentrations were higher than at birth; SGA-BRF infants had GLP-1 concentrations similar to those in AGA-BRF infants but SGA-FOF infants had higher concentrations. In conclusion, nutrition appears to influence the circulating GLP-1 concentrations in SGA infants and may thereby modulate long-term diabetes risk. PMID:26088812

  7. Gestational gigantomastia

    PubMed Central

    John, Mary K; Rangwala, Tasneem Husaini

    2009-01-01

    A case of massive hypertrophy of the breasts in pregnancy was seen in our institution, which is a tertiary referral centre for the United Arab Emirates region with a delivery rate of 7000/year. It is a very rare condition (1 in 100000) and the only case seen in our hospital over the past 20 years. No similar case has been reported from the United Arab Emirates or Gulf regions, to our knowledge. The patient presented at a gestational age of 18 weeks on account of progressive swelling of the breasts which started at 14 weeks’ gestation. In pregnancy she was managed conservatively with analgesics, bromocriptine and breast support. She had bilateral reduction mammoplasty 1 year after delivery. The outcome was satisfactory, and the patient was pleased with the cosmetic result. PMID:21686430

  8. Utility of First Trimester Ultrasonography before 11 Weeks of Gestation: A Retrospective Study

    PubMed Central

    Celen, Sevki; Dover, Necmiye; Seckin, Berna; Goker, Ufuk; Yenicesu, Okan; Danisman, Nuri

    2012-01-01

    We showed the utility of first trimester ultrasonography before 11 weeks of gestation for antenatal followup. We retrospectively analyzed 1295 records of patients who underwent first trimester ultrasonography (transvaginal/abdominal) in our antenatal clinic in Ankara, Turkey. Maternal age, parity, gestational age, and maternal gestational history were compared with ultrasonographic findings. Patients were divided into 12 groups based on ultrasonographic diagnoses in the first ultrasonographic scan, and called for a control examination within 10 days if the diagnostic findings were abnormal. The data were statistically analyzed using Kruskal-Wallis and chi-square tests. We noted 81.3% patients to have single, viable, intrauterine pregnancies, while 18.7% had abnormal or complicated pregnancies with uterine anomalies, ovarian cysts, fibroids, or subchorionic hematomas. Normal and anembryonic pregnancies had significantly lower median diagnostic period in the control ultrasonography than in the first examination. First trimester ultrasonography before 11 weeks of gestation is valuable in determining pregnancy outcomes. PMID:23097712

  9. Sleep Apnea in Early Childhood Associated with Preterm Birth but Not Small for Gestational Age: A Population-Based Record Linkage Study

    PubMed Central

    Raynes-Greenow, Camille H.; Hadfield, Ruth M.; Cistulli, Peter A.; Bowen, Jenny; Allen, Hugh; Roberts, Christine L.

    2012-01-01

    Study Objectives: Investigate the relationship between gestational age and weight for gestational age and sleep apnea diagnosis in a cohort of children aged up to 6 years old. Design: A cohort study, using record linked population health data. Setting: New South Wales, Australia. Participants: 398,961 children, born between 2000 and 2004, aged 2.5 to 6 years. Measurements: The primary outcome was sleep apnea diagnosis in childhood, first diagnosed between 1 and 6 years of age. Children with sleep apnea were identified from hospital records with the ICD-10 code G47.3: sleep apnea, central or obstructive. Results: A total of 4,145 (1.0%) children with a first diagnosis of sleep apnea were identified. Mean age at first diagnosis was 44.2 months (SD 13.9). Adenoidectomy, tonsillectomy, or both were common among the children diagnosed with sleep apnea (85.6%). Children born preterm compared to term were significantly more likely to be diagnosed with sleep apnea (< 32 weeks versus term hazard ratio 2.74 [95% CI: 2.16, 3.49]) this remained even after adjustment for known confounding variables. Children born small for gestational age were not at increased risk of sleep apnea compared to children born appropriate for gestational age, hazard ratio 0.95 (95% CI 0.86-1.06). Conclusions: This is the largest study investigating preterm birth and sleep apnea diagnosis and suggests that diagnosis of sleep disordered breathing is more prevalent in children born preterm, but not those who are small for gestational age. Citation: Raynes-Greenow CH; Hadfield RM; Cistulli PA; Bowen J; Allen H; Roberts CL. Sleep apnea in early childhood associated with preterm birth but not small for gestational age: a population-based record linkage study. SLEEP 2012;35(11):1475-1480. PMID:23115396

  10. Systemic Inflammation Associated with Severe Intestinal Injury in Extremely Low Gestational Age Newborns

    PubMed Central

    Martin, Camilia R.; Bellomy, Melissa; Allred, Elizabeth N.; Fichorova, Raina N.; Leviton, Alan

    2014-01-01

    To define the role of systemic inflammation in infants with intestinal perforation (IP) and necrotizing enterocolitis (NEC), we measured 25 blood protein concentrations on days 1, 7, and 14 in 939 infants born before 28 weeks’ gestation. On days 7 and 14, infants with NEC had elevated levels of CRP, serum amyloid A (SAA), IL-6, and IL-8. Infants with IP had elevated levels of CRP and insulin growth factor binding protein-1 on day 7 and elevated CRP, SAA, TNF-receptor-2, and matrix metalloproteinase-9 levels on day 14. A better understanding of systemic inflammation might help prevent and treat these disorders. PMID:23002960

  11. Effects of gestational age and surface modification on materno-fetal transfer of nanoparticles in murine pregnancy

    NASA Astrophysics Data System (ADS)

    Yang, Hui; Sun, Cuiji; Fan, Zhenlin; Tian, Xin; Yan, Liang; Du, Libo; Liu, Yang; Chen, Chunying; Liang, Xing-Jie; Anderson, Gregory J.; Keelan, Jeffrey A.; Zhao, Yuliang; Nie, Guangjun

    2012-11-01

    Nanoparticle exposure in pregnancy may result in placental damage and fetotoxicity; however, the factors that determine fetal nanoparticle exposure are unclear. Here we have assessed the effect of gestational age and nanoparticle composition on fetal accumulation of maternally-administered nanomaterials in mice. We determined the placental and fetal uptake of 13 nm gold nanoparticles with different surface modifications (ferritin, PEG and citrate) following intravenous administration at E5.5-15.5. We showed that prior to E11.5, all tested nanoparticles could be visualized and detected in fetal tissues in significant amounts; however, fetal gold levels declined dramatically post-E11.5. In contrast, Au-nanoparticle accumulation in the extraembryonic tissues (EET) increased 6-15 fold with gestational age. Fetal and EET accumulation of ferritin- and PEG-modified nanoparticles was considerably greater than citrate-capped nanoparticles. No signs of toxicity were observed. Fetal exposure to nanoparticles in murine pregnancy is, therefore, influenced by both stage of embryonic/placental maturation and nanoparticle surface composition.

  12. Birth Weight, Birth Length, and Gestational Age as Indicators of Favorable Fetal Growth Conditions in a US Sample

    PubMed Central

    Bollen, Kenneth A.

    2016-01-01

    The “fetal origins” hypothesis suggests that fetal conditions not only affect birth characteristics such as birth weight and gestational age, but also have lifelong health implications. Despite widespread interest in this hypothesis, few methodological advances have been proposed to improve the measurement and modeling of fetal conditions. A Statistics in Medicine paper by Bollen, Noble, and Adair examined favorable fetal growth conditions (FFGC) as a latent variable. Their study of Filipino children from Cebu provided evidence consistent with treating FFGC as a latent variable that largely mediates the effects of mother’s characteristics on birth weight, birth length, and gestational age. This innovative method may have widespread utility, but only if the model applies equally well across diverse settings. Our study assesses whether the FFGC model of Cebu replicates and generalizes to a very different population of children from North Carolina (N = 705) and Pennsylvania (N = 494). Using a series of structural equation models, we find that key features of the Cebu analysis replicate and generalize while we also highlight differences between these studies. Our results support treating fetal conditions as a latent variable when researchers test the fetal origins hypothesis. In addition to contributing to the substantive literature on measuring fetal conditions, we also discuss the meaning and challenges involved in replicating prior research. PMID:27097023

  13. Initial evidence that polymorphisms in neurotransmitter-regulating genes contribute to being born small for gestational age

    PubMed Central

    Morgan, Angharad R.; Thompson, John M.D.; Waldie, Karen E.; Cornforth, Christine M.; Turic, Darko; Sonuga-Barke, Edmund J.S.; Lam, Wen-Jiun; Ferguson, Lynnette R.; Mitchell, Edwin A.

    2012-01-01

    Being born small for gestational age (SGA) is a putative risk factor for the development of later cognitive and psychiatric health problems. While the inter-uterine environment has been shown to play an important role in predicting birth weight, little is known about the genetic factors that might be important. Here we test the hypothesis that neurotransmitter-regulating genes implicated in psychiatric disorders previously shown to be associated with SGA (such as attention-deficit hyperactivity disorder) are themselves predictive of SGA. DNA was collected from 227 SGA and 319 appropriate for gestational age children taking part in the Auckland Birthweight Collaborative Study. Candidate single nucleotide polymorphisms in genes regulating activity within dopamine, serotonin, glutamate and gamma-aminobutyric acid pathways were genotyped. Multiple regression analysis, controlling for potentially confounding factors, supported nominally significant associations between SGA and single nucleotide polymorphisms in COMT, HTR2A, SLC1A1 and SLC6A1. This is the first evidence that genes implicated in psychiatric disorders previously linked to SGA status themselves predict SGA. This highlights the possibility that the link between SGA and psychiatric disorders such as attention-deficit hyperactivity disorder may in part be genetically determined – that SGA marks pre-existing genetic risk for later problems.

  14. Placental DNA methylation alterations associated with maternal tobacco smoking at the RUNX3 gene are also associated with gestational age

    PubMed Central

    Maccani, Jennifer ZJ; Koestler, Devin C; Houseman, Eugene Andrés; Marsit, Carmen J; Kelsey, Karl T

    2014-01-01

    Aims The developmental origins of health and disease hypothesis states that later-life disease may be influenced by the quality of the in utero environment. Environmental toxicants can have detrimental effects on fetal development, potentially through effects on placental development and function. Maternal smoking during pregnancy is associated with low birth weight, preterm birth and other complications, and exposure to cigarette smoke in utero has been linked to gross pathologic and molecular changes to the placenta, including differential DNA methylation in placental tissue. The aim of this study was to investigate the relationship between maternal smoking during pregnancy, methylation changes in the placenta and gestational age. Materials & methods We used Illumina®’s (CA, USA) Human Methylation27 BeadChip technology platform to investigate the methylation status of 21,551 autosomal, non-SNP-associated CpG loci in DNA extracted from 206 human placentas and examined loci whose variation in methylation was associated with maternal smoking during pregnancy. Results We found that methylation patterns of a number of loci within the RUNX3 gene were significantly associated with smoking during pregnancy, and one of these loci was associated with decreased gestational age (p = 0.04). Conclusion Our findings, demonstrating maternal smoking-induced changes in DNA methylation at specific loci, suggest a mechanism by which in utero tobacco smoke exposure could exert its detrimental effects upon the health of the fetus. PMID:24283877

  15. The Effects of Antenatal Corticosteroids on Short- and Long-Term Outcomes in Small-for-Gestational-Age Infants

    PubMed Central

    Ishikawa, Hiroshi; Miyazaki, Ken; Ikeda, Tomoaki; Murabayashi, Nao; Hayashi, Kazutoshi; Kai, Akihiko; Ishikawa, Kaoru; Miyamoto, Yoshihiro; Nishimura, Kunihiro; Kono, Yumi; Kusuda, Satoshi; Fujimura, Masanori

    2015-01-01

    Aim: To evaluate the effect of antenatal corticosteroids (ANS) on short- and long-term outcomes in small-for-gestational age (SGA) infants. Methods: A retrospective database analysis was performed. A total of 1,931 single infants (birth weight <1,500 g) born at a gestational age between 22 weeks and 33 weeks 6 days who were determined to be SGA registered in the Neonatal Research Network Database in Japan between 2003 and 2007 were evaluated for short-term outcome and long-term outcome. Results: ANS was administered to a total of 719 infants (37%) in the short-term outcome evaluation group and 344 infants (36%) in the long-term outcome evaluation group. There were no significant differences between the ANS group and the no-ANS group for primary short-term outcome (adjusted odds ratio (OR) 0.73; 95% confidence interval (CI) 0.45-1.20; P-value 0.22) or primary long-term outcome (adjusted OR 0.69; 95% CI 0.40-1.17; P-value 0.17). Conclusions: Our results show that ANS does not affect short- or long-term outcome in SGA infants when the birth weight is less than 1500 g. This study strongly suggests that administration of ANS resulted in few benefits for preterm FGR fetuses. PMID:25897289

  16. PREECLAMPSIA AND SMALL FOR GESTATIONAL AGE ARE ASSOCIATED WITH DECREASED CONCENTRATIONS OF A FACTOR INVOLVED IN ANGIOGENESIS: SOLUBLE TIE-2

    PubMed Central

    Gotsch, Francesca; Romero, Roberto; Kusanovic, Juan Pedro; Chaiworapongsa, Tinnakorn; Dombrowski, Michael; Erez, Offer; Than, Nandor Gabor; Mazaki-Tovi, Shali; Mittal, Pooja; Espinoza, Jimmy; Hassan, Sonia S

    2009-01-01

    OBJECTIVE An anti-angiogenic state has been described in patients with preeclampsia, small for gestational age (SGA) fetuses and fetal death, and changes in the concentration of circulating angiogenic and anti-angiogenic factors can precede the clinical recognition of preeclampsia and small for gestational age by several weeks. Gene deletion studies demonstrate that a selective group of endothelial growth factors are required for vascular development, including members of the vascular endothelial growth factor (VEGF) family, as well as Angiopoietin-1 and Angiopoietin-2, both ligands for the tyrosine kinase endothelial cell receptor Tie-2. These angiogenic factors have been proposed to promote angiogenesis in a coordinated and complementary fashion. Soluble Tie-2 (sTie-2) is the soluble form of the Tie-2 receptor which is detectable in biological fluids. The purpose of this study was to determine whether patients with preeclampsia and mothers who deliver a small for gestational age neonate have changes in the plasma concentrations of sTie-2. STUDY DESIGN This cross-sectional study included patients in the following groups: 1) non-pregnant women (n=40); 2) women with normal pregnancies (n=135); 3) patients with preeclampsia (n=112); and 4) patients who delivered a small for gestational age (SGA) neonate (n=53). Maternal plasma concentrations of sTie-2 were measured by a sensitive immunoassay. Parametric statistics were used for analysis. RESULTS 1) The median maternal plasma concentration of sTie-2 was lower in normal pregnant women than in non-pregnant women [median 16.0 ng/ml (range 5.0–71.6) vs. median 20.7 ng/ml (range 10.8–52.4), respectively; p=0.01)]; 2) Plasma sTie-2 concentrations in normal pregnancy changed significantly as a function of gestational age; 3) Patients with preeclampsia and those who delivered SGA neonates had a lower median maternal plasma concentration of sTie-2 than those with a normal pregnancy [Preeclampsia: median 14.9 ng/ml (range 4

  17. The effect of hypertensive disorders in pregnancy on small for gestational age and stillbirth: a population based study.

    PubMed

    Allen, Victoria M; Joseph, KS; Murphy, Kellie E; Magee, Laura A; Ohlsson, Arne

    2004-08-01

    BACKGROUND: Hypertensive disorders in pregnancy are leading causes of maternal, fetal and neonatal morbidity and mortality worldwide. However, studies attempting to quantify the effect of hypertension on adverse perinatal outcomes have been mostly conducted in tertiary centres. This population-based study explored the frequency of hypertensive disorders in pregnancy and the associated increase in small for gestational age (SGA) and stillbirth. METHODS: We used information on all pregnant women and births, in the Canadian province of Nova Scotia, between 1988 and 2000. Pregnancies were excluded if delivery occurred < 20 weeks, if birthweight was < 500 grams, if there was a high-order multiple pregnancy (greater than twin gestation), or a major fetal anomaly. RESULTS: The study population included 135,466 pregnancies. Of these, 7.7% had mild pregnancy-induced hypertension (PIH), 1.3% had severe PIH, 0.2% had HELLP (hemolysis, elevated liver enzymes, low platelets), 0.02% had eclampsia, 0.6% had chronic hypertension, and 0.4% had chronic hypertension with superimposed PIH. Women with any hypertension in pregnancy were 1.6 (95% CI 1.5-1.6) times more likely to have a live birth with SGA and 1.4 (95% CI 1.1-1.8) times more likely to have a stillbirth as compared with normotensive women. Adjusted analyses showed that women with gestational hypertension without proteinuria (mild PIH) and with proteinuria (severe PIH, HELLP, or eclampsia) were more likely to have infants with SGA (RR 1.5, 95% CI 1.4-1.6 and RR 3.2, 95% CI 2.8-3.6, respectively). Women with pre-existing hypertension were also more likely to give birth to an infant with SGA (RR 2.5, 95% CI 2.2-3.0) or to have a stillbirth (RR 3.2, 95% CI 1.9-5.4). CONCLUSIONS: This large, population-based study confirms and quantifies the magnitude of the excess risk of small for gestational age and stillbirth among births to women with hypertensive disease in pregnancy. PMID:15298717

  18. Metabolism of medium- and long-chain fatty acids by isolated hepatocytes from small-for-gestational-age (SGA) and appropriate for-gestational-age (AGA) piglets

    SciTech Connect

    Odle, J.; Benevenga, N.J.; Crenshaw, T.D. )

    1990-02-26

    Hepatocytes were isolated from full-term, SGA and AGA piglets at 6 or 48 hours postpartum and were incubated with 1 mM (1-{sup 14}C)-octanoate (C8), -nonanoate (C9) or-oleate (C18:1). The cells oxidized (natom 1-C/(h 10{sup 6} cells)) C9 to Co{sub 2} (12.5) and acid soluble products (28.9) faster than C8 (10.9, 20.6, respectively), and both were oxidized faster than C18:1 (3.9, 9.9) regardless of the piglet age or weight. Oleate accumulated in lipid products 8-fold faster than C8 and C9. No differences between cells from SGA and AGA piglets were detected. Recovery of 1-C in CO{sub 2} was 48% higher in incubations with cells from 48 hours old than from 6 hour old piglets. This increase was attributable to a 70% higher oxygen consumption by 48 hour old cells. Theoretical oxygen consumption rates were computed from the fatty acid flux data and compared to measured oxygen consumption. hepatocytes from SGA and AGA piglets were equally capable of satisfying more that 57% of their energy needs from fatty acid oxidation. The oxygen consumption attributable to C9 metabolism was 30% higher than observed for C8 and C18:1. All fatty acids apparently spared endogenous fuels to a greater degree in 6 hour than in 48 hour piglets.

  19. Chronic Lung Disease and Developmental Delay at 2 Years of Age in Children Born Before 28 Weeks' Gestation

    PubMed Central

    Laughon, Matthew; O'Shea, Michael T.; Allred, Elizabeth N.; Bose, Carl; Kuban, Karl; Van Marter, Linda J.; Ehrenkranz, Richard A.; Leviton, Alan

    2009-01-01

    Introduction Extremely low gestational age newborns (ELGANs) are at increased risk of chronic lung disease (CLD) and of developmental delay. Some studies have suggested that CLD contributes to developmental delay. Patients and Methods We examined data collected prospectively on 915 infants born before the 28th week of gestation in 2002–2004 who were assessed at 24 months of age with the Bayley Scales of Infant Development-2nd Edition or the Vineland Adaptive Behavior Scales. We excluded infants who were not able to walk independently (Gross Motor Function Classification System score < 1) and, therefore, more likely to have functionally important fine motor impairments. We defined CLD as receipt of oxygen at 36 weeks' postmenstrual age and classified infants as either not receiving mechanical ventilation (MV) (CLD without MV) or receiving MV (CLD with MV). Results Forty-nine percent of ELGANs had CLD; of these, 14% were receiving MV at 36 weeks' postmenstrual age. ELGANs without CLD had the lowest risk of a Mental Developmental Index (MDI) or a Psychomotor Developmental Index (PDI) of <55, followed by ELGANs with CLD not receiving MV, and ELGANs with CLD receiving MV (9%, 12%, and 18% for the MDI and 7%, 10%, and 20% for the PDI, respectively). In time-oriented multivariate models, the risk of an MDI of <55 was associated with the following variables: gestational age of <25 weeks; single mother; late bacteremia; pneumothorax; and necrotizing enterocolitis. The risk of a PDI of <55 was associated with variables such as single mother, a complete course of antenatal corticosteroids, early and persistent pulmonary dysfunction, pulmonary deterioration during the second postnatal week, pneumothorax, and pulmonary interstitial emphysema. CLD, without or with MV, was not associated with the risk of either a low MDI or a low PDI. However, CLD with MV approached, but did not achieve, nominal statistical significance (odds ratio: 1.9 [95% confidence interval: 0.97–3

  20. Dietary intake in young adults born small or appropriate for gestational age: data from the Haguenau cohort

    PubMed Central

    Matta, Joane; Carette, Claire; Levy Marchal, Claire; Bertrand, Julien; Pétéra, Mélanie; Zins, Marie; Pujos-Guillot, Estelle; Comte, Blandine; Czernichow, Sébastien

    2016-01-01

    Objectives Compare the dietary intake of young adults born small for gestational age (SGA) versus those born appropriate for gestational age (AGA). Design Cross-sectional analysis. Setting Data at the 8-year follow-up Haguenau cohort (France). Data from 229 AGA-born adults and 172 SGA-born adults with available dietary information are presented. Methods Dietary intake was based on a food questionnaire including 19 items. The χ2 test was run to compare intake between SGA-born and AGA-born individuals. An a priori score was calculated based on the adherence to recommendations from the French Nutrition and Health Program and included 8 components with the lowest value indicating a lower adherence to recommendations. The score was then divided into quartiles. Relative risks and 95% CIs, controlling for age and sex in multivariate analysis, were calculated in order to determine the risk of belonging to the first versus the second to the fourth quartiles in SGA-born and AGA-born individuals. Results Intakes of SGA-born adults indicated that they consumed more meat, sugar and less fish than AGA-born individuals (all p<0.05). Multivariate analyses with adjustment for age and sex showed that the relative risk of belonging to the first quartile versus the other three quartiles did not disclose any significant difference in SGA-born versus AGA-born participants: RR=0.92 (95% CI 0.65 to 1.30). Conclusions Aside from the differences found by univariate analyses, no significant differences were obtained in multivariate analyses. Findings suggest that parameters of fetal programming are more associated with the development of metabolic syndrome in adulthood rather than dietary patterns. PMID:27473954

  1. Decorin expression is decreased in first trimester placental tissue from pregnancies with small for gestation age infants at birth.

    PubMed

    Murthi, P; van Zanten, D E; Eijsink, J J H; Borg, A J; Stevenson, J L; Kalionis, B; Chui, A K; Said, J M; Brennecke, S P; Erwich, J J H M

    2016-09-01

    Fetal growth restriction (FGR) is a leading cause of perinatal morbidity and mortality. FGR pregnancies are often associated with histological evidence of placental vascular thrombosis. The proteoglycans are important components and regulators of vascular homeostasis. Previous studies from our laboratory highlighted mRNA and protein expression differences in placental proteoglycan decorin (DCN), within a clinically well-characterised cohort of third-trimester idiopathic FGR compared with gestation-matched uncomplicated control pregnancies. We also showed that decorin contributes to abnormal angiogenesis and increased thrombin generation in vitro. These observations suggest that DCN gene expression may contribute to the etiology of FGR. Small for gestational age (SGA) is frequently used as a proxy for FGR and is defined as a birth weight below the 10th percentile of a birth weight curve. We therefore made use of a unique resource of first trimester tissues obtained via chorionic villus sampling during the first trimester to investigate the temporal relationship between altered DCN expression and any subsequent development of SGA. We hypothesized that placental DCN expression is decreased early in gestation in SGA pregnancies. Surplus chorionic villus specimens from 15 women subsequently diagnosed with FGR and 50 from women with uncomplicated pregnancies were collected. DCN mRNA and DCN protein were determined using real-time PCR and immunoblotting, respectively. Both DCN mRNA and protein were significantly decreased in placentae from first-trimester SGA-pregnancies compared with controls (p < 0.05). This is the first study to report a temporal relationship between altered placental DCN expression and subsequent development of SGA. PMID:27577711

  2. Umbilical Cord Mesenchymal Stromal Cells Affected by Gestational Diabetes Mellitus Display Premature Aging and Mitochondrial Dysfunction

    PubMed Central

    Kim, Jooyeon; Piao, Ying; Pak, Youngmi Kim; Chung, Dalhee; Han, Yu Mi; Hong, Joon Seok; Jun, Eun Jeong; Shim, Jae-Yoon

    2015-01-01

    Human umbilical cord mesenchymal stromal cells (hUC-MSCs) of Wharton's jelly origin undergo adipogenic, osteogenic, and chondrogenic differentiation in vitro. Recent studies have consistently shown their therapeutic potential in various human disease models. However, the biological effects of major pregnancy complications on the cellular properties of hUC-MSCs remain to be studied. In this study, we compared the basic properties of hUC-MSCs obtained from gestational diabetes mellitus (GDM) patients (GDM-UC-MSCs) and normal pregnant women (N-UC-MSCs). Assessments of cumulative cell growth, MSC marker expression, cellular senescence, and mitochondrial function-related gene expression were performed using a cell count assay, senescence-associated β-galactosidase staining, quantitative real-time reverse transcription–polymerase chain reaction, immunoblotting, and cell-based mitochondrial functional assay system. When compared with N-UC-MSCs, GDM-UC-MSCs showed decreased cell growth and earlier cellular senescence with accumulation of p16 and p53, even though they expressed similar levels of CD105, CD90, and CD73 MSC marker proteins. GDM-UC-MSCs also displayed significantly lower osteogenic and adipogenic differentiation potentials than N-UC-MSCs. Furthermore, GDM-UC-MSCs exhibited a low mitochondrial activity and significantly reduced expression of the mitochondrial function regulatory genes ND2, ND9, COX1, PGC-1α, and TFAM. Here, we report intriguing and novel evidence that maternal metabolic derangement during gestation affects the biological properties of fetal cells, which may be a component of fetal programming. Our findings also underscore the importance of the critical assessment of the biological impact of maternal–fetal conditions in biological studies and clinical applications of hUC-MSCs. PMID:25437179

  3. The risk of prematurity and small-for-gestational-age birth in Mexico City: the effects of working conditions and antenatal leave.

    PubMed Central

    Cerón-Mireles, P; Harlow, S D; Sánchez-Carrillo, C I

    1996-01-01

    OBJECTIVES: This study examined the effect of working conditions, occupational stress, and antenatal leave on risk of small-for-gestational age and premature births in Mexico City. METHODS: Over a 3-month period, 2663 (96.2%) of 2767 women who gave birth at three major hospitals and worked at least 3 months during pregnancy were interviewed shortly after delivery. After the exclusion of multiple gestations and birth defects, 261 (10.0%) small-for-gestational-age and 288 (11.0%) preterm births were identified. RESULTS: For small-for-gestational-age births, working more than 50 hours a week (odds ratio [OR] = 1.59), standing more than 7 hours a day (OR = 1.40), and no antenatal leave (OR = 1.55) were associated with an increased risk. Women with no antenatal leave were also much more likely to give birth prematurely (OR = 3.04). CONCLUSIONS: In this study, arduous working conditions and lack of antenatal leave benefits were found to increase the risk of poor birth outcome in Mexican women. Enforcement of existing antenatal leave laws and provision of comparable benefits for the uninsured may reduce the incidence of small-for-gestational-age births and prematurity. PMID:8659657

  4. Associations between prenatal exposure to air pollution, small for gestational age, and term low birthweight in a state-wide birth cohort.

    PubMed

    Vinikoor-Imler, Lisa C; Davis, J Allen; Meyer, Robert E; Messer, Lynne C; Luben, Thomas J

    2014-07-01

    A range of health effects, including adverse pregnancy outcomes, have been associated with exposure to ambient concentrations of particulate matter (PM) and ozone (O3). The objective of this study was to determine whether maternal exposure to fine particulate matter (PM2.5) and O3 during pregnancy is associated with the risk of term low birthweight and small for gestational age infants in both single and co-pollutant models. Term low birthweight and small for gestational age were determined using all birth certificates from North Carolina from 2003 to 2005. Ambient air concentrations of PM2.5 and O3 were predicted using a hierarchical Bayesian model of air pollution that combined modeled air pollution estimates from the EPA׳s Community Multi-Scale Air Quality (CMAQ) model with air monitor data measured by the EPA׳s Air Quality System. Binomial regression, adjusted for multiple potential confounders, was performed. In adjusted single-pollutant models for the third trimester, O3 concentration was positively associated with small for gestational age and term low birthweight births [risk ratios for an interquartile range increase in O3: 1.16 (95% CI 1.11, 1.22) for small for gestational age and 2.03 (95% CI 1.80, 2.30) for term low birthweight]; however, inverse or null associations were observed for PM2.5 [risk ratios for an interquartile range increase in PM2.5: 0.97 (95% CI 0.95, 0.99) for small for gestational age and 1.01 (95% CI 0.97, 1.06) for term low birthweight]. Findings were similar in co-pollutant models and linear models of birthweight. These results suggest that O3 concentrations in both urban and rural areas may be associated with an increased risk of term low birthweight and small for gestational age births. PMID:24769562

  5. Assessment of cardiorespiratory stability using the infant car seat challenge before discharge in preterm infants (<37 weeks' gestational age).

    PubMed

    Narvey, Michael R

    2016-04-01

    Preterm infants younger than 37 weeks corrected gestational age are at increased risk for abnormal control of respiration. The infant car seat challenge has been used as a screening tool to ensure cardiorespiratory stability before discharging preterm infants from many hospitals in Canada. While it is clear that infants placed in a car seat are more likely to experience oxygen desaturation and/or bradycardia than when they are supine, neither positioning predicts an adverse neurodevelopmental outcome or mortality post-discharge. A review of the literature yielded insufficient evidence to recommend routine use of the infant car seat challenge as part of discharge planning for preterm infants. This finding has prompted a change in recommendation from a previous Canadian Paediatric Society position statement published in 2000. PMID:27398056

  6. Maternal and Paternal Age Are Jointly Associated with Childhood Autism in Jamaica

    ERIC Educational Resources Information Center

    Rahbar, Mohammad H.; Samms-Vaughan, Maureen; Loveland, Katherine A.; Pearson, Deborah A.; Bressler, Jan; Chen, Zhongxue; Ardjomand-Hessabi, Manouchehr; Shakespeare-Pellington, Sydonnie; Grove, Megan L.; Beecher, Compton; Bloom, Kari; Boerwinkle, Eric

    2012-01-01

    Several studies have reported maternal and paternal age as risk factors for having a child with Autism Spectrum Disorder (ASD), yet the results remain inconsistent. We used data for 68 age- and sex-matched case-control pairs collected from Jamaica. Using Multivariate General Linear Models (MGLM) and controlling for parity, gestational age, and…

  7. Gestational Age-specific Cut-off Values Are Needed for Diagnosis of Subclinical Hypothyroidism in Early Pregnancy

    PubMed Central

    Kim, Hye Sung; Kim, Byoung Jae; Oh, Sohee; Lee, Da Young; Hwang, Kyu Ri; Jeon, Hye Won

    2015-01-01

    During the first trimester of pregnancy, thyroid-stimulating hormone (TSH) >2.5 mIU/L has been suggested as the universal criterion for subclinical hypothyroidism. However, TSH levels change continuously during pregnancy, even in the first trimester. Therefore the use of a fixed cut-off value for TSH may result in a different diagnosis rate of subclinical hypothyroidism according to gestational age. The objective of this study was to obtain the normal reference range of TSH during the first trimester in Korean gravida and to determine the diagnosis rate of subclinical hypothyroidism using the fixed cut-off value (TSH >2.5 mIU/L). The study population consisted of pregnant women who were measured for TSH during the first trimester of pregnancy (n=492) and nonpregnant women (n=984). Median concentration of TSH in pregnant women was lower than in non-pregnant women. There was a continuous decrease of median TSH concentration during the first trimester of pregnancy (median TSH concentration: 1.82 mIU/L for 3+0 to 6+6 weeks; 1.53 mIU/L for 7+0 to 7+6 weeks; and 1.05 mIU/L for 8+0 to 13+6 weeks). Using the fixed cut-off value of TSH >2.5 mIU/L, the diagnosis rate of subclinical hypothyroidism decreased significantly according to the gestational age (GA) at TSH (25% in 3+0 to 6+6 weeks, 13% in 7+0 to 7+6 weeks, and 9% for 8+0 to 13+6 weeks, P<0.001), whereas the diagnosis rate was 5% in all GA with the use of a GA-specific cut-off value (P=0.995). Therefore, GA-specific criteria might be more appropriate for the diagnosis of subclinical hypothyroidism. PMID:26339172

  8. Gestational Age-specific Cut-off Values Are Needed for Diagnosis of Subclinical Hypothyroidism in Early Pregnancy.

    PubMed

    Kim, Hye Sung; Kim, Byoung Jae; Oh, Sohee; Lee, Da Young; Hwang, Kyu Ri; Jeon, Hye Won; Lee, Seung Mi

    2015-09-01

    During the first trimester of pregnancy, thyroid-stimulating hormone (TSH) >2.5 mIU/L has been suggested as the universal criterion for subclinical hypothyroidism. However, TSH levels change continuously during pregnancy, even in the first trimester. Therefore the use of a fixed cut-off value for TSH may result in a different diagnosis rate of subclinical hypothyroidism according to gestational age. The objective of this study was to obtain the normal reference range of TSH during the first trimester in Korean gravida and to determine the diagnosis rate of subclinical hypothyroidism using the fixed cut-off value (TSH >2.5 mIU/L). The study population consisted of pregnant women who were measured for TSH during the first trimester of pregnancy (n=492) and nonpregnant women (n=984). Median concentration of TSH in pregnant women was lower than in non-pregnant women. There was a continuous decrease of median TSH concentration during the first trimester of pregnancy (median TSH concentration: 1.82 mIU/L for 3+0 to 6+6 weeks; 1.53 mIU/L for 7+0 to 7+6 weeks; and 1.05 mIU/L for 8+0 to 13+6 weeks). Using the fixed cut-off value of TSH >2.5 mIU/L, the diagnosis rate of subclinical hypothyroidism decreased significantly according to the gestational age (GA) at TSH (25% in 3+0 to 6+6 weeks, 13% in 7+0 to 7+6 weeks, and 9% for 8+0 to 13+6 weeks, P<0.001), whereas the diagnosis rate was 5% in all GA with the use of a GA-specific cut-off value (P=0.995). Therefore, GA-specific criteria might be more appropriate for the diagnosis of subclinical hypothyroidism. PMID:26339172

  9. Early Blood Gas Predictors of Bronchopulmonary Dysplasia in Extremely Low Gestational Age Newborns

    PubMed Central

    Sriram, Sudhir; Schreiber, Michael D.; Batton, Daniel G.; Shah, Bhavesh; Bose, Carl; Van Marter, Linda J.; Allred, Elizabeth N.; Leviton, Alan

    2014-01-01

    Aim. To determine among infants born before the 28th week of gestation to what extent blood gas abnormalities during the first three postnatal days provide information about the risk of bronchopulmonary dysplasia (BPD). Methods. We studied the association of extreme quartiles of blood gas measurements (hypoxemia, hyperoxemia, hypocapnea, and hypercapnea) in the first three postnatal days, with bronchopulmonary dysplasia, among 906 newborns, using multivariable models adjusting for potential confounders. We approximated NIH criteria by classifying severity of BPD on the basis of the receipt of any O2 on postnatal day 28 and at 36 weeks PMA and assisted ventilation. Results. In models that did not adjust for ventilation, hypoxemia was associated with increased risk of severe BPD and very severe BPD, while infants who had hypercapnea were at increased risk of very severe BPD only. In contrast, infants who had hypocapnea were at reduced risk of severe BPD. Including ventilation for 14 or more days eliminated the associations with hypoxemia and with hypercapnea and made the decreased risk of very severe BPD statistically significant. Conclusions. Among ELGANs, recurrent/persistent blood gas abnormalities in the first three postnatal days convey information about the risk of severe and very severe BPD. PMID:24959184

  10. Perinatal outcomes in women over 40 years of age compared to those of other gestations

    PubMed Central

    Canhaço, Evandro Eduardo; Bergamo, Angela Mendes; Lippi, Umberto Gazi; Lopes, Reginaldo Guedes Coelho

    2015-01-01

    Objective To clarify if older pregnant women were more likely to have adverse perinatal outcomes when compared to women at an ideal age to have a child. Methods The groups were divided according to age groups: under 20 years, ≥20 to <40 years, and ≥40 years. Results During the period from January 1st, 2008, to December 31st, 2008, there were 76 births from patients younger than 20 years and 91 births from patients aged 40 years or over. To form a third group with intermediate age, the data of 92 patients aged 20 to 40 years were obtained, totaling 259 patients. Patients aged 40 or older had a statistically greater number of cesarean sections and less use of forceps or normal deliveries (p<0.001). The use of spinal anesthesia was statistically higher among those aged 40 years or more (p<0.001). The frequency of male newborns was statistically higher in older patients, a group with statistically fewer first pregnancies (p<0.001). The frequency of premature newborns was statistically higher in patients aged 40 years or more (p=0.004). Conclusion It is crucial to give priority to aged women, so that prenatal care will be appropriate, minimizing maternal complications and improving perinatal outcomes in this unique group. PMID:25993070

  11. Association Between Ambient Levels of Polycyclic Aromatic Hydrocarbons and Small for Gestational Age Hispanic Infants Born Along the United States-Mexico Border.

    PubMed

    Maypole-Keenan, Coty M; Symanski, Elaine; Stock, Thomas H; Waller, D Kim

    2016-02-01

    Few studies have examined associations between polycyclic aromatic hydrocarbons (PAHs) and birth outcomes, and no studies have been conducted in El Paso County Texas, along the United States-Mexico border. Infants born from 2005-2007 to Hispanic mothers with a birth weight less than the 10th percentile for gestational age and sex were classified as small for gestational age (SGA). PAH exposures were estimated for the entire period of gestation and for each trimester of pregnancy using ambient air monitoring data from 2004-2007. Logistic regression was used to estimate odds ratios for the association between PAH levels and SGA infants. There was marked seasonal variation in the carcinogenic PAHs. Established risk factors for SGA were observed to be associated with SGA births in this population. No associations were detected between PAH levels and SGA births. These findings provide no evidence of an association between PAHs and SGA infants. PMID:24585213

  12. Predictors of RSV LRTI Hospitalization in Infants Born at 33 to 35 Weeks Gestational Age: A Large Multinational Study (PONI)

    PubMed Central

    Saliba, Elie; Kosma, Paraskevi; Posfay-Barbe, Klara; Yunis, Khalid; Farstad, Teresa; Unnebrink, Kristina; van Wyk, Jean; Wegzyn, Colleen; Notario, Gerard; Kalus, Stefanie; Campbell, Fiona J.

    2016-01-01

    Background Preterm infants are at high risk of developing respiratory syncytial virus (RSV)-associated lower respiratory tract infection (LRTI). This observational epidemiologic study evaluated RSV disease burden and risk factors for RSV-associated LRTI hospitalization in preterm infants 33 weeks+0 days to 35 weeks+6 days gestational age not receiving RSV prophylaxis. Methods Preterm infants ≤6 months of age during RSV season (1 October 2013–30 April 2014) were followed at 72 sites across 23 countries from September 2013–July 2014 (study period). RSV testing was performed according to local clinical practice. Factors related to RSV-associated hospitalization for LRTI were identified using multivariable logistic regression with backward selection. Results Of the 2390 evaluable infants, 204 and 127 were hospitalized for LRTI during the study period and RSV season, respectively. Among these subjects, 64/204 and 46/127, respectively, were hospitalized for confirmed RSV LRTI. Study period and RSV season normalized RSV hospitalization rates (per 100 infant years) were 4.1 and 6.1, respectively. Factors associated with an increased risk of RSV-related LRTI hospitalization in multivariable analyses were smoking of family members (P<0.0001), non-hemodynamically significant congenital heart disease diagnosis (P = 0.0077), maternal age of ≤25 years at delivery (P = 0.0009), low maternal educational level (P = 0.0426), household presence of children aged 4 to 5 years (P = 0.0038), age on 1 October ≤3 months (P = 0.0422), and presence of paternal atopy (P<0.0001). Conclusions During the 2013–2014 RSV season across 23 countries, for preterm infants 33–35 weeks gestation ≤6 months old on 1 October not receiving RSV prophylaxis, confirmed RSV LRTI hospitalization incidence was 4.1 per 100 infant years during the study period and 6.1 per 100 infant years during the RSV season. This study enhances the findings of single-country studies of common risk factors for

  13. Gestational diabetes

    MedlinePlus

    Gestational diabetes is high blood sugar ( diabetes ) that starts or is first diagnosed during pregnancy. ... woman's blood. You are at greater risk for gestational diabetes if you: Are older than 25 when you ...

  14. Changes in Cesarean Delivery Rates by Gestational Age: United States, 1996-2011

    MedlinePlus

    ... Cesarean delivery rates at 38 weeks declined for all maternal age groups, but increased at 39 weeks. ... Cesarean delivery rates at 38 weeks declined for all racial and ethnic groups, but rose at 39 ...

  15. Exposure to Trihalomethanes through Different Water Uses and Birth Weight, Small for Gestational Age, and Preterm Delivery in Spain

    PubMed Central

    Gracia-Lavedán, Esther; Ibarluzea, Jesús; Santa Marina, Loreto; Ballester, Ferran; Llop, Sabrina; Tardón, Adonina; Fernández, Mariana F.; Freire, Carmen; Goñi, Fernando; Basagaña, Xavier; Kogevinas, Manolis; Grimalt, Joan O.; Sunyer, Jordi

    2011-01-01

    Background: Evidence associating exposure to water disinfection by-products with reduced birth weight and altered duration of gestation remains inconclusive. Objective: We assessed exposure to trihalomethanes (THMs) during pregnancy through different water uses and evaluated the association with birth weight, small for gestational age (SGA), low birth weight (LBW), and preterm delivery. Methods: Mother–child cohorts set up in five Spanish areas during the years 2000–2008 contributed data on water ingestion, showering, bathing, and swimming in pools. We ascertained residential THM levels during pregnancy periods through ad hoc sampling campaigns (828 measurements) and regulatory data (264 measurements), which were modeled and combined with personal water use and uptake factors to estimate personal uptake. We defined outcomes following standard definitions and included 2,158 newborns in the analysis. Results: Median residential THM ranged from 5.9 μg/L (Valencia) to 114.7 μg/L (Sabadell), and speciation differed across areas. We estimated that 89% of residential chloroform and 96% of brominated THM uptakes were from showering/bathing. The estimated change of birth weight for a 10% increase in residential uptake was –0.45 g (95% confidence interval: –1.36, 0.45 g) for chloroform and 0.16 g (–1.38, 1.70 g) for brominated THMs. Overall, THMs were not associated with SGA, LBW, or preterm delivery. Conclusions: Despite the high THM levels in some areas and the extensive exposure assessment, results suggest that residential THM exposure during pregnancy driven by inhalation and dermal contact routes is not associated with birth weight, SGA, LBW, or preterm delivery in Spain. PMID:21810554

  16. Associations between preterm birth, small-for-gestational age, and neonatal morbidity and cognitive function among school-age children in Nepal

    PubMed Central

    2014-01-01

    Background The long term consequences of low birth weight (LBW), preterm birth, small-for-gestational age (SGA, defined as birth weight for given gestational age less than the 10th percentile of the reference), and early newborn morbidity on functional outcomes are not well described in low income settings. Methods In rural Nepal, we conducted neurocognitive assessment of children (n = 1927) at 7–9 y of age, for whom birth condition exposures were available. At follow-up they were tested on aspects of intellectual, executive, and motor function. Results The prevalence of LBW (39.6%), preterm birth (21.2%), and SGA (55.4%) was high, whereas symptoms of birth asphyxia and sepsis were reported in 6.7% and 9.1% of children. In multivariable regression analyses, adjusted for confounders, LBW was strongly associated with scores on the Universal Nonverbal Intelligence Test (UNIT), tests of executive function, and the Movement Assessment Battery for Children (MABC). Preterm was not associated with any of the test scores. Conversely, SGA was significantly (all p < 0.005) associated with lower UNIT scores (−2.04 SE = 0.39); higher proportion failure on Stroop test (0.06, SE = 0.02); and lower scores on the backward digit span test (−0.16, SE = 0.04), MABC (0.98, SE = 0.25), and finger tapping test (−0.66, SE = 0.22) after adjusting for confounders. Head circumference at birth was strongly and significantly associated with all test scores. Neither birth asphyxia nor sepsis symptoms were significantly associated with scores on cognitive or motor tests. Conclusion In this rural South Asian setting, intrauterine growth restriction is high and, may have a negative impact on long term cognitive, executive and motor function. PMID:24575933

  17. National and regional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010

    PubMed Central

    Lee, Anne CC; Katz, Joanne; Blencowe, Hannah; Cousens, Simon; Kozuki, Naoko; Vogel, Joshua P; Adair, Linda; Baqui, Abdullah H; Bhutta, Zulfiqar A; Caulfield, Laura E; Christian, Parul; Clarke, Siân E; Ezzati, Majid; Fawzi, Wafaie; Gonzalez, Rogelio; Huybregts, Lieven; Kariuki, Simon; Kolsteren, Patrick; Lusingu, John; Marchant, Tanya; Merialdi, Mario; Mongkolchati, Aroonsri; Mullany, Luke C; Ndirangu, James; Newell, Marie-Louise; Nien, Jyh Kae; Osrin, David; Roberfroid, Dominique; Rosen, Heather E; Sania, Ayesha; Silveira, Mariangela F; Tielsch, James; Vaidya, Anjana; Willey, Barbara A; Lawn, Joy E; Black, Robert E

    2013-01-01

    Summary Background National estimates for the numbers of babies born small for gestational age and the comorbidity with preterm birth are unavailable. We aimed to estimate the prevalence of term and preterm babies born small for gestational age (term-SGA and preterm-SGA), and the relation to low birthweight (<2500 g), in 138 countries of low and middle income in 2010. Methods Small for gestational age was defined as lower than the 10th centile for fetal growth from the 1991 US national reference population. Data from 22 birth cohort studies (14 low-income and middle-income countries) and from the WHO Global Survey on Maternal and Perinatal Health (23 countries) were used to model the prevalence of term-SGA births. Prevalence of preterm-SGA infants was calculated from meta-analyses. Findings In 2010, an estimated 32·4 million infants were born small for gestational age in low-income and middle-income countries (27% of livebirths), of whom 10·6 million infants were born at term and low birthweight. The prevalence of term-SGA babies ranged from 5·3% of livebirths in east Asia to 41·5% in south Asia, and the prevalence of preterm-SGA infants ranged from 1·2% in north Africa to 3·0% in southeast Asia. Of 18 million low-birthweight babies, 59% were term-SGA and 41% were preterm. Two-thirds of small-for-gestational-age infants were born in Asia (17·4 million in south Asia). Preterm-SGA babies totalled 2·8 million births in low-income and middle-income countries. Most small-for-gestational-age infants were born in India, Pakistan, Nigeria, and Bangladesh. Interpretation The burden of small-for-gestational-age births is very high in countries of low and middle income and is concentrated in south Asia. Implementation of effective interventions for babies born too small or too soon is an urgent priority to increase survival and reduce disability, stunting, and non-communicable diseases. Funding Bill & Melinda Gates Foundation by a grant to the US Fund for UNICEF to

  18. The Effect of Gestational Age on Symptom Severity in Children with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Movsas, Tammy Z.; Paneth, Nigel

    2012-01-01

    Between 2006 and 2010, two research-validated instruments, Social Communication Questionnaire (SCQ) and Social Responsiveness Scale (SRS) were filled out online by 4,188 mothers of Autism Spectrum Disorder (ASD) children, aged 4-21, as part of voluntary parental participation in a large web-based registry. Univariate and multivariate linear…

  19. The Association between Birth Weight and Gestational Age and Asthma in 6-7- and 13-14-Year-Old Children.

    PubMed

    Raheleh, Zamani; Ahmad, Alikhani; Abtin, Heydarzadeh; Roghaye, Zare; Sara, Hashemain; Siavash, Rahimi

    2016-01-01

    Background. Previous studies that assessed the role of birth weight and gestational age in the risk of asthma have been conflicting. Objectives. To examine the association between birth weight and gestational age and symptoms of asthma. Patients and Methods. Subjects were 6656 school children of ages 6-7 and 13-14 years from urban districts of Mazandaran, Iran. ISAAC questionnaires were used. Results. There was an increased risk of "wheeze ever" in both age groups with birth weight under 2.5 kg and in all subgroups of low birth weight (LBW). Birth weight more than 3.5 kg was associated with lower risk of "severe asthma" in age group 6-7 years. With respect to gestational age, higher risks of "wheeze ever," "asthma ever," and "night cough in the past 12 months" were found in age group 13-14 years born before 37 weeks and the risk of "severe asthma" was higher in younger group (6-7 years). A lower risk of "asthma ever" was also found in 6-7-year-old children and 13-14-year-old girls who were born after 40 weeks. Conclusions. This study showed that there is a direct relation between "wheeze ever" and LBW and an inverse relation between risk of "severe asthma" and birth weight more than 3.5 kg. PMID:27379196

  20. In utero analysis of sister chromatid exchange: alterations in suscptibility to mutagenic damage as a function of fetal cell type and gestational age.

    PubMed Central

    Kram, D; Bynum, G D; Senula, G C; Bickings, C K; Schneider, E L

    1980-01-01

    Frequencies of baseline and cyclophosphamide-induced sister chromatid exchanges (SCE) were measured in mouse maternal and fetal cells between days 11 and 19 of gestation. Baseline levels of SCE did not vary as a function of gestational age in either the mother or fetus. Cyclophosphamide-induced SCE frequencies remained constant in maternal cells but declined dramatically in the fetus throughout the latter half of development. Because cyclophosphamide is a metabolically activated mutagen, a direct-acting drug, mitomycin C, was given on days 11 and 15 to determine if the decline in induced SCE levels seen with gestational results from alterations in activating enzymes. A similar decline in mitomycin C-induced SCE levels was noted in fetal tissues as a function of gestational age. Dose-response curves to cyclophosphamide performed on day 13 of gestation showed increases in SCE as a function of cyclophosphamide concentration in both the mother and the fetus. When mutagen-induced SCE levels were compared in different fetal organs, the direct-acting drugs (mitomycin C and daunomycin) were found to induce similar levels in all tissues. Cyclophosphamide, which is metabolically activated, induced higher SCE levels in fetal liver than in lung or gut. Whereas cyclophosphamide induced similar SCE levels in fetal and maternal cells on day 13 of gestation, daunomycin produced fetal SCE levels that were approximately 50% of maternal levels. Simultaneous measurement of the distribution of [14C]cyclophosphamide and [3H]daunomycin in maternal and fetal cells revealed that the lower SCE induction by daunomycin was probably due to decreased ability to cross the placental barrier. PMID:6933526

  1. Insulin and glucagon levels of umbilical cord blood in appropriate for gestational age - preterm infants with or without postnatal hypoglycemia

    PubMed Central

    Park, Jae Hyun; Bae, Jin Gon; Kim, Shin; Kim, Chun Soo; Lee, Sang Lak

    2016-01-01

    Purpose To determine whether serum insulin and glucagon levels of umbilical cord blood correlate with subsequent postnatal hypoglycemia in appropriate for gestational age (AGA) – preterm infants at different gestational ages (GAs). Methods The serum insulin and glucagon levels of umbilical cord blood were measured using magnetic bead based multiplex immunoassay in 69 AGA - premature infants, stratified according to GA: GA 23–30 weeks, early preterm (EP, n=31); GA 31–34 weeks, late preterm (LP, n=38). Postnatal hypoglycemia was defined as a capillary glucose level <40 mg/dL within the first 60 minutes of life, regardless of GA. Results The capillary glucose concentration in EP infants (65.5±21.2 mg/dL) was significantly higher than that of LP infants (55.9±17.3 mg/dL) (P=0.043). The serum glucagon level in EP infants (44.3±28.7 pg/mL) was significantly higher than that in LP infants (28.1±13.6 pg/mL) (P=0.006). There was not a significant difference in serum insulin level between EP and LP infants (372.7±254.2 pg/mL vs. 372.4±209.1 pg/mL, P=0.996). There was a significant difference in the serum glucagon level between infants with and without hypoglycemia (27.7±8.9 mg/dL vs. 36.8±24.6 mg/dL, P=0.036), but not in the serum insulin level (451.9±256.9 pg/mL vs. 357.4±222.2 pg/mL, P=0.211). Postnatal glucose concentration within the first 60 minutes of life had a significant positive correlation with serum glucagon levels (r=0.256, P=0.034), but not with serum insulin levels (r=–0.020, P=0.867). Conclusion Lower glucagon levels of cord blood were seen in premature infants with higher GA, which might contribute to the occurrence of postnatal hypoglycemia. PMID:27462585

  2. Early postnatal hypotension is not associated with indicators of white matter damage or cerebral palsy in extremely low gestational age newborns

    PubMed Central

    Logan, J. Wells; O’Shea, T. Michael; Allred, Elizabeth N.; Laughon, Matthew M.; Bose, Carl L.; Dammann, Olaf; Batton, Daniel G.; Kuban, Karl C.; Paneth, Nigel; Leviton, Alan

    2011-01-01

    Objectives To evaluate, in extremely low gestational age newborns (ELGANs), relationships between indicators of early postnatal hypotension and cranial ultrasound indicators of cerebral white matter damage imaged in the nursery and cerebral palsy diagnoses at 24 month follow-up. Methods The 1041 infants in this prospective study were born at < 28 weeks gestation, were assessed for 3 indicators of hypotension in the first 24 postnatal hours, had at least one set of protocol cranial ultrasound scans, and were evaluated with a structured neurologic exam at 24 months corrected age. Indicators of hypotension included: 1) lowest mean arterial pressure (MAP) in the lowest quartile for gestational age; 2) treatment with a vasopressor; and 3) blood pressure lability, defined as the upper quartile of the difference between each infant’s lowest and highest MAP. Outcomes included indicators of cerebral white matter damage, i.e. moderate/severe ventriculomegaly or an echolucent lesion on cranial ultrasound, and cerebral palsy diagnoses at 24 months gestation. Logistic regression was used to evaluate relationships among hypotension indicators and outcomes, adjusting for potential confounders. Results Twenty-one percent of surviving infants had a lowest blood pressure in the lowest quartile for gestational age, 24% were treated with vasopressors, and 24% had labile blood pressure. Among infants with these hypotension indicators, 10% percent developed ventriculomegaly and 7% developed an echolucent lesion. At 24-months follow-up, 6% had developed quadriparesis, 4% diparesis, and 2% hemiparesis. After adjusting for confounders, we found no association between indicators of hypotension, and indicators of cerebral white matter damage or a cerebral palsy diagnosis. Conclusions The absence of an association between indicators of hypotension and cerebral white matter damage and or cerebral palsy suggests that early hypotension may not be important in the pathogenesis of brain injury

  3. A case-control study to examine the association between breastfeeding during late pregnancy and risk of a small-for-gestational-age birth in Lima, Peru.

    PubMed

    Pareja, Rossina G; Marquis, Grace S; Penny, Mary E; Dixon, Philip M

    2015-04-01

    Excessive demands on maternal nutritional status may be a risk factor for poor birth outcomes. This study examined the association between breastfeeding during late pregnancy (≥ 28 weeks) and the risk of having a small-for-gestational-age (SGA) newborn, using a matched case-control design (78 SGA cases: birthweight <10th percentile for gestational age; 150 non-SGA controls: 50th percentile gestational age). Between March 2006 and April 2007, project midwives visited daily three government hospitals in Lima, Peru and identified cases and matched controls based on hospital, gestational age, and inter-gestational period. Mothers were interviewed and clinical chart extractions were completed. Factors associated with risk of SGA were assessed by their adjusted odds ratios (aOR) from conditional logistic regression. Exposure to an overlap of breastfeeding during late pregnancy was not associated with an increased risk of having a SGA newborn [aOR=0.58, 95% confidence interval (CI): 0.10-3.30]. However, increased risk was associated with having a previous low-birthweight birth (aOR=6.53; 95% CI: 1.43-29.70) and a low intake of animal source foods (<25th percentile; aOR=2.26; 95% CI: 1.01-5.04), and tended to be associated with being short (<150 cm; aOR=2.05; 95% CI: 0.92-4.54). This study found no evidence to support the hypothesis that breastfeeding during late pregnancy increases the risk for SGA; however, studies with greater statistical power are needed to definitively examine this possible association and clarify whether there are other risks to the new baby, the toddler and the pregnant woman. PMID:23020780

  4. Impact of family planning programs in reducing high-risk births due to younger and older maternal age, short birth intervals, and high parity.

    PubMed

    Brown, Win; Ahmed, Saifuddin; Roche, Neil; Sonneveldt, Emily; Darmstadt, Gary L

    2015-08-01

    Several studies show that maternal and neonatal/infant mortality risks increase with younger and older maternal age (<18 and >34 years), high parity (birth order >3), and short birth intervals (<24 months). Family planning programs are widely viewed as having contributed to substantial maternal and neonatal mortality decline through contraceptive use--both by reducing unwanted births and by reducing the burden of these high-risk births. However, beyond averting births, the empirical evidence for the role of family planning in reducing high-risk births at population level is limited. We examined data from 205 Demographic and Health Surveys (DHS), conducted between 1985 and 2013, to describe the trends in high-risk births and their association with the pace of progress in modern contraceptive prevalence rate (yearly increase in rate of MCPR) in 57 developing countries. Using Blinder-Oaxaca decomposition technique, we then examine the contributions of family planning program, economic development (GDP per capita), and educational improvement (secondary school completion rate) on the progress of MCPR in order to link the net contribution of family planning program to the reduction of high-risk births mediated through contraceptive use. Countries that had the fastest progress in improving MCPR experienced the greatest declines in high-risk births due to short birth intervals (<24 months), high parity births (birth order >3), and older maternal age (>35 years). Births among younger women <18 years, however, did not decline significantly during this period. The decomposition analysis suggests that 63% of the increase in MCPR was due to family planning program efforts, 21% due to economic development, and 17% due to social advancement through women's education. Improvement in MCPR, predominately due to family planning programs, is a major driver of the decline in the burden of high-risk births due to high parity, shorter birth intervals, and older maternal age in

  5. Social class, ethnicity and other risk factors for small for gestational age and preterm delivery in The Netherlands.

    PubMed

    Verkerk, P H; Zaadstra, B M; Reerink, J D; Herngreen, W P; Verloove-Vanhorick, S P

    1994-02-01

    Social class and ethnicity are important risk factors for small-for-gestational-age and preterm delivery in many countries. This study was performed to assess whether this is also the case in the Netherlands, a country with a high level of social security, relatively small income differences and easy access to medical care for all its inhabitants. Other risk factors that were taken into account were smoking, drinking, occupation, age and height. Information was collected by interview in the first 3 weeks of life of the mothers of 2027 (response 97%) live-born singletons born in the period from April 1988 to October 1989 in the study area. After adjustment for possible confounding factors very low social class, compared with high social class, was significantly associated with reduced birthweight (-4.0%; 95% CI, -7.4% to -0.7%), but not with preterm delivery (OR, 2.09; 95% CI, 0.67-6.48). The adjusted birthweight of Turkish infants (2.7%; 95% CI, -1.1% to 6.5%) and the adjusted birthweight of infants from Suriname or the Antilles (-1.6%; 95% CI, -5.5% to 2.1%) were not significantly different compared with infants of Dutch mothers. After adjustment, the frequency of preterm birth was lower in Turkish infants, but not significantly (OR, 0.22; 95% CI, 0.04-1.10), whereas the frequency of preterm birth in infants from Suriname or the Antilles was significantly higher (OR, 2.51; 95% CI, 1.04-6.08) compared with Dutch infants. Of the other factors the main risk factors were smoking (negatively related with birth-weight) and maternal age(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8194649

  6. Small-for-Gestational-Age Births are Associated with Maternal Relationship Status: A Population-Wide Analysis.

    PubMed

    Steinberg, Jecca Rhea; Sanders, Lee; Cousens, Simon

    2016-08-01

    Objectives To examine the association between maternal relationship status during pregnancy and infant birth outcomes. Methods Observational study of the National Longitudinal Survey of Youth 1979, a nationally representative sample of 12,686 men and women between the ages of 14 and 21. We used data from surveys of women reporting childbirth between 1979 and 2004. Relationship status was defined as relationship with an opposite-sex partner in the child's birth year. Relationship stability was defined as the consistency in relationship status in the 1 year before, of, and after the child's birth. Childbirth outcome included small-for-gestational age (SGA) infant. We applied random effects logistic regression models to assess the association between relationship status and stability and childbirth outcome-adjusting for maternal race, infant sex, history of miscarriage, employment, maternal age, multiparity, cohort-entry year, household poverty status, and tobacco use. Results The study included 4439 women with 8348 live births. In fully adjusted models, term SGA infants were more commonly born to partnered women (AOR 1.81; 95 % CI 1.20-2.73) and unmarried women (AOR 1.82; CI 1.34-2.47; LRT p value 0.0001), compared to married women. SGA infants were also more commonly born in unstable relationships (AOR 1.72; 95 % CI 1.14-2.63; LRT p value 0.01) compared to stable relationships. Conclusions for Practice Maternal relationship status and stability during pregnancy is independently associated with risk of SGA infant birth. PMID:27007984

  7. Online Calculator to Improve Counseling of Short-Term Neonatal Morbidity and Mortality Outcomes at Extremely Low Gestational Age (23-28 Weeks).

    PubMed

    King, Carol P; da Silva, Orlando; Filler, Guido; Lopes, Laudelino M

    2016-07-01

    Objective Extremely low gestational age (ELGA) infants are at high risk of perinatal and neonatal morbidity and mortality. Accurate and relevant data are essential for developing a health care plan and providing realistic estimates of infants' outcomes. Study Design Retrospective analysis of all infants delivered between 23(0/7) and 28(6/7) weeks' gestation over 11 years at a single center. Using logistic regression analysis, gestational age (GA)-specific mortality and morbidity rates, and the effects of gender, antenatal corticosteroids, multiple gestation, and birth weight (BW) were determined. Results Of the 766 study infants, 644 (84.1%) were admitted to the neonatal intensive care unit, of which 502 (75.8%) survived to discharge. GA, antenatal corticosteroids, and BW were significant predictors of survival (GA: odds ratio [OR] = 1.83, 95% confidence interval [CI] = 1.64-2.04; corticosteroids: OR = 7.62, 95% CI = 5.19-11.18; BW: OR = 1.56, 95% CI = 1.44-1.69). Increasing BW correlated with a decreasing mortality rate. Conclusion This study provides recent outcome data of ELGA infants delivered at a tertiary level center. The results have been translated into an online counseling tool (http://murmuring-brook-6600.herokuapp.com/ELGA.html). PMID:27057769

  8. Effect of Macrophage Migration Inhibitory Factor (MIF) in Human Placental Explants Infected with Toxoplasma gondii Depends on Gestational Age

    PubMed Central

    de Oliveira Gomes, Angelica; de Oliveira Silva, Deise Aparecida; Silva, Neide Maria; de Freitas Barbosa, Bellisa; Franco, Priscila Silva; Angeloni, Mariana Bodini; Fermino, Marise Lopes; Roque-Barreira, Maria Cristina; Bechi, Nicoletta; Paulesu, Luana Ricci; dos Santos, Maria Célia; Mineo, José Roberto; Ferro, Eloisa Amália Vieira

    2011-01-01

    Because macrophage migration inhibitory factor (MIF) is a key cytokine in pregnancy and has a role in inflammatory response and pathogen defense, the objective of the present study was to investigate the effects of MIF in first- and third-trimester human placental explants infected with Toxoplasma gondii. Explants were treated with recombinant MIF, IL-12, interferon-γ, transforming growth factor-β1, or IL-10, followed by infection with T. gondii RH strain tachyzoites. Supernatants of cultured explants were assessed for MIF production. Explants were processed for morphologic analysis, immunohistochemistry, and real-time PCR analysis. Comparison of infected and stimulated explants versus noninfected control explants demonstrated a significant increase in MIF release in first-trimester but not third-trimester explants. Tissue parasitism was higher in third- than in first-trimester explants. Moreover, T. gondii DNA content was lower in first-trimester explants treated with MIF compared with untreated explants. However, in third-trimester explants, MIF stimulus decreased T. gondii DNA content only at the highest concentration of the cytokine. In addition, high expression of MIF receptor was observed in first-trimester placental explants, whereas MIF receptor expression was low in third-trimester explants. In conclusion, MIF was up-regulated and demonstrated to be important for control of T. gondii infection in first-trimester explants, whereas lack of MIF up-regulation in third-trimester placentas may be involved in higher susceptibility to infection at this gestational age. PMID:21641401

  9. In utero development of the fetal intestine: Sonographic evaluation and correlation with gestational age and fetal maturity in dogs.

    PubMed

    Gil, Elaine M U; Garcia, Daniela A A; Froes, Tilde R

    2015-09-15

    Modern high-resolution ultrasound images enable earlier assessment of measures of fetal development, including identification of the bowel. The aim of this study was to describe the ultrasonographic development of fetal bowel and correlate this with gestational age; define whether ultrasonographic visualization of fetal intestinal peristalsis in utero is associated with fetal maturation and determine whether there is a difference in fetal intestinal peristalsis detection time between fetuses delivered by normal delivery and cesarean. A cohort study was conducted in pregnant bitches presented to a veterinary hospital, to assess fetal bowel development. Statistical analysis was used to establish the correlation of the stage of fetal bowel development, as recorded by ultrasound, with outcomes of normal delivery and cesarean section. The study was broken down into three stages: the first stage was a descriptive analysis of fetal bowel development by ultrasound; the second stage compared time (in days) of bowel development between groups (normal delivery vs. cesarean); and the third stage was correlated survival probability for fetuses born on any day after detection of intestinal peristalsis with fetal maturity. All statistical analyses were significant. It is possible to monitor pregnancy progression using ultrasonographic evaluation of bowel development and this can reliably identify the end of fetal organogenesis. However, ultrasonographic detection of bowel segments with visualization of wall layers and associated peristalsis should not be used as the sole indicator for cesarean section planning because it is not possible to determine ultrasonographically whether the bowel is functional (mature). PMID:26025243

  10. Racial disparities in cord blood vitamin D levels and its association with small-for-gestational-age infants

    PubMed Central

    Seto, T L; Tabangin, M E; Langdon, G; Mangeot, C; Dawodu, A; Steinhoff, M; Narendran, V

    2016-01-01

    Objective: To examine the relationship of race and maternal characteristics and their association with cord blood vitamin D levels and small-for-gestational-age (SGA) status. Study Design: Cord blood vitamin D levels were measured in 438 infants (276 black and 162 white). Multivariable logistic regression models were used to evaluate associations between maternal characteristics, vitamin D status and SGA. Results: Black race, Medicaid status, mean body mass index at delivery and lack of prenatal vitamin use were associated with vitamin D deficiency. Black infants had 3.6 greater adjusted odds (95% confidence interval (CI): 2.4, 5.6) of vitamin D deficiency when compared with white infants. Black infants with vitamin D deficiency had 2.4 greater adjusted odds (95% CI: 1.0, 5.8) of SGA. Vitamin D deficiency was not significantly associated with SGA in white infants. Conclusion: Identification of risk factors (black race, Medicaid status, obesity and lack of prenatal vitamin use) can lead to opportunities for targeted prenatal vitamin supplementation to reduce the risk of neonatal vitamin D deficiency and SGA status. PMID:27101387

  11. The Heritability of Gestational Age in a Two-million Member Cohort: Implications for Spontaneous Preterm Birth

    PubMed Central

    Wu, Wilfred; Witherspoon, David J.; Fraser, Alison; Clark, Erin A. S.; Rogers, Alan; Stoddard, Gregory J.; Manuck, Tracy A.; Chen, Karin; Esplin, M. Sean; Smith, Ken R.; Varner, Michael W.; Jorde, Lynn B.

    2015-01-01

    Preterm birth (PTB), defined as birth prior to a gestational age (GA) of 37 completed weeks, affects more than 10% of births worldwide. PTB is the leading cause of neonatal mortality and is associated with a broad spectrum of lifelong morbidity in survivors. The etiology of spontaneous PTB (SPTB) is complex and has an important genetic component. Previous studies have compared monozygotic and dizygotic twin mothers and their families to estimate the heritability of SPTB, but these approaches cannot separate the relative contributions of the maternal and the fetal genomes to GA or SPTB. Using the Utah Population Database, we assessed the heritability of GA in more than 2 million post-1945 Utah births, the largest familial GA dataset ever assembled. We estimated a narrow-sense heritability of 13.3% for GA and a broad-sense heritability of 24.5%. A maternal effect (which includes the effect of the maternal genome) accounts for 15.2% of the variance of GA, and the remaining 60.3% is contributed by individual environmental effects. Given the relatively low heritability of GA and SPTB in the general population, multiplex SPTB pedigrees are likely to provide more power for gene detection than will samples of unrelated individuals. Furthermore, nongenetic factors provide important targets for therapeutic intervention. PMID:25920518

  12. Regional placental blood oxygen level dependent (BOLD) changes with gestational age in normally developing pregnancies using long duration R2* mapping in utero

    NASA Astrophysics Data System (ADS)

    Dighe, Manjiri; Kim, Yun Jung; Seshamani, Sharmishtaa; Blazejewska, Ania I.; Mckown, Susan; Caucutt, Jason; Gatenby, Christopher; Studholme, Colin

    2016-03-01

    The aim of this study was to examine the use of R2* mapping in maternal and fetal sub-regions of the placenta with the aim of providing a reference for blood oxygenation levels during normative development. There have been a number of MR relaxation studies of placental tissues in-utero, but none have reported R2* value changes with age, or examined differences in sub-regions of the placenta. Here specialized long-duration Multi-frame R2* imaging was used to create a stable estimate for R2* values in different placental regions in healthy pregnant volunteers not imaged for clinical reasons. 27 subjects were recruited and scanned up to 3 times during their pregnancy. A multi-slice dual echo EPI based BOLD acquisition was employed and repeated between 90 and 150 times over 3 to 5 minutes to provide a high accuracy estimate of the R2* signal level. Acquisitions were also repeated in 13 cases within a visit to evaluate reproducibility of the method in a given subject. Experimental results showed R2* measurements were highly repeatable within a visit with standard deviation of (0.76). Plots of all visits against gestational age indicated clear correlations showing decreases in R2* with age. This increase was consistent was also consistent over time in multiple visits of the same volunteer during their pregnancy. Maternal and fetal regional changes with gestational age followed the same trend with increase in R2* over the gestational age.

  13. Gestational Age, Infant Birth Weight, and Subsequent Risk of Type 2 Diabetes in Mothers: Nurses' Health Study II

    MedlinePlus

    ... Birth Weight, and Subsequent Risk of Type 2 Diabetes in Mothers: Nurses’ Health Study II Navigate This ... as 10 pounds or more at term. Gestational diabetes In the NHSII 1989 baseline questionnaire and subsequent ...

  14. Serum screening with Down's syndrome markers to predict pre-eclampsia and small for gestational age: Systematic review and meta-analysis

    PubMed Central

    Morris, Rachel K; Cnossen, Jeltsje S; Langejans, Marloes; Robson, Stephen C; Kleijnen, Jos; ter Riet, Gerben; Mol, Ben W; van der Post, Joris AM; Khan, Khalid S

    2008-01-01

    Background Reliable antenatal identification of pre-eclampsia and small for gestational age is crucial to judicious allocation of monitoring resources and use of preventative treatment with the prospect of improving maternal/perinatal outcome. The purpose of this systematic review was to determine the accuracy of five serum analytes used in Down's serum screening for prediction of pre-eclampsia and/or small for gestational age. Methods The data sources included Medline, Embase, Cochrane library, Medion (inception to February 2007), hand searching of relevant journals, reference list checking of included articles, contact with experts. Two reviewers independently selected the articles in which the accuracy of an analyte used in Downs's serum screening before the 25th gestational week was associated with the occurrence of pre-eclampsia and/or small for gestational age without language restrictions. Two authors independently extracted data on study characteristics, quality and results. Results Five serum screening markers were evaluated. 44 studies, testing 169,637 pregnant women (4376 pre-eclampsia cases) and 86 studies, testing 382,005 women (20,339 fetal growth restriction cases) met the selection criteria. The results showed low predictive accuracy overall. For pre-eclampsia the best predictor was inhibin A>2.79MoM positive likelihood ratio 19.52 (8.33,45.79) and negative likelihood ratio 0.30 (0.13,0.68) (single study). For small for gestational age it was AFP>2.0MoM to predict birth weight < 10th centile with birth < 37 weeks positive likelihood ratio 27.96 (8.02,97.48) and negative likelihood ratio 0.78 (0.55,1.11) (single study). A potential clinical application using aspirin as a treatment is given as an example. There were methodological and reporting limitations in the included studies thus studies were heterogeneous giving pooled results with wide confidence intervals. Conclusion Down's serum screening analytes have low predictive accuracy for pre

  15. The Modified Checklist for Autism in Toddlers in extremely low gestational age newborns: individual items associated with motor, cognitive, vision and hearing limitations.

    PubMed

    Luyster, Rhiannon J; Kuban, Karl C K; O'Shea, T Michael; Paneth, Nigel; Allred, Elizabeth N; Leviton, Alan

    2011-07-01

    The Modified Checklist for Autism in Toddlers (M-CHAT) has yielded elevated rates of screening failure for children born preterm or with low birthweight. We extended these findings with a detailed examination of M-CHAT items in a large sample of children born at extremely low gestational age. The sample was grouped according to children's current limitations and degree of impairment. The aim was to better understand how disabilities might influence M-CHAT scores. Fourteen participating institutions of the Extremely Low Gestational Age Newborns (ELGAN) Study prospectively collected information about 1086 infants who were born before the 28th week of gestation and had an assessment at age 24-months. The 24-month visit included a neurological assessment, the Bayley Scales of Infant Development, Second edition (BSID-II), M-CHAT and a medical history form. Outcome measures included the distribution of failed M-CHAT items among groups classified according to cerebral palsy diagnosis, gross motor function, BSID-II scores and vision or hearing impairments. M-CHAT items were failed more frequently by children with concurrently identified impairments (motor, cognitive, vision and hearing). In addition, the frequency of item failure increased with the severity of impairment. The failed M-CHAT items were often, but not consistently, related to children's specific impairments. Importantly, four of the six M-CHAT 'critical items' were commonly affected by presence and severity of concurrent impairments. The strong association between impaired sensory or motor function and M-CHAT results among extremely low gestational age children suggests that such impairments might give rise to false positive M-CHAT screening. PMID:21649679

  16. Relationship of the intake of different food groups by pregnant mothers with the birth weight and gestational age: Need for public and individual educational programs

    PubMed Central

    Akbari, Zahra; Mansourian, Marjan; Kelishadi, Roya

    2015-01-01

    Objective: This study was conducted to investigate the relationship between the intake of different food groups by pregnant mothers and neonatal low birth weight and premature births. Materials and Methods: In this cohort, the target population was 225 pregnant women, randomly selected from different geographical areas of the city of Isfahan, Iran (from April to September, 2012). The main variables in the study were weight and gestational age of the neonates and the type and amount of different food groups used by the mothers. All nutritional variables were compared according to different groups of infants (normal, premature, and low birth weight). In the multivariate analysis, multiple linear and logistic regression models were used to identify those different food frequency questionnaire (FFQ) variables independently associated with the newborn's weight and gestational age, adjusted by maternal consumption of calcium supplementation, folic acid, and omega-3, during pregnancy. Results: A total of 214 (47.7% boys) infants with complete information were included. They had a mean gestational age of 38.72 ± 1.2 weeks. The mean birth weight was 3.11 ± 0.384 kg. The percentages of premature and low birth weight (LBW) infants were 7 and 5%, respectively. At multiple logistic regression controlling for potentially confounding factors that were significantly associated with prematurity and LBW at univariate analysis (maternal consumption of calcium supplementation, folic acid, and omega-3, during pregnancy), type of nutritional groups containing dairy products, proteins, fish, and shrimp group, as well as fruits and vegetables, had a significant positive association with increasing the gestational age (P < 0.05). The group that consumed proteins, fish, and shrimp, as well as fruits and vegetables had a significant positive association with the newborn's weight (P < 0.05). Conclusion: This study indicated the importance of proper nutrition on reducing the rates of LBW and

  17. Risk of childhood undernutrition related to small-for-gestational age and preterm birth in low- and middle-income countries

    PubMed Central

    Christian, Parul; Lee, Sun Eun; Donahue Angel, Moira; Adair, Linda S; Arifeen, Shams E; Ashorn, Per; Barros, Fernando C; Fall, Caroline HD; Fawzi, Wafaie W; Hao, Wei; Hu, Gang; Humphrey, Jean H; Huybregts, Lieven; Joglekar, Charu V; Kariuki, Simon K; Kolsteren, Patrick; Krishnaveni, Ghattu V; Liu, Enqing; Martorell, Reynaldo; Osrin, David; Persson, Lars-Ake; Ramakrishnan, Usha; Richter, Linda; Roberfroid, Dominique; Sania, Ayesha; Ter Kuile, Feiko O; Tielsch, James; Victora, Cesar G; Yajnik, Chittaranjan S; Yan, Hong; Zeng, Lingxia; Black, Robert E

    2013-01-01

    Background Low- and middle-income countries continue to experience a large burden of stunting; 148 million children were estimated to be stunted, around 30–40% of all children in 2011. In many of these countries, foetal growth restriction (FGR) is common, as is subsequent growth faltering in the first 2 years. Although there is agreement that stunting involves both prenatal and postnatal growth failure, the extent to which FGR contributes to stunting and other indicators of nutritional status is uncertain. Methods Using extant longitudinal birth cohorts (n = 19) with data on birthweight, gestational age and child anthropometry (12–60 months), we estimated study-specific and pooled risk estimates of stunting, wasting and underweight by small-for-gestational age (SGA) and preterm birth. Results We grouped children according to four combinations of SGA and gestational age: adequate size-for-gestational age (AGA) and preterm; SGA and term; SGA and preterm; and AGA and term (the reference group). Relative to AGA and term, the OR (95% confidence interval) for stunting associated with AGA and preterm, SGA and term, and SGA and preterm was 1.93 (1.71, 2.18), 2.43 (2.22, 2.66) and 4.51 (3.42, 5.93), respectively. A similar magnitude of risk was also observed for wasting and underweight. Low birthweight was associated with 2.5–3.5-fold higher odds of wasting, stunting and underweight. The population attributable risk for overall SGA for outcomes of childhood stunting and wasting was 20% and 30%, respectively. Conclusions This analysis estimates that childhood undernutrition may have its origins in the foetal period, suggesting a need to intervene early, ideally during pregnancy, with interventions known to reduce FGR and preterm birth. PMID:23920141

  18. The ontogeny of serum insulin-like growth factor-I concentration in foals: effects of dam parity, diet, and age at weaning.

    PubMed

    Cymbaluk, N F; Laarveld, B

    1996-05-01

    The effects of dam parity, age at weaning, and preweaning diet were examined in the ontogeny of serum insulin-like growth factor-I (IGF-I) concentrations in foals. Foals born to 13 primiparous and 19 multiparous draft-cross mares were weighed and bled near birth. About one-half of the foals in each group were weaned early (about 13 wk old); the remaining foals were weaned late (about 16 wk of age). Pooled values for serum IGF-I concentrations between birth and 17 wk of age were higher (P < 0.065) for foals born to multiparous (386 ng/ml) than to primiparous mares (237.5 ng/ml). Colts (378 ng/ml) had higher (P < 0.05) serum IGF-I concentrations than fillies (254.5 ng/ml), regardless of dam parity. Colts (173.5 kg) also tended (P = 0.12) to be heavier than fillies (159.2 kg). Weaning, whether at 13 or 16 wk of age, reduced (P < 0.05) growth rates and serum IGF-I concentrations. Serum IGF-I values recovered to preweaning values within 1-3 wk postweaning concurrent to an improved weight gain. Fifteen 1-d-old foals in a second study were fed milk replacer for 7 wk and were compared with five foals that nursed their mares for 8 wk. During the first 2 wk, replacer-fed foals (0.46 kg/d) did not gain as rapidly (P < 0.03) as mare-nursed foals (1.73 kg/d). The associated serum IGF-I values for replacer foals (139.4 ng/ml) were lower (P < 0.0001) than values for mare-nursed foals (317.4 ng/ml). Despite similarity in gains for both groups there-after, serum IGF-I concentrations of replacer-fed foals were only 36 and 60% of values obtained for mare-nursed foals at 8 (weaning) and 18 wk of age, respectively. The intrinsic differences between mare-nursed and milk-replacer foals in serum IGF-I concentrations persisted to 1 yr of age despite similarities in dietary management and body weight of the foals. At 1 yr of age, the serum IGF-I concentration of mare-nursed foals (1,203 ng/ml) was 48% higher than that of replacer-fed foals (815 ng/ml). These data indicate that dam parity

  19. IMPORTANCE OF BIRTH WEIGHT AS A RISK FACTOR FOR SEVERE RETINOPATHY OF PREMATURITY WHEN GESTATIONAL AGE IS 30 OR MORE WEEKS

    PubMed Central

    Holzman, Ian R.; Ginsburg, Robin N.; Brodie, Scott E.; Stroustrup, Annemarie

    2015-01-01

    Purpose To determine whether birth weight less than1,500 grams is a relevant guideline indicating the need for examination for retinopathy of prematurity (ROP) when gestational age at birth is 30 or more completed weeks. Design A retrospective observational cohort study. Methods 266 infants in a single institutional neonatal intensive care unit (NICU), whose gestational age at birth was 30 or more weeks but whose birth weight was less than 1,500 grams, were examined according to published guidelines. Infants with lethal congenital anomalies or major ocular abnormalities were excluded. Outcomes were vascularization in retinal zone III without a prior need for treatment, or ROP warranting treatment. Results A study outcome was reached by 212 infants. Two hundred and eleven (99.5%) became vascularized through zone III without needing treatment. Only 1 (0.5%) required treatment for ROP. The 95% confidence interval for the occurrence rate of ROP requiring treatment in this cohort was 0.01 to 2.60%. Conclusion Our results suggest that the occurrence rates of ROP requiring treatment in infants with gestational age 30 or more weeks and birth weight less than 1,500 grams is very low, and could indicate the need to revise examination guidelines for this subgroup of infants. PMID:24582994

  20. Novel Interpretation of Molecular Diagnosis of Congenital Toxoplasmosis According to Gestational Age at the Time of Maternal Infection

    PubMed Central

    Sterkers, Yvon; Pratlong, Francine; Albaba, Sahar; Loubersac, Julie; Picot, Marie-Christine; Pretet, Vanessa; Issert, Eric; Boulot, Pierre

    2012-01-01

    From a prospective cohort of 344 women who seroconverted for toxoplasmosis during pregnancy, 344 amniotic fluid, 264 placenta, and 216 cord blood samples were tested for diagnosis of congenital toxoplasmosis using the same PCR assay. The sensitivity and negative predictive value of the PCR assay using amniotic fluid were 86.3% and 97.2%, respectively, and both specificity and positive predictive value were 100%. Using placenta and cord blood, sensitivities were 79.5% and 21.2%, and specificities were 92% and 100%, respectively. In addition, the calculation of pretest and posttest probabilities and the use of logistic regression allowed us to obtain curves that give a dynamic interpretation of the risk of congenital toxoplasmosis according to gestational age at maternal infection, as represented by the three sample types (amniotic fluid, placenta, and cord blood). Two examples are cited here: for a maternal infection at 25 weeks of amenorrhea, a negative result of prenatal diagnosis allowed estimation of the probability of congenital toxoplasmosis at 5% instead of an a priori (pretest) risk estimate of 33%. For an infection at 10 weeks of amenorrhea associated with a pretest congenital toxoplasmosis risk of 7%, a positive PCR result using placenta at birth yields a risk increase to 43%, while a negative result damps down the risk to 0.02%. Thus, with a molecular diagnosis performing at a high level, and in spite of the persistence of false negatives, posttest risk curves using both negative and positive results prove highly informative, allowing a better assessment of the actual risk of congenital toxoplasmosis and finally an improved decision guide to treatment. PMID:23035201

  1. Is the fetoplacental ratio a differential marker of fetal growth restriction in small for gestational age infants?

    PubMed

    Luque-Fernandez, Miguel Angel; Ananth, Cande V; Jaddoe, Vincent W V; Gaillard, Romy; Albert, Paul S; Schomaker, Michael; McElduff, Patrick; Enquobahrie, Daniel A; Gelaye, Bizu; Williams, Michelle A

    2015-04-01

    Higher placental weight relative to birthweight has been described as an adaptive mechanism to fetal hypoxia in small for gestational age (SGA) infants. However, placental weight alone may not be a good marker reflecting intrauterine growth restriction. We hypothesized that fetoplacental ratio (FPR)-the ratio between birthweight and placental weight-may serve as a good marker of SGA after adjustment for surrogates of fetal hypoxemia (maternal iron deficiency anemia, smoking and choriodecidual necrosis). We conducted a within-sibling analysis using data from the US National Collaborative Perinatal Project (1959-1966) of 1,803 women who delivered their first two (or more) consecutive infants at term (n = 3,494). We used variance-component fixed-effect linear regression models to explore the effect of observed time-varying factors on placental weight and conditional logistic regression to estimate the effects of the tertiles of FPRs (1st small, 2nd normal and 3rd large) on the odds of SGA infants. We found placental weights to be 15 g [95 % confidence interval (CI) 8, 23] higher and -7 g (95 % CI -13, -2) lower among women that had anemia and choriodecidual necrosis, respectively. After multivariable adjustment, newborns with a small FPR (1st-tertile ≤7) had twofold higher odds of being SGA (OR 2.0, 95 % CI 1.2, 3.5) than their siblings with a large FPR (3nd-tertile ≥9). A small FPR was associated with higher odds of SGA, suggesting that small FPR may serve as an indicator suggestive of adverse intrauterine environment. This observation may help to distinguish pathological from constitutional SGA. PMID:25630563

  2. Small for gestational age and adulthood risk of disability pension: the contribution of childhood and adulthood conditions.

    PubMed

    Helgertz, Jonas; Vågerö, Denny

    2014-10-01

    Early exiting from the labor force and into disability pension (DP) represents a major social problem in Sweden and elsewhere. We examined how being asymmetric (A-SGA) or symmetric (S-SGA) small for gestational age predicts transitioning into DP. We analyzed a longitudinal sample of 8125 men and women from the Stockholm Birth Cohort (SBC), born in 1953 and not on DP in 1990. The SBC consists of data from various sources, including self-reported information and data from administrative registers. The follow-up period was from 1991 to 2009. Yearly information on the receipt of DP benefits from register data was operationalized as a dichotomous variable. 13 percent of the sample moved into DP during follow-up. Cox proportional hazards regression was used to examine whether disadvantageous fetal growth--A-SGA and S-SGA--predicted DP. Men and women born A-SGA had a substantially increased hazard of DP. The full model suggested a hazard ratio of 1.68 (CI: 1.11-2.54), only being affected slightly by adulthood conditions. Several childhood conditions were also associated with DP. Such factors, however, mainly affected DP risk through adulthood conditions. The effect of SGA on DP appeared particularly strong among individuals from socioeconomically disadvantaged backgrounds. The evidence presented suggests that being A-SGA influences the risk of DP, independent of childhood and adulthood conditions, and similarly for men and women. Due to A-SGA being rather infrequent, reducing the occurrence of A-SGA would, however, only have a marginal impact on the stock of DP pensioners. For the individual affected, the elevation in the risk of DP was nevertheless substantial. Other childhood conditions exercised a larger influence on the stock of DP recipients, but they mostly operated through adulthood attainment. The importance of socioeconomic resources in childhood for the long term health consequences of SGA is interesting from a policy perspective and warrants further research

  3. Atrazine in municipal drinking water and risk of low birth weight, preterm delivery, and small-for-gestational-age status

    PubMed Central

    Villanueva, C; Durand, G; Coutte, M; Chevrier, C; Cordier, S

    2005-01-01

    Background: Atrazine is a herbicide used extensively worldwide. Bioassays have shown that it is embryotoxic and embryolethal. Evidence of adverse reproductive outcomes from exposure in the general population is sparse. Aims: To evaluate the association between atrazine levels in municipal drinking water and the following adverse reproductive outcomes: increased risk of preterm delivery, low birth weight (LBW), and small-for-gestational-age (SGA) status. Methods: A total of 3510 births that took place from 1 October 1997, to 30 September 1998 were analysed. Atrazine measurements were available for 2661 samples from water treatment plants over the past decade. A seasonal pattern was identified, with atrazine peaking from May to September. The geometric mean of the atrazine level for this period was calculated for each water distribution unit and merged with the individual data by municipality of residence. Results: Atrazine levels in water were not associated with an increased risk of LBW or SGA status and were slightly associated with prematurity. There was an increased risk of SGA status in cases in which the third trimester overlapped in whole or in part with the May–September period, compared with those in which the third trimester occurred totally from October to April (OR = 1.37, 95% CI 1.04 to 1.81). If the entire third trimester took place from May to September, the OR was 1.54 (95% CI 1.11 to 2.13). Conclusions: Low levels of atrazine, a narrow exposure range, and limitations in the exposure assessment partly explain the lack of associations with atrazine. Findings point to the third trimester of pregnancy as the potential vulnerable period for an increased risk of SGA birth. Exposures other than atrazine and also seasonal factors may explain the increased risk. PMID:15901888

  4. Placental Insufficiency in Fetuses That Slow in Growth but Are Born Appropriate for Gestational Age: A Prospective Longitudinal Study

    PubMed Central

    Bardien, Nadia; Whitehead, Clare L.; Tong, Stephen; Ugoni, Antony; McDonald, Susan; Walker, Susan P.

    2016-01-01

    Objectives To determine whether fetuses that slow in growth but are then born appropriate for gestational age (AGA, birthweight >10th centile) demonstrate ultrasound and clinical evidence of placental insufficiency. Methods Prospective longitudinal study of 48 pregnancies reaching term and a birthweight >10th centile. We estimated fetal weight by ultrasound at 28 and 36 weeks, and recorded birthweight to determine the relative change in customised weight across two timepoints: 28–36 weeks and 28 weeks-birth. The relative change in weight centiles were correlated with fetoplacental Doppler findings performed at 36 weeks. We also examined whether a decline in growth trajectory in fetuses born AGA was associated with operative deliveries performed for suspected intrapartum compromise. Results The middle cerebral artery pulsatility index (MCA-PI) showed a linear association with fetal growth trajectory. Lower MCA-PI readings (reflecting greater diversion of blood supply to the brain) were significantly associated with a decline in fetal growth, both between 28–36 weeks (p = 0.02), and 28 weeks-birth (p = 0.0002). The MCA-PI at 36 weeks was significantly higher among those with a relative weight centile fall <20%, compared to those with a moderate centile fall of 20–30% (mean MCA-PI 1.94 vs 1.61; p<0.05), or severe centile fall of >30% (mean MCA-PI 1.94 vs 1.56; p<0.01). Of 43 who labored, operative delivery for suspected intrapartum fetal compromise was required in 12 cases; 9/18 (50%) cases where growth slowed, and 3/25 (12%) where growth trajectory was maintained (p = 0.01). Conclusions Slowing in growth across the third trimester among fetuses subsequently born AGA was associated with ultrasound and clinical features of placental insufficiency. Such fetuses may represent an under-recognised cohort at increased risk of stillbirth. PMID:26730589

  5. The Effect of Age, Parity and Body Mass Index on the Efficacy, Safety, Placement and User Satisfaction Associated With Two Low-Dose Levonorgestrel Intrauterine Contraceptive Systems: Subgroup Analyses of Data From a Phase III Trial

    PubMed Central

    Gemzell-Danielsson, Kristina; Apter, Dan; Hauck, Brian; Schmelter, Thomas; Rybowski, Sarah; Rosen, Kimberly; Nelson, Anita

    2015-01-01

    Objective Two low-dose levonorgestrel intrauterine contraceptive systems (LNG-IUSs; total content 13.5 mg [average approx. 8 μg/24 hours over the first year; LNG-IUS 8] and total content 19.5 mg [average approx. 13 μg/24 hours over the first year; LNG-IUS 13]) have previously been shown to be highly effective (3-year Pearl Indices: 0.33 and 0.31, respectively), safe and well tolerated. The present subgroup analyses evaluated whether or not outcomes were affected by parity, age (18–25 vs 26–35 years), or body mass index (BMI, <30 vs ≥30 kg/m2). Methods Nulliparous and parous women aged 18‒35 years with regular menstrual cycles (21‒35 days) requesting contraception were randomized to 3 years of LNG-IUS 8 or LNG-IUS 13 use. Results In the LNG-IUS 8 and LNG-IUS 13 groups, 1432 and 1452 women, respectively, had a placement attempted and were included in the full analysis set; 39.2%, 39.2% and 17.1% were 18–25 years old, nulliparous and had a BMI ≥30 kg/m2, respectively. Both systems were similarly effective regardless of age, parity or BMI; the subgroup Pearl Indices had widely overlapping 95% confidence intervals. Placement of LNG-IUS 8 and LNG-IUS 13 was easier (p < 0.0001) and less painful (p < 0.0001) in women who had delivered vaginally than in women who had not. The complete/partial expulsion rate was 2.2–4.2% across all age and parity subgroups and higher in parous than in nulliparous women (p = 0.004). The incidence of pelvic inflammatory disease was 0.1–0.6% across all age and parity subgroups: nulliparous and younger women were not at higher risk than parous and older women, respectively. The ectopic pregnancy rate was 0.3–0.4% across all age and parity subgroups. Across all age and parity subgroups, the 3-year completion rate was 50.9–61.3% for LNG-IUS 8 and 57.9–61.1% for LNG-IUS 13, and was higher (p = 0.0001) among older than younger women in the LNG-IUS 8 group only. Conclusions LNG-IUS 8 and LNG-IUS 13 were highly effective

  6. The Association between Birth Weight and Gestational Age and Asthma in 6-7- and 13-14-Year-Old Children

    PubMed Central

    Raheleh, Zamani; Ahmad, Alikhani; Abtin, Heydarzadeh; Roghaye, Zare; Sara, Hashemain; Siavash, Rahimi

    2016-01-01

    Background. Previous studies that assessed the role of birth weight and gestational age in the risk of asthma have been conflicting. Objectives. To examine the association between birth weight and gestational age and symptoms of asthma. Patients and Methods. Subjects were 6656 school children of ages 6-7 and 13-14 years from urban districts of Mazandaran, Iran. ISAAC questionnaires were used. Results. There was an increased risk of “wheeze ever” in both age groups with birth weight under 2.5 kg and in all subgroups of low birth weight (LBW). Birth weight more than 3.5 kg was associated with lower risk of “severe asthma” in age group 6-7 years. With respect to gestational age, higher risks of “wheeze ever,” “asthma ever,” and “night cough in the past 12 months” were found in age group 13-14 years born before 37 weeks and the risk of “severe asthma” was higher in younger group (6-7 years). A lower risk of "asthma ever" was also found in 6-7-year-old children and 13-14-year-old girls who were born after 40 weeks. Conclusions. This study showed that there is a direct relation between “wheeze ever” and LBW and an inverse relation between risk of “severe asthma” and birth weight more than 3.5 kg. PMID:27379196

  7. Maternal parity, fetal and childhood growth, and cardiometabolic risk factors.

    PubMed

    Gaillard, Romy; Rurangirwa, Akashi A; Williams, Michelle A; Hofman, Albert; Mackenbach, Johan P; Franco, Oscar H; Steegers, Eric A P; Jaddoe, Vincent W V

    2014-08-01

    We examined the associations of maternal parity with fetal and childhood growth characteristics and childhood cardiometabolic risk factors in a population-based prospective cohort study among 9031 mothers and their children. Fetal and childhood growth were repeatedly measured. We measured childhood anthropometrics, body fat distribution, left ventricular mass, blood pressure, blood lipids, and insulin levels at the age of 6 years. Compared with nulliparous mothers, multiparous mothers had children with higher third trimester fetal head circumference, length and weight growth, and lower risks of preterm birth and small-size-for-gestational-age at birth but a higher risk of large-size-for-gestational-age at birth (P<0.05). Children from multiparous mothers had lower rates of accelerated infant growth and lower levels of childhood body mass index, total fat mass percentage, and total and low-density lipoprotein cholesterol than children of nulliparous mothers (P<0.05). They also had a lower risk of childhood overweight (odds ratio, 0.75 [95% confidence interval, 0.63–0.88]). The risk of childhood clustering of cardiometabolic risk factors was not statistically significantly different (odds ratio, 0.82; 95% confidence interval, 0.64–1.05). Among children from multiparous mothers only, we observed consistent trends toward a lower risk of childhood overweight and lower cholesterol levels with increasing parity (P<0.05). In conclusion, offspring from nulliparous mothers have lower fetal but higher infant growth rates and higher risks of childhood overweight and adverse metabolic profile. Maternal nulliparity may have persistent cardiometabolic consequences for the offspring. PMID:24866145

  8. Serum YKL-40 and gestational diabetes - an observational cohort study.

    PubMed

    Gybel-Brask, Dorte; Johansen, Julia S; Christiansen, Ib J; Skibsted, Lillian; Høgdall, Estrid V S

    2016-09-01

    To examine serum YKL-40 in women developing gestational diabetes mellitus (GDM). In the present large observational cohort study of 1179 pregnant women, we determined serum YKL-40 four times during pregnancy (at gestational age 12, 20, 25, and 32 weeks). Pregnancy outcome was obtained from medical records. Sixty-eight women (5.8%) developed GDM. Serum YKL-40 increased from gestational age (GA) 12 weeks and the following weeks in the women who developed GDM and was independent of BMI, parity, and maternal age (OR = 2.69, 95% CI: 1.45-5.00, p = 0.002). No association was found between serum YKL-40 and the oral glucose tolerance test results. In conclusion, YKL-40 significantly increased in pregnant women with GDM compared with women without GDM, probably reflecting the low-grade inflammation of GDM. However, we did not find an association between serum concentrations of YKL-40 in early pregnancy and the development of GDM and thus we conclude that YKL-40 alone is not usable as a biomarker for early prediction of GDM. PMID:27457220

  9. Ethnic enclaves and gestational diabetes among immigrant women in New York City.

    PubMed

    Janevic, T; Borrell, L N; Savitz, D A; Echeverria, S E; Rundle, A

    2014-11-01

    Previous research has shown that immigrants living in their own ethnic enclave are at decreased risk of poor health outcomes, but this question has not been studied in relation to gestational diabetes, an important early marker of lifecourse cardiovascular health. We ascertained gestational diabetes, census tract of residence, and individual-level covariates for Sub-Saharan African, Chinese, South Central Asian, Non-Hispanic Caribbean, Dominican, Puerto Rican, Mexican, and Central and South American migrant women using linked birth-hospital discharge data for 89,703 singleton live births in New York City for the years 2001-2002. Using 2000 census data, for each immigrant group we defined a given census tract as part of an ethnic enclave based on the population distribution for the corresponding ethnic group. We estimated odds ratios for associations between living in an ethnic enclave and risk of gestational diabetes adjusted for neighborhood deprivation, percent commercial space, education, age, parity, and insurance status, using multilevel logistic regression. Overall, we found no effect of ethnic enclave residence on gestational diabetes in most immigrant groups. Among South Central Asian and Mexican women, living in a residential ethnic enclave was associated with an increased odds of gestational diabetes. Several explanations are proposed for these findings. Mechanisms explaining an increased risk of gestational diabetes in South Central Asian and Mexican ethnic enclaves should be examined. PMID:25259656

  10. Blood Biomarkers of Late Pregnancy Exposure to Trihalomethanes in Drinking Water and Fetal Growth Measures and Gestational Age in a Chinese Cohort

    PubMed Central

    Cao, Wen-Cheng; Zeng, Qiang; Luo, Yan; Chen, Hai-Xia; Miao, Dong-Yue; Li, Li; Cheng, Ying-Hui; Li, Min; Wang, Fan; You, Ling; Wang, Yi-Xin; Yang, Pan; Lu, Wen-Qing

    2015-01-01

    Background: Previous studies have suggested that elevated exposure to disinfection by-products (DBPs) in drinking water during gestation may result in adverse birth outcomes. However, the findings of these studies remain inconclusive. Objective: The purpose of our study was to examine the association between blood biomarkers of late pregnancy exposure to trihalomethanes (THMs) in drinking water and fetal growth and gestational age. Methods: We recruited 1,184 pregnant women between 2011 and 2013 in Wuhan and Xiaogan City, Hubei, China. Maternal blood THM concentrations, including chloroform (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM), and bromoform (TBM), were measured as exposure biomarkers during late pregnancy. We estimated associations with gestational age and fetal growth indicators [birth weight, birth length, and small for gestational age (SGA)]. Results: Total THMs (TTHMs; sum of TCM, BDCM, DBCM, and TBM) were associated with lower mean birth weight (–60.9 g; 95% CI: –116.2, –5.6 for the highest vs. lowest tertile; p for trend = 0.03), and BDCM and DBCM exposures were associated with smaller birth length (e.g., –0.20 cm; 95% CI: –0.37, –0.04 for the highest vs. lowest tertile of DBCM; p for trend = 0.02). SGA was increased in association with the second and third tertiles of TTHMs (OR = 2.91; 95% CI: 1.32, 6.42 and OR = 2.25; 95% CI: 1.01, 5.03; p for trend = 0.08). Conclusions: Our results suggested that elevated maternal THM exposure may adversely affect fetal growth. Citation: Cao WC, Zeng Q, Luo Y, Chen HX, Miao DY, Li L, Cheng YH, Li M, Wang F, You L, Wang YX, Yang P, Lu WQ. 2016. Blood biomarkers of late pregnancy exposure to trihalomethanes in drinking water and fetal growth measures and gestational age in a Chinese cohort. Environ Health Perspect 124:536–541; http://dx.doi.org/10.1289/ehp.1409234 PMID:26340795

  11. Gestational diabetes

    MedlinePlus

    Gestational diabetes is high blood sugar ( diabetes ) that starts or is first diagnosed during pregnancy. ... 9 pounds or had a birth defect Have high blood pressure Have too much amniotic fluid Have ...

  12. microRNA expression in the cervix during pregnancy is associated with length of gestation.

    PubMed

    Sanders, Alison P; Burris, Heather H; Just, Allan C; Motta, Valeria; Svensson, Katherine; Mercado-Garcia, Adriana; Pantic, Ivan; Schwartz, Joel; Tellez-Rojo, Martha M; Wright, Robert O; Baccarelli, Andrea A

    2015-01-01

    Preterm birth is a leading cause of infant mortality and can lead to poor life-long health and adverse neurodevelopmental outcomes. The pathophysiologic mechanisms that precede preterm labor remain elusive, and the role that epigenetic phenomena play is largely unstudied. The objective of this study was to assess the association between microRNA (miRNA) expression levels in cervical cells obtained from swabs collected during pregnancy and the length of gestation. We analyzed cervical samples obtained between 16 and 19 weeks of gestation from 53 women in a prospective cohort from Mexico City, and followed them until delivery. Cervical miRNA was extracted and expression was quantified using the NanoString nCounter Analysis System. Linear regression models were used to examine the association between miRNA expression levels and gestational age at delivery, adjusted for maternal age, education, parity, body mass index, smoke exposure, and inflammation assessed on a Papanicolaou smear. We identified 6 miRNAs that were significantly associated with gestational age at the time of delivery, including miR-21, 30e, 142, 148b, 29b, and 223. Notably, per each doubling in miR-21 expression, gestations were 0.9 (95% CI: 0.2-1.5) days shorter on average (P = 0.009). Per each doubling in miR-30e, 142, 148b, 29b, and 223 expression, gestations were shorter by 1.0 to 1.6 days. The predicted targets of the miRNAs were enriched for molecules involved in DNA replication and inflammatory processes. The levels of specific miRNAs in the human cervix during pregnancy are predictive of gestational age at delivery, and should be validated in future studies as potential biomarkers of preterm birth risk. PMID:25611922

  13. Age at Menarche, Level of Education, Parity and the Risk of Hysterectomy: A Systematic Review and Meta-Analyses of Population-Based Observational Studies

    PubMed Central

    Wilson, Louise F.; Mishra, Gita D.

    2016-01-01

    Background Although rates have declined, hysterectomy is still a frequent gynaecological procedure. To date, there has been no systematic quantification of the relationships between early/mid-life exposures and hysterectomy. We performed a systematic review and meta-analyses to quantify the associations between age at menarche, education level, parity and hysterectomy. Methods Eligible studies were identified by searches in PubMed and Embase through March 2015. Study-specific estimates were summarised using random effects meta-analysis. Heterogeneity was explored using sub-group analysis and meta-regression. Results Thirty-two study populations were identified for inclusion in at least one meta-analysis. Each year older at menarche was associated with lower risk of hysterectomy—summary hazard ratio 0.86 (95% confidence interval: 0.78, 0.95; I2 = 0%); summary odds ratio 0.88 (95% confidence interval: 0.82, 0.94; I2 = 61%). Low education levels conferred a higher risk of hysterectomy in the lowest versus highest level meta-analysis (summary hazard ratio 1.87 (95% confidence interval: 1.25, 2.80; I2 = 86%), summary odds ratio 1.51 (95% confidence interval: 1.35, 1.69; I2 = 90%)) and dose-response meta-analysis (summary odds ratio 1.17 (95% confidence interval: 1.12, 1.23; I2 = 85%) per each level lower of education). Sub-group analysis showed that the birth cohort category of study participants, the reference category used for level of education, the year the included article was published, quality of the study (as assessed by the authors) and control for the key variables accounted for the high heterogeneity between studies in the education level meta-analyses. In the meta-analyses of studies of parity and hysterectomy the results were not statistically significant. Conclusions The present meta-analyses suggest that the early life factors of age at menarche and lower education level are associated with hysterectomy, although this evidence should be interpreted with

  14. Impaired visual fixation at age 2 years in children born before the 28th week of gestation. Antecedents and correlates in the multi-center ELGAN Study

    PubMed Central

    Phadke, Anuradha; Msall, Michael E; Droste, Patrick; Allred, Elizabeth N; O'Shea, T. Michael; Kuban, Karl; Dammann, Olaf; Leviton, Alan

    2014-01-01

    Background Very little is known about the prevalence, antecedents and correlates of impaired visual fixation in former very preterm newborns. Methods In the multi-center ELGAN Study sample of 1057 infants born before the 28th week of gestation who had a developmental assessment at 2 years corrected age, we identified 73 who were unable to follow an object across the midline. We compared them to the 984 infants who could follow an object across the midline. Results In this sample of very preterm newborns, those who had impaired visual fixation were much more likely than those without impaired visual fixation to have been born after the shortest of gestations (odds ratio = 3.2; 99% confidence interval =1.4, 7.5) and exposed to maternal aspirin (OR: 5.2; 99% CI: 2.2, 12). They were also more likely than their peers to have had prethreshold ROP (OR: 4.1; 99% CI: 1.8, 9.0). At age 2 years, the children with impaired fixation were more likely than others to be unable to walk (even with assistance) (OR: 7.5; 99% CI: 2.2, 26) and have a Mental Development Index more than 3 standard deviations below the mean of a normative sample (OR:3.6; 99% CI: 1.4, 8.2). Conclusion Risk factors for brain and retinal damage, such as very low gestational age, appear to be risk factors for impaired visual fixation. This inference is further supported by the co-occurrence at age 2 years of impaired visual fixation, inability to walk, and a very low Mental Development Index PMID:24938138

  15. Maternal serum cadmium level during pregnancy and its association with small for gestational age infants: a population-based birth cohort study.

    PubMed

    Wang, Hua; Liu, Lu; Hu, Yong-Fang; Hao, Jia-Hu; Chen, Yuan-Hua; Su, Pu-Yu; Fu, Lin; Yu, Zhen; Zhang, Gui-Bin; Wang, Lei; Tao, Fang-Biao; Xu, De-Xiang

    2016-01-01

    The association between maternal cadmium (Cd) exposure during pregnancy and the increased risk of fetal growth restriction (FGR) remains controversial. The present study evaluated the association between maternal serum Cd level and risk of small for gestational age (SGA) infants in a Chinese population. The present study analyzed a subsample of the C-ABCS cohort that recruited 3254 eligible mother-and-singleton-offspring pairs. Maternal serum Cd level during pregnancy was measured by graphite furnace atomic absorption spectrometry. The rate and odds ratio (OR) for SGA infant were calculated. The rate for SGA infant was 10.6% among subjects with H-Cd (≥1.06 μg/L), significantly higher than 7.5% among subjects with L-Cd (<1.06 μg/L). OR was 1.45 (95% CI: 1.11, 1.90; P = 0.007) among subjects with H-Cd. Adjusted OR for SGA infants was 1.43 (95% CI: 1.09, 1.88; P = 0.007) among subjects with H-Cd. Taken together, we observe the fact that maternal Cd exposure at middle gestational stage, elevates the risk of SGA in contrast to early gestational stage. The present results might be interesting and worth more discussing, and guarantee to further studies. PMID:26934860

  16. Maternal serum cadmium level during pregnancy and its association with small for gestational age infants: a population-based birth cohort study

    PubMed Central

    Wang, Hua; Liu, Lu; Hu, Yong-Fang; Hao, Jia-Hu; Chen, Yuan-Hua; Su, Pu-Yu; Fu, Lin; Yu, Zhen; Zhang, Gui-Bin; Wang, Lei; Tao, Fang-Biao; Xu, De-Xiang

    2016-01-01

    The association between maternal cadmium (Cd) exposure during pregnancy and the increased risk of fetal growth restriction (FGR) remains controversial. The present study evaluated the association between maternal serum Cd level and risk of small for gestational age (SGA) infants in a Chinese population. The present study analyzed a subsample of the C-ABCS cohort that recruited 3254 eligible mother-and-singleton-offspring pairs. Maternal serum Cd level during pregnancy was measured by graphite furnace atomic absorption spectrometry. The rate and odds ratio (OR) for SGA infant were calculated. The rate for SGA infant was 10.6% among subjects with H-Cd (≥1.06 μg/L), significantly higher than 7.5% among subjects with L-Cd (<1.06 μg/L). OR was 1.45 (95% CI: 1.11, 1.90; P = 0.007) among subjects with H-Cd. Adjusted OR for SGA infants was 1.43 (95% CI: 1.09, 1.88; P = 0.007) among subjects with H-Cd. Taken together, we observe the fact that maternal Cd exposure at middle gestational stage, elevates the risk of SGA in contrast to early gestational stage. The present results might be interesting and worth more discussing, and guarantee to further studies. PMID:26934860

  17. Effect of combination vitamin E and single long-acting progesterone dose on enhancing pregnancy outcomes in the first two parities of young rabbit does.

    PubMed

    Salem, Anas A; Gomaa, Yasmin A

    2014-11-10

    Vitamin E (Vit. E) is needed for young rabbits to prevent reproductive abnormalities, abortion and poor survivability of kits. Also, exogenous progesterone (P4) is needed for rabbits to enhance early embryonic development because of inadequate corpus luteum (CL) development at this age. Hence, the aim of this study was to investigate the effect of injecting Vit. E and the combination Vit. E+P4 in young does on live body weight (LBW) gain, gestation length (GL), numbers of services/conception (NS), conception rate (CR), abortion rate (AR), litter size (LS), kit weight (KW), total litter weight (TLW), mortality rate (MR) and progesterone (P4) concentration. The group treated with Vit. E+P4 had a greater LBW gain and lesser AR at first and second pregnancy. Treatments did not have significant impact on GL and LS in the first two parities. Treatments resulted in a significantly lesser MR and greater TLW at the second parity. The Vit. E+P4 treatment resulted in a significantly lesser NS at the first parity, while Vit. E alone resulted in a significant reduction in NS at the second parity. Vit. E+P4 had a positive effect on CR at the first parity compared with controls. Vit. E alone increased CR at the second parity compared with that of the control group. The mean P4 concentration from mating to mid-pregnancy at first parity was significantly greater in the Vit. E+P4 than Vit. E and control groups. In conclusion, treatment with Vit. E+P4 at the first parity may be economically applied on rabbit farms because this treatment resulted in a greater maintenance of the first pregnancy and improved reproductive performance at the second parity as compared with results from the Vit. E treated and control groups. PMID:25234054

  18. Attempting to Honor Beliefs of Jehovah’s Witnesses at the Edge of Viability in an Infant Born at 23 Weeks’ Gestational Age

    PubMed Central

    Sauer, Charles W.; Marc-Aurele, Krishelle L.

    2016-01-01

    Patient: Male, 23 weeks’ gestational age newborn Final Diagnosis: 23 weeks’ extreme prematurity • intraventricular hemorrhage • anemia • respiratory distress syndrome Symptoms: Hypotension • metabolic acidosis • tachycardia Medication: — Clinical Procedure: Transfusion of packed red blood cells Specialty: Pediatrics and Neonatology Objective: Rare disease Background: Infants born at 23 weeks’ gestation have a poor prognosis and require intensive care, including blood transfusions, to survive. Generally speaking, the decision to forgo life support is acceptable. Jehovah’s Witnesses believe that life is sacred and want lifesaving interventions except for blood transfusions. Therefore, an ethical dilemma exists when a baby is born on the edge of viability to parents that are Jehovah’s Witnesses. In this case, if parents and healthcare professionals disagree on the best interests of the child, the medical team should obtain a court order from the state to intervene. Case Report: We present the case of an infant born at 23 weeks’ gestation to parents who are Jehovah’s Witnesses. The parents wanted full life-support, except for blood transfusions, to be given. The clinical team obtained a court order to transfuse the infant. The infant unfortunately died despite all efforts. Conclusions: Currently, it is nearly impossible to honor the beliefs of Jehovah’s Witnesses to provide lifesaving treatments without blood transfusions for infants born at the border of viability. If the goal is to prolong life, the standard of care for a premature infant is for a doctor to obtain a court order to override the beliefs and wishes of Jehovah’s Witness parents and transfuse blood products as medically indicated. Although bloodless techniques for high-risk surgeries are under development, care for premature infants at 23 weeks’ gestation necessitates red cell transfusions. PMID:27255268

  19. Maternal Obesity, Overweight and Gestational Diabetes Affect the Offspring Neurodevelopment at 6 and 18 Months of Age – A Follow Up from the PREOBE Cohort

    PubMed Central

    Torres-Espinola, Francisco J.; Berglund, Staffan K; García-Valdés, Luz Mª; Segura, Mª Teresa; Jerez, Antonio; Campos, Daniel; Moreno-Torres, Rosario; Rueda, Ricardo; Catena, Andrés; Pérez-García, Miguel; Campoy, Cristina

    2015-01-01

    Background Brain development in fetal life and early infancy is critical to determine lifelong performance in various neuropsychological domains. Metabolic pathologies such as overweight, obesity, and gestational diabetes in pregnant women are prevalent and increasing risk factors that may adversely affect long-term brain development in their offspring. Objective The objective of this research was to investigate the influence of maternal metabolic pathologies on the neurodevelopment of the offspring at 6 and 18 months of life. Design This was a prospective case-control study of 331 mother- and child pairs from Granada, Spain. The mothers were included during pregnancy into four groups according to their pre-gestational body mass index and their gestational diabetes status; overweight (n:56), obese (n:64), gestational diabetic (n:79), and healthy normal weight controls (n:132). At 6 months and 18 months we assessed the children with the Bayley III scales of neurodevelopment. Results At 6 months (n=215), we found significant group differences in cognition composite language, and expressive language. Post hoc test revealed unexpectedly higher scores in the obese group compared to the normal weight group and a similar trend in overweight and diabetic group. The effects on language remained significant after adjusting for confounders with an adjusted odds ratio for a value above median in composite language score of 3.3 (95% CI: 1.1, 10.0; p=0.035) for children of obese mothers. At 18 month (n=197), the offspring born to obese mothers had lost five points in language composite scores and the previous differences in language and cognition was replaced by a suggestive trend of lower gross motor scores in the overweight, obese, and diabetic groups. Conclusions Infants of obese mothers had a temporary accelerated development of cognition and language, followed by a rapid deceleration until 18 months of age, particularly of language scores. This novel observation prompts

  20. Maternal Continuing Folic Acid Supplementation after the First Trimester of Pregnancy Increased the Risk of Large-for-Gestational-Age Birth: A Population-Based Birth Cohort Study

    PubMed Central

    Wang, Sufang; Ge, Xing; Zhu, Beibei; Xuan, Yujie; Huang, Kun; Rutayisire, Erigene; Mao, Leijing; Huang, Sanhuan; Yan, Shuangqin; Tao, Fangbiao

    2016-01-01

    Supplementation with folic acid (FA) was proven to prevent neural tube defects (NTDs) and was recommended worldwide before and during early pregnancy. However, much less is known regarding the role of FA after the 12th gestational week (GW). This study aimed to investigate the related effects of continued FA supplementation after the first trimester of pregnancy on fetal growth. The study subjects came from the Ma’anshan-Anhui Birth Cohort Study (MABC) that recruited 3474 pregnant women from the city of Ma’anshan in Anhui Province in China during the period of May 2013 to September 2014. The information on use of vitamin and mineral supplements was recorded in different periods (the first/second/third trimester of pregnancy). Small-for-gestational-age (SGA) births were live-born infants that were <10th percentile of birth weight, and large-for-gestational-age (LGA) births were live-born infants that were ≥90th percentile of birth weight according to nomograms based on gender and gestational age from the latest standards. We used multivariable logistic regression to evaluate the effects of FA supplement consumption in the second/third trimester of pregnancy on the risk of LGA and SGA. In addition, propensity score analysis was also performed to examine the effects. In this prospective birth cohort study conducted in Chinese women who had taken FA in the first trimester of pregnancy, we found that continued FA supplementation with 400 micrograms/day in the second and third trimesters of pregnancy significantly increased the risk of LGA (RR = 1.98 (1.29, 3.04)). This relation was strong or monotonic after adjusting for maternal age, newborn’s gender, maternal pre-pregnancy BMI, maternal education level, smoking, alcohol consumption and calcium supplementation. We did not observe that continuing FA supplementation after the first trimester of pregnancy remarkably decreased the risk of SGA. The propensity score analysis showed similar results. To confirm these

  1. Maternal Continuing Folic Acid Supplementation after the First Trimester of Pregnancy Increased the Risk of Large-for-Gestational-Age Birth: A Population-Based Birth Cohort Study.

    PubMed

    Wang, Sufang; Ge, Xing; Zhu, Beibei; Xuan, Yujie; Huang, Kun; Rutayisire, Erigene; Mao, Leijing; Huang, Sanhuan; Yan, Shuangqin; Tao, Fangbiao

    2016-01-01

    Supplementation with folic acid (FA) was proven to prevent neural tube defects (NTDs) and was recommended worldwide before and during early pregnancy. However, much less is known regarding the role of FA after the 12th gestational week (GW). This study aimed to investigate the related effects of continued FA supplementation after the first trimester of pregnancy on fetal growth. The study subjects came from the Ma'anshan-Anhui Birth Cohort Study (MABC) that recruited 3474 pregnant women from the city of Ma'anshan in Anhui Province in China during the period of May 2013 to September 2014. The information on use of vitamin and mineral supplements was recorded in different periods (the first/second/third trimester of pregnancy). Small-for-gestational-age (SGA) births were live-born infants that were <10th percentile of birth weight, and large-for-gestational-age (LGA) births were live-born infants that were ≥90th percentile of birth weight according to nomograms based on gender and gestational age from the latest standards. We used multivariable logistic regression to evaluate the effects of FA supplement consumption in the second/third trimester of pregnancy on the risk of LGA and SGA. In addition, propensity score analysis was also performed to examine the effects. In this prospective birth cohort study conducted in Chinese women who had taken FA in the first trimester of pregnancy, we found that continued FA supplementation with 400 micrograms/day in the second and third trimesters of pregnancy significantly increased the risk of LGA (RR = 1.98 (1.29, 3.04)). This relation was strong or monotonic after adjusting for maternal age, newborn's gender, maternal pre-pregnancy BMI, maternal education level, smoking, alcohol consumption and calcium supplementation. We did not observe that continuing FA supplementation after the first trimester of pregnancy remarkably decreased the risk of SGA. The propensity score analysis showed similar results. To confirm these

  2. Risk of Preterm or Small-for-Gestational-Age Birth After Influenza Vaccination During Pregnancy: Caveats When Conducting Retrospective Observational Studies.

    PubMed

    Vazquez-Benitez, Gabriela; Kharbanda, Elyse O; Naleway, Allison L; Lipkind, Heather; Sukumaran, Lakshmi; McCarthy, Natalie L; Omer, Saad B; Qian, Lei; Xu, Stanley; Jackson, Michael L; Vijayadev, Vinutha; Klein, Nicola P; Nordin, James D

    2016-08-01

    Vaccines are increasingly targeted toward women of reproductive age, and vaccines to prevent influenza and pertussis are recommended during pregnancy. Prelicensure clinical trials typically have not included pregnant women, and when they are included, trials cannot detect rare events. Thus, postmarketing vaccine safety assessments are necessary. However, analysis of observational data requires detailed assessment of potential biases. Using data from 8 Vaccine Safety Datalink sites in the United States, we analyzed the association of monovalent H1N1 influenza vaccine (MIV) during pregnancy with preterm birth (<37 weeks) and small-for-gestational-age birth (birth weight < 10th percentile). The cohort included 46,549 pregnancies during 2009-2010 (40% of participants received the MIV). We found potential biases in the vaccine-birth outcome association that might occur due to variable access to vaccines, the time-dependent nature of exposure to vaccination within pregnancy (immortal time bias), and confounding from baseline differences between vaccinated and unvaccinated women. We found a strong protective effect of vaccination on preterm birth (relative risk = 0.79, 95% confidence interval: 0.74, 0.85) when we ignored potential biases and no effect when accounted for them (relative risk = 0.91; 95% confidence interval: 0.83, 1.0). In contrast, we found no important biases in the association of MIV with small-for-gestational-age birth. Investigators conducting studies to evaluate birth outcomes after maternal vaccination should use statistical approaches to minimize potential biases. PMID:27449414

  3. Diagnosing gestational diabetes.

    PubMed

    Ryan, E A

    2011-03-01

    The newly proposed criteria for diagnosing gestational diabetes will result in a gestational diabetes prevalence of 17.8%, doubling the numbers of pregnant women currently diagnosed. These new diagnostic criteria are based primarily on the levels of glucose associated with a 1.75-fold increased risk of giving birth to large-for-gestational age infants (LGA) in the Hyperglycemia Adverse Pregnancy Outcome (HAPO) study; they use a single OGTT. Thus, of 23,316 pregnancies, gestational diabetes would be diagnosed in 4,150 women rather than in 2,448 women if a twofold increased risk of LGA were used. It should be recognised that the majority of women with LGA have normal glucose levels during pregnancy by these proposed criteria and that maternal obesity is a stronger predictor of LGA. The expected benefit of a diagnosis of gestational diabetes in these 1,702 additional women would be the prevention of 140 cases of LGA, 21 cases of shoulder dystocia and 16 cases of birth injury. The reproducibility of an OGTT for diagnosing mild hyperglycaemia is poor. Given that (1) glucose is a weak predictor of LGA, (2) treating these extra numbers has a modest outcome benefit and (3) the diagnosis may be based on a single raised OGTT value, further debate should occur before resources are allocated to implementing this change. PMID:21203743

  4. Gestational Age Assessment in the Ghana Randomized Air Pollution and Health Study (GRAPHS): Ultrasound Capacity Building, Fetal Biometry Protocol Development, and Ongoing Quality Control

    PubMed Central

    Boamah, Ellen A; Asante, KP; Ae-Ngibise, KA; Kinney, Patrick L; Jack, Darby W; Manu, Grace; Azindow, Irene T; Owusu-Agyei, Seth

    2014-01-01

    Background Four million premature deaths occur yearly as a result of smoke from cooking fires. The Ghana Randomized Air Pollution and Health Study (GRAPHS) is underway in the Kintampo North municipality and South district of rural Ghana to evaluate the impact of improved cook stoves introduced during pregnancy on birth weight and childhood pneumonia. These hypotheses are being tested in a cluster-randomized intervention trial among 1415 maternal-infant pairs within 35 communities assigned to a control arm (traditional cooking) or one of two intervention arms (cooking with an improved biomass stove; cooking with liquefied petroleum gas stoves). Objective The trial is designed to ensure delivery of the stove intervention prior to the period of maximal fetal growth. To answer questions about the impact of household air pollution on pregnancy outcome, accurate gestational age assessment is critical. This manuscript describes in detail the development of the gestational dating protocol, intensive ultrasound training involved, ultrasound capacity building, and ultrasound quality control program. Methods Ultrasound training occurred in several phases over the course of 2 years. Training included a basic obstetric ultrasound course offered to all midwives performing antenatal care at the two study hospitals, followed by a more intense period of hands-on training focused on fetal biometry for a select group of providers demonstrating aptitude in the basic course. A standard operating procedure was developed describing how to obtain all fetal biometric measurements. Consensus was obtained on how biometric images are used in the trial to establish gestational age and estimate the delivery date. An ongoing ultrasound quality control program including the use of an image scorecard was also designed. Results Publication of trial results is anticipated in late 2016. Conclusions Use of ultrasound should be strongly considered in field-based trials involving pregnant women to

  5. Birth weight for gestational age norms for a large cohort of infants born to HIV-negative women in Botswana compared with norms for U.S.-born black infants

    PubMed Central

    2011-01-01

    Background Standard values for birth weight by gestational age are not available for sub-Saharan Africa, but are needed to evaluate incidence and risk factors for intrauterine growth retardation in settings where HIV, antiretrovirals, and other in utero exposures may impact birth outcomes. Methods Birth weight data were collected from six hospitals in Botswana. Infants born to HIV-negative women between 26-44 weeks gestation were analyzed to construct birth weight for gestational age charts. These data were compared with published norms for black infants in the United States. Results During a 29 month period from 2007-2010, birth records were reviewed in real-time from 6 hospitals and clinics in Botswana. Of these, 11,753 live infants born to HIV-negative women were included in the analysis. The median gestational age at birth was 39 weeks (1st quartile 38, 3rd quartile 40 weeks), and the median birth weight was 3100 grams (1st quartile 2800, 3rd quartile 3400 grams). We constructed estimated percentile curves for birth weight by gestational age which demonstrate increasing slope during the third trimester and leveling off beyond 40 weeks. Compared with black infants in the United States, Botswana-born infants had lower median birth weight for gestational age from weeks 37 through 42 (p < .02). Conclusions We present birth weight for gestational age norms for Botswana, which are lower at term than norms for black infants in the United States. These findings suggest the importance of regional birth weight norms to identify and define risk factors for higher risk births. These data serve as a reference for Botswana, may apply to southern Africa, and may help to identify infants at risk for perinatal complications and inform comparisons among infants exposed to HIV and antiretrovirals in utero. PMID:22176889

  6. Body composition and circulating high-molecular-weight adiponectin and IGF-I in infants born small for gestational age: breast- versus formula-feeding.

    PubMed

    de Zegher, Francis; Sebastiani, Giorgia; Diaz, Marta; Sánchez-Infantes, David; Lopez-Bermejo, Abel; Ibáñez, Lourdes

    2012-08-01

    Prenatal growth restraint, if followed by postnatal overweight, confers risk for adult disease including diabetes. The mechanisms whereby neonatal nutrition may modulate such risk are poorly understood. We studied the effects of nutrition (breast-feeding [BRF] vs. formula-feeding [FOF]) on weight partitioning and endocrine state (as judged by high-molecular-weight [HMW] adiponectin and IGF-I) of infants born small for gestational age (SGA). Body composition (by absorptiometry), HMW adiponectin, and IGF-I were assessed at birth and 4 months in BRF infants born appropriate for gestational age (AGA; n = 72) and SGA infants receiving BRF (n = 46) or FOF (n = 56), the latter being randomized to receive a standard (FOF1) or protein-rich formula (FOF2). Compared with AGA-BRF infants, the catchup growth of SGA infants was confined to lean mass, independently of nutrition. Compared with AGA-BRF infants, SGA-BRF infants had normal HMW adiponectin and IGF-I levels at 4 months, whereas SGA-FOF infants had elevated levels of HMW adiponectin (particularly SGA-FOF1) and IGF-I (particularly SGA-FOF2). In conclusion, neonatal nutrition seems to influence endocrinology more readily than body composition of SGA infants. Follow-up will disclose whether the endocrine abnormalities in SGA-FOF infants can serve as early markers of an unfavorable metabolic course and whether they may contribute to design early interventions that prevent subsequent disease, including diabetes. PMID:22648385

  7. Variations and Determinants of Mortality and Length of Stay of Very Low Birth Weight and Very Low for Gestational Age Infants in Seven European Countries.

    PubMed

    Fatttore, Giovanni; Numerato, Dino; Peltola, Mikko; Banks, Helen; Graziani, Rebecca; Heijink, Richard; Over, Eelco; Klitkou, Søren Toksvig; Fletcher, Eilidh; Mihalicza, Péter; Sveréus, Sofia

    2015-12-01

    The EuroHOPE very low birth weight and very low for gestational age infants study aimed to measure and explain variation in mortality and length of stay (LoS) in the populations of seven European nations (Finland, Hungary, Italy (only the province of Rome), the Netherlands, Norway, Scotland and Sweden). Data were linked from birth, hospital discharge and mortality registries. For each infant basic clinical and demographic information, infant mortality and LoS at 1 year were retrieved. In addition, socio-economic variables at the regional level were used. Results based on 16,087 infants confirm that gestational age and Apgar score at 5 min are important determinants of both mortality and LoS. In most countries, infants admitted or transferred to third-level hospitals showed lower probability of death and longer LoS. In the meta-analyses, the combined estimates show that being male, multiple births, presence of malformations, per capita income and low population density are significant risk factors for death. It is essential that national policies improve the quality of administrative datasets and address systemic problems in assigning identification numbers at birth. European policy should aim at improving the comparability of data across jurisdictions. PMID:26633869

  8. Mother's education and the risk of preterm and small for gestational age birth: a DRIVERS meta-analysis of 12 European cohorts

    PubMed Central

    Ruiz, Milagros; Goldblatt, Peter; Morrison, Joana; Kukla, Lubomír; Švancara, Jan; Riitta-Järvelin, Marjo; Taanila, Anja; Saurel-Cubizolles, Marie-Josèphe; Lioret, Sandrine; Bakoula, Chryssa; Veltsista, Alexandra; Porta, Daniela; Forastiere, Francesco; van Eijsden, Manon; Vrijkotte, Tanja G M; Eggesbø, Merete; White, Richard A; Barros, Henrique; Correia, Sofia; Vrijheid, Martine; Torrent, Maties; Rebagliato, Marisa; Larrañaga, Isabel; Ludvigsson, Johnny; Olsen Faresjö, Åshild; Hryhorczuk, Daniel; Antipkin, Youriy; Marmot, Michael; Pikhart, Hynek

    2015-01-01

    Background A healthy start to life is a major priority in efforts to reduce health inequalities across Europe, with important implications for the health of future generations. There is limited combined evidence on inequalities in health among newborns across a range of European countries. Methods Prospective cohort data of 75 296 newborns from 12 European countries were used. Maternal education, preterm and small for gestational age births were determined at baseline along with covariate data. Regression models were estimated within each cohort and meta-analyses were conducted to compare and measure heterogeneity between cohorts. Results Mother's education was linked to an appreciable risk of preterm and small for gestational age (SGA) births across 12 European countries. The excess risk of preterm births associated with low maternal education was 1.48 (1.29 to 1.69) and 1.84 (0.99 to 2.69) in relative and absolute terms (Relative/Slope Index of Inequality, RII/SII) for all cohorts combined. Similar effects were found for SGA births, but absolute inequalities were greater, with an SII score of 3.64 (1.74 to 5.54). Inequalities at birth were strong in the Netherlands, the UK, Sweden and Spain and marginal in other countries studied. Conclusions This study highlights the value of comparative cohort analysis to better understand the relationship between maternal education and markers of fetal growth in different settings across Europe. PMID:25911693

  9. A Triplet Pregnancy with Spontaneous Delivery of a Fetus at Gestational Age of 20 Weeks and Pregnancy Continuation of Two Other Fetuses until Week 33

    PubMed Central

    Ghorbani, Maryam; Moghadam, Somayeh

    2016-01-01

    Introduction: The prevalence of pregnancies with triplet or more has been increased due to using assisted reproductive treatments. Meanwhile, multiple pregnancies have higher risks and long-term maternal-fetal complications compared to twin and singleton pregnancies. Delayed interval delivery (DID) is a new approach in the management of multiple pregnancies following delivery or abortion. The purpose of this paper is to evaluate the benefits of DID and presents a case that used this method. Methods: This paper covers a report on a case of triplet pregnancy resulting from assisted reproductive techniques with spontaneous delivery of a fetus at gestational age of 20 weeks and the use of conservative DID for two other fetuses until the 33rd week. Results: In our case, the delivery of two other fetuses occurred spontaneously at gestational age of 33 weeks after the delivery of the first fetus at week 20. Conclusions: Using DID is a useful and reliable method, but requires careful monitoring, especially in patients with a history of infertility. PMID:26383220

  10. Maternal Plane of Nutrition during Late Gestation and Weaning Age Alter Angus × Simmental Offspring Longissimus Muscle Transcriptome and Intramuscular Fat.

    PubMed

    Moisá, Sonia J; Shike, Daniel W; Shoup, Lindsay; Rodriguez-Zas, Sandra L; Loor, Juan J

    2015-01-01

    In model organisms both the nutrition of the mother and the young offspring could induce long-lasting transcriptional changes in tissues. In livestock, such changes could have important roles in determining nutrient use and meat quality. The main objective was to evaluate if plane of maternal nutrition during late-gestation and weaning age alter the offspring's Longissimus muscle (LM) transcriptome, animal performance, and metabolic hormones. Whole-transcriptome microarray analysis was performed on LM samples of early (EW) and normal weaned (NW) Angus × Simmental calves born to grazing cows receiving no supplement [low plane of nutrition (LPN)] or 2.3 kg high-grain mix/day [medium plane of nutrition (MPN)] during the last 105 days of gestation. Biopsies of LM were harvested at 78 (EW), 187 (NW) and 354 (before slaughter) days of age. Despite greater feed intake in MPN offspring, blood insulin was greater in LPN offspring. Carcass intramuscular fat content was greater in EW offspring. Bioinformatics analysis of the transcriptome highlighted a modest overall response to maternal plane of nutrition, resulting in only 35 differentially expressed genes (DEG). However, weaning age and a high-grain diet (EW) strongly impacted the transcriptome (DEG = 167), especially causing a lipogenic program activation. In addition, between 78 and 187 days of age, EW steers had an activation of the innate immune system due presumably to macrophage infiltration of intramuscular fat. Between 187 and 354 days of age (the "finishing" phase), NW steers had an activation of the lipogenic transcriptome machinery, while EW steers had a clear inhibition through the epigenetic control of histone acetylases. Results underscored the need to conduct further studies to understand better the functional outcome of transcriptome changes induced in the offspring by pre- and post-natal nutrition. Additional knowledge on molecular and functional outcomes would help produce more efficient beef cattle

  11. Maternal Plane of Nutrition during Late Gestation and Weaning Age Alter Angus × Simmental Offspring Longissimus Muscle Transcriptome and Intramuscular Fat

    PubMed Central

    Moisá, Sonia J.; Shike, Daniel W.; Shoup, Lindsay; Rodriguez-Zas, Sandra L.; Loor, Juan J.

    2015-01-01

    In model organisms both the nutrition of the mother and the young offspring could induce long-lasting transcriptional changes in tissues. In livestock, such changes could have important roles in determining nutrient use and meat quality. The main objective was to evaluate if plane of maternal nutrition during late-gestation and weaning age alter the offspring’s Longissimus muscle (LM) transcriptome, animal performance, and metabolic hormones. Whole-transcriptome microarray analysis was performed on LM samples of early (EW) and normal weaned (NW) Angus × Simmental calves born to grazing cows receiving no supplement [low plane of nutrition (LPN)] or 2.3 kg high-grain mix/day [medium plane of nutrition (MPN)] during the last 105 days of gestation. Biopsies of LM were harvested at 78 (EW), 187 (NW) and 354 (before slaughter) days of age. Despite greater feed intake in MPN offspring, blood insulin was greater in LPN offspring. Carcass intramuscular fat content was greater in EW offspring. Bioinformatics analysis of the transcriptome highlighted a modest overall response to maternal plane of nutrition, resulting in only 35 differentially expressed genes (DEG). However, weaning age and a high-grain diet (EW) strongly impacted the transcriptome (DEG = 167), especially causing a lipogenic program activation. In addition, between 78 and 187 days of age, EW steers had an activation of the innate immune system due presumably to macrophage infiltration of intramuscular fat. Between 187 and 354 days of age (the “finishing” phase), NW steers had an activation of the lipogenic transcriptome machinery, while EW steers had a clear inhibition through the epigenetic control of histone acetylases. Results underscored the need to conduct further studies to understand better the functional outcome of transcriptome changes induced in the offspring by pre- and post-natal nutrition. Additional knowledge on molecular and functional outcomes would help produce more efficient beef

  12. Mid- and long-term outcome of 166 premature infants weighing less than 1,000 g at birth, all small for gestational age.

    PubMed

    Monset-Couchard, M; de Bethmann, O; Kastler, B

    2002-01-01

    This longitudinal study reported the mid- and long-term neurodevelopmental outcome of 166 premature infants born with an extremely low birth weight (<1,000 g), all small for gestational age (<10th percentile birth weight for gestational age). Nine girls were lost to follow-up before 3 years of age, and 6 children were excluded a posteriori because of specific conditions diagnosed in the 1st year of life (severe abnormalities in 5). Of the remaining 151 children, 2% had cerebral palsy, 15% had lesser motor disturbances (reduced to 2% after psychomotor training), 8% had early severe developmental delays, and added mild and moderate delays and increasing cognitive gaps amounted to 28% in the 14th year. Visual deficits increased with age up to 63% of the older children. Seven children had deafness and 13 had hearing losses after otitis media. Language delays were observed at some stage in 31% of cases, as well as behavioral disturbances in 42% (severe problems in 12%). At last evaluation, 34% of the children were normal (12% of the older ones), 51% had minor deficiencies, 18% had moderate and 3% had major disabilities. Children entered the first grade in the 7th year in only 84% of cases, which dropped to 63% at proper level in the second grade; 47% entered high school at the proper age, 7/15 obtained the 'baccalauréat' in the 19th/20th year. The school performance was heavily dependent on the socioeconomic and cultural level of the family. PMID:12011568

  13. Low Birth Weight, Small for Gestational Age and Preterm Births before and after the Economic Collapse in Iceland: A Population Based Cohort Study

    PubMed Central

    Eiríksdóttir, Védís Helga; Ásgeirsdóttir, Tinna Laufey; Bjarnadóttir, Ragnheiður Ingibjörg; Kaestner, Robert; Cnattingius, Sven; Valdimarsdóttir, Unnur Anna

    2013-01-01

    Objective Infants born small for gestational age (SGA) or preterm have increased rates of perinatal morbidity and mortality. Stressful events have been suggested as potential contributors to preterm birth (PB) and low birth weight (LBW). We studied the effect of the 2008 economic collapse in Iceland on the risks of adverse birth outcomes. Study design The study population constituted all Icelandic women giving birth to live-born singletons from January 1st 2006 to December 31st 2009. LBW infants were defined as those weighing <2500 grams at birth, PB infants as those born before 37 weeks of gestation and SGA as those with a birth weight for gestational age more than 2 standard deviations (SD's) below the mean according to the Swedish fetal growth curve. We used logistic regression analysis to estimate odds ratios [OR] and corresponding 95 percent confidence intervals [95% CI] of adverse birth outcomes by exposure to calendar time of the economic collapse, i.e. after October 6th 2008. Results Compared to the preceding period, we observed an increased adjusted odds in LBW-deliveries following the collapse (aOR = 1.24, 95% CI [1.02, 1.52]), particularly among infants born to mothers younger than 25 years (aOR = 1.85, 95% CI [1.25, 2.72]) and not working mothers (aOR = 1.61, 95% CI [1.10, 2.35]). Similarly, we found a tendency towards higher incidence of SGA-births (aOR = 1.14, 95% CI [0.86, 1.51]) particularly among children born to mothers younger than 25 years (aOR = 1.87, 95% CI [1.09, 3.23]) and not working mothers (aOR = 1.86, 95% CI [1.09, 3.17]). No change in risk of PB was observed. The increase of LBW was most distinct 6–9 months after the collapse. Conclusion The results suggest an increase in risk of LBW shortly after the collapse of the Icelandic national economy. The increase in LBW seems to be driven by reduced fetal growth rate rather than shorter gestation. PMID:24324602

  14. Gestational surrogacy.

    PubMed

    Brinsden, Peter R

    2003-01-01

    Gestational surrogacy is a treatment option available to women with certain clearly defined medical problems, usually an absent uterus, to help them have their own genetic children. IVF allows the creation of embryos from the gametes of the commissioning couple and subsequent transfer of these embryos to the uterus of a surrogate host. The indications for treatment include absent uterus, recurrent miscarriage, repeated failure of IVF and certain medical conditions. Treatment by gestational surrogacy is straightforward and follows routine IVF procedures for the commissioning mother, with the transfer of fresh or frozen-thawed embryos to the surrogate host. The results of treatment are good, as would be expected from the transfer of embryos derived from young women and transferred to fit, fertile women who are also young. Clinical pregnancy rates achieved in large series are up to 40% per transfer and series have reported 60% of hosts achieving live births. The majority of ethical or legal problems that have arisen out of surrogacy have been from natural or partial surrogacy arrangements. The experience of gestational surrogacy has been largely complication-free and early results of the follow-up of children, commissioning couples and surrogates are reassuring. In conclusion, gestational surrogacy arrangements are carried out in a few European countries and in the USA. The results of treatment are satisfactory and the incidence of major ethical or legal complications has been limited. IVF surrogacy is therefore a successful treatment for a small group of women who would otherwise not be able to have their own genetic children. PMID:14640380

  15. Comparison of Birth-and Conception-Based Definitions of Postnatal Age in Developmental and Reproductive Rodent Toxicity Studies: lnfluence of Gestation Length on Measurements of Offspring Body Weight and Puberty in Controls

    EPA Science Inventory

    Most laboratories conducting developmental and reproductive toxicity studies in rodents assign age by defining postnatal day (PND) 0 or 1 as the day of birth (DOB); i.e., gestation length affects PND and the timing of postnatal measurements. Some laboratories, however, define age...

  16. Effects of gestational and postnatal age on body temperature, oxygen consumption, and activity during early skin-to-skin contact between preterm infants of 25-30-week gestation and their mothers.

    PubMed

    Bauer, K; Pyper, A; Sperling, P; Uhrig, C; Versmold, H

    1998-08-01

    Temporary skin-to-skin contact between preterm infant and the mother is increasingly used in neonatal medicine to promote bonding. It is not known at which gestational age (GA) and postnatal age skin-to-skin contact outside the incubator is a sufficiently warm environment and is tolerated by preterm infants without a decrease in body temperature, oxygen consumption (VO2) increase, or unrest. We conducted a prospective clinical study of 27 spontaneously breathing preterm infants of 25-30-wk GA. Rectal temperature (Trecta), VO2 (indirect calorimetry), and activity were continuously measured in the incubator (60 min), during skin-to-skin contact (60 min), and back in the incubator (60 min) in wk 1 and 2 of life. In wk 1 the change in Trectal during skin-to-skin contact was related to GA (r=0.585, p=0.0027): infants of 25-27-wk GA lost heat during skin-to-skin contact, whereas infants of 28-30 wk gained heat and their mean Trectal during skin-to-skin contact was 0.3 degrees C higher than before (p < 0.01). No significant changes of VO2 or activity occurred. In wk 2 the infants' VO2 was higher than in wk 1, but VO2 during skin-to-skin contact was the same as in the incubator. Only small fluctuations in Trectal occurred. In wk 2 all infants slept more during skin-to-skin contact than in the incubator (p < 0.02). We conclude that, for preterm infants of 28-30-wk GA, skin-to-skin contact was a sufficiently warm environment as early as postnatal wk 1. For infants of 25-27-wk GA skin-to-skin contact should be postponed until wk 2 of life, when their body temperature remains stable and they are more quiet during skin-to-skin contact than in the incubator. PMID:9702922

  17. Associations of consumption of fruits and vegetables during pregnancy with infant birth weight or small for gestational age births: a systematic review of the literature

    PubMed Central

    Murphy, Mary M; Stettler, Nicolas; Smith, Kimberly M; Reiss, Richard

    2014-01-01

    Maternal nutrition is recognized as one of the determinants of fetal growth. Consumption of fruits and vegetables is promoted as part of a healthful diet; however, intakes are typically lower than recommended levels. The purpose of this study was to systematically review results from studies examining the relationship between maternal consumption of fruits and vegetables during pregnancy with infant birth weight or risk for delivering a small for gestational age baby. A comprehensive search of PubMed and EMBASE was conducted and abstracts were screened using predefined criteria. Eleven relevant studies were identified and systematically reviewed, including six prospective cohort studies, three retrospective cohort studies, and two case–control studies. Seven studies were conducted in cohorts from highly developed countries. One prospective study from a highly developed area reported increased risk for small for gestational age birth by women with low vegetable intakes (odds ratio 3.1; 95% confidence interval 1.4–6.9; P=0.01); another large prospective study reported a 10.4 g increase in birth weight per quintile increase in fruit intake (95% confidence interval 6.9–3.9; P<0.0001) and increases of 8.4 or 7.7 g per quintile intake of fruits and vegetables (combined) or fruits, vegetables, and juice (combined), respectively. One retrospective study reported an association between low fruit intake and birth weight. In less developed countries, increased vegetable or fruit intake was associated with increased birth weight in two prospective studies. Overall, limited inconclusive evidence of a protective effect of increased consumption of vegetables and risk for small for gestational age birth, and increased consumption of fruits and vegetables and increased birth weight among women from highly developed countries was identified. Among women in less developed countries, limited inconclusive evidence suggests that increased consumption of vegetables or fruits may be

  18. The Parity Theorem Shuffle

    ERIC Educational Resources Information Center

    Smith, Michael D.

    2016-01-01

    The Parity Theorem states that any permutation can be written as a product of transpositions, but no permutation can be written as a product of both an even number and an odd number of transpositions. Most proofs of the Parity Theorem take several pages of mathematical formalism to complete. This article presents an alternative but equivalent…

  19. Prevalence and Risk Factors of Gestational Diabetes in Iran: A Systematic Review and Meta-Analysis

    PubMed Central

    JAFARI-SHOBEIRI, Mehri; GHOJAZADEH, Morteza; AZAMI-AGHDASH, Saber; NAGHAVI-BEHZAD, Mohammad; PIRI, Reza; POURALI-AKBAR, Yasmin; NASROLLAH-ZADEH, Raheleh; BAYAT-KHAJEH, Parvaneh; MOHAMMADI, Marzieh

    2015-01-01

    Background: Gestational Diabetes (GD) is one of the major public health issues. The purpose of the present study was to perform a systematic review and meta-analysis to assess the risk factors and prevalence rate of this disorder in Iran. Methods: This systematic review and meta- analysis article was prepared using the databases of Science Direct, Pub-Med, Scopus, Magiran, Iranmedex and SID, Google search engine, Gray Literature, reference lists check and hand searching using keywords such as “prevalence”, “gestational diabetes mellitus”, “GDM”, “risk factor*”, “Iran” and “Postpartum Diabetes”. The selected papers were fully reviewed and the required information for the systematic review was extracted and summarized using extraction table in Microsoft Office Excel software. Results: Twenty-four of 1011 papers were quite relevant to the objectives of the review so they were included. The mean age of the participants was 29.43±4.97 yr and the prevalence of GDM was 3.41% (the highest and the lowest prevalence rates were 18.6% and 1.3% respectively). Among the influential factors mentioned in the literature, potential causes of GDM are gestational age, history of gestational diabetes, family history of diabetes, body mass index, abortions and parity, and history of macrosomia. Conclusion: Considering the high prevalence of postpartum diabetes and its related factors in Iran, strategic planning for disease prevention and reduction is inevitable. PMID:26587467

  20. Breastfeeding Outcome Comparison by Parity

    PubMed Central

    Schaefer, Eric W.; Beiler, Jessica S.; Rose, Chelsea M.; Paul, Ian M.

    2015-01-01

    Abstract Objective: Anecdotally, breastfeeding experiences differ between those who have previously nursed an infant and those who are primiparous. This analysis contrasted breastfeeding outcomes between primiparous women and those with previous experience spanning from maternity stay through 6 months postpartum. Study Design: A secondary analysis was conducted of data collected in a randomized, controlled trial with mothers and “well” newborns ≥34 weeks of gestation comparing two post–hospital discharge care models. Mothers completed an in-person interview during the postpartum stay and phone surveys at 2 weeks, 2 months, and 6 months where questionnaires related to breastfeeding were completed. All participants intended to breastfeed. Chi-squared and Wilcoxon rank sum tests were used to test for differences between parity groups. Breastfeeding duration by parity group was compared using a Kaplan–Meier plot and a logrank test. A Cox proportional hazards model was used to evaluate the relationship between breastfeeding duration and parity after adjusting for covariates. Results: Among 1,099 mothers available for analysis, 542 (49%) were primiparous. Multiparous mothers had a longer intended breastfeeding duration (median, 9 vs. 6 months; p<0.001). Following delivery, primiparous mothers had a longer median time to first breastfeeding attempt (119 vs. 96 minutes; p<0.001) and were more likely to have eight or fewer feeding attempts in the first 24 hours (33% vs. 44%; p<0.001)). More primiparous women reported early breastfeeding problems (35% vs. 20%; p<0.001) and mixed feeding at hospital discharge (39% vs. 23%; p<0.001) despite reporting less breastfeeding-associated pain during the first week (p=0.04). Multiparous women were more likely to breastfeed through 6 months (p<0.001). In a multivariable Cox model for breastfeeding duration, an interaction existed between intended breastfeeding duration and parity (p=0.006); among those intending to breastfeed

  1. DNA Methylation and Expression Patterns of Selected Genes in First-Trimester Placental Tissue from Pregnancies with Small-for-Gestational-Age Infants at Birth.

    PubMed

    Leeuwerke, Mariëtte; Eilander, Michelle S; Pruis, Maurien G M; Lendvai, Ágnes; Erwich, Jan Jaap H M; Scherjon, Sicco A; Plösch, Torsten; Eijsink, Jasper J H

    2016-02-01

    Variations in DNA methylation levels in the placenta are thought to influence gene expression and are associated with complications of pregnancy, like fetal growth restriction (FGR). The most important cause for FGR is placental dysfunction. Here, we examined whether changes in DNA methylation, followed by gene expression changes, are mechanistically involved in the etiology of FGR. In this retrospective case-control study, we examined the association between small-for-gestational-age (SGA) children and both DNA methylation and gene expression levels of the genes WNT2, IGF2/H19, SERPINA3, HERVWE1, and PPARG in first-trimester placental tissue. We also examined the repetitive element LINE-1. These candidate genes have been reported in the literature to be associated with SGA. We used first-trimester placental tissue from chorionic villus biopsies. A total of 35 SGA children (with a birth weight below the 10th percentile) were matched to 70 controls based on their gestational age. DNA methylation levels were analyzed by pyrosequencing and mRNA levels were analyzed by real-time PCR. None of the average DNA methylation levels, measured for each gene, showed a significant difference between SGA placental tissue compared to control tissue. However, hypermethylation of WNT2 was detected on two CpG positions in SGA. This was not associated with changes in gene expression. Apart from two CpG positions of the WNT2 gene, in early placenta samples, no evident changes in DNA methylation or expression were found. This indicates that the already reported changes in term placenta are not present in the early placenta, and therefore must arise after the first trimester. PMID:26740591

  2. Literature-Informed Analysis of a Genome-Wide Association Study of Gestational Age in Norwegian Women and Children Suggests Involvement of Inflammatory Pathways

    PubMed Central

    Bacelis, Jonas; Juodakis, Julius; Sengpiel, Verena; Zhang, Ge; Myhre, Ronny; Muglia, Louis J.; Nilsson, Staffan; Jacobsson, Bo

    2016-01-01

    Background Five-to-eighteen percent of pregnancies worldwide end in preterm birth, which is the major cause of neonatal death and morbidity. Approximately 30% of the variation in gestational age at birth can be attributed to genetic factors. Genome-wide association studies (GWAS) have not shown robust evidence of association with genomic loci yet. Methods We separately investigated 1921 Norwegian mothers and 1199 children from pregnancies with spontaneous onset of delivery. Individuals were further divided based on the onset of delivery: initiated by labor or prelabor rupture of membranes. Genetic association with ultrasound-dated gestational age was evaluated using three genetic models and adaptive permutations. The top-ranked loci were tested for enrichment in 12 candidate gene-sets generated by text-mining PubMed abstracts containing pregnancy-related keywords. Results The six GWAS did not reveal significant associations, with the most extreme empirical p = 5.1 × 10−7. The top loci from maternal GWAS with deliveries initiated by labor showed significant enrichment in 10 PubMed gene-sets, e.g., p = 0.001 and 0.005 for keywords "uterus" and "preterm" respectively. Enrichment signals were mainly caused by infection/inflammation-related genes TLR4, NFKB1, ABCA1, MMP9. Literature-informed analysis of top loci revealed further immunity genes: IL1A, IL1B, CAMP, TREM1, TFRC, NFKBIA, MEFV, IRF8, WNT5A. Conclusion Our analyses support the role of inflammatory pathways in determining pregnancy duration and provide a list of 32 candidate genes for a follow-up work. We observed that the top regions from GWAS in mothers with labor-initiated deliveries significantly more often overlap with pregnancy-related genes than would be expected by chance, suggesting that increased sample size would benefit similar studies. PMID:27490719

  3. Fast Food Consumption and Gestational Diabetes Incidence in the SUN Project

    PubMed Central

    Dominguez, Ligia J.; Martínez-González, Miguel A.; Basterra-Gortari, Francisco Javier; Gea, Alfredo; Barbagallo, Mario; Bes-Rastrollo, Maira

    2014-01-01

    Background Gestational diabetes prevalence is increasing, mostly because obesity among women of reproductive age is continuously escalating. We aimed to investigate the incidence of gestational diabetes according to the consumption of fast food in a cohort of university graduates. Methods The prospective dynamic “Seguimiento Universidad de Navarra” (SUN) cohort included data of 3,048 women initially free of diabetes or previous gestational diabetes who reported at least one pregnancy between December 1999 and March 2011. Fast food consumption was assessed through a validated 136-item semi-quantitative food frequency questionnaire. Fast food was defined as the consumption of hamburgers, sausages, and pizza. Three categories of fast food were established: low (0–3 servings/month), intermediate (>3 servings/month and ≤2 servings/week) and high (>2 servings/week). Non-conditional logistic regression models were used to adjust for potential confounders. Results We identified 159 incident cases of gestational diabetes during follow-up. After adjusting for age, baseline body mass index, total energy intake, smoking, physical activity, family history of diabetes, cardiovascular disease/hypertension at baseline, parity, adherence to Mediterranean dietary pattern, alcohol intake, fiber intake, and sugar-sweetened soft drinks consumption, fast food consumption was significantly associated with a higher risk of incident gestational diabetes, with multivariate adjusted OR of 1.31 (95% conficence interval [CI]:0.81–2.13) and 1.86 (95% CI: 1.13–3.06) for the intermediate and high categories, respectively, versus the lowest category of baseline fast food consumption (p for linear trend: 0.007). Conclusion Our results suggest that pre-pregnancy higher consumption of fast food is an independent risk factor for gestational diabetes. PMID:25215961

  4. Childhood Cognitive Ability: Relationship to Gestational Diabetes Mellitus in India

    PubMed Central

    Veena, S R; Krishnaveni, G V; Srinivasan, K; Kurpad, A V; Muthayya, S; Hill, J C; Kiran, K N; Fall, C H D

    2012-01-01

    Aims/Hypothesis To test the hypothesis that maternal gestational diabetes mellitus (GDM) is associated with poorer cognitive ability in children born to mothers with GDM compared to children born to non-GDM mothers in India. Methods During 1997-98 maternal GDM status was assessed at 30±2 weeks of gestation. Between 2007-2008, at a mean age of 9.7 years, 515 children (32-offspring of GDM mothers (ODM’s); 483-offspring of non-GDM mothers (controls)) from the Mysore Parthenon birth cohort underwent cognitive function assessment using tests from the Kaufman Assessment Battery for children-second edition and additional tests measuring learning, long-term storage/retrieval, short-term memory, reasoning, attention and concentration, visuo-spatial and verbal abilities. Results Compared to controls, ODM’S scored higher in tests for learning, long-term retrieval/storage (p=0.008), reasoning (p=0.02), verbal ability (p=0.01) and attention and concentration (p=0.003). In multiple regression, adjusted for the child’s age, sex, gestation, neonatal weight and head circumference, maternal age, parity, BMI, parent’s socio-economic status, education and rural/urban residence, this difference remained significant only for learning, long-term retrieval/storage (β=0.4SD (95% CI: 0.01, 0.75); p=0.042) and verbal ability (β=0.5SD (95% CI: 0.09, 0.83); p=0.015) and not with other test scores. Conclusions/interpretation In this population of healthy Indian children, there was no evidence of lower cognitive ability in ODM’s. In fact some cognitive scores were higher in ODM’s. PMID:20614102

  5. Fate of R parity

    SciTech Connect

    Perez, Pavel Fileviez; Spinner, Sogee

    2011-02-01

    The possible origin of the R-parity-violating interactions in the minimal supersymmetric standard model and its connection to the radiative symmetry-breaking mechanism is investigated in the context of the simplest model where the radiative symmetry-breaking mechanism can be implemented. We find that, in the majority of the parameter space, R parity is spontaneously broken at the low scale. These results hint that R-parity-violating processes could be observed at the Large Hadron Collider, if supersymmetry is realized in nature.

  6. The effects of dexamethasone treatment in early gestation on hypothalamic-pituitary-adrenal responses and gene expression at 7 months of postnatal age in sheep.

    PubMed

    Li, Shaofu; Nitsos, Ilias; Polglase, Graeme R; Braun, Thorsten; Moss, Timothy J M; Newnham, John P; Challis, John R G

    2012-03-01

    We determined the effects of prenatal dexamethasone administration in early gestation on development of the hypothalamic-pituitary-adrenal (HPA) axis up to 7 months of postnatal age with measurements of hormone levels and gene expression. Plasma adrenocorticotropic hormone and cortisol levels after corticotropin-releasing hormone (CRH)/arginine vasopressin challenge were lower in treatment females than in control females and treatment males. Calculation of cortisol to adrenocorticotropic hormone ratios indicated however that the adrenals of treatment females were more responsive to adrenocorticotropic hormone than control females or treatment males. Effects of treatment and sex dependence at 7 months of age were observed in levels of hypothalamic CRH messenger RNA (mRNA), hypothalamic arginine vasopressin mRNA, pituitary proopiomelanocortin mRNA, pituitary prohormone convertase 1 and prohormone convertase 2, glucocorticoid receptor and mineralocorticoid receptor in the hypothalamus and hippocampus, adrenal adrenocorticotropic hormone receptor, steroidogenic acute regulatory, 3β hydroxysteroid dehydrogenase, and 11β hydroxysteroid dehydrogenase type 2 mRNA. The results indicate that exposure to glucocorticoids in early pregnancy produces persisting and sex-dependent effects on the hypothalamic-pituitary-adrenal axis at 7 months of age. PMID:22101239

  7. Gonadotropin-induced puberty does not impair reproductive performance of gilts over three parities.

    PubMed

    Eckhardt, O H O; Martins, S M M K; Pinese, M E; Horta, F C; Rosseto, A C; Torres, M A; De Andrade, A F C; Muro, B B D; Marino, C T; Rodrigues, P H M; Moretti, A S

    2014-12-01

    The aim of this study was to evaluate the reproductive performance of three parities of gilts treated or not treated with gonadotropin to induce puberty. Sixty gilts received 600 IU of equine chorionic gonadotropin (eCG) followed by 2.5 mg of porcine luteinizing hormone (LH) 72 h later. Fifty-nine other gilts were exposed only to a mature boar for 15 min twice daily. Artificial insemination (AI) was performed at 0, 12 and 24 h after the detection of oestrus, and gestation was confirmed by ultrasound after 35 days. Sows were inseminated at the first post-weaning oestrus. The total numbers of piglets born, piglets born alive, stillborn, mummified foetuses, as well as pregnancy and farrowing rates were evaluated for each of the three parities. Culling rates, farrowing intervals and weaning-to-oestrous intervals (WEI) were also analysed. Mean age at puberty and oestrous manifestation were not significantly different between treatments (p = 0.0639; 179.20 ± 17.52 compared with 173.96 ± 16.94, 91.66% compared with 94.92%) across the experimental period. However, females that underwent puberty induction showed modest increases both in the number of total pigs born and in the number of piglets born alive. In conclusion, puberty induction through exogenous gonadotropin administration in field conditions did not induce a more concentrated first oestrous manifestation, but trended to a modest increase in the number of pigs born alive in the first parity and a reduced culling rate during the first gestation. PMID:25251704

  8. Gestational trophoblastic disease

    MedlinePlus

    ... type of cancer) Hydatiform mole (also called a molar pregnancy) References Goldstein DP, Berkowitz RS. Gestational trophoblastic disease. ... 90. McGee J, Covens A. Gestational trophoblastic disease: hydatidiform mole, nonmetastatic and metastatic gestational trophoblastic tumor: diagnosis and ...

  9. Mental Health in Low-to-Moderate Risk Preterm, Low Birth Weight, and Small for Gestational Age Children at 4 to 5 Years: The Role of Early Maternal Parenting

    ERIC Educational Resources Information Center

    Westrupp, Elizabeth M.; Mensah, Fiona K.; Giallo, Rebecca; Cooklin, Amanda; Nicholson, Jan M.

    2012-01-01

    Objectives: The majority of children born preterm, with low birth weight, or small for gestational age are born with low-to-moderate risk (LTM), yet most research focuses on the high-risk group. Little is known about whether children with LTM perinatal risk are at greater risk for mental health problems, or what the role of early maternal…

  10. Gestational diabetes: A clinical update

    PubMed Central

    Kampmann, Ulla; Madsen, Lene Ring; Skajaa, Gitte Oeskov; Iversen, Ditte Smed; Moeller, Niels; Ovesen, Per

    2015-01-01

    Gestational diabetes mellitus (GDM) is increasing in prevalence in tandem with the dramatic increase in the prevalence of overweight and obesity in women of childbearing age. Much controversy surrounds the diagnosis and management of gestational diabetes, emphasizing the importance and relevance of clarity and consensus. If newly proposed criteria are adopted universally a significantly growing number of women will be diagnosed as having GDM, implying new therapeutic challenges to avoid foetal and maternal complications related to the hyperglycemia of gestational diabetes. This review provides an overview of clinical issues related to GDM, including the challenges of screening and diagnosis, the pathophysiology behind GDM, the treatment and prevention of GDM and the long and short term consequences of gestational diabetes for both mother and offspring. PMID:26240703

  11. Air pollutant exposure and preterm and term small-for-gestational-age births in Detroit, Michigan: Long-term trends and associations

    PubMed Central

    Le, Hien Q.; Batterman, Stuart A.; Wirth, Julia J.; Wahl, Robert L.; Hoggatt, Katherine J.; Sadeghnejad, Alireza; Hultin, Mary Lee; Depa, Michael

    2015-01-01

    Studies in a number of countries have reported associations between exposure to ambient air pollutants and adverse birth outcomes, including low birth weight, preterm birth (PTB) and, less commonly, small for gestational age (SGA). Despite their growing number, the available studies have significant limitations, e.g., incomplete control of temporal trends in exposure, modest sample sizes, and a lack of information regarding individual risk factors such as smoking. No study has yet examined large numbers of susceptible individuals. We investigated the association between ambient air pollutant concentrations and term SGA and PTB outcomes among 164,905 singleton births in Detroit, Michigan occurring between 1990 and 2001. SO2, CO, NO2, O3 and PM10 exposures were used in single and multiple pollutant logistic regression models to estimate odds ratios (OR) for these outcomes, adjusted for the infant’s sex and gestational age, the mother’s race, age group, education level, smoking status and prenatal care, birth season, site of residence, and long-term exposure trends. Term SGA was associated with CO levels exceeding 0.75 ppm (OR=1.14, 95% confidence interval=1.02–1.27) and NO2 exceeding 6.8 ppb (1.11, 1.03–1.21) exposures in the first month, and with PM10 exceeding 35 μg/m3 (1.22, 1.03–1.46) and O3 (1.11, 1.02–1.20) exposure in the third trimester. PTB was associated with SO2 (1.07, 1.01–1.14) exposure in the last month, and with (hourly) O3 exceeding 92 ppb (1.08, 1.02–1.14) exposure in the first month. Exposure to several air pollutants at modest concentrations was associated with adverse birth outcomes. This study, which included a large Black population, suggests the importance of the early period of pregnancy for associations between term SGA with CO and NO2, and between O3 with PTB; and the late pregnancy period for associations between term SGA and O3 and PM10, and between SO2 with PTB. It also highlights the importance of accounting for

  12. A High Ductal Flow Velocity Is Associated with Successful Pharmacological Closure of Patent Ductus Arteriosus in Infants 22–27 Weeks Gestational Age

    PubMed Central

    Olsson, Karl Wilhelm; Jonzon, Anders; Sindelar, Richard

    2012-01-01

    Objective. To identify factors affecting closure of patent ductus arteriosus (PDA) in newborn infants born at 22–27 weeks gestational age (GA) during pharmacological treatment with cyclooxygenase inhibitors. Method. Infants born at 22–27 weeks of GA between January 2006 and December 2009 who had been treated pharmacologically for PDA were identified retrospectively. Medical records were assessed for clinical, ventilatory, and outcome parameters. Echocardiographic examinations during treatment were reviewed. Results. Fifty-six infants were included in the study. Overall success rate of ductal closure with pharmacological treatment was 52%. Infants whose PDA was successfully closed had a higher GA (25 + 4 weeks versus 24 + 3 weeks; P = 0.047), and a higher pretreatment left to right maximal ductal flow velocity (1.6 m/s versus 1.1 m/s; P = 0.023). Correcting for GA, preeclampsia, antenatal steroids, and age at start of treatment, a higher maximal ductal flow velocity was still associated with successful ductal closure (OR 3.04; P = 0.049). Conclusion. Maximal ductal flow velocity was independently associated with success of PDA treatment. PMID:23316351

  13. Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: a pooled country analysis

    PubMed Central

    Katz, Joanne; Lee, Anne CC; Kozuki, Naoko; Lawn, Joy E; Cousens, Simon; Blencowe, Hannah; Ezzati, Majid; Bhutta, Zulfiqar A; Marchant, Tanya; Willey, Barbara A; Adair, Linda; Barros, Fernando; Baqui, Abdullah H; Christian, Parul; Fawzi, Wafaie; Gonzalez, Rogelio; Humphrey, Jean; Huybregts, Lieven; Kolsteren, Patrick; Mongkolchati, Aroonsri; Mullany, Luke C; Ndyomugyenyi, Richard; Nien, Jyh Kae; Osrin, David; Roberfroid, Dominique; Sania, Ayesha; Schmiegelow, Christentze; Silveira, Mariangela F; Tielsch, James; Vaidya, Anjana; Velaphi, Sithembiso C; Victora, Cesar G; Watson-Jones, Deborah; Black, Robert E

    2013-01-01

    Summary Background Babies with low birthweight (<2500 g) are at increased risk of early mortality. However, low birthweight includes babies born preterm and with fetal growth restriction, and not all these infants have a birthweight less than 2500 g. We estimated the neonatal and infant mortality associated with these two characteristics in low-income and middle-income countries. Methods For this pooled analysis, we searched all available studies and identified 20 cohorts (providing data for 2 015 019 livebirths) from Asia, Africa, and Latin America that recorded data for birthweight, gestational age, and vital statistics through 28 days of life. Study dates ranged from 1982 through to 2010. We calculated relative risks (RR) and risk differences (RD) for mortality associated with preterm birth (<32 weeks, 32 weeks to <34 weeks, 34 weeks to <37 weeks), small-for-gestational-age (SGA; babies with birthweight in the lowest third percentile and between the third and tenth percentile of a US reference population), and preterm and SGA combinations. Findings Pooled overall RRs for preterm were 6·82 (95% CI 3·56–13·07) for neonatal mortality and 2·50 (1·48–4·22) for post-neonatal mortality. Pooled RRs for babies who were SGA (with birthweight in the lowest tenth percentile of the reference population) were 1·83 (95% CI 1·34–2·50) for neonatal mortality and 1·90 (1·32–2·73) for post-neonatal mortality. The neonatal mortality risk of babies who were both preterm and SGA was higher than that of babies with either characteristic alone (15·42; 9·11–26·12). Interpretation Many babies in low-income and middle-income countries are SGA. Preterm birth affects a smaller number of neonates than does SGA, but is associated with a higher mortality risk. The mortality risks associated with both characteristics extend beyond the neonatal period. Differentiation of the burden and risk of babies born preterm and SGA rather than with low birthweight could guide

  14. Quantifying Low Birth Weight, Preterm Birth and Small-for-Gestational-Age Effects of Malaria in Pregnancy: A Population Cohort Study

    PubMed Central

    Rijken, Marcus J.; De Livera, Alysha M.; Lee, Sue J.; Boel, Machteld E.; Rungwilailaekhiri, Suthatsana; Wiladphaingern, Jacher; Paw, Moo Kho; Pimanpanarak, Mupawjay; Pukrittayakamee, Sasithon; Simpson, Julie A.; Nosten, François; McGready, Rose

    2014-01-01

    Background The association between malaria during pregnancy and low birth weight (LBW) is well described. This manuscript aims to quantify the relative contribution of malaria to small-for-gestational-age (SGA) infants and preterm birth (PTB) in pregnancies accurately dated by ultrasound on the Thai-Myanmar border at the Shoklo Malaria Research Unit. Methods and Findings From 2001 to 2010 in a population cohort of prospectively followed pregnancies, we analyzed all singleton newborns who were live born, normal, weighed in the first hour of life and with a gestational age (GA) between 28+0 and 41+6 weeks. Fractional polynomial regression was used to determine the mean birthweight and standard deviation as functions of GA. Risk differences and factors of LBW and SGA were studied across the range of GA for malaria and non-malaria pregnancies. From 10,264 newborns records, population centiles were created. Women were screened for malaria by microscopy a median of 22 [range 1–38] times and it was detected and treated in 12.6% (1,292) of pregnancies. Malaria was associated with LBW, PTB, and SGA compared to those without malaria. Nearly two-thirds of PTB were classified as LBW (68% (539/789)), most of which 83% (447/539) were not SGA. After GA 39 weeks, 5% (298/5,966) of non-LBW births were identified as SGA. Low body mass index, primigravida, hypertension, smoking and female sex of the newborn were also significantly and independently associated with LBW and SGA consistent with previous publications. Conclusions Treated malaria in pregnancy was associated with an increased risk for LBW, PTB, and SGA, of which the latter are most important for infant survival. Using LBW as an endpoint without adjusting for GA incorrectly estimated the effects of malaria in pregnancy. Ultrasound should be used for dating pregnancies and birth weights should be expressed as a function (or adjusted for GA) of GA in future malaria in pregnancy studies. PMID:24983755

  15. Parity in knot theory

    SciTech Connect

    Manturov, Vassily O

    2010-06-29

    In this work we study knot theories with a parity property for crossings: every crossing is declared to be even or odd according to a certain preassigned rule. If this rule satisfies a set of simple axioms related to the Reidemeister moves, then certain simple invariants solving the minimality problem can be defined, and invariant maps on the set of knots can be constructed. The most important example of a knot theory with parity is the theory of virtual knots. Using the parity property arising from Gauss diagrams we show that even a gross simplification of the theory of virtual knots, namely, the theory of free knots, admits simple and highly nontrivial invariants. This gives a solution to a problem of Turaev, who conjectured that all free knots are trivial. In this work we show that free knots are generally not invertible, and provide invariants which detect the invertibility of free knots. The passage to ordinary virtual knots allows us to strengthen known invariants (such as the Kauffman bracket) using parity considerations. We also discuss other examples of knot theories with parity. Bibliography: 27 items.

  16. [Neuromuscular status of children of different gestational age on the stage of transition from intrauterine immersion to the earth's gravity].

    PubMed

    2012-01-01

    The work was aimed at describing the neuromuscular status of premature baby in the context of the ontogenetic and zero gravity model using the results of superficial interference electromyography (IEMG). Throughout six postnatal weeks, IEMG of premature babies is similar to EMG of full-term child on the first days of extrauterine life; IEMG is characterized by a "simplified" temporal structure, low amplitude and frequency, IEMG dynamics of fullterm child is slow in contrast to premature baby; the reason seems to be maximum long intrauterine life during which the motor system gets better prepared and maturates. On the other hand, complexity and high amplitude of premature baby IEMG as compared with full-term child of the same postconceptual age are associated with the inevitable sensory stimulation after birth. Abilitation procedures provided to premature baby could be adapted to the purposes of post-flight rehabilitation of cosmonauts. PMID:22953537

  17. The p53 family member p73 modulates the proproliferative role of IGFBP3 in short children born small for gestational age

    PubMed Central

    Marzano, Flaviana; Ventura, Annamaria; Francesco Caratozzolo, Mariano; Aiello, Italia; Mastropasqua, Francesca; Brunetti, Giacomina; Cavallo, Luciano; Sbisà, Elisabetta; Faienza, Maria Felicia; Tullo, Apollonia

    2015-01-01

    The regulation of insulin-like growth factor–binding protein 3 (IGFBP3) gene expression is complex, because it can be induced by agents that both stimulate and inhibit the proliferation. The principal aim of this study was to investigate whether p73, a member of the p53 gene family, has a role in the regulation of the IGFBP3 expression and whether this regulation occurs in a context of cell survival or death. We demonstrate that IGFBP3 is a direct TAp73α (the p73 isoform that contains the trans-activation domain) target gene and activates the expression of IGFBP3 in actively proliferating cells. As IGFBP3 plays a key role in regulating the growth hormone/insulin-like growth factor type 1 (GH/IGF1) axis, whose alterations in gene expression appear to have a role in the growth failure of children born small for gestational age (SGA), we measured the mRNA expression levels of p73 and IGFBP3 in a group of SGA children. We found that mRNA expression levels of p73 and IGFBP3 are significantly lower in SGA children compared with controls and, in particular, p73 mRNA expression is significantly lower in SGA children with respect to height. Our results shed light on the intricate GH/IGF pathway, suggesting p73 as a good biomarker of the clinical risk for SGA children to remain short in adulthood. PMID:26063735

  18. The Fall of Parity.

    ERIC Educational Resources Information Center

    Forman, Paul

    1982-01-01

    Physicists had assumed that the world is distinguishable from its mirror image and constructed theories to ensure that the corresponding mathematical property (parity) is conserved in all subatomic processes. However, a scientific experiment demonstrated an intrinsic handedness to at least one physical process. The experiment, equipment, and…

  19. Does parity affect mortality among parous women?

    PubMed Central

    Koski‐Rahikkala, H; Pouta, A; Pietiläinen, K; Hartikainen, A‐L

    2006-01-01

    Objective To find out whether there is an association between parity and mortality. Design Prospective cohort study. Setting Northern Finland, 1966–2001. Participants and methods 12 055 women in the two northernmost provinces of Finland were followed up from pregnancy in 1966–2001, the coverage percentage being 96%. The data on age, smoking, body mass index, socioeconomic position, age at menarche and age at first birth were collected during pregnancy, and data on deaths were obtained from the National Cause of Death Statistics, maintained by Statistics Finland. The Cox proportional hazard model was used to estimate relative mortality between parity groups. Results Total mortality was lowest among the women with 2–4 children (reference group). High parity was associated with an up to twofold risk of mortality from vascular complications, but after adjustment for all background factors, this significance disappeared. Mortality from haemorrhagic stroke was fourfold higher among the women with ⩾10 births compared with those of the reference group. No differences in cerebral infarction or total cancer mortality were seen between the groups. Primiparity was associated with increased mortality from accidental death (relative risk 2.6, 95% confidence interval 1.6 to 4.4). Conclusions High parity was associated with an increased risk of mortality from vascular complications, especially haemorrhagic stroke, and primiparity with an increased risk of accidental death. PMID:17053286

  20. Imbalance of mononuclear cell infiltrates in the placental tissue from foetuses after spontaneous abortion versus therapeutic termination from 8th to 12th weeks of gestational age.

    PubMed

    Lambropoulou, M; Tamiolakis, D; Venizelos, J; Liberis, V; Galazios, G; Tsikouras, P; Karamanidis, D; Petrakis, G; Constantinidis, T; Menegaki, M; Papadopoulos, N

    2006-12-01

    Placental macrophages (Hofbauer cells) are located close to trophoblastic cells and foetal capillaries, which make them perfect candidates for involvement in regulatory processes within the villous core. Their capacity of producing several cytokines and prostaglandin-synthesising enzymes, and expressing vascular endothelial growth factor, indicate a possible role in placental development and angiogenesis in order to support pregnancy. Common cells to Hofbauer macrophages sharing similar cell surface markers (HLA-A, -B, -C and leukocyte common antigen) have been reported in the stroma, decidua and amnion, indicating additional foetal protection. Yet this is not always the case. Most spontaneous abortions occur before 12 weeks' gestation, and most are due to chromosomal errors in the conceptus. Relatively few truly spontaneous abortions take place between 12 and 20 weeks' gestation. Thereafter, between 20 and 30 weeks, another type of premature spontaneous termination becomes prevalent, which is due to ascending infection. The numbers of cells expressing the various markers of the monocytemacrophage lineage change throughout pregnancy. In the present study, we investigated the immunohistochemical expression of mononuclear infiltrations in paraffin-embedded placentas, from foetuses after spontaneous abortion (8th, 10th and 12th weeks of gestational age), and those after therapeutic abortion at the same time, using a panel of monoclonal antibodies for the identification of leukocytes (CD45/LCA), B-lymphocytes (CD20/L-26), T lymphocytes (CD45RO/UCHL1), CD68 and CD14 cells. Immunologic factors in human reproductive failure are plausible mechanisms of infertility and spontaneous abortion. Approximately 25% of cases of premature ovarian failure appear to result from an autoimmune aetiology. Unfortunately, current therapeutic options for these women are limited to exogenous hormone or gamete substitution. Local inflammations at the sites of endometriosis implants are

  1. Is the atherosclerotic phenotype of preeclamptic placentas due to altered lipoprotein concentrations and placental lipoprotein receptors? Role of a small-for-gestational-age phenotype

    PubMed Central

    Hentschke, Marta R.; Poli-de-Figueiredo, Carlos E.; Pinheiro da Costa, Bartira E.; Kurlak, Lesia O.; Williams, Paula J.; Mistry, Hiten D.

    2013-01-01

    Atherosis of spiral arteries in uteroplacental beds from preeclamptic women resemble those of atherosclerosis, characterized by increased plasma lipids and lipoproteins. We hypothesized that: 1) lipoprotein receptors/transporters in the placenta would be upregulated in preeclampsia, associated with increased maternal and fetal lipoprotein concentrations; and 2) expression of these would be reduced in preeclamptic placentae from women delivering small-for-gestational-age (SGA) infants. Placental biopsies and maternal and umbilical serum samples were taken from 27 normotensive and 24 preeclamptic women. Maternal/umbilical cord serum LDL, HDL, total cholesterol, and triglycerides were measured. Placental mRNA expression of lipoprotein receptors/transporters were quantified using quantitative RT-PCR. Protein localization/expression of LDL receptor-related protein 1 (LRP-1) in the preeclamptic placentae with/without SGA was measured by immunohistochemistry. Placental mRNA expression of all genes except paraoxonase-1 (PON-1), microsomal triglyceride transfer protein (MTTP), and protein disulfide isomerase family A member 2 (PDIA2) were observed. No differences for any lipoprotein receptors/transporters were found between groups; however, in the preeclamptic group placental LRP-1 expression was lower in SGA delivering mothers (n = 7; P = 0.036). LRP-1 protein was localized around fetal vessels and Hofbauer cells. This is the first detailed study of maternal/fetal lipoprotein concentrations and placental lipoprotein receptor mRNA expression in normotensive and preeclamptic pregnancies. These findings do not support a role of altered lipid metabolism in preeclampsia, but may be involved in fetal growth. PMID:23898049

  2. IGF-IR Signal Transduction Protein Content and Its Activation by IGF-I in Human Placentas: Relationship with Gestational Age and Birth Weight

    PubMed Central

    Iñiguez, Germán; Castro, Juan José; Garcia, Mirna; Kakarieka, Elena; Johnson, M. Cecilia; Cassorla, Fernando; Mericq, Verónica

    2014-01-01

    Introduction The human placenta expresses the IGF-I and IGF-IR proteins and their intracellular signal components (IRS-1, AKT and mTOR). The aim of this study was to assess the IGF-IR content and activation of downstream signaling molecules in placentas from newborns who were classified by gestational age and birth weight. We studied placentas from 25 term appropriate (T-AGA), 26 term small (T-SGA), 22 preterm AGA (PT-AGA), and 20 preterm SGA (PT-SGA) newborns. The total and phosphorylated IGF-IR, IRS-1, AKT, and mTOR contents were determined by Western Blot and normalized by actin or with their respective total content. The effect of IGF-I was determined by stimulating placental explants with recombinant IGF-I 10-8 mol/L for 15, 30, and 60 minutes. Results The IGF-IR content was higher in T-SGA compared to T-AGA placentas, and the IRS-1 content was higher in PT-placentas compared with their respective T-placentas. The effect of IGF-I on the phosphorylated forms of IGF-IR was increased in T-SGA (150%) and PT-SGA (300%) compared with their respective AGA placentas. In addition, AKT serine phosphorylation was higher in PT-SGA compared to PT-AGA and T-SGA placentas (90% and 390% respectively). Conclusion The higher protein content and response to IGF-I of IGF-IR, IRS-1, and AKT observed in SGA placentas may represent a compensatory mechanism in response to fetal growth restriction. PMID:25050889

  3. Maternal Antioxidant Levels in Pregnancy and Risk of Preeclampsia and Small for Gestational Age Birth: A Systematic Review and Meta-Analysis

    PubMed Central

    Cohen, Jacqueline M.; Beddaoui, Margaret; Kramer, Michael S.; Platt, Robert W.; Basso, Olga; Kahn, Susan R.

    2015-01-01

    Background Oxidative stress in preeclampsia and small for gestational age (SGA) birth suggests antioxidant supplementation could prevent these conditions. However, it remains unclear whether maternal antioxidant levels are systematically lower in these pregnancies. Objective To conduct a systematic review of the association between maternal antioxidant levels during pregnancy and preeclampsia or SGA. Methods We searched PubMed, Embase, and several other databases from 1970–2013 for observational studies that measured maternal blood levels of non-enzymatic antioxidants (vitamins A, C, E, and carotenoids) during pregnancy or within 72 hours of delivery. The entire review process was done in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale and additional questions. We pooled the standardized mean difference (SMD) across studies, stratified by outcome and pregnancy trimester, and investigated heterogeneity using meta-regression. Results We reviewed 1,882 unique citations and 64 studies were included. Most studies were small with important risk of bias. Among studies that addressed preeclampsia (n = 58) and SGA (n = 9), 16% and 66%, respectively, measured levels prior to diagnosis. The SMDs for vitamins A, C, and E were significantly negative for overall preeclampsia, but not for mild or severe preeclampsia subtypes. Significant heterogeneity was observed in all meta-analyses and most could not be explained. Evidence for lower carotenoid antioxidants in preeclampsia and SGA was limited and inconclusive. Publication bias appears likely. Conclusions Small, low-quality studies limit conclusions that can be drawn from the available literature. Observational studies inconsistently show that vitamins C and E or other antioxidants are lower in women who develop preeclampsia or SGA. Reverse causality remains a possible explanation for associations observed. New clinical trials are not warranted in light of this evidence; however, additional rigorous

  4. Pre-conceptional intake of folic acid supplements is inversely associated with risk of preterm birth and small-for-gestational-age birth: a prospective cohort study.

    PubMed

    Zheng, Ju-Sheng; Guan, Yuhong; Zhao, Yimin; Zhao, Wei; Tang, Xuejuan; Chen, Hua; Xu, Meilong; Wu, Lingping; Zhu, Shanlin; Liu, Huijuan; Huang, Tao; Li, Duo

    2016-02-14

    Associations of folic acid supplementation with risk of preterm birth (PTB) and small-for-gestational-age (SGA) birth were unclear for the Chinese populations. The aim of the present study was to investigate the associations in a large Chinese prospective cohort study: the Jiaxing Birth Cohort. In the Jiaxing Birth Cohort, 240 954 pregnant women visited local clinics or hospitals within their first trimester in Southeast China during 1999-2012. Information on anthropometric parameters, folic acid supplementation and other maternal characteristics were collected by in-person interviews during their first visit. Pregnancy outcomes were recorded during the follow-up of these participants. Multinomial logistic regression was used to examine the association of folic acid supplementation with pregnancy outcomes. The prevalence of folic acid supplementation was 24·9% in the cohort. The prevalence of PTB and SGA birth was 3·48 and 9·2%, respectively. Pre-conceptional folic acid supplementation was associated with 8% lower risk of PTB (relative risk (RR) 0·92; 95% CI 0·85, 1·00; P=0·04) and 19% lower risk of SGA birth (RR 0·81; 95% CI 0·70, 0·95; P=0·008), compared with non-users. Higher frequency of pre-conceptional folic acid use was associated with lower risk of PTB (P trend=0·032) and SGA birth (P trend=0·046). No significant association between post-conceptional initiation of folic acid supplementation and either outcome was observed. In conclusion, the present study suggests an association between pre-conceptional, but not post-conceptional, folic acid supplementation and lower risk of PTB and SGA birth in the Jiaxing Birth Cohort. Further research in other cohorts of large sample size is needed to replicate these findings. PMID:26651997

  5. Free thyroxine values in dried blood spots on filter paper in newborns are related to both gestational age and birth body weight.

    PubMed

    Pacchiarotti, A; Bartalena, L; Chiovato, L; Falcone, M; Buratti, L; Ciampi, M; Giusti, L F; Grasso, L; Fenzi, G F; Martino, E

    1988-01-01

    The results of free thyroxine (FT4) measurements in dried blood spots on filter paper in 744 euthyroid newborns (616 at term, 128 preterm), 10 newborns with congenital hypothyroidism and 4 euthyroid newborns with congenital TBG deficiency are reported. FT4 was measured by column adsorption chromatography of free hormone followed by radioimmunoassay in the eluate. FT4 values averaged 24 +/- 0.2 pmol/L (mean +/- SE) in euthyroid newborns, 23.0 +/- 0.9 pmol/L in euthyroid newborns with TBG deficiency (p = NS), and 5.7 +/- 0.4 pmol/L in hypothyroid newborns (p less than 0.001 vs both groups). Total T4 (TT4) values in newborns with TBG deficiency were not different from those in hypothyroid newborns, but were significantly lower than those in euthyroid newborns without TBG abnormalities. FT4 values were higher in full-term newborns than in preterm newborns (25.2 +/- 0.3 vs 21.2 +/- 0.5 pmol/L, p less than 0.001). In both full-term and preterm newborns FT4 values in dried blood spots increased with birth body weight (bbw), virtually plateauing when bbw was greater than 2,500 g. The cut-off values established on the basis of the bbw (8.0 and 13.1 pmol/L for a bbw of less than or equal to 2,500 g and greater than 2,500 g, respectively) showed higher specificity and predictive value of positive results than the cut-off values based on the gestational age. In any case, the sensitivity, specificity and predictive values of FT4 determinations proved to be higher than those of TT4 and TSH measurements.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3139742

  6. Large for Gestational Age (LGA)

    MedlinePlus

    ... Subjects Women's Health Issues Symptoms General Abdomen & Digestive Bleeding Brain & Nervous System Chest & Respiratory Children's Symptoms Eye ... a tube placed in the nose or intense intervention, such as respiratory support with a ventilator. Other ...

  7. Small for Gestational Age (SGA)

    MedlinePlus

    ... Throat (ENT) Dental/Orthodontics Urology Orthopedics Child Development Psychology Special Education Services DO WE NEED TO IMPROVE ... body proportions and head circumference Improved psychological and cognitive function Possible Adverse Side Effects of GHT for ...

  8. Appropriate for gestational age (AGA)

    MedlinePlus

    ... the first day of the woman's last menstrual cycle to the current date. A normal pregnancy can ... looking at the baby. Weight, length, head circumference, vital signs, reflexes, muscle tone, posture, and the status ...

  9. Parity nonconservation in hydrogen.

    SciTech Connect

    Dunford, R. W.; Holt, R. J.

    2011-01-01

    We discuss the prospects for parity violation experiments in atomic hydrogen and deuterium to contribute to testing the Standard Model (SM). We find that, if parity experiments in hydrogen can be done, they remain highly desirable because there is negligible atomic-physics uncertainty and low energy tests of weak neutral current interactions are needed to probe for new physics beyond the SM. Analysis of a generic APV experiment in deuterium indicates that a 0.3% measurement of C{sub 1D} requires development of a slow (77K) metastable beam of {approx} 5 x 10{sup 14}D(2S)s{sup -1} per hyperfine component. The advent of UV radiation from free electron laser (FEL) technology could allow production of such a beam.

  10. Gestational weight gain trajectories in primary care

    PubMed Central

    Piccinini-Vallis, Helena; Lee-Baggley, Dayna; Stewart, Moira; Ryan, Bridget

    2016-01-01

    Objective To identify gestational weight gain trajectories, stratified by prepregnancy body mass index (BMI), of women with singleton pregnancies who received prenatal care in a primary care setting, and to compare these trajectories with the 2009 Institute of Medicine gestational weight gain recommendations. Design Retrospective cohort study. Setting Halifax, NS. Participants Women who received prenatal care at the Dalhousie Family Medicine clinics in Halifax from 2009 to 2013. Main outcome measures For each prenatal visit, gestational age and weight measurements were obtained. Multilevel modeling was used to analyze the gestational weight gain trajectories. The upper limit of the guideline-recommended weekly gestational weight gain was compared with the 95% CI of the observed mean weekly gestational weight gain for each prepregnancy BMI category. Results A total of 280 women were included in the analyses. There was a significant interaction between prepregnancy BMI category and gestational weight gain over time (P < .001), with gestational weight gain being significantly lower among women with prepregnancy BMI of 30.0 kg/m2 or greater compared with those with BMI of 18.5 to less than 25.0 kg/m2 and 25.0 to less than 30.0 kg/m2. When comparing women’s weight gain with the recommendations, women with prepregnancy BMI of 25.0 to less than 30.0 kg/m2 had the most guideline discordance, deviating from the weight gain recommendations at 20 weeks’ gestation. Conclusion These results are relevant and of benefit to women and clinicians wishing to address excess gestational weight gain, and to researchers and policy makers developing interventions aimed at curbing gestational weight gain in primary care. Although our results showed women with prepregnancy BMI of 25.0 to less than 30.0 kg/m2 gained the most excess, guideline-discordant weight, interventions should target all women planning or experiencing a pregnancy.

  11. Maternal and neonatal FTO rs9939609 polymorphism affect insulin sensitivity markers and lipoprotein profile at birth in appropriate-for-gestational-age term neonates.

    PubMed

    Gesteiro, Eva; Sánchez-Muniz, Francisco J; Ortega-Azorín, Carolina; Guillén, Marisa; Corella, Dolores; Bastida, Sara

    2016-06-01

    The influence of maternal fat mass and obesity (FTO) gene polymorphism on neonatal insulin sensitivity/resistance biomarkers and lipoprotein profile has not been tested. The study aimed to assess the association between the FTO rs9939609 polymorphism in mother-neonate couples and neonatal anthropometrical measurements, insulin sensitivity/resistance, and lipid and lipoprotein concentrations at birth. Fifty-three term, appropriate-for-gestational-age, Caucasian newborns together with their respective mothers participated in a cross-sectional study. Sixty-six percent of mothers and neonates carried the A allele (being AA or AT). TT mothers gained less weight during pregnancy, but non-significant maternal gene influence was found for neonatal bodyweight, body mass index, or ponderal index. Neonates from AA + AT mothers showed lower glucose, insulin, and homeostatic model assessment insulin resistance (HOMA-IR) but higher homeostatic model assessment insulin sensitivity (HOMA-IS) and homocysteine than neonates whose mothers were TT. AA + AT neonates had higher insulin and HOMA-IR than TT. The genotype neonatal × maternal association was tested in the following four groups of neonates: TT neonates × TT mothers (nTT × mTT), TT neonates × AA + AT mothers (nTT × mAA + AT), AA + AT neonates × TT mothers (nAA + AT × mTT), and AA + AT neonates × AA + AT mothers (nAA + AT × mAA + AT). Non-significant interactions between neonatal and maternal alleles were found for any parameter tested. However, maternal alleles affected significantly glucose, insulin, HOMA-IR, and homocysteine while neonatal alleles the arylesterase activity. Most significant differences were found between nATT + AA × mTT and nATT + AA × mAA + AT. Glycemia, insulinemia, and HOMA-IR were lower, while the Mediterranean diet adherence (MDA) was higher in the mAA + AT vs. mTT whose children were AA + AT. This dietary fact seems to counterbalance the potential negative effect on glucose homeostasis of

  12. Long-term outcomes in multiple gestations.

    PubMed

    Rand, Larry; Eddleman, Keith A; Stone, Joanne

    2005-06-01

    Children born from a multiple gestation are at increased risk for cerebral palsy, learning disability, and language and neurobehavioral deficits. With the increased incidence of multiple pregnancies and use of assisted reproductive technology (ART), these issues are more commonly affecting parents. Long-term outcomes are a critical part of preconceptual and early pregnancy counseling for parents faced with a multiple gestation or considering ART, and the provider should be well versed on issues surrounding zygosity, gestational age, higher-order multiples, and the effects of options such as multifetal pregnancy reduction. PMID:15922795

  13. Rate of Gestational Diabetes Mellitus and Pregnancy Outcomes in Patients with Chronic Hypertension.

    PubMed

    Leon, Mateo G; Moussa, Hind N; Longo, Monica; Pedroza, Claudia; Haidar, Ziad A; Mendez-Figueroa, Hector; Blackwell, Sean C; Sibai, Baha M

    2016-07-01

    Objective This study aims to determine the rate of gestational diabetes mellitus (GDM) in pregnancies complicated by chronic hypertension and to compare the adverse outcomes in chronic hypertensive pregnancies with and without GDM. Study Design A secondary analysis from a multicenter trial of low-dose aspirin for preeclampsia prevention in women with chronic hypertension. The rate of GDM was evaluated among singleton pregnancies complicated with chronic hypertension and grouped according to their GDM status. Pregnancy outcomes and rates of preterm delivery < 35 weeks and < 32 weeks, preeclampsia, indicated preterm birth, small for gestational age, abruptio placentae, and perinatal death were compared between those with and without GDM. A subgroup analysis comparing women who developed superimposed preeclampsia with and without GDM was studied. Multivariate logistic-regression analysis was used to adjust for potentially confounding factors. Results A total of 763 women met the inclusion criteria: 129 (17%) developed GDM. Parity, race, maternal baseline blood pressure, antihypertensive drug use, and assignment to low-dose aspirin were not significantly different between the groups with and without GDM. Using univariate analysis, maternal age (33 vs. 24%, p = 0.03) and body mass index (88 vs. 57%, p < 0.001) were higher in those who had GDM, whereas the rate of preterm delivery < 32 weeks (12 vs. 5%, p = 0.02) was higher among those without GDM. Using logistic-regression analysis, the rate of composite adverse outcomes (adjusted odds ratio [aOR], 0.77; 95% confidence interval [CI], 0.41-1.47) that included indicated preterm birth, small for gestational age, abruptio placentae, and perinatal death showed no significant differences.Superimposed preeclampsia developed in 34 (26%) women with GDM and in 182 (29%) without GDM. When superimposed preeclampsia was present, it developed at an earlier gestational age among the group without GDM (35

  14. Attempting to Honor Beliefs of Jehovah's Witnesses at the Edge of Viability in an Infant Born at 23 Weeks' Gestational Age.

    PubMed

    Sauer, Charles W; Marc-Aurele, Krishelle L

    2016-01-01

    BACKGROUND Infants born at 23 weeks' gestation have a poor prognosis and require intensive care, including blood transfusions, to survive. Generally speaking, the decision to forgo life support is acceptable. Jehovah's Witnesses believe that life is sacred and want lifesaving interventions except for blood transfusions. Therefore, an ethical dilemma exists when a baby is born on the edge of viability to parents that are Jehovah's Witnesses. In this case, if parents and healthcare professionals disagree on the best interests of the child, the medical team should obtain a court order from the state to intervene. CASE REPORT We present the case of an infant born at 23 weeks' gestation to parents who are Jehovah's Witnesses. The parents wanted full life-support, except for blood transfusions, to be given. The clinical team obtained a court order to transfuse the infant. The infant unfortunately died despite all efforts. CONCLUSIONS Currently, it is nearly impossible to honor the beliefs of Jehovah's Witnesses to provide lifesaving treatments without blood transfusions for infants born at the border of viability. If the goal is to prolong life, the standard of care for a premature infant is for a doctor to obtain a court order to override the beliefs and wishes of Jehovah's Witness parents and transfuse blood products as medically indicated. Although bloodless techniques for high-risk surgeries are under development, care for premature infants at 23 weeks' gestation necessitates red cell transfusions. PMID:27255268

  15. A prominent large high-density lipoprotein at birth enriched in apolipoprotein C-I identifies a new group of infancts of lower birth weight and younger gestational age

    SciTech Connect

    Kwiterovich Jr., Peter O.; Cockrill, Steven L.; Virgil, Donna G.; Garrett, Elizabeth; Otvos, James; Knight-Gibson, Carolyn; Alaupovic, Petar; Forte, Trudy; Farwig, Zachlyn N.; Macfarlane, Ronald D.

    2003-10-01

    Because low birth weight is associated with adverse cardiovascular risk and death in adults, lipoprotein heterogeneity at birth was studied. A prominent, large high-density lipoprotein (HDL) subclass enriched in apolipoprotein C-I (apoC-I) was found in 19 percent of infants, who had significantly lower birth weights and younger gestational ages and distinctly different lipoprotein profiles than infants with undetectable, possible or probable amounts of apoC-I-enriched HDL. An elevated amount of an apoC-I-enriched HDL identifies a new group of low birth weight infants.

  16. High inter-individual variation in the gestation length of the hedgehog tenrec, Echinops telfairi (Afrotheria).

    PubMed

    Künzle, H; Poulsen Nautrup, C; Schwarzenberger, F

    2007-02-01

    The gestation length (GL) of Tenrecs (Tenrecinae, Afrotheria) is still uncertain. This lack of knowledge also applies to the lesser hedgehog tenrec, Echinops telfairi, the species most commonly bred and maintained in captivity. The animals used in this study were held under controlled conditions (light, temperature and humidity). In order to determine the GL, groups of female tenrecs were subjected to various mating procedures followed by isolation periods of different lengths. A total of n=249 pregnancies were analysed and the number of offspring per litter was 3.29+/-0.09. The length of gestation could be determined in n=199 pregnancies and a mean GL of 67.53+/-0.36 days was calculated. Initial attempts with isolation periods of less than 16 days did not allow to accurately define the GL. Experiments with longer isolation periods and females subjected to only one mating procedure (n=10) revealed a variation in the GLs of 57-79 days. However, in one female a GL of only 50 days was also observed indicating an even greater range in GL variation. There was a statistically significant tendency for shorter GLs in the animals that conceived later in the mating season, but no statistical evidence was found that age, parity or litter size played an essential role in determining the GL. In conclusion, an unexpected high variability in gestation length in E. telfairi was demonstrated although the study animals were kept under controlled environmental conditions. The factors and mechanisms regulating this high intra-species variability in gestation length need further investigations. PMID:16569484

  17. [Gestational diabetes mellitus].

    PubMed

    Kautzky-Willer, Alexandra; Harreiter, Jürgen; Bancher-Todesca, Dagmar; Berger, Angelika; Repa, Andreas; Lechleitner, Monika; Weitgasser, Raimund

    2016-04-01

    Gestational diabetes (GDM) is defined as any degree of glucose intolerance with onset during pregnancy and is associated with increased feto-maternal morbidity as well as long-term complications in mothers and offspring. Women detected to have diabetes early in pregnancy receive the diagnosis of overt, non-gestational, diabetes (glucose: fasting > 126 mg/dl, spontaneous > 200 mg/dl or HbA1c > 6.5 % before 20 weeks of gestation). GDM is diagnosed by an oral glucose tolerance test (OGTT) or fasting glucose concentrations (> 92 mg/dl). Screening for undiagnosed type 2 diabetes at the first prenatal visit (Evidence level B) is recommended in women at increased risk using standard diagnostic criteria (high risk: history of GDM or pre-diabetes (impaired fasting glucose or impaired glucose tolerance); malformation, stillbirth, successive abortions or birth weight > 4,500 g in previous pregnancies; obesity, metabolic syndrome, age > 45 years, vascular disease; clinical symptoms of diabetes (e. g. glucosuria)). Performance of the OGTT (120 min; 75 g glucose) may already be indicated in the first trimester in some women but is mandatory between 24 and 28 gestational weeks in all pregnant women with previous non-pathological glucose metabolism (Evidence level B). Based on the results of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study GDM is defined, if fasting venous plasma glucose exceeds 92 mg/dl or 1 h 180 mg/dl or 2 h 153 mg/dl after glucose loading (OGTT; international consensus criteria). In case of one pathological value a strict metabolic control is mandatory. This diagnostic approach was recently also recommended by the WHO. All women should receive nutritional counseling and be instructed in blood glucose self-monitoring and to increase physical activity to moderate intensity levels- if not contraindicated. If blood glucose levels cannot be maintained in the normal range (fasting < 95 mg/dl and 1 h after meals < 140

  18. Effects of Gestational Housing on Reproductive Performance and Behavior of Sows with Different Backfat Thickness

    PubMed Central

    Kim, K. H.; Hosseindoust, A.; Ingale, S. L.; Lee, S. H.; Noh, H. S.; Choi, Y. H.; Jeon, S. M.; Kim, Y. H.; Chae, B. J.

    2016-01-01

    The present study investigated the effects of back-fat thickness at d 107 of gestation and housing types during gestation on reproductive performance and behavior of sows. A total of 64 crossbred sows (Landrace×Yorkshire) in their 3 to 4 parities were allotted to one of four treatments (n = 16) over two consecutive parities. During each parity, sows were assigned to two gestational housing types (stall or group housing) and two level of back-fat thickness (<20 or ≥20) at d 107 of gestation. Gestating sows were transferred from gestational crates to stalls or pens (group housing) 5 weeks before farrowing. All sows were moved to farrowing crates on d 109 of gestation. At weaning, back-fat thickness changes were lesser (p<0.05) in sows having back-fat thickness <20 mm than that of sows with ≥20 mm back-fat thickness at 107 d of gestation. Group housed sows had greater (p<0.05) feed intake and shorter (p<0.05) weaning-to-estrus interval than that of sows in stalls. At weaning, back-fat thickness changes were lesser (p<0.05) in group housed sows than that of sows in stalls. The number of piglets at weaning, growth rate and average daily gain were greater (p<0.05) in group housed sows than that of sows in stalls. During gestation, walking duration was more (p<0.05) in group housed sows. Group housed sows had lesser (p<0.05) farrowing duration and greater (p<0.05) eating time than that of sows in stalls. Result obtained in present study indicated that sows with ≥20 mm back-fat thickness at 107 days had better reproductive performance. Additionally, group housing of sows during last five week of gestation improved the performance and behavior and reproductive efficiency of sows. PMID:26732338

  19. Fourth Generation Parity

    SciTech Connect

    Lee, Hye-Sung; Soni, Amarjit

    2013-01-01

    We present a very simple 4th-generation (4G) model with an Abelian gauge interaction under which only the 4G fermions have nonzero charge. The U(1) gauge symmetry can have a Z_2 residual discrete symmetry (4G-parity), which can stabilize the lightest 4G particle (L4P). When the 4G neutrino is the L4P, it would be a neutral and stable particle and the other 4G fermions would decay into the L4P leaving the trace of missing energy plus the standard model fermions. Because of the new symmetry, the 4G particle creation and decay modes are different from those of the sequential 4G model, and the 4G particles can be appreciably lighter than typical experimental bounds.

  20. Effect of L-arginine supplementation to gestation and lactation diets on the expression of immune related genes in white blood cells of lactating sows

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A study was conducted to investigate the effects of L-arginine HCl supplementation on immune related gene expression in leukocytes of first parity sows. Nineteen first parity sows (BW of 180.7 ± 2.7 kg and BF of 15.3 ± 0.2 mm) were used in this study. On d 30 of gestation, pregnant gilts were assign...

  1. How to Treat Gestational Diabetes

    MedlinePlus

    ... A Listen En Español How to Treat Gestational Diabetes Be sure to see the latest Diabetes Forecast ... and a healthy start for your baby. Gestational Diabetes – Looking Ahead Gestational diabetes usually goes away after ...

  2. Polychlorinated biphenyls: influence on birthweight and gestation

    SciTech Connect

    Taylor, P.R.; Lawrence, C.E.; Hwang, H.L.; Paulson, A.S.

    1984-10-01

    Fifty-one infants born to women employed at two capacitor manufacturing facilities with a history of high exposure to polychlorinated biphenyls (PCBs) had a mean birthweight of 153 grams less than that of 337 infants born to women who had worked in low-exposure areas (90 per cent confidence interval, -286 to -20 g); mean gestational age was 6.6 days shorter in the high-exposure infants (90 per cent CI, -10.3 to -2.9 days). After adjusting for gestational age, the difference in birthweight was markedly reduced, indicating that the observed reduction in birthweight was due mainly to shortening of gestational age in the high-exposure group.

  3. Effects of Maternal and Infant Characteristics on Birth Weight and Gestation Length in a Colony of Rhesus Macaques (Macaca mulatta)

    PubMed Central

    Hopper, Kelly J; Capozzi, Denise K; Newsome, Joseph T

    2008-01-01

    A retrospective study using maternal and birth statistics from an open, captive rhesus macaque colony was done to determine the effects of parity, exposure to simian retrovirus (SRV), housing, maternal parity, and maternal birth weight on infant birth weight, viability and gestation length. Retrospective colony statistics for a 23-y period indicated that birth weight, but not gestation length, differed between genders. Adjusted mean birth weights were higher in nonviable infants. Mothers positive for SRV had shorter gestations, but SRV exposure did not affect neonatal birth weights or viability. Infants born in cages had longer gestations than did those born in pens, but neither birth weight nor viability differed between these groups. Maternal birth weight did not correlate with infant birth weight but positively correlated with gestation length. Parity was correlated with birth weight and decreased viability. Increased parity of the mother was associated with higher birth weight of the infant. A transgenerational trend toward increasing birth weight was noted. The birth statistics of this colony were consistent with those of other macaque colonies. Unlike findings for humans, maternal birth weight had little predictive value for infant outcomes in rhesus macaques. Nonviable rhesus infants had higher birth weights, unlike their human counterparts, perhaps due to gestational diabetes occurring in a sedentary caged population. Similar to the situation for humans, multiparity had a protective effect on infant viability in rhesus macaques. PMID:19149417

  4. Screening for Gestational Diabetes

    MedlinePlus

    ... Task Force learned about the potential benefits and harms of screening for gestational diabetes: (1) All women ... not enough evidence to judge the benefits and harms of screening women before 24 weeks of pregnancy. ...

  5. Neonatal Mortality and Long-Term Outcome of Infants Born between 27 and 32 Weeks of Gestational Age in Breech Presentation: The EPIPAGE Cohort Study

    PubMed Central

    Azria, Elie; Kayem, Gilles; Langer, Bruno; Marchand-Martin, Laetitia; Marret, Stephane; Fresson, Jeanne; Pierrat, Véronique; Arnaud, Catherine; Goffinet, François; Kaminski, Monique; Ancel, Pierre-Yves

    2016-01-01

    Objective To determine whether breech presentation is an independent risk factor for neonatal morbidity, mortality, or long-term neurologic morbidity in very preterm infants. Design Prospective population-based cohort. Population Singletons infants without congenital malformations born from 27 to 32 completed weeks of gestation enrolled in France in 1997 in the EPIPAGE cohort. Methods The neonatal and long-term follow-up outcomes of preterm infants were compared between those in breech presentation and those in vertex presentation. The relation of fetal presentation with neonatal mortality and neurodevelopmental outcomes was assessed using multiple logistic regression models. Results Among the 1518 infants alive at onset of labor included in this analysis (351 in breech presentation), 1392 were alive at discharge. Among those eligible to follow up and alive at 8 years, follow-up data were available for 1188 children. Neonatal mortality was significantly higher among breech than vertex infants (10.8% vs. 7.5%, P = 0.05). However the differences were not significant after controlling for potential confounders. Neonatal morbidity did not differ significantly according to fetal presentation. Severe cerebral palsy was less frequent in the group born in breech compared to vertex presentation but there was no difference after adjustment. There was no difference according to fetal presentation in cognitive deficiencies/learning disabilities or overall deficiencies. Conclusion Our data suggest that breech presentation is not an independent risk factor for neonatal mortality or long-term neurologic deficiencies among very preterm infants. PMID:26744838

  6. Chirality and gravitational parity violation.

    PubMed

    Bargueño, Pedro

    2015-06-01

    In this review, parity-violating gravitational potentials are presented as possible sources of both true and false chirality. In particular, whereas phenomenological long-range spin-dependent gravitational potentials contain both truly and falsely chiral terms, it is shown that there are models that extend general relativity including also coupling of fermionic degrees of freedom to gravity in the presence of torsion, which give place to short-range truly chiral interactions similar to that usually considered in molecular physics. Physical mechanisms which give place to gravitational parity violation together with the expected size of the effects and their experimental constraints are discussed. Finally, the possible role of parity-violating gravity in the origin of homochirality and a road map for future research works in quantum chemistry is presented. PMID:25919812

  7. [Gestational trophoblastic disease].

    PubMed

    Allias, Fabienne; Bolze, Pierre-Adrien; Gaillot-Durand, Lucie; Devouassoux-Shisheboran, Mojgan

    2014-12-01

    Gestational trophoblastic disease encompresses a group of interrelated diseases, following a pregnancy after a variable period of time. Hydatiform mole corresponds to premalignant disorders composed of villi with excess of paternal genetic material, with a malignant potential more important for complete mole than partial mole. Gestational trophoblastic neoplasia includes invasive mole, choriocarcinoma, placental site trophoblatic tumor and epithelioid trophoblastic tumor. Their histological diagnosis may be problematic on curettage material and needs to be correlated to serum hCG level and radiological findings. The use of chemotherapy has dramatically improved the prognosis of these lesions. All patients with this rare disease need to be registered in the national service for gestational trophoblastic disease (http://www.mole-chorio.com), which coordinates their management at the national level. PMID:25499859

  8. Pulmonary disease in gestational trophoblastic neoplasms.

    PubMed Central

    McNair, O. M.; Polk, O. D.

    1992-01-01

    Gestational trophoblastic neoplasms can present as pulmonary nodules without significant disease of the reproductive organs. This article describes a case of metastatic gestational trophoblastic disease to the lungs. This entity must be considered in the differential diagnosis in any female of reproductive age who presents with multiple pulmonary nodules. Thoracotomy has a limited role in the initial evaluation of patients with this disease. However, it may be needed in patients who have evidence of persistent pulmonary disease, despite appropriate therapy. Images Figure 1 Figure 2 Figure 3 PMID:1324326

  9. Embodied markedness of parity? Examining handedness effects on parity judgments.

    PubMed

    Huber, Stefan; Klein, Elise; Graf, Martina; Nuerk, Hans-Christoph; Moeller, Korbinian; Willmes, Klaus

    2015-11-01

    Parity is important semantic information encoded by numbers. Interestingly, there are hand-based effects in parity judgment tasks: right-hand responses are faster for even and left-hand responses for odd numbers. As this effect was initially explained by the markedness of the words even vs. odd and right vs. left, it was denoted as the linguistic markedness of response codes (MARC) effect. In the present study, we investigated whether the MARC effect differs for right and left handers. We conducted a parity judgment task, in which right- and left-handed participants had to decide whether a presented single or two-digit number was odd or even by pressing a corresponding response key. We found that handedness modulated the MARC effect for unit digits. While we replicated a regular MARC effect for right handers, there was no evidence for a MARC effect for left handers. However, closer inspection revealed that the MARC effect in left handers depended on the degree of left-handedness with a reversed MARC effect for most left-handed participants. Furthermore, although parity of tens digits interfered with the processing of unit digits, the MARC effect for tens digits was not modulated by handedness. Our findings are discussed in the light of three different accounts for the MARC effect: the linguistic markedness account, the polarity correspondence principle, and the body-specificity hypothesis. PMID:25394996

  10. Permutation parity machines for neural cryptography.

    PubMed

    Reyes, Oscar Mauricio; Zimmermann, Karl-Heinz

    2010-06-01

    Recently, synchronization was proved for permutation parity machines, multilayer feed-forward neural networks proposed as a binary variant of the tree parity machines. This ability was already used in the case of tree parity machines to introduce a key-exchange protocol. In this paper, a protocol based on permutation parity machines is proposed and its performance against common attacks (simple, geometric, majority and genetic) is studied. PMID:20866488

  11. Permutation parity machines for neural cryptography

    SciTech Connect

    Reyes, Oscar Mauricio; Zimmermann, Karl-Heinz

    2010-06-15

    Recently, synchronization was proved for permutation parity machines, multilayer feed-forward neural networks proposed as a binary variant of the tree parity machines. This ability was already used in the case of tree parity machines to introduce a key-exchange protocol. In this paper, a protocol based on permutation parity machines is proposed and its performance against common attacks (simple, geometric, majority and genetic) is studied.

  12. Input-output, expandable-parity network

    NASA Technical Reports Server (NTRS)

    Mckevitt, J. F., III

    1974-01-01

    Large-scale integrated circuit generates and checks parity of four eight-bit registers. In addition, circuit will indicate by output signal whether parity error exists. Circuit can also generate or check parity of words up to 32 bits. This is done by making appropriate internal wiring connections on the large-scale integrated chip.

  13. Impact of Insulin Resistance on Insulin-Like Growth Factor-1/Insulin Like Growth Factor-Binding Protein-3 Axis and on Early Weight Gain in Small for Gestational Age Infants

    PubMed Central

    Dizdarer, Ceyhun; Korkmaz, Hüseyin Anıl; Büyükocak, Özlem Murat; Tarancı, Selda Mohan; Çoban, Ayşe

    2013-01-01

    Objective: To assess insulin-like growth factor-1 (IGF-1)/IGF-binding protein-3 (IGFBP-3) axis and insulin resistance (IR) and the relationship of these parameters with growth in appropriate for gestational age (AGA) and small for gestational age (SGA) infants at birth and in early infancy. Methods: Postnatal blood samples for measurement of glucose, insulin, IGF-1, and IGFBP-3 were taken from 60 infants (30 AGA and 30 SGA) at birth and at one, three, and six months of age. Both SGA and AGA infants were divided into two groups: growing well and not growing well. Blood glucose, insulin, IGF-1, and IGFBP-3 values were assessed in all infants. Results: Homeostasis model assessment-IR (HOMA-IR) values in well-growing SGA infants in the third and sixth months were found to be higher than in not well-growing SGA infants (3.9±0.8 vs. 1.0±0.3 at 3 months and 3.3±0.9 vs. 2.4±0.9 at 6 months, p<0.05). IGF-1 levels in well-growing SGA infants at 3 and 6 months were found to be higher than those in not well-growing SGA infants (83.80±44.50 vs. 73.50±17.60 ng/mL at 3 months and 95.12±50.74 vs. 87.67±22.91 ng/mL at 6 months, p<0.05). The IGF-1 values were significantly lower in well-growing SGA infants than in well-growing AGA infants (83.80±44.50 vs. 103.31±30.81 ng/mL at 3 months and 95.12±50.74 vs. 110.87±26.44 ng/mL at 6 months, p<0.05). Conclusions: This study demonstrates the effects of accelerated early infant growth on IGF-1/IGFBP-3 axis in SGA-born infants. Conflict of interest:None declared. PMID:23748063

  14. Prevention of gestational diabetes through lifestyle intervention: study design and methods of a Finnish randomized controlled multicenter trial (RADIEL)

    PubMed Central

    2014-01-01

    Background Maternal overweight, obesity and consequently the incidence of gestational diabetes are increasing rapidly worldwide. The objective of the study was to assess the efficacy and cost-effectiveness of a combined diet and physical activity intervention implemented before, during and after pregnancy in a primary health care setting for preventing gestational diabetes, later type 2 diabetes and other metabolic consequences. Methods RADIEL is a randomized controlled multi-center intervention trial in women at high risk for diabetes (a previous history of gestational diabetes or prepregnancy BMI ≥30 kg/m2). Participants planning pregnancy or in the first half of pregnancy were parallel-group randomized into an intervention arm which received lifestyle counseling and a control arm which received usual care given at their local antenatal clinics. All participants visited a study nurse every three months before and during pregnancy, and at 6 weeks, 6 and 12 months postpartum. Measurements and laboratory tests were performed on all participants with special focus on dietary and exercise habits and metabolic markers. Of the 728 women [mean age 32.5 years (SD 4.7); median parity 1 (range 0-9)] considered to be eligible for the study 235 were non-pregnant and 493 pregnant [mean gestational age 13 (range 6 to 18) weeks] at the time of enrollment. The proportion of nulliparous women was 29.8% (n = 217). Out of all participants, 79.6% of the non-pregnant and 40.4% of the pregnant women had previous gestational diabetes and 20.4% of the non-pregnant and 59.6% of the pregnant women were recruited because of a prepregnancy BMI ≥30 kg/m2. Mean BMI at first visit was 30.1 kg/m2 (SD 6.2) in the non-pregnant and 32.7 kg/m2 (SD 5.6) in the pregnant group. Discussion To our knowledge, this is the first randomized lifestyle intervention trial, which includes, besides the pregnancy period, both the prepregnancy and the postpartum period. This study design also

  15. Effect of birth weight, maternal education and prenatal smoking on offspring intelligence at school age.

    PubMed

    Rahu, Kaja; Rahu, Mati; Pullmann, Helle; Allik, Jüri

    2010-08-01

    To examine the combined effect of birth weight, mothers' education and prenatal smoking on psychometrically measured intelligence at school age 1,822 children born in 1992-1999 and attending the first six grades from 45 schools representing all of the fifteen Estonian counties with information on birth weight, gestational age and mother's age, marital status, education, parity and smoking in pregnancy, and intelligence tests were studied. The scores of Raven's Standard Progressive Matrices were related to the birth weight: in the normal range of birth weight (>or=2500 g) every 500 g increase in birth weight was accompanied by around 0.7-point increase in IQ scores. A strong association between birth weight and IQ remained even if gestational age and mother's age, marital status, education, place of residence, parity and smoking during pregnancy have been taken into account. Maternal prenatal smoking was accompanied by a 3.3-point deficit in children's intellectual abilities. Marriage and mother's education had an independent positive correlation with offspring intelligence. We concluded that the statistical effect of birth weight, maternal education and smoking in pregnancy on offspring's IQ scores was remarkable and remained even if other factors have been taken into account. PMID:20634008

  16. A meta-analysis to identify animal and management factors influencing gestating sow efficiency.

    PubMed

    Douglas, S L; Szyszka, O; Stoddart, K; Edwards, S A; Kyriazakis, I

    2014-12-01

    A meta-analysis on the effects of management and animal-based factors on the reproductive efficiency of gestating sows can provide information on single-factor and interaction effects that may not have been detected in individual studies. This study analyzed the effects of such factors on the number of piglets born alive per litter (BA), piglet birth weight (BiW) and weaning weight (WW), and number of piglets born alive per kilogram of sow feed intake during gestation (BA/FI). A total of 51 papers and 7 data sources were identified for the meta-analysis, out of which 23 papers and 5 sets of production data were useable (a total of 121 treatments). The information gathered included the dependent variables as well as information regarding animal, management, and feed characteristics. While a number of factors were individually significant, the multivariate models identified significant effects only of 1) floor type (P=0.003), sow BW at the end of gestation (P=0.002), and housing (stalls vs. loose; P=0.004) on BA; as floor type and housing were confounded, they were included in 2 separate models. The BA was higher on solid (12.1) in comparison to partly slatted (11.4) and fully slatted floors (10.2); 2) sow gestation environment (P=0.017) and gestation feed allowance (P=0.046) on BiW, with BiW of pigs higher for sows kept outdoors rather than indoors (1.75 versus 1.49 kg); 3) parity number (P=0.003) and feed intake during gestation (P=0.017) on WW; in addition there was an interaction between parity number×feed ME and parity number×feed CP content of feed during gestation on WW, with the positive effects of feed ME and CP contents seen during early rather than later parities; and 4) floor type (P=0.019) and feed crude fiber (P=0.003) for BA/FI with a greater number for those kept on solid floors (5.11) versus partially and fully slatted floors (4.07 and 4.05). The meta-analysis confirmed the significant effect of several well-known factors on the efficiency of

  17. Gestational mutations in radiation carcinogenesis

    NASA Astrophysics Data System (ADS)

    Meza, R.; Luebeck, G.; Moolgavkar, S.

    Mutations in critical genes during gestation could increase substantially the risk of cancer. We examine the consequences of such mutations using the Luebeck-Moolgavkar model for colorectal cancer and the Lea-Coulson modification of the Luria-Delbruck model for the accumulation of mutations during gestation. When gestational mutation rates are high, such mutations make a significant contribution to cancer risk even for adult tumors. Furthermore, gestational mutations ocurring at distinct times during emryonic developmemt lead to substantially different numbers of mutated cells at birth, with early mutations leading to a large number (jackpots) of mutated cells at birth and mutation occurring late leading to only a few mutated cells. Thus gestational mutations could confer considerable heterogeneity of the risk of cancer. If the fetus is exposed to an environmental mutagen, such as ionizing radiation, the gestational mutation rate would be expected to increase. We examine the consequences of such exposures during gestation on the subsequent development of cancer.

  18. Correlation between gestational weight gain and birth weight of the infants.

    PubMed

    Shrestha, I; Sunuwar, L; Bhandary, S; Sharma, P

    2010-06-01

    Birth weight is an important determinant of infant's well being as low birth weight is known to increase the risk adult onset of diseases like type-2 diabetes and ischemic heart disease. Maternal weight gain is one of the most important independent predictors of infant birth weight. Institute of Medicine of the National Academics, USA has recommended that total weight gain of mothers should be according to their prepregnancy body mass index (BMI). Therefore, this study was conducted to observe the total weight gained by the pregnant women and the correlation between the weights gained by them with the birth weight of their infants. 98 women who delivered full term single baby at Patan hospital were included after taking their verbal consent. The details of the newborn and the history of the pregnant women were taken from the hospital records. The information about the family income, dietary habit, birth spacing and the type of work done by the pregnant women was obtained from the women themselves. The mean weight gain of the mothers was 9.48 (SD = 3.41) kilograms and the mean birth weight of the infants was found to be 2965.66 (SD = 364.37) grams. Multiple Liner Regression Models showed the effect of Gestational weight gain (GWG), Age and Parity on birth weight of the infant. Step-wise multiple regressions gave rise to models that showed effect of GWG and age on birth weight of the infants. This study concluded that gestational weight gain has positive linear relationship (correlation) with the birth weight of infants. PMID:21222408

  19. Maternal Antenatal Complications and the Risk of Neonatal Cerebral White Matter Damage and Later Cerebral Palsy in Children Born at an Extremely Low Gestational Age

    PubMed Central

    Allred, Elizabeth N.; Boggess, Kim A.; Kuban, Karl; O'Shea, T. Michael; Paneth, Nigel

    2009-01-01

    In a 2002–2004 prospective cohort study of deliveries of infants at <28 weeks at 14 US centers, the authors sought the antecedents of white matter damage evident in newborn cranial ultrasound scans (ventriculomegaly and an echolucent lesion) and of cerebral palsy diagnoses at age 2 years. Of the 1,455 infants enrolled, those whose mothers received an antenatal steroid tended to have lower risks of ventriculomegaly and an echolucent lesion than their peers (10% vs. 23%, P < 0.001 and 7% vs. 11%, P = 0.06, respectively). Risk of ventriculomegaly was increased for infants delivered because of preterm labor (adjusted odds ratio (OR) = 2.3, 95% confidence interval (CI): 1.1, 4.9), preterm premature rupture of fetal membranes (OR = 3.6, 95% CI: 1.5, 8.7), and cervical insufficiency (OR = 2.8, 95% CI: 1.4, 5.5) when compared with infants delivered because of preeclampsia. Risk of an echolucent lesion was increased for infants delivered because of preterm labor (OR = 2.7, 95% CI: 1.2, 5.7) and intrauterine growth retardation (OR = 3.3, 95% CI: 1.2, 9.4). The doubling of diparesis risk associated with preterm labor and with preterm premature rupture of fetal membranes did not achieve statistical significance, nor did the doubling of quadriparesis risk and the tripling of diparesis risk associated with cervical insufficiency. PMID:19713285

  20. Hypertension in gestational diabetes mellitus: pathophysiology and long-term consequences.

    PubMed

    Sibai, Baha M; Ross, Michael G

    2010-03-01

    Gestational hypertension and gestational diabetes mellitus are the most frequent obstetric disorders during pregnancy. The rates of both disorders are expected to increase as a result of delayed pregnancy at a later maternal age, the epidemic of obesity and the increased frequency of using assisted reproductive technology in women with infertility. Pregnancies complicated one or both of these disorders are also associated with adverse consequences for the mother and infant (both acute and long-term). The objectives of this review are to describe the association between gestational hypertension and gestational diabetes, and to discuss approaches to management and summarize long-term consequences of gestational hypertension. PMID:20121395

  1. Comparison of Birth-and Conception-Based Definitions of Postnatal Age in Developmental and Reproductive Rodent Toxicity Studies: Influence of Gestation Length and Timing of Neonatal Examinations on Litter Data in Controls

    EPA Science Inventory

    Laboratories conducting developmental and reproductive toxicity studies with rodents use varied protocols for determining the timing of neonatal litter examinations and subsequent measurements. Most laboratories determine timing based on the day of birth (DOB); l.e., gestation le...

  2. Observed parity-odd CMB temperature bispectrum

    SciTech Connect

    Shiraishi, Maresuke; Liguori, Michele; Fergusson, James R. E-mail: michele.liguori@pd.infn.it

    2015-01-01

    Parity-odd non-Gaussianities create a variety of temperature bispectra in the cosmic microwave background (CMB), defined in the domain: ℓ{sub 1} + ℓ{sub 2} + ℓ{sub 3} = odd. These models are yet unconstrained in the literature, that so far focused exclusively on the more common parity-even scenarios. In this work, we provide the first experimental constraints on parity-odd bispectrum signals in WMAP 9-year temperature data, using a separable modal parity-odd estimator. Comparing theoretical bispectrum templates to the observed bispectrum, we place constraints on the so-called nonlineality parameters of parity-odd tensor non-Gaussianities predicted by several Early Universe models. Our technique also generates a model-independent, smoothed reconstruction of the bispectrum of the data for parity-odd configurations.

  3. General parity-odd CMB bispectrum estimation

    SciTech Connect

    Shiraishi, Maresuke; Liguori, Michele; Fergusson, James R. E-mail: michele.liguori@pd.infn.it

    2014-05-01

    We develop a methodology for estimating parity-odd bispectra in the cosmic microwave background (CMB). This is achieved through the extension of the original separable modal methodology to parity-odd bispectrum domains (ℓ{sub 1}+ℓ{sub 2}+ℓ{sub 3} = odd). Through numerical tests of the parity-odd modal decomposition with some theoretical bispectrum templates, we verify that the parity-odd modal methodology can successfully reproduce the CMB bispectrum, without numerical instabilities. We also present simulated non-Gaussian maps produced by modal-decomposed parity-odd bispectra, and show the consistency with the exact results. Our new methodology is applicable to all types of parity-odd temperature and polarization bispectra.

  4. About measurements of Higgs boson parity

    NASA Astrophysics Data System (ADS)

    Ginzburg, I. F.

    2016-02-01

    Recently CMS and ATLAS announced that they had measured the Higgs boson parity. In this note we show that their approach can determine this parity only under the additional assumption that an extension of Standard Model of some special type is realized in Nature. We show that the used approach gives no information about the Higgs boson parity when assuming most other extensions of the Standard Model.

  5. Predictive Risk Factors in the Treatment of Gestational Diabetes Mellitus

    PubMed Central

    Aktun, Lebriz Hale; Yorgunlar, Betul; Karaca, Nilay; Akpak, Yaşam Kemal

    2015-01-01

    OBJECTIVE This study aims to investigate predictive risk factors in the treatment of gestational diabetes mellitus (GDM). PATIENTS AND METHODS A total of 256 pregnant women who underwent 75 g oral glucose tolerance test (OGTT) during 24–28 weeks of pregnancy were included according to the World Health Organization criteria. Demographic characteristics of the patients, including age, parity, family history of diabetes, body weight before pregnancy, and body weight at the diagnosis of GDM, were recorded. Fasting insulin and hemoglobin A1c (HbA1c) values at the time of diagnosis were evaluated. The patients were divided into two groups: those requiring insulin treatment (insulin group, n = 89) and those receiving diet therapy (diet group, n = 167) during pregnancy according to the American Diabetes Association recommendations. RESULTS A total of 34.76% of the pregnant women with GDM required insulin treatment. The mean age of these patients was significantly higher compared to the diet group (34.9 ± 0.6 years vs. 31.9 ± 0.6 years; P = 0.004). Body mass index before pregnancy was also significantly higher in the insulin group than that in the diet group (32 ± 0.9 kg/m2 vs. 29 ± 0.7 kg/m2; P = 0.004). Fasting blood glucose (FBG) during OGTT was 105.6 ± 2.1 mg/dL and 96.7 ± 1.1 mg/dL in the insulin group and diet group, respectively (P < 0.001). There was no significant difference in fasting plasma glucose during OGTT between the groups (P = 0.069), while plasma glucose at two hours was 161.1 ± 6.8 mg/dL in the insulin group and 145.1 ± 3.7 mg/dL in the diet group (P = 0.027). At the time of diagnosis, HbA1c values were significantly higher in the insulin group compared to the diet group (5.3 ± 0.1 vs. 4.9 ± 0.1; P = 0.001). There was no significant difference in FBG and homeostasis model assessment-insulin resistance values between the groups (P = 0.908, P = 0.073). CONCLUSION Our study results suggest that age, family history of diabetes, body weight before

  6. Parity violation in electron scattering

    NASA Astrophysics Data System (ADS)

    Souder, P.; Paschke, K. D.

    2016-02-01

    By comparing the cross sections for left- and right-handed electrons scattered from various unpolarized nuclear targets, the small parity-violating asymmetry can be measured. These asymmetry data probe a wide variety of important topics, including searches for new fundamental interactions and important features of nuclear structure that cannot be studied with other probes. A special feature of these experiments is that the results are interpreted with remarkably few theoretical uncertainties, which justifies pushing the experiments to the highest possible precision. To measure the small asymmetries accurately, a number of novel experimental techniques have been developed.

  7. After parity--what's next.

    PubMed

    Shern, David L; Beronio, Kirsten K; Harbin, Henry T

    2009-01-01

    A new law prohibiting unequal treatment limits and financial requirements for mental health and substance abuse (MH/SA) benefits establishes critical protections for 113 million Americans. The new parity law doesn't mandate coverage for MH/SA treatment and anticipates management of the benefit. Given these features, clear regulations mapping the intent of the law are critical. Education regarding the costs of untreated or ineffectively treated MH/SA conditions is needed to encourage comprehensive coverage, because academic performance and worker productivity are at stake. As health care reform proceeds, we must use the new law to reinforce the centrality of mental health to overall health. PMID:19414871

  8. Racial/Ethnic Disparities in Inadequate Gestational Weight Gain Differ by Pre-pregnancy Weight.

    PubMed

    Headen, Irene; Mujahid, Mahasin S; Cohen, Alison K; Rehkopf, David H; Abrams, Barbara

    2015-08-01

    Pre-pregnancy body mass index (BMI) varies by race/ethnicity and modifies the association between gestational weight gain (GWG) and adverse pregnancy outcomes, which disproportionately affect racial/ethnic minorities. Yet studies investigating whether racial/ethnic disparities in GWG vary by pre-pregnancy BMI are inconsistent, and none studied nationally representative populations. Using categorical measures of GWG adequacy based on Institute of Medicine recommendations, we investigated whether associations between race/ethnicity and GWG adequacy were modified by pre-pregnancy BMI [underweight (<18.5 kg/m(2)), normal weight (18.5-24.9 kg/m(2)), overweight (25.0-29.9 kg/m(2)), or obese (≥30.0 kg/m(2))] among all births to Black, Hispanic, and White mothers in the 1979 USA National Longitudinal Survey of Youth cohort (n = 6,849 pregnancies; range 1-10). We used generalized estimating equations, adjusted for marital status, parity, smoking during pregnancy, gestational age, and multiple measures of socioeconomic position. Effect measure modification between race/ethnicity and pre-pregnancy BMI was significant for inadequate GWG (Wald test p value = 0.08). Normal weight Black [risk ratio (RR) 1.34, 95 % confidence interval (CI) 1.18, 1.52] and Hispanic women (RR 1.33, 95 % CI 1.15, 1.54) and underweight Black women (RR 1.38, 95 % CI 1.07, 1.79) experienced an increased risk of inadequate GWG compared to Whites. Differences in risk of inadequate GWG between minority women, compared to White women, were not significant among overweight and obese women. Effect measure modification between race/ethnicity and pre-pregnancy BMI was not significant for excessive GWG. The magnitude of racial/ethnic disparities in inadequate GWG appears to vary by pre-pregnancy weight class, which should be considered when designing interventions to close racial/ethnic gaps in healthy GWG. PMID:25652057

  9. Inversion of parity splitting in alternating parity bands at high angular momenta

    SciTech Connect

    Jolos, R.V.; Minkov, N.; Scheid, W.

    2005-12-15

    The angular-momentum dependence of parity splitting in ground-state alternating parity bands and especially the sign inversion of parity splitting are considered. It is shown that the complicated odd-even staggering structure of the alternating parity bands can be interpreted as the result of two simultaneously manifesting effects: (1) penetration of the barrier separating two minima with the opposite signs of the reflection asymmetric deformation and (2) alignment of the angular momentum of the intrinsic excitations.

  10. A Qualitative Study to Examine Perceptions and Barriers to Appropriate Gestational Weight Gain among Participants in the Special Supplemental Nutrition Program for Women Infants and Children Program

    PubMed Central

    2016-01-01

    Women of reproductive age are particularly at risk of obesity because of excessive gestational weight gain (GWG) and postpartum weight retention, resulting in poor health outcomes for both mothers and infants. The purpose of this qualitative study was to examine perceptions and barriers to GWG among low-income women in the WIC program to inform the development of an intervention study. Eleven focus groups were conducted and stratified by ethnicity, and each group included women of varying age, parity, and prepregnancy BMI ranges. Participants reported receiving pressure from spouse and family members to “eat for two” among multiple barriers to appropriate weight gain during pregnancy. Participants were concerned about gaining too much weight but had minimal knowledge of weight gain goals during pregnancy. Receiving regular weight monitoring was reported, but participants had inconsistent discussions about weight gain with healthcare providers. Most were not aware of the IOM guidelines nor the fact that gestational weight gain goals differed by prepregnancy weight status. Results of these focus groups analyses informed the design of a pregnancy weight tracker and accompanying educational handout for use in an intervention study. These findings suggest an important opportunity for GWG education in all settings where pregnant women are seen. PMID:27403341

  11. A Qualitative Study to Examine Perceptions and Barriers to Appropriate Gestational Weight Gain among Participants in the Special Supplemental Nutrition Program for Women Infants and Children Program.

    PubMed

    Kim, Loan Pham; Koleilat, Maria; Whaley, Shannon E

    2016-01-01

    Women of reproductive age are particularly at risk of obesity because of excessive gestational weight gain (GWG) and postpartum weight retention, resulting in poor health outcomes for both mothers and infants. The purpose of this qualitative study was to examine perceptions and barriers to GWG among low-income women in the WIC program to inform the development of an intervention study. Eleven focus groups were conducted and stratified by ethnicity, and each group included women of varying age, parity, and prepregnancy BMI ranges. Participants reported receiving pressure from spouse and family members to "eat for two" among multiple barriers to appropriate weight gain during pregnancy. Participants were concerned about gaining too much weight but had minimal knowledge of weight gain goals during pregnancy. Receiving regular weight monitoring was reported, but participants had inconsistent discussions about weight gain with healthcare providers. Most were not aware of the IOM guidelines nor the fact that gestational weight gain goals differed by prepregnancy weight status. Results of these focus groups analyses informed the design of a pregnancy weight tracker and accompanying educational handout for use in an intervention study. These findings suggest an important opportunity for GWG education in all settings where pregnant women are seen. PMID:27403341

  12. Parity Violation in Electron Scattering

    SciTech Connect

    Beise, Elizabeth

    2007-10-26

    About thirty years ago, electron scattering from nucleons was used [1] to identify, and then measure, the properties of the weak interaction, the only force of nature known to violate the symmetry parity. The basic technique has not fundamentally changed, which is to look for a small asymmetry in count rate from scattering a polarized electron beam from an unpolarized target. Since then, parity-violating (PV) electron scattering has developed substantially, a result of significant improvements in polarized electron beams, accelerator advancements, and developments in cryogenic targets that make it possible to carry out experiments with much higher statistical precision. In the last decade PV experiments have focused on using the complementary electron-quark flavor coupling of the weak interaction to identify and place limits on contributions of strange quark-antiquark pairs to the charge and magnetism of the proton. This observable provides a unique window into the structure of the proton since strange quark contributions can arise only from the sea of quarks and gluons that are responsible for the vast majority of the nucleon's mass. This paper will report on recent results aimed at this goal, along with a brief overview of future directions.

  13. Dose-response relationship between alcohol consumption before and during pregnancy and the risks of low birth weight, preterm birth and small-size-for-gestational age (SGA) – A systematic review and meta-analyses

    PubMed Central

    Patra, Jayadeep; Bakker, Rachel; Irving, Hyacinth; Jaddoe, Vincent W.V.; Malini, Shobha; Rehm, Jürgen

    2011-01-01

    Background The effects of moderate alcohol consumption during pregnancy on adverse pregnancy outcomes have been inconsistent. Objective To review systematically and perform meta-analyses on the effect of maternal alcohol exposure on the risk of low birth weight, preterm birth and small-size-for-gestational age (SGA). Search Strategy Using Medical Subject Headings, a literature search of MEDLINE, EMBASE, CINAHL, CABS, WHOlist, SIGLE, ETOH, and Web of Science between 1 January 1980 and 1 August 2009 was performed followed by manual searches. Selection Criteria Case control or cohort studies were assessed for quality (STROBE), 36 available studies were included. Data collection and Analysis Two reviewers independently extracted the information on low birth weight, preterm birth and SGA using a standardized protocol. Meta-analyses on dose-response relationship were performed using linear as well as first-order and second-order fractional polynomial regressions to estimate best fitting curves to the data. Main Results Compared to abstainers, the overall dose-response relationships for low birth weight and SGA had no effect up to 10 g/day (an average of about 1 drink/day) and preterm birth had no effect up to 18 g/day (an average of 1.5 drinks/day) of pure alcohol consumption; thereafter, the relationship had monotonically increasing risk for increasing maternal alcohol consumption. Moderate consumption during pre-pregnancy was associated with reduced risks for both outcomes. Conclusions Dose-response relationship indicates that heavy alcohol consumption during pregnancy increases the risks of all three outcomes while light to moderate alcohol consumption shows no effect. Preventive measures during antenatal consults should be initiated. PMID:21729235

  14. Gestational hypothyroxinemia and cognitive function in offspring.

    PubMed

    Kasatkina, E P; Samsonova, L N; Ivakhnenko, V N; Ibragimova, G V; Ryabykh, A V; Naumenko, L L; Evdokimova, Yu A

    2006-07-01

    The effects of gestational hypothyroxinemia on the neurointellectual prognosis of children in the first year of life living in an industrial city (megalopolis) with mild iodine deficiency were studied in 13 children of mothers with thyroid hormone-corrected gestational hypothyroxinemia in the first trimester and 10 children of mothers with normal levels of free thyroxine by assessing cognitive functions at ages six, nine, and 12 months using the Gnome mental development scale. The results showed that maternal free thyroxine levels at the early stages (5-9 weeks) of pregnancy correlated significantly with the coefficients of mental development among the children at ages 6, 9, and 12 months, i.e., represented one of the factors defining the neuropsychological development of offspring. Early (not later than nine weeks) correction of gestational hypothyroxinemia with levothyroxine at a mean daily dose of at lest 1.2 microg/kg improved the neurointellectual prognosis of the offspring, increasing the coefficient of mental development of children to 92-97 points during the first year of life, i.e., to the level of development of mental functions of children born to mothers with normal thyroxine levels. PMID:16783515

  15. Assessment of Gestational Age and Neuromaturation

    ERIC Educational Resources Information Center

    Allen, Marilee C.

    2005-01-01

    Neuromaturation is the functional development of the central nervous system (CNS). It is by its very nature a dynamic process, a continuous interaction between the genome and first the intrauterine environment, then the extrauterine environment. Understanding neuromaturation and being able to measure it is fundamental to infant neurodevelopmental…

  16. Derivation of Dark Matter Parity from Lepton Parity.

    PubMed

    Ma, Ernest

    2015-07-01

    It is shown that in extensions of the standard model of quarks and leptons where the additive lepton number L is broken by two units, so that Z_{2} lepton parity, i.e., (-1)L which is either even or odd, remains exactly conserved, there is the possibility of stable dark matter without additional symmetry. This applies to many existing simple models of Majorana neutrino mass with dark matter, including some radiative models. Several well-known examples are discussed. This new insight leads to the construction of a radiative type II seesaw model of neutrino mass with dark matter where the dominant decay of the doubly charged Higgs boson ξ++ is into W+W+ instead of the expected li+lj+ lepton pairs for the well-known tree-level model. PMID:26182089

  17. Derivation of Dark Matter Parity from Lepton Parity

    NASA Astrophysics Data System (ADS)

    Ma, Ernest

    2015-07-01

    It is shown that in extensions of the standard model of quarks and leptons where the additive lepton number L is broken by two units, so that Z2 lepton parity, i.e., (-1 )L which is either even or odd, remains exactly conserved, there is the possibility of stable dark matter without additional symmetry. This applies to many existing simple models of Majorana neutrino mass with dark matter, including some radiative models. Several well-known examples are discussed. This new insight leads to the construction of a radiative type II seesaw model of neutrino mass with dark matter where the dominant decay of the doubly charged Higgs boson ξ++ is into W+W+ instead of the expected li+lj+ lepton pairs for the well-known tree-level model.

  18. [Gestational diabetes mellitus].

    PubMed

    Anazawa, Sonoko

    2015-12-01

    Five years have passed since the criteria of gestational diabetes mellitus (GDM) were revised. Under these new criteria, prevalence of GDM has increased from 2-3% to 8-10%. This increase raises many arguments especially about cost effectiveness of managing newly diagnosed mild GDM showing only one abnormal value in 75 gOGTT. No evidence is yet to be found. But in our everyday experience, we find out few poor perinatal outcome with mild GDM mothers who are treated only with diet regimen to control their body weight. Considering later development to type 2 diabetes with these mild GDM mothers, they show no obvious difference from non GDM mothers in the retrospective study. PMID:26666146

  19. 7 CFR 1782.17 - Parity lien.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 12 2014-01-01 2013-01-01 true Parity lien. 1782.17 Section 1782.17 Agriculture... (CONTINUED) SERVICING OF WATER AND WASTE PROGRAMS § 1782.17 Parity lien. In order for the Agency to agree to... documents, the requirements as specified in 7 CFR part 1780, subpart D, and as provided in applicable...

  20. 7 CFR 1782.17 - Parity lien.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... documents, the requirements as specified in 7 CFR part 1780, subpart D, and as provided in applicable State... 7 Agriculture 12 2012-01-01 2012-01-01 false Parity lien. 1782.17 Section 1782.17 Agriculture... (CONTINUED) SERVICING OF WATER AND WASTE PROGRAMS § 1782.17 Parity lien. In order for the Agency to agree...

  1. 7 CFR 1782.17 - Parity lien.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... documents, the requirements as specified in 7 CFR part 1780, subpart D, and as provided in applicable State... 7 Agriculture 12 2010-01-01 2010-01-01 false Parity lien. 1782.17 Section 1782.17 Agriculture... (CONTINUED) SERVICING OF WATER AND WASTE PROGRAMS § 1782.17 Parity lien. In order for the Agency to agree...

  2. 7 CFR 1782.17 - Parity lien.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... documents, the requirements as specified in 7 CFR part 1780, subpart D, and as provided in applicable State... 7 Agriculture 12 2013-01-01 2013-01-01 false Parity lien. 1782.17 Section 1782.17 Agriculture... (CONTINUED) SERVICING OF WATER AND WASTE PROGRAMS § 1782.17 Parity lien. In order for the Agency to agree...

  3. 7 CFR 1782.17 - Parity lien.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... documents, the requirements as specified in 7 CFR part 1780, subpart D, and as provided in applicable State... 7 Agriculture 12 2011-01-01 2011-01-01 false Parity lien. 1782.17 Section 1782.17 Agriculture... (CONTINUED) SERVICING OF WATER AND WASTE PROGRAMS § 1782.17 Parity lien. In order for the Agency to agree...

  4. Parity violation in low-energy

    SciTech Connect

    Martin Savage

    2001-12-01

    Parity violation in low-energy nuclear observables is included in the pionless effective field theory. The model-independent relation between the parity-violating asymmetry in polarized np -> d gamma and the non-nucleon part of the deuteron anapole moment is discussed. The asymmetry in np -> d gamma computed with KSW power-counting, and recently criticized by Desplanques, is discussed.

  5. Severe obesity, gestational weight gain, and adverse birth outcomes123

    PubMed Central

    Bodnar, Lisa M; Siega-Riz, Anna Maria; Simhan, Hyagriv N; Himes, Katherine P; Abrams, Barbara

    2010-01-01

    Background: The 2009 Institute of Medicine (IOM) Committee to Reevaluate Gestational Weight Gain Guidelines concluded that there were too few data to inform weight-gain guidelines by obesity severity. Therefore, the committee recommended a single range, 5–9 kg at term, for all obese women. Objective: We explored associations between gestational weight gain and small-for-gestational-age (SGA) births, large-for-gestational-age (LGA) births, spontaneous preterm births (sPTBs), and medically indicated preterm births (iPTBs) among obese women who were stratified by severity of obesity. Design: We studied a cohort of singleton, live-born infants without congenital anomalies born to obesity class 1 (prepregnancy body mass index [BMI (in kg/m2)]: 30–34.9; n = 3254), class 2 (BMI: 35–39.9; n = 1451), and class 3 (BMI: ≥40; n = 845) mothers. We defined the adequacy of gestational weight gain as the ratio of observed weight gain to IOM-recommended gestational weight gain. Results: The prevalence of excessive gestational weight gain declined, and weight loss increased, as obesity became more severe. Generally, weight loss was associated with an elevated risk of SGA, iPTB, and sPTB, and a high weight gain tended to increase the risk of LGA and iPTB. Weight gains associated with probabilities of SGA and LGA of ≤10% and a minimal risk of iPTB and sPTB were as follows: 9.1–13.5 kg (obesity class 1), 5.0–9 kg (obesity class 2), 2.2 to <5.0 kg (obesity class 3 white women), and <2.2 kg (obesity class 3 black women). Conclusion: These data suggest that the range of gestational weight gain to balance risks of SGA, LGA, sPTB, and iPTB may vary by severity of obesity. PMID:20357043

  6. Models of dynamical R-parity violation

    NASA Astrophysics Data System (ADS)

    Csáki, Csaba; Kuflik, Eric; Slone, Oren; Volansky, Tomer

    2015-06-01

    The presence of R-parity violating interactions may relieve the tension between existing LHC constraints and natural supersymmetry. In this paper we lay down the theoretical framework and explore models of dynamical R-parity violation in which the breaking of R-parity is communicated to the visible sector by heavy messenger fields. We find that R-parity violation is often dominated by non-holomorphic operators that have so far been largely ignored, and might require a modification of the existing searches at the LHC. The dynamical origin implies that the effects of such operators are suppressed by the ratio of either the light fermion masses or the supersymmetry breaking scale to the mediation scale, thereby providing a natural explanation for the smallness of R-parity violation. We consider various scenarios, classified by whether R-parity violation, flavor breaking and/or supersymmetry breaking are mediated by the same messenger fields. The most compact case, corresponding to a deformation of the so called flavor mediation scenario, allows for the mediation of supersymmetry breaking, R-parity breaking, and flavor symmetry breaking in a unified manner.

  7. Gestational weight gain among Hispanic women.

    PubMed

    Sangi-Haghpeykar, Haleh; Lam, Kim; Raine, Susan P

    2014-01-01

    To describe gestational weight gain among Hispanic women and to examine psychological, social, and cultural contexts affecting weight gain. A total of 282 Hispanic women were surveyed post-partum before leaving the hospital. Women were queried about their prepregnancy weight and weight gained during pregnancy. Adequacy of gestational weight gain was based on guidelines set by the Institute of Medicine in 2009. Independent risk factors for excessive or insufficient weight gain were examined by logistic regression. Most women were unmarried (59 %), with a mean age of 28.4 ± 6.6 years and an average weight gain of 27.9 ± 13.3 lbs. Approximately 45 % of women had gained too much, 32 % too little, and only 24 % had an adequate amount of weight gain. The mean birth weight was 7.3, 7.9, and 6.8 lbs among the adequate, excessive, and insufficient weight gain groups. Among women who exercised before pregnancy, two-thirds continued to do so during pregnancy; the mean gestational weight gain of those who continued was lower than those who stopped (26.8 vs. 31.4 lbs, p = 0.04). Independent risk factors for excessive weight gain were being unmarried, U.S. born, higher prepregnancy body mass index, and having indifferent or negative views about weight gain. Independent risk factors for insufficient weight gain were low levels of support and late initiation of prenatal care. Depression, stress, and a woman's or her partner's happiness regarding pregnancy were unrelated to weight gain. The results of this study can be used by prenatal programs to identify Hispanic women at risk for excessive or insufficient gestational weight gain. PMID:23456347

  8. What I Need to Know about Gestational Diabetes

    MedlinePlus

    ... of Diabetes: Neonatal Diabetes Mellitus and MODY Gestational Diabetes What is gestational diabetes? Gestational diabetes is a type of diabetes that ... 8747 and request a copy. What causes gestational diabetes? Gestational diabetes happens when your body can't ...

  9. Quantum metrology to probe atomic parity nonconservation

    SciTech Connect

    Mandal, P.; Mukherjee, M.

    2010-11-15

    An entangled state prepared in a decoherence-free subspace, together with a Ramsey-type measurement, can probe parity violation in heavy alkali-metal ions such as Ba{sup +} or Ra{sup +}. Here we propose an experiment with Ba{sup +} as an example to measure the small parity-violating effect in this system. It has been shown that a measurement on a maximally correlated system will reduce the uncertainty as compared to that on a single ion measurement, and also provides a feasible solution to measure the nuclear-spin-dependent part of the total parity-violating light shift in an ionic system.

  10. Gestational diabetes - self-care

    MedlinePlus

    ... most women with gestational diabetes will not need diabetes medicines or insulin. If changing your diet does not control your blood sugar levels, you may need oral medicine (taken by mouth) or insulin therapy (shots).

  11. Parity and the risk of developing rheumatoid arthritis: results from the Swedish EIRA study

    PubMed Central

    Orellana, Cecilia; Wedrén, Sara; Källberg, Henrik; Holmqvist, Marie; Karlsson, Elisabeth W.; Alfredsson, Lars; Bengtsson, Camilla

    2014-01-01

    Objective To study the impact of parity history on the risk of ACPA- (antibodies to citrullinated peptides antigens) positive/-negative rheumatoid arthritis (RA), in different age-groups. Method Data from a population-based case-control study of female incident RA cases were analysed (2035 cases, 2911 controls, aged 18-70). Parity history was assessed through questionnaire. Parous women were compared with nulliparous, by calculating odds ratios (OR) with 95% confidence interval (CI). Results Parity was associated with an increased risk of ACPA-negative RA in the age-group 18-44 (OR=2.1, 95% CI 1.4-3.2), but not in the age-group 45-70 (OR=0.9, 95% CI 0.7-1.3). Among young women, an increased risk of ACPA-negative RA was found in those with delivery during the year of symptom onset (OR=2.6, 95% CI 1.4-4.8) and at young age at first birth (<23) (OR=2.5, 95% CI 1.5-4.1).Parity and the postpartum period were not associated with ACPA-positive RA, but older age at first birth was weakly associated with a decreased risk. Conclusions The increased risk of ACPA-negative RA in parous women of reproductive age seemed to be conferred to an increased postpartum risk and to young age at first birth. Further research is needed to explore the biological mechanisms behind our findings. PMID:23887288

  12. Trying to understand gestational diabetes

    PubMed Central

    Catalano, P. M.

    2014-01-01

    Women with normal glucose tolerance pre-gravid and developing gestational diabetes in late gestation have subclinical metabolic dysfunction prior to conception compared with women with normal glucose tolerance. Because of the 60 % decrease in insulin sensitivity with normal pregnancy, these women develop clinical hyperglycaemia/gestational diabetes in late gestation. The metabolic dysfunction includes impaired insulin response, decreased hepatic suppression of glucose production during insulin infusion and decreased insulin-stimulated glucose uptake in skeletal muscle, i.e. peripheral insulin resistance. The insulin resistance in normal glucose tolerance pregnancy is related to a decrease in the post-receptor insulin signalling cascade, specifically decreased insulin receptor substrate 1 tyrosine phosphorylation. In women with normal glucose tolerance this is reversed post-partum. In contrast, in gestational diabetes, in addition to the decrease in insulin receptor substrate 1 tyrosine phosphorylation, there is an additional decrease in tyrosine phosphorylation of the intracellular portion of the insulin receptor that is not related to the insulin receptor protein content. Post-partum women with gestational diabetes, who had retention of gestational weight gain, had no significant improvement in insulin sensitivity and increased inflammation expressed as increased plasma and skeletal muscle tumour necrosis factor alpha. The increased inflammation or meta-inflammation is a hallmark of obesity and during pregnancy develops in both white adipose tissue and placenta. Last gene array studies of placenta were associated with alterations in gene expression relating primarily to lipid in contrast to glucose metabolic pathways in gestational diabetes compared with Type 1 diabetes. Future studies are directed at decreasing inflammation prior to and during pregnancy using various lifestyle and nutritional interventions. PMID:24341419

  13. Quantum nondemolition measurement of parity and generation of parity eigenstates in optical fields

    SciTech Connect

    Gerry, Christopher C.; Benmoussa, A.; Campos, R. A.

    2005-11-15

    The parity of photonic number states is known to be an important observable for quantized electromagnetic fields with applications to quantum information processing and to Heisenberg-limited measurement of phase shifts in quantum interferometry performed with maximally entangled states and with twin number states. In this paper we describe an approach to the quantum nondemolition measurement of parity for quantized optical fields. The method proposed involves the use of a cross-Kerr interaction where we assume a large Kerr nonlinearity is available through the techniques of electromagnetically induced transparency. Our proposed method does not require the measurement of photon number but rather measures parity directly. The method not only allows for the quantum nondemolition measurement of parity but also allows for the von Neumann projection of parity eigenstates from an arbitrary field state. The generation and detection of higher-order parity eigenstates is also discussed. Losses from dissipation and the effects of detector efficiency are considered.

  14. Assisted Gestation and Transgender Women.

    PubMed

    Murphy, Timothy F

    2015-07-01

    Developments in uterus transplant put assisted gestation within meaningful range of clinical success for women with uterine infertility who want to gestate children. Should this kind of transplantation prove routine and effective for those women, would there be any morally significant reason why men or transgender women should not be eligible for the same opportunity for gestation? Getting to the point of safe and effective uterus transplantation for those parties would require a focused line of research, over and above the study of uterus transplantation for non-transgender women. Some commentators object to the idea that the state has any duty to sponsor research of this kind. They would limit all publicly-funded fertility research to sex-typical ways of having children, which they construe as the basis of reproductive rights. This objection has no force against privately-funded research, of course, and in any case not all social expenditures are responses to 'rights' properly speaking. Another possible objection raised against gestation by transgender women is that it could alter the social meaning of sexed bodies. This line of argument fails, however, to substantiate a meaningful objection to gestation by transgender women because social meanings of sexed bodies do not remain constant and because the change in this case would not elicit social effects significant enough to justify closing off gestation to transgender women as a class. PMID:25522123

  15. 47 CFR 51.213 - Toll dialing parity implementation plans.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 3 2013-10-01 2013-10-01 false Toll dialing parity implementation plans. 51... parity implementation plans. (a) A LEC must file a plan for providing intraLATA toll dialing parity... dialing parity within a state until the implementation plan has been approved by the appropriate...

  16. 47 CFR 51.213 - Toll dialing parity implementation plans.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 3 2012-10-01 2012-10-01 false Toll dialing parity implementation plans. 51... parity implementation plans. (a) A LEC must file a plan for providing intraLATA toll dialing parity... dialing parity within a state until the implementation plan has been approved by the appropriate...

  17. 47 CFR 51.213 - Toll dialing parity implementation plans.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 3 2014-10-01 2014-10-01 false Toll dialing parity implementation plans. 51... parity implementation plans. (a) A LEC must file a plan for providing intraLATA toll dialing parity... dialing parity within a state until the implementation plan has been approved by the appropriate...

  18. 47 CFR 51.213 - Toll dialing parity implementation plans.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 3 2011-10-01 2011-10-01 false Toll dialing parity implementation plans. 51... parity implementation plans. (a) A LEC must file a plan for providing intraLATA toll dialing parity... dialing parity within a state until the implementation plan has been approved by the appropriate...

  19. T-Parity in Little Higgs Models

    SciTech Connect

    Krohn, David

    2008-11-23

    We examine quantum anomalies in the context of little Higgs theories. In particular, we investigate the restrictions imposed upon little Higgs models when one requires an exact T-parity. Applications to LHC phenomenology are briefly discussed.

  20. Inflight parity vector compensation for FDI

    NASA Astrophysics Data System (ADS)

    Hall, S. R.; Motyka, P.; Gai, E.; Deyst, J. J., Jr.

    The performance of a failure detection and isolation (FDI) algorithm applied to a redundant strapdown inertial measurement unit (IMU) is limited by sensor errors such as input axis misalignment, scale factor errors, and biases. This paper presents a technique for improving the performance of FDI algorithms applied to redundant strapdown IMUs. A Kalman filter provides estimates of those linear combinations of sensor errors that affect the parity vector. These estimates are used to form a compensated parity vector which does not include the effects of sensor errors. The compensated parity vector is then used in place of the uncompensated parity vector to make FDI decisions. Simulation results are presented in which the algorithm is tested in a realistic flight environment that includes vehicle maneuvers, the effects of turbulence, and sensor failures. The results show that the algorithm can significantly improve FDI performance, especially during vehicle maneuvers.

  1. R parity from the heterotic string.

    PubMed

    Gaillard, Mary K

    2005-04-15

    In T-duality invariant effective supergravity with gaugino condensation as the mechanism for supersymmetry breaking, there is a residual discrete symmetry that could play the role of R parity in supersymmetric extensions of the standard model. PMID:15904056

  2. Parity nonconservation in atomic Zeeman transitions

    SciTech Connect

    Angstmann, E. J.; Dinh, T. H.; Flambaum, V. V.

    2005-11-15

    We discuss the possibility of measuring nuclear anapole moments in atomic Zeeman transitions and perform the necessary calculations. Advantages of using Zeeman transitions include variable transition frequencies and the possibility of enhancement of parity nonconservation effects.

  3. Positronic complexes with unnatural parity

    SciTech Connect

    Bromley, M. W. J.; Mitroy, J.; Varga, K.

    2007-06-15

    The structure of the unnatural parity states of PsH, LiPs, NaPs, and KPs are investigated with the configuration interaction and stochastic variational methods. The binding energies (in hartree) are found to be 8.17x10{sup -4}, 4.42x10{sup -4}, 15.14x10{sup -4}, and 21.80x10{sup -4}, respectively. These states are constructed by first coupling the two electrons into a configuration which is predominantly {sup 3}P{sup e}, and then adding a p-wave positron. All the active particles are in states in which the relative angular momentum between any pair of particles is at least L=1. The LiPs state is Borromean since there are no three-body bound subsystems (of the correct symmetry) of the (Li{sup +}, e{sup -}, e{sup -}, e{sup +}) particles that make up the system. The dominant decay mode of these states will be radiative decay into a configuration that autoionizes or undergoes positron annihilation.

  4. Parity-time-symmetric teleportation

    NASA Astrophysics Data System (ADS)

    Ra'di, Y.; Sounas, D. L.; Alù, A.; Tretyakov, S. A.

    2016-06-01

    We show that electromagnetic plane waves can be fully "teleported" through thin, nearly fully reflective sheets, assisted by a pair of parity-time-symmetric lossy and active sheets in front and behind the screen. The proposed structure is able to almost perfectly absorb incident waves over a wide range of frequency and incidence angles, while waves having a specific frequency and incidence angle are replicated behind the structure in synchronization with the input signal. It is shown that the proposed structure can be designed to teleport waves at any desired frequency and incidence angle. Furthermore, we generalize the proposed concept to the case of teleportation of electromagnetic waves over electrically long distances, enabling full absorption at one surface and the synthesis of the same signal at another point located electrically far away from the first surface. The physical principle behind this selective teleportation is discussed, and similarities and differences with tunneling and cloaking concepts based on PT symmetry are investigated. From the application point of view, the proposed structure works as an extremely selective filter, both in frequency and spatial domains.

  5. Testing R-parity with geometry

    NASA Astrophysics Data System (ADS)

    He, Yang-Hui; Jejjala, Vishnu; Matti, Cyril; Nelson, Brent D.

    2016-03-01

    We present a complete classification of the vacuum geometries of all renormalizable superpotentials built from the fields of the electroweak sector of the MSSM. In addition to the Severi and affine Calabi-Yau varieties previously found, new vacuum manifolds are identified; we thereby investigate the geometrical implication of theories which display a manifest matter parity (or R-parity) via the distinction between leptonic and Higgs doublets, and of the lepton number assignment of the right-handed neutrino fields.

  6. Effects of Parity on Blood Pressure among African-American Women

    PubMed Central

    Taylor, Jacquelyn Y.; Chambers, Angelina N.; Funnell, Beth; Wu, Chun Yi

    2010-01-01

    It has been well established that age, ethnicity, weight, and lifestyle behaviors can affect blood pressure (BP). Co-morbid conditions such as HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets), pre-eclampsia, and previous hypertension diagnosis might also be risks for chronic hypertension among women who have had children. Although parity has been linked to changes in blood pressure in White women, these findings have not been replicated among African-American women. The purpose of this study was to determine if the number of pregnancies urban African-American women have effects BMI and blood pressure readings later in life. Results indicated that women with a previous diagnosis of hypertension had higher SBP and DBP, and a slightly higher BMI than women who had never been diagnosed. Additionally, women with a prior history of hypertension had more children than those without a diagnosis of hypertension. As parity increased, SBP increased. However, DBP decreased after 3 to 4 children, even with increases in BMI. This study shows that parity may increase African-American women’s risk for hypertension in terms of increased SBP and BMI with increased parity. However, increased parity and BMI may also serve as protective factors in lowering DBP. Further studies, with larger samples followed throughout their pregnancies, is needed before more definitive statements may be drawn about the effects of parity on BMI and blood pressure readings among African-American women can be made. PMID:19397049

  7. Oral contraception, parity, breast feeding, and severity of rheumatoid arthritis.

    PubMed Central

    Jorgensen, C; Picot, M C; Bologna, C; Sany, J

    1996-01-01

    OBJECTIVE: To investigate the influence of breast feeding, use of the oral contraceptive pill (OCP), and parity on rheumatoid arthritis (RA). METHODS: One hundred and seventy six women with RA were compared with 145 control subjects; all had at least one child. RA patients were classified as having severe (n = 82) or mild disease (n = 89) according to clinical joint evaluation, radiological score, biological inflammation, and the presence of HLA-DR1 or -DR4 alleles. RESULTS: The mean age of RA patients was 58 years, and the mean age at the time of diagnosis of RA was 46 years. The mean time between onset of RA and the first birth was 23.6 (SD 3.8) years. The OCP user rates were 33% in the RA group and 47.6% in the control group (p < 0.02). OCP use was related to the mother's year of birth. The relative risk for developing RA was 0.598 (95% confidence interval (CI) 0.33 to 1.1) in women who had used OCP for more than five years compared with those who had never used OCPs. In contrast, the age at which the first pregnancy occurred, the number of children breast fed, and the duration of breast feeding were comparable in RA patients and healthy subjects. Among the RA patients, parity, duration of breast feeding, and the number of breast fed children were significantly increased in those with severe disease. Having more than three children increased the risk of developing severe disease 4.8-fold when adjusted for age and OCP use. Forty six percent of women with severe RA had a history of breast feeding duration greater than six months before disease onset, compared with 26% of patients with mild disease (p < 0.008). Having more than three breast fed children increased the risk of poor disease prognosis 3.7-fold. In contrast, OCP use had a protective role in the course of RA (44% of RA patients with mild disease were OCP users, compared with 21.7% of those with severe RA; p < 0.001). Among those using OCP for more than five years, the relative risk of developing severe

  8. Ethical issues in gestational surrogacy.

    PubMed

    Ber, R

    2000-01-01

    The introduction of contraceptive technologies has resulted in the separation of sex and procreation. The introduction of new reproductive technologies (mainly IVF and embryo transfer) has led not only to the separation of procreation and sex, but also to the redefinition of the terms mother and family. For the purpose of this essay, I will distinguish between: 1. the genetic mother--the donor of the egg; 2. the gestational mother--she who bears and gives birth to the baby; 3. the social mother--the woman who raises the child. This essay will deal only with the form of gestational surrogacy in which the genetic parents intend to be the social parents, and the surrogate mother has no genetic relationship to the child she bears and delivers. I will raise questions regarding medical ethical aspects of surrogacy and the obligation(s) of the physician(s) to the parties involved. I will argue that the gestational surrogate is "a womb to rent," that there is great similarity between gestational commercial surrogacy and organ transplant marketing. Furthermore, despite claims to freedom of choice and free marketing, I will claim that gestational surrogacy is a form of prostitution and slavery, exploitation of the poor and needy by those who are better off. The right to be a parent, although not constitutional, is intuitive and deeply rooted. However, the issue remains whether this right overrules all other rights, and at what price to the parties involved. I will finally raise the following provocative question to society: In the interim period between today's limited technology and tomorrow's extra-corporeal gestation technology (ectogenesis), should utilizing females in PVS (persistent vehetative state) for gestational surrogacy be socially acceptable/permissible--provided they have left permission in writing? PMID:10967951

  9. Associations of body mass and body fat distribution with parity among African-American and Caucasian women: The CARDIA Study.

    PubMed

    Lewis, C E; Smith, D E; Caveny, J L; Perkins, L L; Burke, G L; Bild, D E

    1994-11-01

    Associations of parity with body fat and its distribution are poorly understood; therefore, we examined the relationships between parity and obesity in young adult women. Body mass index (BMI), skin-folds, and waist-hip ratio were compared in 1452 African-American and 1268 Caucasian nonpregnant women aged 18 to 30, adjusting for age (where no age-parity interactions were present), education, physical activity (assessed by questionnaire) and fitness (assessed by graded exercise test), dietary fat intake, alcohol and smoking. Adjusted mean BMI was significantly higher in African-American women aged 25-30 years with three or more children (28.5 kg/m2) than in those with two (27.0 kg/m2), one (26.2 kg/m2), or no children (26.3 kg/m2). Similar trends were found in Caucasians (BMI = 23.3, 23.4, 23.7, 25.0 kg/m2 for parity = 0, 1, 2, > or = 3, respectively), but the mean BMI was significantly higher in African Americans in each parity group. The association between BMI and parity was not present among women 18-24 years of age. Skinfolds were directly associated with parity in African Americans only. Waist-hip ratios were generally lower among nulliparous than parous women in both ethnic groups; race differences were present only among nulliparas. In conclusion, parity was associated with BMI in women aged 25 to 30 years but did not explain ethnicity-related differences in body mass. PMID:16358400

  10. The baboon model (Papio hamadryas) of fetal loss: Maternal weight, age, reproductive history and pregnancy outcome

    PubMed Central

    Schlabritz-Loutsevitch, Natalia; Moore, Charleen M.; Lopez-Alvarenga, Juan Carlos; Dunn, Betty G.; Dudley, Donald; Hubbard, Gene B.

    2010-01-01

    Background Several risk factors are associated with the incidence of human stillbirths. The prevention of stillbirths in women is a pressing clinical problem. Methods We reviewed 402 pathology records of fetal loss occurring in a large baboon (Papio spp.) colony during a 15-year period. Clinical histories of 565 female baboons with one or more fetal losses during a 20-year period were analyzed for weight, age, and reproductive history. Results Fetal loss was most common at term (35.57%) and preterm (28.61%) and less common in the first half of gestation (11.20%) and post-term (5.22%). Greater maternal weight, older age, history of stillbirth and higher parity were independent predictors for stillbirth. An exponential increase in the incidence of fetal loss was observed beginning at age 14 years in baboons. Conclusion Fetal loss and maternal risk factors associated with stillbirths in baboons were similar to those documented in women. PMID:19017195

  11. The management of gestational diabetes

    PubMed Central

    Cheung, N Wah

    2009-01-01

    The incidence of gestational diabetes is increasing. As gestational diabetes is associated with adverse pregnancy outcomes, and has long-term implications for both mother and child, it is important that it is recognized and appropriately managed. This review will examine the pharmacological options for the management of gestational diabetes, as well as the evidence for blood glucose monitoring, dietary and exercise therapy. The medical management of gestational diabetes is still evolving, and recent randomized controlled trials have added considerably to our knowledge in this area. As insulin therapy is effective and safe, it is considered the gold standard of pharmacotherapy for gestational diabetes, against which other treatments have been compared. The current experience is that the short acting insulin analogs lispro and aspart are safe, but there are only limited data to support the use of long acting insulin analogs. There are randomized controlled trials which have demonstrated efficacy of the oral agents glyburide and metformin. Whilst short-term data have not demonstrated adverse effects of glyburide and metformin on the fetus, and they are increasingly being used in pregnancy, there remain long-term concerns regarding their potential for harm. PMID:19436673

  12. Serum concentrations of micronutrients, packed cell volume, and blood hemoglobin during the first two gestations and lactations of sows.

    PubMed Central

    Girard, C L; Robert, S; Matte, J J; Farmer, C; Martineau, G P

    1996-01-01

    The objective of the present work was to describe the changes in serum concentrations of some micronutrients during the first 2 gestations and lactations of 33 gilts in order to establish blood reference values for a rapid assessment of nutritional status. In both parities, blood samples were taken from the jugular vein at mating, 5, 10 and 15 wk of gestation and l d and 4 wk after parturition (weaning). Reference values (mean, standard deviation, minimum, maximum) for serum folates, vitamin B12, vitamin B6 metabolites (pyridoxal and pyridoxal-5-phosphate), calcium, phosphorus, sodium, zinc, copper and iron, as well as blood hemoglobin and packed cell volume are reported for each studied time. Differences between parities and between each time are also reported. Results from the present report demonstrate that knowledge of the physiological state of the sows is critical for the assessment of nutritional status of an individual or a breeding herd by interpretation of analyses of blood constituents. PMID:8809380

  13. Maternal reproductive experience enhances early postnatal outcome following gestation and birth of rats in hypergravity

    NASA Technical Reports Server (NTRS)

    Ronca, A. E.; Baer, L. A.; Daunton, N. G.; Wade, C. E.

    2001-01-01

    A major goal of space life sciences research is to broaden scientific knowledge of the influence of gravity on living systems. Recent spaceflight and centrifugation studies demonstrate that reproduction and ontogenesis in mammals are amenable to study under gravitational conditions that deviate considerably from those typically experienced on Earth (1 x g). In the present study, we tested the hypothesis that maternal reproductive experience determines neonatal outcome following gestation and birth under increased (hyper) gravity. Primigravid and bigravid female rats and their offspring were exposed to 1.5 x g centrifugation from Gestational Day 11 either through birth or through the first postnatal week. On the day of birth, litter sizes were identical across gravity and parity conditions, although significantly fewer live neonates were observed among hypergravity-reared litters born to primigravid dams than among those born to bigravid dams (82% and 94%, respectively; 1.0 x g controls, 99%). Within the hypergravity groups, neonatal mortality was comparable across parity conditions from Postnatal Day 1 through Day 7, at which time litter sizes stabilized. Maternal reproductive experience ameliorated neonatal losses during the first 24 h after birth but not on subsequent days, and neonatal mortality was associated with changes in maternal care patterns. These results indicate that repeated maternal reproductive experience affords protection against neonatal losses during exposure to increased gravity. Differential mortality of neonates born to primigravid versus bigravid dams denotes gravitational load as one environmental mechanism enabling the expression of parity-related variations in birth outcome.

  14. The Association of Restless Legs Syndrome to History of Gestational Diabetes in an Appalachian Primary Care Population

    PubMed Central

    Innes, Kim E.; Kandati, Sahiti; Flack, Kathryn L.; Agarwal, Parul; Selfe, Terry Kit

    2015-01-01

    Objective: Restless legs syndrome (RLS) is a burdensome sensorimotor disorder that has been linked to diabetes and obesity. However, the relationship of RLS to gestational diabetes mellitus (GDM), a common pregnancy complication strongly associated with obesity and a harbinger of diabetes, remains unknown. In this study, we examined the association of RLS to history of GDM in a sample of older female primary care patients. Methods: Participants were community-dwelling women aged ≥ 40 years drawn from an anonymous survey study of West Virginia adult primary care patients. Data gathered included detailed information on demographics, lifestyle factors, reproductive history, sleep patterns, and medical history; the survey also included an RLS diagnostic questionnaire. Women who were pregnant or had missing data on key variables were excluded from the analyses. Results: Of the 498 participants included in the final analytic sample, 24.5% met diagnostic criteria for RLS (17.9% with symptoms at least once/week). After adjustment for demographics, lifestyle characteristics, body mass index, diabetes and other comorbid conditions, parity, and other factors, those reporting history of GDM were almost three times as likely to meet criteria for RLS (odds ratio [OR] = 2.7, 95% confidence interval [CI] = 1.3, 5.3). This association increased in magnitude with increasing symptom frequency (adjusted OR for RLS symptoms ≥ 3×/week = 4.8, CI 2.1, 11.2, p for trend = 0.004). Conclusions: History of GDM was strongly and positively related to RLS in this study of older female primary care patients, offering further support for a possible role of metabolic dysregulation in RLS development. Citation: Innes KE, Kandati S, Flack KL, Agarwal P, Selfe TK. The association of restless legs syndrome to history of gestational diabetes in an Appalachian primary care population. J Clin Sleep Med 2015;11(10):1121–1130. PMID:26156957

  15. [Obstetric consequences of uncontrolled gestational diabetes--a case study].

    PubMed

    Murlewska, Julia; Pietryga, Marek; Bagnosz-Magnuszewska, Alina; Zawiejska, Agnieszka; Brazert, Jacek; Gadzinowski, Janusz; Wender-Ozegowska, Ewa

    2011-08-01

    This paper presents a case of a pregnant woman who was admitted to the obstetrics and gynecology department because of a new onset of uncontrolled diabetes in 27 weeks gestation. The maternal and fetal diabetic complications suggested a chronic character of the disease which must have been undiagnosed before pregnancy. Many of the co-existing infections caused a life-threatening ketoacidosis. Fortunately with the adequate treatment it was possible to ensure appropriate birth weight of the newborn baby despite the ultrasound markers for LGA (Large For Gestational Age) observed during pregnancy. Intensive insulin therapy was obligatorily continued by the mother after the delivery. PMID:21957610

  16. Role of Exercise in Reducing Gestational Diabetes Mellitus.

    PubMed

    Mottola, Michelle F; Artal, Raul

    2016-09-01

    Exercise plays an important role in reducing the prevalence of gestational diabetes mellitus (GDM) in women with or without risk factors. GDM risk factors include obesity, family history of diabetes, high-risk ethnicity, increased maternal age, history of GDM, delivering a macrosomic infant, excessive gestational weight gain early in pregnancy (before glucose screening), sedentary behavior, low physical activity, and vitamin D deficiency. Most GDM patients can be managed with lifestyle modifications that include medical nutrition therapy and physical activity. When adherence is high and women are fully engaged in the exercise program, GDM can be effectively managed and prevented. PMID:27135873

  17. Increasing Parity Is Associated with Cumulative Effects on Memory

    PubMed Central

    2012-01-01

    Abstract Background The purpose of this investigation was to determine if reproductive experience is associated with cumulative effects on human memory performance during pregnancy and if these effects persist into the postpartum period. Methods Verbal recall memory performance was assessed in 254 women four times during pregnancy and at 3 months postpartum. The relation between parity and memory function was evaluated with hierarchical linear modeling and analysis of covariance (ANCOVA). Results The data indicate that the previously documented adverse effects of pregnancy on memory performance are compounded with successive pregnancies. During gestation and postpartum, multiparity was associated with poorer memory function, and these effects did not appear to be due to differences in maternal demographics, depressive symptoms, or sleep quality. Conclusions Animal models demonstrate that the effects of reproduction on brain structure and function are both cumulative and enduring. However, little is known about the influence of reproductive experience on the human female brain. These findings provide evidence that in humans, reproduction is associated with striking and perhaps persisting changes in cognitive function. PMID:23036056

  18. The effects of gestation dating on the calculation of patient specific risks in Down's syndrome screening.

    PubMed

    Bishop, J; Dunstan, F D; Nix, B J; Reynolds, T M

    1995-09-01

    In Down's syndrome screening using biochemical markers, the marker concentrations are adjusted for the gestational age of the fetus, since they are known to change with gestational age. This adjustment is performed by referring to the population median of each marker for the appropriate gestational age group. The measurement of gestational age is subject to error, whatever method is used, and the population median used is actually the median of a mixture of distributions for different true gestational ages. We show how the proportions in this mixture can be estimated and how the true median corresponding to a given true gestational age can be estimated. For simplicity, we consider the case of using a single marker, namely maternal serum alpha-fetoprotein, and show that the usual estimation method has considerable bias. The effect of this mixture on the calculation of patient-specific risks is discussed and we show that detection rates can be improved by allowing for this error in the dating process. The overall detection rate is increased by about 1%. The increase in detection rate is age-dependent and for some maternal ages the increase is of the order of 5%. The comparative effects of different methods for dating are discussed. PMID:8830621

  19. Feeding distiller’s grains as an energy source to gestating and lactating beef heifers: Impact on female progeny growth, puberty attainment, and reproductive processes.

    PubMed

    Gunn, P J; Schoonmaker, J P; Lemenager, R P; Bridges, G A

    2015-02-01

    This study compared postweaning growth, puberty attainment, and reproductive processes of female progeny (n = 33) born to Angus-Simmental beef heifers treated with either a control diet or a diet in which dried distiller’s grains with solubles (DDGS) were fed as an energy source during late gestation and early lactation. From 192 d of gestation through 118 ± 4 d in lactation, dams were fed either a corn silage–based control diet (CON) orcorn residue with DDGS, where DDGS were supplemented as an energy source (DG). Diets were formulated to provide similar daily NEg between diets, but CP requirements were drastically exceeded in the DG treatment. Heifer progeny (n = 33) were weaned, commingled at 191 ± 4 d of age, and similarly managed for the remainder of the project. Heifer BW and blood samples for progesterone assessment to determine onset of puberty were collected weekly beginning at weaning. At 255 ± 4 d of age, a single follicular wave was mapped via ultrasonography in 10 prepubertal heifers per treatment. Prepubertal antral follicle count and ovarian size were determined at 253 ± 4 d of age. Hip height was recorded at 213,297, and 437 ± 4 d of age. Estrous synchronization and AI was initiated at 447 ± 4 d of age. Binary data were analyzed with the GLIMMIX procedures of SAS and all other data were analyzed with the MIXED procedures of SAS. Progeny from DG-treated dams tended to be heavier (P = 0.08) than progeny from CON-treated dams from weaning until breeding. In addition, DG progeny had a greater (P < 0.01) frame score than CON throughout the developmental period. Ovarian size, antral follicle count, and follicular growth parameters did not differ between treatments. Age at puberty did not differ between CON (303 ± 10 d) and DG (320 ± 10 d) progeny; however, BW at puberty was greater (P = 0.01) for DG (326 ± 7 kg) than CON (298 ± 8 kg) progeny. Pregnancy rates to AI were greater (P = 0.05) in DG progeny (70.6%) than CON (33.3%), but overall

  20. Advances in ultrasound imaging for congenital malformations during early gestation

    PubMed Central

    Rayburn, William F.; Jolley, Jennifer A.; Simpson, Lynn L.

    2015-01-01

    With refinement in ultrasound technology, detection of fetal structural abnormalities has improved and there have been detailed reports of the natural history and expected outcomes for many anomalies. The ability to either reassure a high-risk woman with normal intrauterine images or offer comprehensive counseling and offer options in cases of strongly suspected lethal or major malformations has shifted prenatal diagnoses to the earliest possible gestational age. When indicated, scans in early gestation are valuable in accurate gestational dating. Stricter sonographic criteria for early nonviability guard against unnecessary intervention. Most birth defects are without known risk factors, and detection of certain malformations is possible in the late first trimester. The best time for a standard complete fetal and placental scan is 18–20 weeks. In addition, certain soft anatomic markers provide clues to chromosomal aneuploidy risk. Maternal obesity and multifetal pregnancies are now more common and further limit early gestation visibility. Other advanced imaging techniques during early gestation in select cases of suspected malformations include fetal echocardiography and magnetic resonance imaging. PMID:25820190

  1. Impact of Maternal Glucose and Gestational Weight Gain on Child Obesity over the First Decade of Life in Normal Birth Weight Infants.

    PubMed

    Hillier, Teresa A; Pedula, Kathryn L; Vesco, Kimberly K; Oshiro, Caryn E S; Ogasawara, Keith K

    2016-08-01

    Objective To determine, among children with normal birth weight, if maternal hyperglycemia and weight gain independently increase childhood obesity risk in a very large diverse population. Methods Study population was 24,141 individuals (mothers and their normal birth weight offspring, born 1995-2003) among a diverse population with universal GDM screening [50-g glucose-challenge test (GCT); 3 h. 100 g oral glucose tolerance test (OGTT) if GCT+]. Among the 13,037 full-term offspring with normal birth weight (2500-4000 g), annual measured height/weight was ascertained between ages 2 and 10 years to calculate gender-specific BMI-for-age percentiles using USA norms (1960-1995 standard). Results Among children who began life with normal birth weight, we found a significant trend for developing both childhood overweight (>85 %ile) and obesity (>95 %ile) during the first decade of life with both maternal hyperglycemia (normal GCT, GCT+ but no GDM, GDM) and excessive gestational weight gain [>40 pounds (18.1 kg)]; p < 0.0001 for both trends. These maternal glucose and/or weight gain effects to imprint for childhood obesity in the first decade remained after adjustment for potential confounders including maternal age, parity, as well as pre-pregnancy BMI. The attributable risk (%) for childhood obesity was 28.5 % (95 % CI 15.9-41.1) for GDM and 16.4 % (95 % CI 9.4-23.2) for excessive gestational weight gain. Conclusions for Practice Both maternal hyperglycemia and excessive weight gain have independent effects to increase childhood obesity risk. Future research should focus on prevention efforts during pregnancy as a potential window of opportunity to reduce childhood obesity. PMID:27154523

  2. Institutions, Politics, and Mental Health Parity

    PubMed Central

    Hernandez, Elaine M.; Uggen, Christopher

    2013-01-01

    Mental health parity laws require insurers to extend comparable benefits for mental and physical health care. Proponents argue that by placing mental health services alongside physical health services, such laws can help ensure needed treatment and destigmatize mental illness. Opponents counter that such mandates are costly or unnecessary. The authors offer a sociological account of the diffusion and spatial distribution of state mental health parity laws. An event history analysis identifies four factors as especially important: diffusion of law, political ideology, the stability of mental health advocacy organizations and the relative health of state economies. Mental health parity is least likely to be established during times of high state unemployment and under the leadership of conservative state legislatures. PMID:24353902

  3. Res-Parity: Parity Violation in Inelastic scattering at Low Q2

    SciTech Connect

    Reimer, Paul; Bosted, Peter; Arrington, John; Mkrtchyan, Hamlet; Zheng, Xiaochao

    2006-05-16

    Parity violating electron scattering has become a well established tool which has been used, for example, to probe the Standard Model and the strange-quark contribution to the nucleon. While much of this work has focused on elastic scattering, the RES-Parity experiment, which has been proposed to take place at Jefferson Laboratory, would focus on inelastic scattering in the low-Q2, low-W domain. RES-Parity would search for evidence of quark-hadron duality and resonance structure with parity violation in the resonance region. In terms of parity violation, this region is essentially unexplored, but the interpretation of other high-precision electron scattering experiments will rely on a reasonable understanding of scattering at lower energy and low-W through the effects of radiative corrections. RES-Parity would also study nuclear effects with the weak current. Because of the intrinsic broad band energy spectrum of neutrino beams, neutrino experiments are necessarily dependent on an untested, implicit assumption that these effects are identical to electromagnetic nuclear effects. RES-Parity is a relatively straight forward experiment. With a large expected asymmetry (~ 0.5 × 10-4) these studies may be completed with in a relatively brief period.

  4. Prevention of Gestational Diabetes Mellitus (GDM).

    PubMed

    Kalra, Sanjay; Gupta, Yashdeep; Kumar, Arun

    2016-09-01

    Prevention of Gestational diabetes mellitus holds the key to prevention of the diabetes and metabolic syndrome epidemic sweeping the world. This review discusses prevention of gestational diabetes and provides a scientific framework for the study of this topic. It classifies prevention in various ways, and suggests strategies which fit the different levels of prevention of gestational diabetes. The review also cites recent evidence and best practices to support the feasibility of prevention of gestational diabetes. PMID:27582141

  5. Does parity worsen diabetes-related chronic complications in women with type 1 diabetes?

    PubMed Central

    Gomes, Marilia Brito; Negrato, Carlos Antonio; Almeida, Ana; de Leon, Antonio Ponce

    2016-01-01

    AIM: To determine the relationship between parity, glycemic control, cardiovascular risk factors and diabetes-related chronic complications in women with type 1 diabetes. METHODS: This was a multicenter cross-sectional study conducted between December 2008 and December 2010 in 28 public clinics in 20 cities from the 4 Brazilian geographic regions. Data were obtained from 1532 female patients, 59.2% Caucasians, and aged 25.2 ± 10.6 years. Diabetes duration was of 11.5 ± 8.2 years. Patient’s information was obtained through a questionnaire and a chart review. Parity was stratified in five groups: Group 0 (nulliparous), group 1 (1 pregnancy), group 2 (2 pregnancies), group 3 (3 pregnancies), group 4 (≥ 4 pregnancies). Test for trend and multivariate random intercept logistic and linear regression models were used to evaluate the effect of parity upon glycemic control, cardiovascular risk factors and diabetes-related complications. RESULTS: Parity was not related with glycemic control and nephropathy. Moreover, the effect of parity upon hypertension, retinopathy and macrovascular disease did not persist after adjustments for demographic and clinical variables in multivariate analysis. For retinopathy, the duration of diabetes and hypertension were the most important independent variables and for macrovascular disease, these variables were age and hypertension. Overweight or obesity was noted in a total of 538 patients (35.1%). A linear association was found between the frequency of overweight or obesity and parity (P = 0.004). Using a random intercept multivariate linear regression model with body mass index (BMI) as dependent variable a borderline effect for parity (P = 0.06) was noted after adjustment for clinical and demographic data. The observed variability of BMI was not attributable to differences between centers. CONCLUSION: Our results suggest that parity has a borderline effect on body mass index but does not have an important effect upon hypertension

  6. Racial/Ethnic Disparities in Inadequate Gestational Weight Gain Differ by Pre-pregnancy Weight

    PubMed Central

    Headen, Irene; Mujahid, Mahasin S.; Cohen, Alison K.; Rehkopf, David H.; Abrams, Barbara

    2015-01-01

    Objectives Pre-pregnancy body mass index (BMI) varies by race/ethnicity and modifies the association between gestational weight gain (GWG) and adverse pregnancy outcomes, which disproportionately affect racial/ethnic minorities. Yet studies investigating whether racial/ethnic disparities in GWG vary by pre-pregnancy BMI are inconsistent, and none studied nationally representative populations. Methods Using categorical measures of GWG adequacy based on Institute of Medicine recommendations, we investigated whether associations between race/ethnicity and GWG adequacy were modified by pre-pregnancy BMI [underweight (<18.5kg/m2), normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), or obese (≥30.0 kg/m2) ] among all births to Black, Hispanic, and White mothers in the 1979 USA National Longitudinal Survey of Youth cohort (n=6849 pregnancies; range=1-10). We used generalized estimating equations, adjusted for marital status, parity, smoking during pregnancy, gestational age, and multiple measures of socioeconomic position. Results Effect measure modification between race/ethnicity and pre-pregnancy BMI was significant for inadequate GWG (Wald test p-value=0.08). Normal weight Black (Risk Ratio (RR)=1.34, 95% confidence interval (CI): 1.18, 1.52) and Hispanic women (RR=1.33, 95%CI: 1.15, 1.54) and underweight Black women (RR=1.38; 95% CI: 1.07, 1.79) experienced an increased risk of inadequate GWG compared to Whites. Differences in risk of inadequate GWG between minority women, compared to White women, were not significant among overweight and obese women. Effect measure modification between race/ethnicity and pre-pregnancy BMI was not significant for excessive GWG. Conclusions The magnitude of racial/ethnic disparities in inadequate GWG appears to vary by pre-pregnancy weight class, which should be considered when designing interventions to close racial/ethnic gaps in healthy GWG. PMID:25652057

  7. KK parity in warped extra dimension

    NASA Astrophysics Data System (ADS)

    Agashe, Kaustubh; Falkowski, Adam; Low, Ian; Servant, Géraldine

    2008-04-01

    We construct models with a Kaluza-Klein (KK) parity in a five-dimensional warped geometry, in an attempt to address the little hierarchy problem present in setups with bulk Standard Model fields. The lightest KK particle (LKP) is stable and can play the role of dark matter. We consider the possibilities of gluing two identical slices of AdS5 in either the UV (IR-UV-IR model) or the IR region (UV-IR-UV model) and discuss the model-building issues as well as phenomenological properties in both cases. In particular, we find that the UV-IR-UV model is not gravitationally stable and that additional mechanisms might be required in the IR-UV-IR model to address flavor issues. Collider signals of the warped KK parity are different from either the conventional warped extra dimension without KK parity, in which the new particles are not necessarily pair-produced, or the KK parity in flat universal extra dimensions, where each KK level is nearly degenerate in mass. Dark matter and collider properties of a TeV mass KK Z gauge boson as the LKP are discussed.

  8. Parity violation in deep inelastic scattering

    SciTech Connect

    Souder, P.

    1994-04-01

    AA beam of polarized electrons at CEBAF with an energy of 8 GeV or more will be useful for performing precision measurements of parity violation in deep inelastic scattering. Possible applications include precision tests of the Standard Model, model-independent measurements of parton distribution functions, and studies of quark correlations.

  9. Obstacles to Gender Parity in Engineering Education

    ERIC Educational Resources Information Center

    Rohatynskyj, Marta; Davidson, Valerie; Stiver, Warren; Hayward, Maren

    2008-01-01

    Low rates of women's enrolment in engineering programs has been identified as a global problem within the general concern to enable women to attain parity in education in all areas. A Western women in engineering meta-narrative is identified which contains a complex of obstacles that typify the situation of Western women. The question is asked…

  10. 7 CFR 989.61 - Above parity situations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Above parity situations. 989.61 Section 989.61... GROWN IN CALIFORNIA Order Regulating Handling Grade and Condition Standards § 989.61 Above parity... season average price to producers for raisins is in excess of the parity level specified in section...

  11. 7 CFR 993.53 - Above parity situations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Above parity situations. 993.53 Section 993.53... CALIFORNIA Order Regulating Handling Grade and Size Regulations § 993.53 Above parity situations. The minimum... estimated season average price for prunes is in excess of the parity level specified in section 2(1) of...

  12. 7 CFR 989.61 - Above parity situations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Above parity situations. 989.61 Section 989.61... GROWN IN CALIFORNIA Order Regulating Handling Grade and Condition Standards § 989.61 Above parity... season average price to producers for raisins is in excess of the parity level specified in section...

  13. 7 CFR 989.61 - Above parity situations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Above parity situations. 989.61 Section 989.61... GROWN IN CALIFORNIA Order Regulating Handling Grade and Condition Standards § 989.61 Above parity... season average price to producers for raisins is in excess of the parity level specified in section...

  14. 47 CFR 51.205 - Dialing parity: General.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 3 2013-10-01 2013-10-01 false Dialing parity: General. 51.205 Section 51.205... Obligations of All Local Exchange Carriers § 51.205 Dialing parity: General. A local exchange carrier (LEC) shall provide local and toll dialing parity to competing providers of telephone exchange service...

  15. 7 CFR 993.53 - Above parity situations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Above parity situations. 993.53 Section 993.53... CALIFORNIA Order Regulating Handling Grade and Size Regulations § 993.53 Above parity situations. The minimum... estimated season average price for prunes is in excess of the parity level specified in section 2(1) of...

  16. 7 CFR 993.53 - Above parity situations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Above parity situations. 993.53 Section 993.53... CALIFORNIA Order Regulating Handling Grade and Size Regulations § 993.53 Above parity situations. The minimum... estimated season average price for prunes is in excess of the parity level specified in section 2(1) of...

  17. 7 CFR 993.53 - Above parity situations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Above parity situations. 993.53 Section 993.53... CALIFORNIA Order Regulating Handling Grade and Size Regulations § 993.53 Above parity situations. The minimum... estimated season average price for prunes is in excess of the parity level specified in section 2(1) of...

  18. 7 CFR 989.61 - Above parity situations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Above parity situations. 989.61 Section 989.61... GROWN IN CALIFORNIA Order Regulating Handling Grade and Condition Standards § 989.61 Above parity... season average price to producers for raisins is in excess of the parity level specified in section...

  19. 47 CFR 51.205 - Dialing parity: General.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 3 2011-10-01 2011-10-01 false Dialing parity: General. 51.205 Section 51.205... Obligations of All Local Exchange Carriers § 51.205 Dialing parity: General. A local exchange carrier (LEC) shall provide local and toll dialing parity to competing providers of telephone exchange service...

  20. 47 CFR 51.205 - Dialing parity: General.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Dialing parity: General. 51.205 Section 51.205... Obligations of All Local Exchange Carriers § 51.205 Dialing parity: General. A local exchange carrier (LEC) shall provide local and toll dialing parity to competing providers of telephone exchange service...

  1. 47 CFR 51.205 - Dialing parity: General.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 3 2012-10-01 2012-10-01 false Dialing parity: General. 51.205 Section 51.205... Obligations of All Local Exchange Carriers § 51.205 Dialing parity: General. A local exchange carrier (LEC) shall provide local and toll dialing parity to competing providers of telephone exchange service...

  2. 7 CFR 993.53 - Above parity situations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Above parity situations. 993.53 Section 993.53... CALIFORNIA Order Regulating Handling Grade and Size Regulations § 993.53 Above parity situations. The minimum... estimated season average price for prunes is in excess of the parity level specified in section 2(1) of...

  3. 47 CFR 51.205 - Dialing parity: General.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 3 2014-10-01 2014-10-01 false Dialing parity: General. 51.205 Section 51.205... Obligations of All Local Exchange Carriers § 51.205 Dialing parity: General. A local exchange carrier (LEC) shall provide local and toll dialing parity to competing providers of telephone exchange service...

  4. 7 CFR 989.61 - Above parity situations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Above parity situations. 989.61 Section 989.61... GROWN IN CALIFORNIA Order Regulating Handling Grade and Condition Standards § 989.61 Above parity... season average price to producers for raisins is in excess of the parity level specified in section...

  5. 47 CFR 51.213 - Toll dialing parity implementation plans.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... parity implementation plans. (a) A LEC must file a plan for providing intraLATA toll dialing parity... dialing parity within a state until the implementation plan has been approved by the appropriate state commission or the Commission. (b) A LEC's implementation plan must include: (1) A proposal that explains...

  6. One plus two-body random matrix ensembles with parity: Density of states and parity ratios

    SciTech Connect

    Vyas, Manan; Srivastava, P. C.; Kota, V. K. B.

    2011-06-15

    One plus two-body embedded Gaussian orthogonal ensemble of random matrices with parity [EGOE(1+2)-{pi}] generated by a random two-body interaction (modeled by GOE in two-particle spaces) in the presence of a mean field for spinless identical fermion systems is defined, generalizing the two-body ensemble with parity analyzed by Papenbrock and Weidenmueller [Phys. Rev. C 78, 054305 (2008)], in terms of two mixing parameters and a gap between the positive ({pi}=+) and negative ({pi}=-) parity single-particle (sp) states. Numerical calculations are used to demonstrate, using realistic values of the mixing parameters appropriate for some nuclei, that the EGOE(1+2)-{pi} ensemble generates Gaussian form (with corrections) for fixed parity eigenvalue densities (i.e., state densities). The random matrix model also generates many features in parity ratios of state densities that are similar to those predicted by a method based on the Fermi-gas model for nuclei. We have also obtained, by applying the formulation due to Chang et al. [Ann. Phys. (NY) 66, 137 (1971)], a simple formula for the spectral variances defined over fixed-(m{sub 1},m{sub 2}) spaces, where m{sub 1} is the number of fermions in the positive parity sp states and m{sub 2} is the number of fermions in the negative parity sp states. Similarly, using the binary correlation approximation, in the dilute limit, we have derived expressions for the lowest two-shape parameters. The smoothed densities generated by the sum of fixed-(m{sub 1},m{sub 2}) Gaussians with lowest two-shape corrections describe the numerical results in many situations. The model also generates preponderance of positive parity ground states for small values of the mixing parameters, and this is a feature seen in nuclear shell-model results.

  7. Quantitative assessment of gestational sac shape: the gestational sac shape score

    PubMed Central

    Deter, R.L.; Li, J.; Lee, W.; Liu, S.; Romero, R.

    2012-01-01

    Objective To develop a quantitative method for characterizing gestational sac shape. Methods Twenty first-trimester gestational sacs in normal pregnancies were studied with three-dimensional (3D) ultrasonography. The 3D coordinates of surface-point sets were obtained for each sac using 30-, 15- and six-slice sampling. Cubic spline interpolation was used with the 15- and six-slice surface-point samples to generate coordinates for those 30-slice surface points not measured. Interpolated and measured values, the latter from the 30-slice sample, were compared and the percent error calculated. Cubic spline interpolation was used to determine the coordinates of a standard surface-point sample (3660) for each sac in each slice sample. These coordinate data were used to give each sac a standard configuration by moving its center of gravity to the origin, aligning its inertial axes along the coordinate axes and converting its volume to 1.0 mL. In this form, a volume shape descriptor could be generated for each sac that was then transformed into a vector containing only shape information. The 20 shape vectors of each slice sample were subjected to principal components analysis, and principal component scores (PCSs) calculated. The first four PCSs were used to define a gestational sac shape score (GSSS-30, GSSS-15 or GSSS-6) for each sac in a given slice sample. The characteristics of each set of GSSSs were determined and those for the GSSS-15 and GSSS-6 were compared with the GSSS-30 characteristics. Results Cubic spline interpolations were very accurate in most cases, with means close to 0%, and approximately 95% of the errors being less than 10%. GSSS-30 accounted for 67.6% of the shape variance, had a mean of zero and an SD of 1.1, was normally distributed and was not related to menstrual age (R = −0.16, P = 0.51). GSSS-15 and GSSS-6 had essentially the same characteristics. No significant differences between individual GSSS-30 values and those for GSSS-15 or GSSS-6

  8. Gestational Diabetes Mellitus Is Associated With Changes in the Concentration and Bioactivity of Placenta-Derived Exosomes in Maternal Circulation Across Gestation.

    PubMed

    Salomon, Carlos; Scholz-Romero, Katherin; Sarker, Suchismita; Sweeney, Emma; Kobayashi, Miharu; Correa, Paula; Longo, Sherri; Duncombe, Gregory; Mitchell, Murray D; Rice, Gregory E; Illanes, Sebastian E

    2016-03-01

    Although there is significant interest in elucidating the role of placenta-derived exosomes (PdEs) during pregnancy, the exosomal profile in pregnancies complicated by gestational diabetes mellitus (GDM) remains to be established. The aim of this study was to compare the gestational-age profile of PdEs in maternal plasma of GDM with normal pregnancies and to determine the effect of exosomes on cytokine release from human umbilical vein endothelial cells. A prospective cohort of patients was sampled at three time points during pregnancy for each patient (i.e., 11-14, 22-24, and 32-36 weeks' gestation). A retrospective stratified study design was used to quantify exosomes present in maternal plasma of normal (n = 13) and GDM (n = 7) pregnancies. Gestational age and pregnancy status were identified as significant factors contributing to variation in plasma exosome concentration (ANOVA, P < 0.05). Post hoc analyses established that PdE concentration increased during gestation in both normal and GDM pregnancies; however, the increase was significantly greater in GDM (∼2.2-fold, ∼1.5-fold, and ∼1.8-fold greater at each gestational age compared with normal pregnancies). Exosomes isolated from GDM pregnancies significantly increased the release of proinflammatory cytokines from endothelial cells. Although the role of exosomes during GDM remains to be fully elucidated, exosome profiles may be of diagnostic utility for screening asymptomatic populations. PMID:26718504

  9. Aging.

    PubMed

    Park, Dong Choon; Yeo, Seung Geun

    2013-09-01

    Aging is initiated based on genetic and environmental factors that operate from the time of birth of organisms. Aging induces physiological phenomena such as reduction of cell counts, deterioration of tissue proteins, tissue atrophy, a decrease of the metabolic rate, reduction of body fluids, and calcium metabolism abnormalities, with final progression onto pathological aging. Despite the efforts from many researchers, the progression and the mechanisms of aging are not clearly understood yet. Therefore, the authors would like to introduce several theories which have gained attentions among the published theories up to date; genetic program theory, wear-and-tear theory, telomere theory, endocrine theory, DNA damage hypothesis, error catastrophe theory, the rate of living theory, mitochondrial theory, and free radical theory. Although there have been many studies that have tried to prevent aging and prolong life, here we introduce a couple of theories which have been proven more or less; food, exercise, and diet restriction. PMID:24653904

  10. Aging

    PubMed Central

    Park, Dong Choon

    2013-01-01

    Aging is initiated based on genetic and environmental factors that operate from the time of birth of organisms. Aging induces physiological phenomena such as reduction of cell counts, deterioration of tissue proteins, tissue atrophy, a decrease of the metabolic rate, reduction of body fluids, and calcium metabolism abnormalities, with final progression onto pathological aging. Despite the efforts from many researchers, the progression and the mechanisms of aging are not clearly understood yet. Therefore, the authors would like to introduce several theories which have gained attentions among the published theories up to date; genetic program theory, wear-and-tear theory, telomere theory, endocrine theory, DNA damage hypothesis, error catastrophe theory, the rate of living theory, mitochondrial theory, and free radical theory. Although there have been many studies that have tried to prevent aging and prolong life, here we introduce a couple of theories which have been proven more or less; food, exercise, and diet restriction. PMID:24653904

  11. Amino acid supplementation of low-protein diets for swine: effects of gestation treatment on reproductive performance of gilts and sows.

    PubMed

    Corley, J R; Esch, M W; Bahr, J M; Easter, R A

    1983-01-01

    The effect of lysine and tryptophan addition to an all-corn diet fortified with vitamins and minerals fed to gestating gilts and sows was studied in a series of five trials. The experiments were designed to establish the effect of the addition of the two amino acids on: 1) N balance, 2) reproductive performance over two consecutive parities and 3) the immune response of the gestating gilt and transfer of immune proteins to the nursing pig. Nitrogen retention by gravid gilts fed an all-corn gestation diet increased (P less than .05) in response to lysine addition, but was not affected by subsequent addition of tryptophan. Daily N retention of gravid gilts fed the corn or corn and amino acid-supplemented diets was lower than that of gilts fed a 12% crude protein (CP) diet. Reproductive performance for two parities, as evaluated by gestation and lactation weight gain and, number and weight of pigs at birth and at 28 d was similar among treatments. Evaluation of the amino acid status of gestating gilts by measurement of the development of specific antibody response to sheep red blood cells and bovine serum albumin showed a trend for improved antibody development in gilts fed corn diets supplemented with both lysine and tryptophan and in the passive immunity of their offspring. Total whey protein and globulin content of 0-h colostrum was not affected by dietary treatment. The lack of a depression in reproductive performance of gilts fed an all-corn diet could be because of compensatory N retention. During the 4 to 5 d before parturition, all gilts were fed the 12% protein control diet. Gilts that were fed a corn diet from d 1 to 108 of gestation retained 40% more (P less than .01) N from d 109 to 114 of gestation than gilts that had been fed the 12% protein diet throughout gestation. PMID:6402477

  12. Effects of Dietary Energy Levels on the Physiological Parameters and Reproductive Performance of Gestating Gilts

    PubMed Central

    Jin, S. S.; Jung, S. W.; Jang, J. C.; Chung, W. L.; Jeong, J. H.; Kim, Y. Y.

    2016-01-01

    This experiment was conducted to investigate the effects of dietary energy levels on the physiological parameters and reproductive performance of gestating first parity sows. A total of 52 F1 gilts (Yorkshire×Landrace) were allocated to 4 dietary treatments using a completely randomized design. Each treatment contained diets with 3,100, 3,200, 3,300, or 3,400 kcal of metabolizable energy (ME)/kg, and the daily energy intake of the gestating gilts in each treatment were 6,200, 6,400, 6,600, and 6,800 kcal of ME, respectively. During gestation, the body weight (p = 0.04) and weight gain (p = 0.01) of gilts linearly increased with increasing dietary energy levels. Backfat thickness was not affected at d110 of gestation by dietary treatments, but increased linearly (p = 0.05) from breeding to d 110 of gestation. There were no significant differences on the litter size or litter birth weight. During lactation, the voluntary feed intake of sows tended to decrease when the dietary energy levels increased (p = 0.08). No difference was observed in backfat thickness of the sows within treatments; increasing energy levels linearly decreased the body weight of sows (p<0.05) at d 21 of lactation and body weight gain during lactation (p<0.01). No significant differences were observed in the chemical compositions of colostrum and milk. Therefore, these results indicated that high-energy diets influenced the bodyweight and backfat thickness of sows during gestation and lactation. NRC (2012) suggested that the energy requirement of the gestation gilt should be between 6,678 and 7,932 kcal of ME/d. Similarly, our results suggested that 3,100 kcal of ME/kg is not enough to maintain the reproductive performance for gilts during gestation with 2 kg feed daily. Gilts in the treatment 3,400 kcal of ME/kg have a higher weaning number of piglets, but bodyweight and backfat loss were higher than other treatments during lactation. But bodyweight and backfat loss were higher than other

  13. Effects of Dietary Energy Levels on the Physiological Parameters and Reproductive Performance of Gestating Gilts.

    PubMed

    Jin, S S; Jung, S W; Jang, J C; Chung, W L; Jeong, J H; Kim, Y Y

    2016-07-01

    This experiment was conducted to investigate the effects of dietary energy levels on the physiological parameters and reproductive performance of gestating first parity sows. A total of 52 F1 gilts (Yorkshire×Landrace) were allocated to 4 dietary treatments using a completely randomized design. Each treatment contained diets with 3,100, 3,200, 3,300, or 3,400 kcal of metabolizable energy (ME)/kg, and the daily energy intake of the gestating gilts in each treatment were 6,200, 6,400, 6,600, and 6,800 kcal of ME, respectively. During gestation, the body weight (p = 0.04) and weight gain (p = 0.01) of gilts linearly increased with increasing dietary energy levels. Backfat thickness was not affected at d110 of gestation by dietary treatments, but increased linearly (p = 0.05) from breeding to d 110 of gestation. There were no significant differences on the litter size or litter birth weight. During lactation, the voluntary feed intake of sows tended to decrease when the dietary energy levels increased (p = 0.08). No difference was observed in backfat thickness of the sows within treatments; increasing energy levels linearly decreased the body weight of sows (p<0.05) at d 21 of lactation and body weight gain during lactation (p<0.01). No significant differences were observed in the chemical compositions of colostrum and milk. Therefore, these results indicated that high-energy diets influenced the bodyweight and backfat thickness of sows during gestation and lactation. NRC (2012) suggested that the energy requirement of the gestation gilt should be between 6,678 and 7,932 kcal of ME/d. Similarly, our results suggested that 3,100 kcal of ME/kg is not enough to maintain the reproductive performance for gilts during gestation with 2 kg feed daily. Gilts in the treatment 3,400 kcal of ME/kg have a higher weaning number of piglets, but bodyweight and backfat loss were higher than other treatments during lactation. But bodyweight and backfat loss were higher than other

  14. Vitamin D status and gestational diabetes mellitus

    PubMed Central

    Muthukrishnan, Jayaraman; Dhruv, Goel

    2015-01-01

    Context: Vitamin D (Vit D) deficiency and gestational diabetes mellitus (GDM) are increasingly being seen in Indian women. The role of Vit D in causing GDM is not clear. Aims: (1) To compare Vit D status in pregnant women with or without GDM. (2) Frequency of GDM in women with Vit D insufficiency and deficiency. (3) To reassess glucose tolerance after replacement of Vit D in those women with Vit D deficiency and GDM. Settings and Design: Tertiary Care Hospital, Antenatal Care Department based prospective, controlled study. Subjects and Methods: Seventy-eight consecutive women (<28 weeks gestational period) were screened for GDM by glucose tolerance test (GTT) (75 g 2 h). Fifty-nine of these women were confirmed to have GDM (2 h postglucose > 140 mg/dl). Eight of these women were excluded as per laid exclusion criteria. Remaining 19 women with normal glucose tolerance (NGT) were included as controls. Serum 25-OH Vit D level was estimated by radioimmuno assay. Standard advice regarding diet, sunlight exposure, and exercise was given to all by the same dietician. Women with Vit D levels below 20 ng/ml were prescribed 60,000 IU of oral cholecalciferol to be administered twice weekly for 4 weeks. GTT was repeated after 6 weeks. Frequency of glucose intolerance was compared between Vit D sufficient and deficient groups. Women with GDM and Vit D deficiency who revert to NGT after supplementation with cholecalciferol were evaluated. Statistical Analysis used: Paired t-test for comparing means, and Fisher's test for comparing proportions. Results: Baseline characteristics of GDM and NGT with respect to their age, prepregnancy body mass index, and gestational period were comparable. Serum 25-OH Vit D levels were significantly lower in GDM 24.7 (±17.6) ng/ml versus NGT (45.8 ± 28) group (P = 0.0004). Frequency of GDM was similar irrespective of Vit D status 67% versus 42% (P = 0.09). Standard advice on diet and exercise with or without Vit D supplementation did not

  15. Polarization test of Higgs spin and parity

    NASA Astrophysics Data System (ADS)

    Arash, Firooz

    2015-04-01

    Photon polarization measurements provide a model independent determination of the spin and the parity of the Higgs resonance. The test described here is based on very general principles and is completely independent of dynamical assumptions. A set of observables are identified that discriminate resonances with JP = 0+, 0-, 2- and 2+. Furthermore, the same set can be used to gain useful and important information on the magnitude of each helicity amplitude contributing to the gg → γγ process.

  16. Parity violation in the compound nucleus

    SciTech Connect

    Mitchell, G. E.; Crawford, B. E.; Grossmann, C. A.; Lowie, L. Y.; Bowman, J. D.; Knudson, J.; Penttilae, S.; Seestrom, S. J.; Smith, D. A.; Yen, Yi-Fen; Yuan, V. W.; Delheij, P. P. J.; Haseyama, T.; Masaike, A.; Matsuda, Y.; Postma, H.; Roberson, N. R.; Sharapov, E. I.; Stephenson, S. L.

    1999-06-10

    Measurements have been performed on the helicity dependence of the neutron resonance cross section for many nuclei by our TRIPLE Collaboration. A large number of parity violations are observed. Generic enhancements amplify the signal for symmetry breaking and the stochastic properties of the compound nucleus permit the strength of the symmetry-breaking interaction to be determined without knowledge of the wave functions of individual states. A total of 15 nuclei have been analyzed with this statistical approach. The results are summarized.

  17. THE HEALTH OF OLDER WOMEN AFTER HIGH PARITY IN TAFT, IRAN.

    PubMed

    Chavoshi, Meimanat Hosseini; Abbasi-Shavazi, Mohammad Jalal; Engelman, Michal; Agree, Emily; Bishai, David M

    2011-11-01

    High parity has been hypothesised to lead to a shorter and less healthy life. Using the 2007 Taft Ageing Health and Fertility Survey consisting of 696 women aged 50-79, this paper examines the extent to which women's health in middle and older ages is affected by their childbearing histories. The results show that high parity (> 8) is associated with a reduction of GP-rated health by 0.094 points on a scale from 1 to 10. These health reductions are four times as large as those of an extra year of age, and are robust to controlling for birth interval, age, area of residence, education, marital status, work history, economic satisfaction and surviving daughters. There is a positive but curvilinear relationship between shorter birth intervals (< 2 years) and GP-rated health accounting for socio-demographic factors. Our analysis suggests that parity and birth intervals, along with socio-demographic characteristics, affect women's well-being in later life. PMID:25221610

  18. Pregnancy outcome in immigrant women with gestational diabetes mellitus.

    PubMed

    Dalfrà, Maria Grazia; Ragazzi, Eugenio; Masin, Michela; Bonsembiante, Barbara; Cosma, Chiara; Barison, Antonella; Toniato, Rosanna; Fedele, Domenico; Lapolla, Annunziata

    2011-06-01

    Recent studies show adverse outcomes of pregnancy among immigrant women from countries with high diabetes rates. We compared maternal and fetal outcomes in immigrant and Italian women with gestational diabetes mellitus (GDM) followed up at our center. Maternal characteristics considered were age, pre-pregnancy body mass index (BMI), HbA1c, frequency of insulin treatment, timing and mode of delivery, and hypertensive disorders; and, for fetal outcome, infants large or small for gestational age, and fetal complications. Pre-pregnancy BMI and HbA1c were higher in immigrant GDM women than in Italians, and more of them were on insulin. No differences in maternal outcome emerged between the two groups. More large for gestational age (LGA) babies were born to immigrant women than to Italians, but no other differences emerged. Apart from newborn LGA, maternal and fetal outcomes were comparable in our immigrant and Italian GDM women. Immigrant GDM women have favourable outcomes if given access to health care and language and cultural barriers are removed. PMID:20528567

  19. Prospective Study of Pre-Gravid Sugar-Sweetened Beverage Consumption and the Risk of Gestational Diabetes Mellitus

    PubMed Central

    Chen, Liwei; Hu, Frank B.; Yeung, Edwina; Willett, Walter; Zhang, Cuilin

    2009-01-01

    OBJECTIVE Consumption of sugar-sweetened beverages (SSBs) was related to an elevated risk of type 2 diabetes and insulin resistance in several recent studies among middle- or older-aged populations. Studies on SSB consumption and glucose intolerance among pregnant women, however, are lacking. We therefore examined the association between regular SSB consumption before pregnancy and the risk of gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS This was a prospective study among 13,475 U.S. women who reported at least one singleton pregnancy between 1992 and 2001 in the Nurses' Health Study II. GDM was self-reported and validated by medical record review in a subsample. Cox proportional hazards models with multivariate adjustments were applied to examine the association of SSB consumption with GDM risk. RESULTS During 10 years of follow-up, 860 incident GDM case subjects were identified. After adjustment for age, parity, race, physical activity, smoking, alcohol intake, prepregnancy BMI, and Western dietary pattern, intake of sugar-sweetened cola was positively associated with the risk of GDM, whereas no significant association was found for other SSBs and diet beverages. Compared with women who consumed <1 serving/month, those who consumed ≥5 servings/week of sugar-sweetened cola had a 22% greater GDM risk (relative risk 1.22 [95% CI 1.01–1.47]). CONCLUSIONS Findings from this study suggest that prepregnancy higher consumption of sugar-sweetened cola (≥5 servings/week) is associated with an elevated GDM risk, whereas no significant association with GDM risk was observed for other SSBs and diet beverages. PMID:19940226

  20. Gestational age dependency in the prenatal toxicity and in the disposition kinetics of the novel anticonvulsant HEPP (D,L-3-hydroxy-3-ethyl-3-phenylpropionamide) after subcutaneous administration in pregnant rats.

    PubMed

    Gómez-Martínez, Lisbeth E

    2007-01-01

    HEPP (D,L-3-hydroxy-3-ethyl-3-phenylpropionamide) is a novel anticonvulsant with promising anticonvulsant profile, which is being actively researched. The potential maternal and embryo/fetal toxicities of HEPP were evaluated in pregnant rats following subcutaneous (s.c.) administration during organogenesis (gestation days 6 through 14, GDs 6-14) and the fetal period (GDs 14-21). Single- and multiple-dose pharmacokinetics were also evaluated at the same periods in order to establish possible correlations with some maternal or embryo/fetal toxicity end points. Embryotoxicity was mainly indicated by a significant dose-concentration dependency in the increase in resorptions, high percentage of fully resorbed litters, and decrease in embryo body weights during the GD6-14 dosing period. No gross external alterations were observed in live fetuses. There was no indication of maternal toxicity; but a marked increase in maternal body weight was evident following dosing from GD14 to GD21. The maternal plasma profile following single subcutaneous dose of 50 mg/kg on both GD14 and GD21 showed a monoexponential elimination pattern. Statistically significant differences between treatments (GD14 versus GD21) were observed in elimination (k(el) = 0.12 versus 0.15 h(-1)), absorption (k(a) = 2.01 versus 3.14 h(-1)), maximum plasma concentration time points (T(max) = 1.49 versus 1.01 h); maximum plasma concentration (C(max) = 40.23 versus 36.31 microg/ml) and areas under the concentration-time curve (AUCs(0-infinity) = 421.88 versus 274 microg h/ml. Based on comparisons of C(max), T(max), and AUCs(0-infinity) between the actual data and single intraperitoneal (i.p.) data previously published, the s.c. administration exhibited slower disposition and higher absorbed amount. After multiple-dose administrations of 50 and 100 mg/kg every 12 h (07:00 and 19:00 h), steady-state plasma levels were lower than the computer prediction, and only slight accumulation was observed. In both dosing

  1. Parity Symmetry and Parity Breaking in the Quantum Rabi Model with Addition of Ising Interaction

    NASA Astrophysics Data System (ADS)

    Wang, Qiong; He, Zhi; Yao, Chun-Mei

    2015-04-01

    We explore the possibility to generate new parity symmetry in the quantum Rabi model after a bias is introduced. In contrast to a mathematical treatment in a previous publication [J. Phys. A 46 (2013) 265302], we consider a physically realistic method by involving an additional spin into the quantum Rabi model to couple with the original spin by an Ising interaction, and then the parity symmetry is broken as well as the scaling behavior of the ground state by introducing a bias. The rule can be found that the parity symmetry is broken by introducing a bias and then restored by adding new degrees of freedom. Experimental feasibility of realizing the models under discussion is investigated. Supported by the National Natural Science Foundation of China under Grant Nos. 61475045 and 11347142, the Natural Science Foundation of Hunan Province, China under Grant No. 2015JJ3092

  2. Incretins, Pregnancy, and Gestational Diabetes.

    PubMed

    Nikolic, Dragana; Al-Rasadi, Khalid; Al Busaidi, Noor; Al-Waili, Khalid; Banerjee, Yajnavalka; Al-Hashmi, Khamis; Montalto, Giuseppe; Rizvi, Ali A; Rizzo, Manfredi; Al-Dughaishi, Tamima

    2016-01-01

    The number of pregnant women affected by gestational diabetes mellitus (GDM) is increasing among Caucasians, and East Asians. GDM also increases the risk for later advent of type 2 diabetes mellitus (T2DM), obesity, and cardiovascular disease in both women and their offspring. The underlying mechanism of GDM is not fully elucidated. Incretins such as glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP), have been suggested to have a role in maternal metabolism and weight as well as fetal growth. These hormones might be implicated in mechanisms that compensate for the increment in glycemia and insulin resistance seen during pregnancy, while other factors, such as heredity, environment and lifestyle, but also different race/ethnic background might also lead to the comorbid health problems. Some studies indicate that pregnancy is associated with a diminished GLP-1 response which is more prominently evident in women with GDM and normalizes after delivery. Postprandial GIP level seems to be unaffected by pregnancy, despite its increased level in GDM. On the other hand, the reduced incretin effect observed in GDM may represent a risk factor for obesity, T2DM and metabolic disorders even in the offspring of these women. Further investigations are needed to establish the exact role of incretins in pregnancy and gestational glucose intolerance. PMID:26813306

  3. Placental lipases in pregnancies complicated by gestational diabetes mellitus (GDM).

    PubMed

    Barrett, Helen L; Kubala, Marta H; Scholz Romero, Katherin; Denny, Kerina J; Woodruff, Trent M; McIntyre, H David; Callaway, Leonie K; Nitert, Marloes Dekker

    2014-01-01

    Infants of women with gestational diabetes mellitus (GDM) are more likely to be born large for gestational age with a higher percentage body fat. Elevated maternal lipids may contribute to this. Placental lipases such as lipoprotein lipase (LPL), endothelial lipase (EL) and hormone sensitive lipase (HSL) are involved in transferring lipids from mother to fetus. Previous studies of expression of these lipases in placentae in women with diabetes in pregnancy have reported divergent results. Intracellular lipases such as adipose triglyceride lipase (ATGL), and HSL are central to lipid droplet metabolism. The activities of these lipases are both influenced by Perilipin 1, and ATGL is also activated by a co-factor comparative gene identification-58 (CGI-58) and inhibited by G0/G1 switch gene 2 (GS02). None of these modifying factors or ATGL have been examined previously in placenta. The purpose of this study was therefore to examine the expression of ATGL, HSL, LPL, EL, as well as Perilipin 1, GS02 and CGI-58 in term pregnancies complicated by GDM. mRNA and protein expression of the lipases were measured in placentae from 17 women with GDM and 17 normoglycaemic pregnancies, matched for maternal BMI and gestational age of delivery. ATGL mRNA expression was increased and HSL mRNA expression reduced in placentae from GDM although there was no differences in protein expression of any of the lipases. All lipases were localised to trophoblasts and endothelial cells. The expression of Perilipin 1 and CGI-58 mRNA was increased and GS02 not altered in GDM. These results suggest that there is no difference in expression in these four lipases between GDM and normoglycaemic placentae, and therefore altered lipid transfer via these lipases does not contribute to large for gestational age in infants of women with GDM. PMID:25118138

  4. Effects of omega-3 fatty acid supplementation to gestation and lactation diets on the expression of immune related genes in white blood cells of lactating sows

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Forty-nine first parity sows (BW of 197.7 ± 2.5 kg and BF of 14.87 ± 0.21 mm) were used in this study. On d 60 of gestation, pregnant gilts were assigned to one of two dietary treatments which consisted of either a corn-soy meal basal diet (CON) or the basal diet supplemented with 1% Fertilium™ (Uni...

  5. Consanguinity: A Risk Factor for Preterm Birth at Less Than 33 Weeks’ Gestation

    PubMed Central

    Mumtaz, Ghina; Nassar, Anwar H.; Mahfoud, Ziyad; El-Khamra, Akaber; Al-Choueiri, Nathalie; Adra, Abdallah; Murray, Jeffrey C.; Zalloua, Pierre; Yunis, Khalid A.

    2010-01-01

    Consanguinity promotes homozygosity of recessive susceptibility gene variants and can be used to investigate a recessive component in diseases whose inheritance is uncertain. The objective of this study was to assess the association between consanguinity and preterm birth (PTB), stratified by gestational age and clinical presentation (spontaneous vs. medically indicated). Data were collected on 39,745 singleton livebirths without major birth defects, admitted to 19 hospitals in Lebanon, from September 2003 to December 2007. Deliveries before completed 33 weeks’ gestation and deliveries at 33–36 weeks’ gestation were compared, with respect to cousin marriage, with those after completed 36 weeks’ gestation by using multinomial multiple logistic regression. Overall, infants of consanguineous parents had a statistically significant 1.6-fold net increased risk of being born at less than 33 weeks’ gestation compared with infants of unrelated parents. This association was statistically significant only with spontaneous PTB. There was no increased risk of being born at 33–36 weeks’ gestation associated with consanguinity for both clinical presentations of PTB. Our findings support a genetic contribution to early onset PTB and suggest that early PTB should be targeted in future genetic studies rather than the classic lumping of all births less than 37 weeks’ gestation. PMID:20978088

  6. The sensitivity of length of pregnancy using clinical estimate of gestation versus last menstrual period: an example with particulate matter and preterm birth

    EPA Science Inventory

    Estimating gestational age is usually based on last menstrual period date (LMP) or clinical estimation (CGA); both approaches introduce error and potential bias. Differences in the two methods of gestational age assignment may lead to misclassification and differences in risk est...

  7. Exercise: An Alternative Therapy for Gestational Diabetes.

    ERIC Educational Resources Information Center

    Artal, Raul

    1996-01-01

    Exercise is encouraged in the management of pregnant women with gestational diabetes or women with Type II diabetes who become pregnant. Although non-weight-bearing exercises may be best for sedentary women, moderate workouts appear to be safe for most women with gestational diabetes. The role of exercise, risk factors, warning signs, and examples…

  8. Parity anomalies in gauge theories in 2 + 1 dimensions

    SciTech Connect

    Rao, S.; Yahalom, R.

    1986-01-01

    We show that the introduction of massless fermions in an abelian gauge theory in 2+1 dimensions does not lead to any parity anomaly despite a non-commutativity of limits in the structure function of the odd part of the vacuum polarization tensor. However, parity anomaly does exist in non-abelian theories due to a conflict between gauge invariance under large gauge transformations and the parity symmetry. 6 refs.

  9. Regulation and localization of vascular endothelial growth factor within the mammary glands during the transition from late gestation to lactation.

    PubMed

    VanKlompenberg, M K; Manjarín, R; Donovan, C E; Trott, J F; Hovey, R C

    2016-01-01

    The vascular network within the developing mammary gland (MG) grows in concert with the epithelium to prepare for lactation, although the mechanisms coordinating this vascular development are unresolved. Vascular endothelial growth factor A (VEGF-A) mediates angiogenesis and vascular permeability in the MG during pregnancy and lactation, where its expression is upregulated by prolactin. Given our previous finding that late-gestational hyperprolactinemia induced by domperidone (DOM) increased subsequent milk yield from gilts, we sought to establish changes in vascular development during late gestation and lactation in the MGs of these pigs and determine whether DOM altered MG angiogenesis and the factors regulating it. Gilts received either no treatment (n = 6) or DOM (n = 6) during late gestation, then had their MG biopsied from late gestation through lactation to assess microvessel density, VEGF-A distribution and messenger RNA expression, and aquaporin (AQP) gene expression. Microvessel density in the MG was unchanged during gestation then increased between days 2 and 21 of lactation (P < 0.05). The local expression of messenger RNA for VEGF-A120, VEGF-A147, VEGF-A164, VEGF-A164b, VEGF-A188, VEGF receptors-1 and -2, and AQP1 and AQP3 all generally increased during the transition from gestation to lactation (P < 0.05). Immunostaining localized VEGF-A to the apical cytoplasm of secretory epithelial cells, consistent with a far greater concentration of VEGF-A in colostrum and/or milk vs plasma (P < 0.0001). There was no effect of DOM on any of the variables analyzed. In summary, we found that vascular development in the MG increases during lactation in first-parity gilts and that VEGF-A is a part of the mammary secretome. Although late-gestational hyperprolactinemia increases milk yield, there was no evidence that it altered vascular development. PMID:26490114

  10. [Gestational diabetes mellitus: importance of blood glucose monitoring].

    PubMed

    Flores Le-Roux, Juana A; Benaiges Boix, David; Pedro-Botet, Juan

    2013-01-01

    Gestational diabetes mellitus (GDM) is common during pregnancy, and is frequently associated with maternal and perinatal complications. Intensive treatment of hyperglycaemia during pregnancy has been shown to reduce perinatal morbidity. In women with pregestational type 1 or 2 diabetes, hyperglycaemia during labour and delivery is an important factor in the development of neonatal hypoglycaemia. There are no generally accepted recommendations for women with GDM. Recent studies evaluating patients with GDM show that peripartum glucose control can be achieved in these women without the need for insulin use in the majority of cases. Hyperglycaemia during labour is not related with treatment established during pregnancy but rather with non-compliance of endocrinological follow-up. Factors such as ethnic origin, neonatal hypoxaemia, and large for gestational age seem to play an important role in the development of neonatal hypoglycaemia. PMID:24183482

  11. The role of adipokines in gestational diabetes mellitus

    PubMed Central

    Al-Badri, Marwa R.; Zantout, Mira S.

    2015-01-01

    Gestational diabetes mellitus (GDM) is a complication of pregnancy that is characterized by impaired glucose tolerance with onset or first recognition during pregnancy. The reported prevalence of GDM varies between 0.6% and 20% of pregnancies depending on screening method, gestational age and the population studied. GDM is characterized by pancreatic β-cell function that is insufficient to meet the body’s insulin needs. Available evidence suggests that β-cell defects in GDM result from the same spectrum of causes that underline hyperglycemia in general, including autoimmune disease, monogenic causes and insulin resistance. Adipokines are proteins secreted from the adipocytes and are believed to have a metabolic influence. Our review suggests that, in GDM, various adipokines, mainly leptin and adiponectin, are dysregulated. These two adipokines might have both prognostic and pathophysiological significance in this disease. PMID:26137214

  12. Integrable nonlinear parity-time-symmetric optical oscillator

    NASA Astrophysics Data System (ADS)

    Hassan, Absar U.; Hodaei, Hossein; Miri, Mohammad-Ali; Khajavikhan, Mercedeh; Christodoulides, Demetrios N.

    2016-04-01

    The nonlinear dynamics of a balanced parity-time-symmetric optical microring arrangement are analytically investigated. By considering gain and loss saturation effects, the pertinent conservation laws are explicitly obtained in the Stokes domain, thus establishing integrability. Our analysis indicates the existence of two regimes of oscillatory dynamics and frequency locking, both of which are analogous to those expected in linear parity-time-symmetric systems. Unlike other saturable parity-time-symmetric systems considered before, the model studied in this work first operates in the symmetric regime and then enters the broken parity-time phase.

  13. Performance consequences of parity placement in disk arrays

    NASA Technical Reports Server (NTRS)

    Lee, Edward K.; Katz, Randy H.

    1991-01-01

    The performance of a variety of parity placement schemes are defined and investigated to demonstrate that, at relatively large request sizes of hundreds of kilobytes, the choice of parity placement significantly affects performance (20 to 30 percent for the disk array configurations that are common today). It is shown that the left-symmetric, extended-left-symmetric and flat-left-symmetric are the best RAID level 5 parity placements. The placement with the highest read performance, flat-left-symmetric, has the lowest write performance, while the placement with the lowest read performance, left-symmetric, has the highest write performance. Suggestions for optimizing parity placements are included.

  14. Positive and negative parity hyperons in nuclear medium

    NASA Astrophysics Data System (ADS)

    Azizi, K.; Er, N.; Sundu, H.

    2015-09-01

    The effects of the nuclear medium on the residue, mass, and self-energy of the positive- and negative-parity Σ , Λ , and Ξ hyperons are investigated using the QCD sum-rule method. In the calculations, the general interpolating currents of hyperons with an arbitrary mixing parameter are used. We compare the results obtained in medium with those of the vacuum and calculate the shifts in the corresponding parameters. It is found that the shifts on the residues in nuclear matter are overall positive for both the positive- and negative-parity hyperons, except for the positive-parity Σ hyperon which has a negative shift. The shifts on the masses of these baryons are found to be negative. The shifts on the residues and masses of negative-parity states are large compared to those of positive-parity states. The maximum shift belongs to the residue of the negative-parity Λ hyperon. The vector self-energies gained by the positive-parity baryons are large compared to the vector self-energies of the negative-parity particles. The maximum value of the vector self-energy belongs to the positive-parity Σ hyperon. The numerical values are compared with the existing predictions in the literature.

  15. Observation of a Large Atomic Parity Violation Effect in Ytterbium

    SciTech Connect

    Tsigutkin, K.; Dounas-Frazer, D.; Family, A.; Stalnaker, J. E.; Yashchuk, V. V.; Budker, D.

    2009-08-14

    Atomic parity violation has been observed in the 6s{sup 2} {sup 1}S{sub 0}->5d6s {sup 3}D{sub 1} 408-nm forbidden transition of ytterbium. The parity-violating amplitude is found to be 2 orders of magnitude larger than in cesium, where the most precise experiments to date have been performed. This is in accordance with theoretical predictions and constitutes the largest atomic parity-violating amplitude yet observed. This also opens the way to future measurements of neutron distributions and anapole moments by comparing parity-violating amplitudes for various isotopes and hyperfine components of the transition.

  16. Genetics of gestational diabetes mellitus.

    PubMed

    Radha, Venkatesan; Kanthimathi, Sekar; Anjana, Ranjit Mohan; Mohan, Viswanathan

    2016-09-01

    Gestational diabetes mellitus (GDM) has now become a major public health problem because of its prevalence and its associated complications during pregnancy. Earlier studies have suggested that type 2 diabetes mellitus (T2DM) and GDM might have similar pathophysiology, such as increased insulin resistance, decreased insulin secretion resulting in hyperglycaemia. Evidence for a genetic basis of GDM has been poorly understood. To some extent, the current advancement in genomic techniques has thrown better light on the genetics of GDM. Based on the candidate gene approach and genome wide association studies, genetic loci in several genes that are responsible for insulin secretion, insulin resistance, lipid and glucose metabolism and other pathways have shown association with the GDM susceptibility. Understanding the possible underlying genetic factors of GDM would help us in gaining knowledge on the pathophysiologic mechanism of the disease. PMID:27582142

  17. Parity-time symmetry under magnetic flux

    NASA Astrophysics Data System (ADS)

    Jin, L.; Song, Z.

    2016-06-01

    We study a parity-time-(PT -) symmetric ring lattice, with one pair of balanced gain and loss located at opposite positions. The system remains PT -symmetric when threaded by a magnetic flux; however, the PT symmetry is sensitive to the magnetic flux in the presence of a large balanced gain and loss, or in a large system. We find a threshold gain or loss above which any nontrivial magnetic flux breaks the PT symmetry. We obtain the maximally tolerable magnetic flux for the exact PT -symmetric phase, which is approximately linearly dependent on a weak gain or loss.

  18. Odd-parity D states in He.

    NASA Technical Reports Server (NTRS)

    Bhatia, A. K.

    1972-01-01

    The states considered lie below the n = 2 threshold of He(+) and decay radiatively to the lower states. The most general D-state wave function of odd parity of two electrons is examined. The results presented are optimized with respect to four nonlinear parameters for 112 terms. A mass-polarization correction is given for all the states listed. The positions of the D states, including the reduced mass and the mass-polarization corrections, with respect to the ground state of He are reported.

  19. Understanding parity violation in molecular systems.

    PubMed

    Faglioni, Francesco; Lazzeretti, Paolo

    2002-01-01

    Parity-violation energy (E(PV)) due to weak nuclear interactions between nucleons and electrons in chiral molecular systems provides a fundamental tool to verify our understanding of electronic behavior in complex systems. We used both a relativistic and a nonrelativistic approach to study a number of simple molecules and analyze the corresponding E(PV) in terms of intuitive electrodynamic concepts. We developed a qualitative model to predict the sign of E(PV) and its behavior against selected geometric distortions. Our model provides a valuable tool to screen large sets of molecules and select interesting candidates for more expensive investigations. PMID:11800715

  20. Parity violation in the compound nucleus

    SciTech Connect

    Mitchell, G.E.; Crawford, B.E.; Grossmann, C.A.; Lowie, L.Y.; Bowman, J.D.; Knudson, J.; Penttilae, S.; Seestrom, S.J.; Smith, D.A.; Yen, Y.; Yuan, V.W.; Delheij, P.P.; Haseyama, T.; Masaike, A.; Matsuda, Y.; Postma, H.; Roberson, N.R.; Sharapov, E.I.; Stephenson, S.L.

    1999-06-01

    Measurements have been performed on the helicity dependence of the neutron resonance cross section for many nuclei by our TRIPLE Collaboration. A large number of parity violations are observed. Generic enhancements amplify the signal for symmetry breaking and the stochastic properties of the compound nucleus permit the strength of the symmetry-breaking interaction to be determined without knowledge of the wave functions of individual states. A total of 15 nuclei have been analyzed with this statistical approach. The results are summarized. {copyright} {ital 1999 American Institute of Physics.}

  1. Dispersion corrections to parity violating electron scattering

    SciTech Connect

    Gorchtein, M.; Horowitz, C. J.; Ramsey-Musolf, M. J.

    2010-08-04

    We consider the dispersion correction to elastic parity violating electron-proton scattering due to {gamma}Z exchange. In a recent publication, this correction was reported to be substantially larger than the previous estimates. In this paper, we study the dispersion correction in greater detail. We confirm the size of the disperion correction to be {approx}6% for the QWEAK experiment designed to measure the proton weak charge. We enumerate parameters that have to be constrained to better than relative 30% in order to keep the theoretical uncertainty for QWEAK under control.

  2. Parity nonconservation in the hydrogen atom

    SciTech Connect

    Chupp, T.E.

    1983-01-01

    The development of experiments to detect parity nonconserving (PNC) mixing of the 2s/sub a/2/ and 2p/sub 1/2/ levels of the hydrogen atom in a 570 Gauss magnetic field is described. The technique involves observation of an asymmetry in the rate of microwave induced transitions at 1608 MHz due to the interference of two amplitudes, one produced by applied microwave and static electric fields and the other produced by an applied microwave field and the 2s/sub 1/2/-2p/sub 1/2/ mixing inducd by a PNC Hamiltonian.

  3. Polarization test of Higgs spin and parity

    SciTech Connect

    Arash, Firooz

    2015-04-10

    Photon polarization measurements provide a model independent determination of the spin and the parity of the Higgs resonance. The test described here is based on very general principles and is completely independent of dynamical assumptions. A set of observables are identified that discriminate resonances with J{sup P} = 0{sup +}, 0{sup −}, 2{sup −} and 2{sup +}. Furthermore, the same set can be used to gain useful and important information on the magnitude of each helicity amplitude contributing to the gg → γγ process.

  4. Metabolic effects of growth factors and polycyclic aromatic hydrocarbons on cultured human placental cells of early and late gestation

    SciTech Connect

    Guyda, H.J. )

    1991-03-01

    The metabolic effects of epidermal growth factor (EGF), insulin, insulin-like growth factor-I (IGF-I), and IGF-II were determined on human placental cells in monolayer culture obtained from early gestation (less than 20 weeks) and late gestation (38-42 weeks). Parameters studied were uptake of aminoisobutyric acid (AIB), uptake of 3-O-methylglucose and (3H)thymidine incorporation into cell protein. Since benzo(alpha)pyrene (BP) inhibits EGF binding and autophosphorylation in cultured human placental cells, particularly in early gestation, we also studied the effect of benzo(alpha)pyrene and other polycyclic aromatic hydrocarbons (PAHs) on EGF-mediated AIB uptake. The metabolic effects of EGF, insulin, and the IGFs in cultured human placental cells varied with gestational age and the growth factor studied. All three classes of growth factors stimulated AIB uptake in both early and late gestation at concentrations from 10-100 micrograms/L, well within a physiological range. However, insulin stimulation of AIB uptake was maximal at a high concentration in both early and late gestation cells, suggesting an action via type 1 IGF receptors rather than via insulin receptors. EGF stimulated 3-O-methylglucose uptake only in term placental cells. No significant stimulation of (3H)thymidine incorporation by any of the growth factors tested was seen with either early or late gestation cells. The effect of PAHs on AIB uptake by cultured placental cells was variable. BP alone stimulated AIB uptake by both very early and late gestation cells and enhanced EGF-stimulated AIB uptake. alpha-naphthoflavone alone inhibited AIB uptake at all gestational ages and inhibited EGF-stimulated AIB uptake. beta-Naphthoflavone and 3-methylcholanthrene minimally inhibited AIB uptake by early gestation cells and did not modify EGF-stimulated uptake at any gestational period.

  5. Preconception Cardiovascular Risk Factor Differences Between Gestational Hypertension and Preeclampsia

    PubMed Central

    Klungsøyr, Kari; Øyen, Nina; Tell, Grethe S.; Næss, Øyvind; Skjærven, Rolv

    2016-01-01

    Preconception predictors of gestational hypertension and preeclampsia may identify opportunities for early detection and improve our understanding of the pathogenesis and life course epidemiology of these conditions. Female participants in community-based Cohort Norway health surveys, 1994 to 2003, were prospectively followed through 2012 via record linkages to Medical Birth Registry of Norway. Analyses included 13 217 singleton pregnancies (average of 1.59 births to 8321 women) without preexisting hypertension. Outcomes were gestational hypertension without proteinuria (n=237) and preeclampsia (n=429). Mean age (SD) at baseline was 27.9 years (4.5), and median follow-up was 4.8 years (interquartile range 2.6–7.8). Gestational hypertension and preeclampsia shared several baseline risk factors: family history of diabetes mellitus, pregravid diabetes mellitus, a high total cholesterol/high-density lipoprotein cholesterol ratio (>5), overweight and obesity, and elevated blood pressure status. For preeclampsia, a family history of myocardial infarction before 60 years of age and elevated triglyceride levels (≥1.7 mmol/L) also predicted risk while physical activity was protective. Preterm preeclampsia was predicted by past-year binge drinking (≥5 drinks on one occasion) with an adjusted odds ratio of 3.7 (95% confidence interval 1.3–10.8) and by past-year physical activity of ≥3 hours per week with an adjusted odds ratio of 0.5 (95% confidence interval 0.3–0.8). The results suggest similarities and important differences between gestational hypertension, preeclampsia, and preterm preeclampsia. Modifiable risk factors could be targeted for improving pregnancy outcomes and the short- and long-term sequelae for mothers and offspring. PMID:27113053

  6. Absorption of methylmercury by the fetal guinea pig during mid to late gestation

    SciTech Connect

    Kelman, B.J.; Steinmetz, S.E.; Walter, B.K.; Sasser, L.B.

    1980-01-01

    Pregnant guinea pigs were injected with CH/sub 3/ /sup 203/HgCl at 22, 40, 47, 59, and 66 days of gestation, and fetal tissues were obtained 24 hours later. Autologous fetal erythrocytes were labeled with /sup 51/Cr and used to label the fetal blood pool at each gestational age except 22 days so that tissue-bound Hg could be calculated. In general, Hg absorbed by the whole fetus increased during gestation, in parallel with increasing tissue mass, while Hg found in whole placentas remained the same. Liver, kidney, blood, and brain contained the highest Hg concentration early in gestation. While it is difficult to interpret the potential effects of the increased Hg concentrations, particular attention should be paid to the brain, since it is considered a target tissue in MeHg toxicity.

  7. Genetic and environmental causes of variation in gestation length of Jersey crossbred cattle

    PubMed Central

    Kumar, Anshuman; Mandal, Ajoy; Gupta, A. K.; Ratwan, Poonam

    2016-01-01

    Aim: The objective of this study was to investigate the effect of genetic and non-genetic factors and estimate the genetic parameter for gestation length (GL) of Jersey crossbred cattle. Materials and Methods: The data included the 986 parturition records on Jersey crossbred cattle maintained at the Eastern Regional Station of ICAR-National Dairy Research Institute, Kalyani, West Bengal, India during 36 years (1978-2013). The data were analyzed applying mixed model least square technique considering the fixed effects of genetic group, season of calving, period of calving, parity of animal, birth weight, and sex of calf born from animal. The effect of sire was included as a random effect in the model. Results: The genetic group of animal, season of calving, parity of animal, and birth weight of calf born were found to be a significant source of variation in the GL, whereas the period of calving and sex of calf did not affect this trait. Cows with <50% and >62.5% Jersey inheritance had the shortest and longest GLs, respectively. Cows calved in summer and rainy season had shorter GL than those calved in the winter season. Older cows in 4th parity carried calves for longer days than the cows in 1st parity. The increase in calf birth weight significantly (p<0.01) contributed to a linear increase in GL value in this study. The heritability estimate of GL was 0.24±0.08. Conclusion: It can be concluded that selection for lower GL without distressing future growth of calf can be used to reduce calving difficulty, but a very small standard deviation of GL limits the benefit. Moreover, more accurate prediction of calving date will help in better management and health care of pregnant animals. PMID:27182128

  8. Dietary lysine requirement of sows increases in late gestation.

    PubMed

    Samuel, R S; Moehn, S; Pencharz, P B; Ball, R O

    2012-12-01

    Current AA recommendations for sows are to provide a fixed amount of AA intake throughout gestation; however, the demand for nutrients changes from maternal lean tissue in early gestation (EG) to fetal and mammary growth in late gestation (LG). The objective of this study was to determine the Lys requirement in EG (d 24 to 45) and LG (d 86 to 110) using the indicator AA oxidation method with simultaneous determination of heat production. Each of 7 Large White × Landrace sows received 6 diets in random order in both EG and LG. Three semisynthetic diets (14.0 MJ ME/kg) based on corn were formulated and mixed to produce a basal diet (60% of 1998 NRC Lys requirement) and high diets for EG and LG (150% and 185% of 1998 NRC Lys requirements, respectively). The 6 test diets provided Lys intakes of 7.5 to 19.3 g/d in EG and 8.1 to 23.7 g/d in LG. Sows were placed in respiration chambers, and expired air and blood were collected every 30 min for 5.5 h. The tracer AA, l-[1-(13)C]Phe, was given orally at a rate of 2 mg/(kg BW ⋅ h) over the last 4 h, divided into 8, 0.5-h meals. Expired air was measured for (13)CO(2) enrichment, and plasma was measured for l-[1-(13)C]Phe enrichment and free Lys concentration. Background (13)CO(2) was subtracted from plateau (13)CO(2) enrichment. Requirements were determined using a 2-phase nonlinear model. Mean maternal BW gain in gestation (43.7 kg; pooled SE, 1.2 kg), litter size (14.6 total born piglets; pooled SE, 0.8), and litter weight (19.4 kg; pooled SE, 0.9 kg) did not differ between parities. Sow weight gain and BW was greater (P = 0.001) in LG than EG. Lysine requirement was 9.4 and 17.4 g/d in EG and LG, respectively. Phenylalanine retention in LG was maximized at a Lys intake of 17.7 g/d. Heat production was more (P = 0.069) and energy retention less (P = 0.019) in LG than EG. Energy retention in LG was not different from 0. Quantitative Phe kinetics in EG were not affected by Lys intake. In LG, Phe retention increased with Lys

  9. Parity effect in a mesoscopic Fermi gas

    NASA Astrophysics Data System (ADS)

    Hofmann, Johannes; Lobos, Alejandro M.; Galitski, Victor

    2016-06-01

    We develop a quantitative analytic theory that accurately describes the odd-even effect observed experimentally in a one-dimensional, trapped Fermi gas with a small number of particles [G. Zürn et al., Phys. Rev. Lett. 111, 175302 (2013), 10.1103/PhysRevLett.111.175302]. We find that the underlying physics is similar to the parity effect known to exist in ultrasmall mesoscopic superconducting grains and atomic nuclei. However, in contrast to superconducting nanograins, the density (Hartree) correction dominates over the superconducting pairing fluctuations and leads to a much more pronounced odd-even effect in the mesoscopic, trapped Fermi gas. We calculate the corresponding parity parameter and separation energy using both perturbation theory and a path integral framework in the mesoscopic limit, generalized to account for the effects of the trap, pairing fluctuations, and Hartree corrections. Our results are in an excellent quantitative agreement with experimental data and exact diagonalization. Finally, we discuss a few-particle to many-particle crossover between the perturbative mesoscopic regime and nonperturbative many-body physics that the system approaches in the thermodynamic limit.

  10. Positive parity states in {sup 11}Be

    SciTech Connect

    Esbensen, H.; Sagawa, H.; Brown, B.A.

    1995-08-01

    A good example of a nucleus which contains a one-neutron halo is {sup 11}Be, and many different measurements of the {sup 11}Be {yields} {sup 10}Be + n breakup reaction were performed in recent years. These measurements are often compared to predictions of simple single-particle models for the valence neutron. In order to obtain a more realistic description, we calculated the ground state and the low-lying, positive parity states of {sup 11}Be in a particle-rotor model, making use of a quadrupole, neutron-core coupling that is consistent with the known B(E2)-value. Our model describes the low-lying positive parity states rather well. The ground-state wave function that we obtain consists mainly of an s{sub 1/2} single-particle state coupled to the 0{sup +} ground state of the core (87%). This is in reasonable agreement with shell-model predictions and with the measured spectroscopic factor. The large s-wave content of the ground state implies a very large rms radius for the valence neutron, and the calculated matter distribution agrees very well with the one extracted from fragmentation data.

  11. Muon anomaly and dark parity violation.

    PubMed

    Davoudiasl, Hooman; Lee, Hye-Sung; Marciano, William J

    2012-07-20

    The muon anomalous magnetic moment exhibits a 3.6σ discrepancy between experiment and theory. One explanation requires the existence of a light vector boson, Z(d) (the dark Z), with mass 10-500 MeV that couples weakly to the electromagnetic current through kinetic mixing. Support for such a solution also comes from astrophysics conjectures regarding the utility of a U(1)(d) gauge symmetry in the dark matter sector. In that scenario, we show that mass mixing between the Z(d) and ordinary Z boson introduces a new source of "dark" parity violation, which is potentially observable in atomic and polarized electron scattering experiments. Restrictive bounds on the mixing (m(Z(d))/m(Z))δ are found from existing atomic parity violation results, δ2<2×10(-5). Combined with future planned and proposed polarized electron scattering experiments, a sensitivity of δ2∼10(-6) is expected to be reached, thereby complementing direct searches for the Z(d) boson. PMID:22861837

  12. Association between Maternal Smoking during Pregnancy and Low Birthweight: Effects by Maternal Age

    PubMed Central

    Zheng, Wei; Suzuki, Kohta; Tanaka, Taichiro; Kohama, Moriyasu; Yamagata, Zentaro

    2016-01-01

    Background Maternal smoking during pregnancy has been consistently related to low birthweight. However, older mothers, who are already at risk of giving birth to low birthweight infants, might be even more susceptible to the effects of maternal smoking. Therefore, this study aimed to examine the modified association between maternal smoking and low birthweight by maternal age. Methods Data were obtained from a questionnaire survey of all mothers of children born between 2004 and 2010 in Okinawa, Japan who underwent medical check-ups at age 3 months. Variables assessed were maternal smoking during pregnancy, maternal age, gestational age, parity, birth year, and complications during pregnancy. Stratified analyses were performed using a logistic regression model. Results In total, 92641 participants provided complete information on all variables. Over the 7 years studied, the proportion of mothers smoking during pregnancy decreased from 10.6% to 5.0%, while the prevalence of low birthweight did not change remarkably (around 10%). Maternal smoking was significantly associated with low birthweight in all age groups. The strength of the association increased with maternal age, both in crude and adjusted models. Conclusions Consistent with previous studies conducted in Western countries, this study demonstrates that maternal age has a modifying effect on the association between maternal smoking and birthweight. This finding suggests that specific education and health care programs for older smoking mothers are important to improve their foetal growth. PMID:26795494

  13. Gestational dexamethasone alters fetal neuroendocrine axis.

    PubMed

    Ahmed, R G

    2016-09-01

    This study tested whether the maternal transport of dexamethasone (DEXA) may affect the development of the neuroendocrine system. DEXA (0.2mg/kg b.w., subcutaneous injection) was administered to pregnant rats from gestation day (GD) 1-20. In the DEXA-treated group, a decrease in maternal serum thyroxine (T4), triiodothyronine (T3), and increase in thyrotropin (TSH) levels (hypothyroid status) were observed at GDs 15 & 20 with respect to control group. The reverse pattern (hyperthyroid status) was observed in their fetuses at embryonic days (EDs) 15 & 20. Although the maternal body weight was diminished, the weight of the thyroid gland was increased at studied GDs as compared to the control group. The fetal growth retardation, hyperleptinemia, hyperinsulinism, and cytokines distortions (transforming growth factor-beta; TGF-β, tumor necrosis factor-alpha; TNF-α, and interferon-γ; IFN-γ) were noticed at examined EDs if compared to the control group. Alternatively, the maternofetal thyroid dysfunctions due to the maternal DEXA administration attenuated the levels of fetal cerebral norepinephrine (NE) and epinephrine (E), and elevated the levels of dopamine (DA) and 5-hydroxytryptamine (5-HT) at considered days. These alterations were age-dependent and might damage the nerve transmission. Finally, maternal DEXA might act as neuroendocrine disruptor causing dyshormonogenesis and fetal cerebral dysfunction. PMID:27220267

  14. A Prospective Study of Pre-pregnancy Serum Concentrations of Perfluorochemicals and the Risk of Gestational Diabetes

    PubMed Central

    Zhang, Cuilin; Sundaram, Rajeshwari; Maisog, José; Calafat, Antonia M.; Barr, Dana Boyd; Buck Louis, Germaine M.

    2014-01-01

    OBJECTIVE To examine preconception serum concentrations of perfluorooctanoic acid (PFOA) and six other PFCs in relation to gestational diabetes (GDM) risk. DESIGN Prospective cohort with longitudinal follow-up. SETTING 16 counties in Michigan and Texas, 2005-2009. PATIENT(S) Among 501 women recruited upon discontinuing contraception for purposes of becoming pregnant, 258 (51%) became pregnant and were eligible for the study of which 28 (11%) women reported having physician-diagnosed GDM during followup. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The odds ratios (ORs) and 95% confidence intervals (CIs) of GDM associated with each standard deviation (SD) increment of preconception serum PFOA concentrations (ng/mL, log-transformed) and six other PFCs were estimated using logistic regression after adjusting for age, pre-pregnancy body mass index, smoking, and parity conditional on gravidity. RESULT(S) Preconception geometric mean (95% CI) PFOA concentrations (in ng/ml) were higher for women with than without GDM (3.94 (3.15-4.93) vs. 3.07 (2.83-3.12), respectively). Each SD increment in PFOA was associated with a 1.87 fold increased GDM risk (adjusted OR (95% CI): 1.86 (1.14, 3.02)). A slightly increased risk associated with each SD increment for the six other PFCs was observed as well (all ORs >1.0; range 1.06-1.27), although the associations were not statistically significant. CONCLUSIONS Our findings suggested that higher environmentally relevant concentrations of PFOA were significantly associated with an increased GDM risk. If corroborated, these findings may be suggestive of a possible environmental etiology for GDM. PMID:25450302

  15. Possible alternative parity bands in the heaviest nuclei

    SciTech Connect

    Shneidman, T. M.; Jolos, R. V.; Adamian, G. G.; Antonenko, N. V.

    2006-09-15

    The low-lying alternative parity bands in heaviest nuclei are predicted for the first time. The parity splitting and electric dipole, quadrupole, and octupole transition moments of heavy nuclei are calculated within a cluster model. The model is based on the assumption that reflection asymmetric shapes are produced by the motion of the nuclear system in the mass asymmetry coordinate.

  16. 47 CFR 51.209 - Toll dialing parity.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 3 2012-10-01 2012-10-01 false Toll dialing parity. 51.209 Section 51.209... Obligations of All Local Exchange Carriers § 51.209 Toll dialing parity. (a) A LEC shall implement throughout each state in which it offers telephone exchange service intraLATA and interLATA toll dialing...

  17. 47 CFR 51.207 - Local dialing parity.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Local dialing parity. 51.207 Section 51.207 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) INTERCONNECTION Obligations of All Local Exchange Carriers § 51.207 Local dialing parity. A LEC shall permit...

  18. 47 CFR 51.207 - Local dialing parity.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 3 2011-10-01 2011-10-01 false Local dialing parity. 51.207 Section 51.207 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) INTERCONNECTION Obligations of All Local Exchange Carriers § 51.207 Local dialing parity. A LEC shall permit...

  19. 47 CFR 51.209 - Toll dialing parity.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 3 2014-10-01 2014-10-01 false Toll dialing parity. 51.209 Section 51.209... Obligations of All Local Exchange Carriers § 51.209 Toll dialing parity. (a) A LEC shall implement throughout each state in which it offers telephone exchange service intraLATA and interLATA toll dialing...

  20. 47 CFR 51.207 - Local dialing parity.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 3 2014-10-01 2014-10-01 false Local dialing parity. 51.207 Section 51.207 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) INTERCONNECTION Obligations of All Local Exchange Carriers § 51.207 Local dialing parity. A LEC shall permit...

  1. 47 CFR 51.207 - Local dialing parity.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 3 2013-10-01 2013-10-01 false Local dialing parity. 51.207 Section 51.207 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) INTERCONNECTION Obligations of All Local Exchange Carriers § 51.207 Local dialing parity. A LEC shall permit...

  2. 12 CFR 560.220 - Alternative Mortgage Transaction Parity Act.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 6 2014-01-01 2012-01-01 true Alternative Mortgage Transaction Parity Act. 560.220 Section 560.220 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY LENDING AND INVESTMENT Alternative Mortgage Transactions § 560.220 Alternative Mortgage Transaction Parity...

  3. 47 CFR 51.215 - Dialing parity: Cost recovery.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 3 2013-10-01 2013-10-01 false Dialing parity: Cost recovery. 51.215 Section... (CONTINUED) INTERCONNECTION Obligations of All Local Exchange Carriers § 51.215 Dialing parity: Cost recovery. (a) A LEC may recover the incremental costs necessary for the implementation of toll dialing...

  4. 47 CFR 51.215 - Dialing parity: Cost recovery.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Dialing parity: Cost recovery. 51.215 Section... (CONTINUED) INTERCONNECTION Obligations of All Local Exchange Carriers § 51.215 Dialing parity: Cost recovery. (a) A LEC may recover the incremental costs necessary for the implementation of toll dialing...

  5. 12 CFR 560.220 - Alternative Mortgage Transaction Parity Act.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 6 2013-01-01 2012-01-01 true Alternative Mortgage Transaction Parity Act. 560.220 Section 560.220 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY LENDING AND INVESTMENT Alternative Mortgage Transactions § 560.220 Alternative Mortgage Transaction Parity...

  6. 47 CFR 51.209 - Toll dialing parity.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Toll dialing parity. 51.209 Section 51.209... Obligations of All Local Exchange Carriers § 51.209 Toll dialing parity. (a) A LEC shall implement throughout each state in which it offers telephone exchange service intraLATA and interLATA toll dialing...